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1.
Transl Psychiatry ; 10(1): 337, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009366

RESUMO

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Transtornos Mentais , Pandemias , Pneumonia Viral , Psicotrópicos , China/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Prognóstico , Escalas de Graduação Psiquiátrica , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
3.
J Toxicol Sci ; 45(7): 391-399, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32612007

RESUMO

This study was aimed at examining propofol- (a known anesthetic) induced emotion-related behavioral disorders in mice, and exploring the possible molecular mechanisms. A total of 60 mice were divided into two groups: control and propofol group. Mice were injected with propofol (150 mg/kg, ip) at 8:00 a.m. (once a day, lasting for 30 days). During the 30 days, loss of righting reflex (LORR) and return of righting reflex (RORR) of mice were recorded every day. At the 1st (T1) and 30th (T2) day of drug discontinuance (T2), 15 mice of each group were selected to perform the open field test; then the mice underwent perfusion fixation, and the midbrain and corpus striatum were separated for immunofluorescence assay with anti-tyrosine hydroxylase (Th) and anti- dopamine transporter (DAT) antibodies. Results showed that after propofol injection, LORR and RORR increased and decreased, respectively. Long-term use of propofol resulted in decreased activities of mice (activity trajectory, line crossing, rearing time, scratching times and defecating frequency). Immunofluorescence assay showed long-term use of propofol induced decrease of Th and DAT. Collectively, our present work suggested long-term abuse of propofol induces neuropsychiatric function impairments, and the possible mechanisms are related to dopamine dyssynthesis via down-regulating tyrosine hydroxylase and dopamine transporter.


Assuntos
Anestésicos/toxicidade , Comportamento Animal/efeitos dos fármacos , Corpo Estriado/metabolismo , Corpo Estriado/patologia , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Neurônios Dopaminérgicos/patologia , Transtornos Mentais/induzido quimicamente , Propofol/toxicidade , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Transtornos Relacionados ao Uso de Substâncias/patologia , Tirosina 3-Mono-Oxigenase/metabolismo , Área Tegmentar Ventral/metabolismo , Área Tegmentar Ventral/patologia , Anestésicos/efeitos adversos , Animais , Neurônios Dopaminérgicos/metabolismo , Emoções/efeitos dos fármacos , Masculino , Transtornos Mentais/metabolismo , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Camundongos Endogâmicos C57BL , Propofol/efeitos adversos , Reflexo de Endireitamento/efeitos dos fármacos
4.
Nat Commun ; 11(1): 3593, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32681096

RESUMO

During pregnancy, maternal endocrine signals drive fetal development and program the offspring's physiology. A disruption of maternal glucocorticoid (GC) homeostasis increases the child's risk of developing psychiatric disorders later in life. We here show in mice, that the time of day of antenatal GC exposure predicts the behavioral phenotype of the adult offspring. Offspring of mothers receiving GCs out-of-phase compared to their endogenous circadian GC rhythm show elevated anxiety, impaired stress coping, and dysfunctional stress-axis regulation. The fetal circadian clock determines the vulnerability of the stress axis to GC treatment by controlling GC receptor (GR) availability in the hypothalamus. Similarly, a retrospective observational study indicates poorer stress compensatory capacity in 5-year old preterm infants whose mothers received antenatal GCs towards the evening. Our findings offer insights into the circadian physiology of feto-maternal crosstalk and assign a role to the fetal clock as a temporal gatekeeper of GC sensitivity.


Assuntos
Relógios Circadianos/efeitos dos fármacos , Glucocorticoides/efeitos adversos , Exposição Materna/efeitos adversos , Transtornos Mentais/etiologia , Efeitos Tardios da Exposição Pré-Natal/psicologia , Ansiedade , Comportamento/efeitos dos fármacos , Feminino , Glucocorticoides/administração & dosagem , Humanos , Recém-Nascido Prematuro/psicologia , Masculino , Transtornos Mentais/metabolismo , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Gravidez , Complicações na Gravidez/tratamento farmacológico , Cuidado Pré-Natal , Efeitos Tardios da Exposição Pré-Natal/etiologia , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo
6.
Am J Nurs ; 120(7): 61-68, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32590604

RESUMO

BACKGROUND: Inpatient falls are among the most common hospital incidents reported. Fall-related injuries have significant implications for patients, staff, and organizations. Adult behavioral health inpatients are responsible for higher rates of injurious falls and challenge traditional fall prevention methods. An inpatient behavioral health unit in an acute care hospital identified an increased rate of injury from falls per 1,000 patient-days in three months; three falls resulted in major injury. PURPOSE: The purpose of this quality improvement (QI) report is to describe the redesign of a fall prevention program for adult behavioral health inpatients using evidence-based practice (EBP) and QI methods. METHODS: Root cause analyses (RCAs) were conducted on all three fall-related major injuries. Concurrently, a literature review identified EBP recommendations for fall prevention on behavioral health units. A fall prevention action program was developed consisting of four elements: RN education to improve Morse Fall Scale scoring, individualized fall prevention patient plans, revised staff workflow, and improved fall prevention communication. RESULTS: There were no fall-related injuries for six months and no fall-related major injuries for 12 months following implementation of the fall prevention program. Overall, this reduction in fall-related major injuries was sustained over a 21-month period. CONCLUSION: An interprofessional team approach using EBP and RCA is effective in redesigning and implementing a fall prevention program for the adult inpatient behavioral health population.


Assuntos
Acidentes por Quedas/prevenção & controle , Transtornos Mentais/fisiopatologia , Adulto , Prática Clínica Baseada em Evidências , Humanos , Pacientes Internados , Recursos Humanos de Enfermagem no Hospital , Melhoria de Qualidade , Medição de Risco/métodos
11.
PLoS One ; 15(5): e0232813, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428002

RESUMO

Worldwide, nearly 3 million people die every year because of being overweight or obese. Although obesity is a metabolic disease, behavioral aspects are important in its etiology. Hunger changes the rewarding potential of food in normal-weight controls. In obesity, impairments related to reward processing are present, but it is not clear whether these are due to mental disorders more common among this population. Therefore, in this pilot study, we aimed at investigating whether fasting influence mood reactivity to reward in people with obesity. Women with obesity (n = 11, all mentally healthy) and normal weight controls (n = 17) were compared on a computerized monetary reward task (the wheel of fortune), using self-reports of mood and affect (e.g., PANAS and mood evaluation during the task) as dependent variables. This task was done in 2 satiety conditions, during fasting and after eating. Partially, in line with our expectation of a reduced affect and mood reactivity to monetary reward in participants with obesity accentuated by fasting, our results indicated a significant within-group difference across time (before and after the task), with monetary gains significantly improving positive affect in healthy controls (p>0.001), but not in individuals with obesity (p = 0.32). There were no significant between-group differences in positive affect before (p = 0.328) and after (p = 0.70) the task. In addition, women with obesity, compared to controls, reported more negative affect in general (p < 0.05) and less mood reactivity during the task in response to risky gains (p < 0.001) than healthy controls. The latter was independent of the level of satiety. These preliminary results suggest an impairment in mood reactivity to monetary reward in women with obesity which is not connected to the fasting state. Increasing the reinforcing potential of rewards other than food in obesity may be one target of intervention in order to verify if that could reduce overeating.


Assuntos
Afeto/fisiologia , Fome/fisiologia , Transtornos Mentais/fisiopatologia , Obesidade/psicologia , Adulto , Índice de Massa Corporal , Jejum/fisiologia , Jejum/psicologia , Feminino , Alimentos/efeitos adversos , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Projetos Piloto , Recompensa
12.
Nat Rev Neurosci ; 21(5): 277-295, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32269316

RESUMO

The past decade has witnessed exponentially growing interest in the lateral habenula (LHb) owing to new discoveries relating to its critical role in regulating negatively motivated behaviour and its implication in major depression. The LHb, sometimes referred to as the brain's 'antireward centre', receives inputs from diverse limbic forebrain and basal ganglia structures, and targets essentially all midbrain neuromodulatory systems, including the noradrenergic, serotonergic and dopaminergic systems. Its unique anatomical position enables the LHb to act as a hub that integrates value-based, sensory and experience-dependent information to regulate various motivational, cognitive and motor processes. Dysfunction of the LHb may contribute to the pathophysiology of several psychiatric disorders, especially major depression. Recently, exciting progress has been made in identifying the molecular and cellular mechanisms in the LHb that underlie negative emotional state in animal models of drug withdrawal and major depression. A future challenge is to translate these advances into effective clinical treatments.


Assuntos
Gânglios da Base/fisiologia , Gânglios da Base/fisiopatologia , Habenula/fisiologia , Habenula/fisiopatologia , Sistema Límbico/fisiologia , Sistema Límbico/fisiopatologia , Mesencéfalo/fisiologia , Mesencéfalo/fisiopatologia , Animais , Saúde , Humanos , Transtornos Mentais/fisiopatologia , Vias Neurais/fisiologia , Vias Neurais/fisiopatologia
13.
Fortschr Neurol Psychiatr ; 88(3): 184-193, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32232807

RESUMO

Past research has revealed a variety of olfactory deficits associated with psychiatric and neurodegenerative disorders. These deficits are evident in psychophysical olfactory testing as well as neurophysiological and neuroanatomical examinations. The specific type of olfactory dysfunction appears disorder specific. For example, with regard to affective disorders, the functional and anatomical overlap between olfactory and emotion-specific brain areas has been suggested as a major underlying factor for olfactory dysfunction. Based on converging evidence of changes in olfactory perception related to Major Depression, Schizophrenia, Alzheimer's and Parkinson's Disease, olfactory testing has been discussed as an important additional diagnostic marker. Hence, valid methods for objective and reliable olfactory testing as well as guidelines for the interpretation of the respective diagnostic findings are required. The aim of this review is to provide an overview of reported olfactory deficits in psychiatric and neurodegenerative disorders. In addition, a selection of olfactory tests, available in German-speaking countries, with regard to the respective disorder-related olfactory deficit in question are presented and classified. Original data regarding an empirical validation of the Düsseldorf Odour Discrimination Test in a clinical population are presented.


Assuntos
Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/diagnóstico , Transtornos do Olfato/complicações , Transtornos do Olfato/diagnóstico , Encéfalo/fisiopatologia , Humanos , Transtornos Mentais/fisiopatologia , Doenças Neurodegenerativas/fisiopatologia , Transtornos do Olfato/fisiopatologia , Olfato
14.
BMC Neurol ; 20(1): 137, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32295523

RESUMO

BACKGROUND: Executive control dysfunction is observed in a sizable number of patients with temporal lobe epilepsy (TLE). Neural oscillations in the theta band are increasingly recognized as having a crucial role in executive control network. The purpose of this study was to investigate the alterations in the theta band in executive control network and explore the functional brain network mechanisms of executive control dysfunction in TLE patients. METHODS: A total of 20 TLE patients and 20 matched healthy controls (HCs) were recruited in the present study. All participants were trained to perform the executive control task by attention network test while the scalp electroencephalogram (EEG) data were recorded. The resting state signals were collected from the EEG in the subjects with quiet and closed eyes conditions. Functional connectivity among EEGs in the executive control network and resting state network were respectively calculated. RESULTS: We found the significant executive control impairment in the TLE group. Compared to the HCs, the TLE group showed significantly weaker functional connectivity among EEGs in the executive control network. Moreover, in the TLE group, we found that the functional connectivity was significantly positively correlated with accuracy and negatively correlated with EC_effect. In addition, the functional connectivity of the executive control network was significantly higher than that of the resting state network in the HCs. In the TLE group, however, there was no significant change in functional connectivity strengths between the executive control network and resting state network. CONCLUSION: Our results indicate that the decreased functional connectivity in theta band may provide a potential mechanism for executive control deficits in TLE patients.


Assuntos
Epilepsia do Lobo Temporal/fisiopatologia , Função Executiva , Transtornos Mentais/fisiopatologia , Adolescente , Adulto , Atenção , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Eletroencefalografia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Rede Nervosa/fisiopatologia , Adulto Jovem
16.
Nat Rev Neurosci ; 21(4): 231-242, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32157237

RESUMO

The idea that predictions shape how we perceive and comprehend the world has become increasingly influential in the field of systems neuroscience. It also forms an important framework for understanding neuropsychiatric disorders, which are proposed to be the result of disturbances in the mechanisms through which prior information influences perception and belief, leading to the production of suboptimal models of the world. There is a widespread tendency to conceptualize the influence of predictions exclusively in terms of 'top-down' processes, whereby predictions generated in higher-level areas exert their influence on lower-level areas within an information processing hierarchy. However, this excludes from consideration the predictive information embedded in the 'bottom-up' stream of information processing. We describe evidence for the importance of this distinction and argue that it is critical for the development of the predictive processing framework and, ultimately, for an understanding of the perturbations that drive the emergence of neuropsychiatric symptoms and experiences.


Assuntos
Encéfalo/fisiologia , Percepção/fisiologia , Humanos , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Modelos Neurológicos , Redes Neurais de Computação
17.
Hum Genet ; 139(5): 593-604, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32152699

RESUMO

Gastrointestinal infections can be life threatening, but not much is known about the host's genetic contribution to susceptibility to gastrointestinal infections or the latter's association with psychiatric disorders. We utilized iPSYCH, a genotyped population-based sample of individuals born between 1981 and 2005 comprising 65,534 unrelated Danish individuals (45,889 diagnosed with mental disorders and 19,645 controls from a random population sample) in which all individuals were linked utilizing nationwide population-based registers to estimate the genetic contribution to susceptibility to gastrointestinal infections, identify genetic variants associated with gastrointestinal infections, and examine the link between gastrointestinal infections and psychiatric and neurodevelopmental disorders. The SNP heritability of susceptibility to gastrointestinal infections ranged from 3.7% to 6.4% on the liability scale. Significant correlations were found between gastrointestinal infections and the combined group of mental disorders (OR = 2.09; 95% CI: 1.82-2.4, P = 1.87 × 10-25). Correlations with autism spectrum disorder, attention deficit hyperactivity disorder, and depression were also significant. We identified a genome-wide significant locus associated with susceptibility to gastrointestinal infections (OR = 1.13; 95% CI: 1.08-1.18, P = 2.9 × 10-8), where the top SNP was an eQTL for the ABO gene. The risk allele was associated with reduced ABO expression, providing, for the first time, genetic evidence to support previous studies linking the O blood group to gastrointestinal infections. This study also highlights the importance of integrative work in genetics, psychiatry, infection, and epidemiology on the road to translational medicine.


Assuntos
Gastroenteropatias/epidemiologia , Marcadores Genéticos , Predisposição Genética para Doença , Transtornos Mentais/fisiopatologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Estudos de Casos e Controles , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Gastroenteropatias/genética , Gastroenteropatias/microbiologia , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Incidência , Masculino , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas
18.
AIDS Care ; 32(sup2): 198-205, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32172592

RESUMO

This paper aimed to assess the impact of maternal common mental disorders (CMD) among caregivers living with HIV on the cognitive functioning of their child. Data were collected at baseline and 12 months follow-up from mother-child dyads recruited as part of an ongoing trial in Zimbabwe. Symptoms of CMD were assessed using the Shona Symptom Questionnaire. Mixed-effects linear regression was used to assess child cognitive scores at follow-up (using the Mullen Scales of Early Learning) in relation to caregiver CMD prevalence over 12 months. At baseline, caregivers reporting CMD (n = 230; 40.1%) were less likely to have completed higher education (46.9% vs. 56.9%; p = 0.02), more likely to be unmarried (27.8% vs. 16.0%; p < 0.01), and experience food insecurity (50.0% vs. 29.4%; p < 0.01) compared to the group without CMD (n = 344). There were 4 CMD patterns over time: (i) Emerging CMD (n = 101; 19.7% of caregivers) defined as those who were below the cut-off at baseline, and above it at 12 months; (ii) Improving CMD (n = 76; 14.8%) defined as those who reported CMD at baseline, and were below the cut-off by follow-up; (iii) No CMD (n = 206; 40.1%) defined as those who did not report CMD symptoms at either time point; and (iv) Chronic CMD (n = 131; 25.5%) defined as those who reported CMD above the cut-off at both time points. Children of caregivers with chronic CMD (n = 131, 25.5%) had lower receptive language scores (aMD:-2.81, 95%CI -5.1 to -0.6; p = 0.05) compared to the reference group with no CMD (n = 206, 40.1%). Exposure to caregiver CMD over a prolonged period may affect child receptive vocabulary skills.


Assuntos
Cuidadores/psicologia , Desenvolvimento Infantil/fisiologia , Transtornos Cognitivos/diagnóstico , Cognição/fisiologia , Infecções por HIV/psicologia , Transtornos Mentais/psicologia , Mães/psicologia , Adulto , Fármacos Anti-HIV , Criança , Transtornos Cognitivos/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Idioma , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Prevalência , Inquéritos e Questionários , Zimbábue/epidemiologia
19.
Behav Ther ; 51(2): 253-267, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32138936

RESUMO

Standardized developmentally based assessment systems have transformed the capacity to identify transdiagnostic behavioral markers of mental disorder risk in early childhood, notably, clinically significant irritability and externalizing behaviors. However, behavior-based instruments that both differentiate risk for persistent psychopathology from normative misbehavior, and are feasible for community clinicians to implement, are in nascent phases of development. Young children's facial expressions during frustration challenges may form the basis for novel assessments tools that are flexible, quick, and easy to implement as markers of psychopathology to complement validated questionnaires. However, the accuracy of facial expressions to correctly classify young children falling above and below clinical cut-offs is unknown. Our goal was to test how facial expressions during frustration, defined by different facial muscular movements, related to individual differences in irritability and externalizing behaviors and discriminated children with clinically significant levels from peers. Participants were 79 children (ages 3-7) who completed a short, moderately frustrating computer task while facial expressions were recorded. Only negative facial expressions that included eye constriction related to irritability and externalizing behaviors and were clinically discriminating. Moreover, these expressions significantly discriminated children with and without clinically significant irritability and externalizing symptoms with high Area Under the Curve (AUC) values (> .75) indicating good clinical utility. In contrast, expressions without eye constriction showed no clinical utility. The presence of negative expressions with eye constriction in response to a short frustration prompt may serve as an indicator of early psychopathology, raising the potential for novel assessment tools that may enhance precision of early identification.


Assuntos
Expressão Facial , Músculos Faciais/fisiopatologia , Humor Irritável/fisiologia , Transtornos Mentais/fisiopatologia , Criança , Pré-Escolar , Feminino , Frustração , Humanos , Masculino , Comportamento Problema
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