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1.
PLoS One ; 15(3): e0229991, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163458

RESUMO

AIM: In glaucoma, depression and disturbed sleep has been associated with degeneration of the intrinsically photosensitive retinal ganglion cells, that mediate non-image forming effects of light such as regulation of circadian rhythm, alertness and mood. In this study we assessed associations between seasonal mood and behavior variation and retinal ganglion cell damage in outpatients with glaucoma. METHODS: The seasonal pattern assessment questionnaire was administered to outpatients with glaucoma. Data on visual field defects identified by autoperimetry and retinal nerve fiber layer thickness visualized by ocular coherence tomography were collected from patient charts. The correlations between seasonality and retinal damage were tested and the adjusted effects of retinal function on seasonality were evaluated in a linear regression model. RESULTS: In total, 113 persons completed the questionnaire. Of these, 4% fulfilled the criteria for seasonal affective disorder (SAD) and 8% for subsyndromal seasonal affective disorder (sSAD). Mean global seasonal score was 4.3. There were no significant correlations between seasonality and either visual field or retinal nerve fiber layer thickness. In the adjusted analysis there were trends toward differential effects of visual field on seasonality in subgroups with different sex and type of glaucoma. CONCLUSION: There were no strong associations between seasonality and visual field or retinal nerve fiber layer thickness. Sex, age and glaucoma subtype may modify light effects on complex regulatory systems.


Assuntos
Glaucoma/patologia , Transtornos do Humor/patologia , Células Ganglionares da Retina/fisiologia , Idoso , Comportamento , Feminino , Glaucoma/classificação , Glaucoma/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Fibras Nervosas/fisiologia , Células Ganglionares da Retina/metabolismo , Estações do Ano , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários , Tomografia de Coerência Óptica , Campos Visuais
2.
Arch Womens Ment Health ; 23(1): 29-41, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30834475

RESUMO

Perinatal mood instability (MI) is a common clinical observation in perinatal women, and existing research indicates that MI is strongly associated with a variety of mental disorders. The purpose of this study is to review the evidence of perinatal MI systematically, with a focus on perinatal MI, its relation to perinatal depression, and its effects on children. A systematic search of the literature using PRISMA guidelines was conducted on seven academic health databases to identify any peer-reviewed articles published in English from 1985 to July 2017. Studies were screened, data were extracted, and quality of the selected studies was assessed. A total of 1927 abstracts were returned from the search, with 1063 remaining for abstract screening after duplicate removal, and 4 quantitative studies were selected for final analysis. The selected studies addressed perinatal MI (n = 2), the relation of perinatal MI to perinatal depression (n = 1), and the effects of perinatal MI on children (n = 1). The selected studies identified that perinatal women experienced a significantly higher level of MI than non-perinatal women, MI is a prominent feature in perinatal women with and without depression, mood lability during the early postpartum predicts psychopathology up to 14 months postpartum, and maternal emotion dysregulation, rather than maternal psychopathology, increases the risk of heightened facial affect synchrony in mother-infant interaction. The study reveals a significant gap in the literature of perinatal MI.


Assuntos
Depressão/epidemiologia , Transtornos do Humor/epidemiologia , Complicações na Gravidez/epidemiologia , Depressão/complicações , Feminino , Humanos , Transtornos do Humor/complicações , Relações Mãe-Filho/psicologia , Narração , Período Pós-Parto/psicologia , Gravidez , Complicações na Gravidez/psicologia
3.
Ugeskr Laeger ; 181(45)2019 Nov 04.
Artigo em Dinamarquês | MEDLINE | ID: mdl-31791452

RESUMO

Many patients with affective disorders have cognitive impairments during remission, which impede their functional recovery and quality of life. The International Society for Bipolar Disorders Targeting Cognition Task Force recommends that clinicians screen for cognitive impairments, when patients are in remission using subjective and objective screening tools. Clinicians should evaluate, whether any impairments are secondary to comorbidity, medication or unhealthy lifestyle. Information to patients and their relatives about how to tackle cognitive impairments can improve daily life functioning.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Transtornos do Humor , Cognição , Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/terapia , Humanos , Transtornos do Humor/complicações , Testes Neuropsicológicos , Qualidade de Vida
4.
Artigo em Inglês | MEDLINE | ID: mdl-31795239

RESUMO

Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2 p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2 p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28-3.38) and depression (OR = 3.13, IC = 1.45-6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.


Assuntos
Hipotireoidismo/complicações , Hipotireoidismo/tratamento farmacológico , Transtornos do Humor/complicações , Tiroxina/uso terapêutico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Hipotireoidismo/psicologia , Prevalência , Inquéritos e Questionários
5.
Aten. prim. (Barc., Ed. impr.) ; 51(10): 626-636, dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185945

RESUMO

Objective: To study the relationship between maternal affective disorders (AD) before and during pregnancy, and pre-term birth. Design: Retrospective observational study. Location: Sexual and reproductive health units at the Institut Català de la Salut (ICS) in Catalonia, Spain. Participants: Pregnant women with a result of live-born child from 1/1/2012 to 30/10/2015. Interventions: Data were obtained from the ICS Primary Care electronic medical record. Main measurements: Diagnosis of AD before and during pregnancy, months of pregnancy, and possible confusion factors were collected. Descriptive statistical analysis (median, interquartile range, and absolute and relative frequency), bivariate analysis (Wilcoxon test and Chi-square test), and multivariate analysis (logistic regression) were performed. Results: 102,086 women presented valid information for the study. Prevalence of AD during pregnancy was 3.5% (4.29% in pre-term and 3.46% in term births; p < 0.004). Pregnant women with pre-term births presented a higher age, smoking habit, lower inter-pregnancy interval, and a lower socio-economic status. Pre-term birth was significantly associated to previous history of stress and dissociative disorder (SDD), anxiety, obsessive-compulsive disorder (OCD) and eating disorders (ED), and use of antidepressants. It was also associated to abuse of alcohol, smoking, and use of psychoactive substances, as well as SDD, ED, use of antipsychotics, and divorce during pregnancy. Multivariate analysis confirmed the relationship between pre-term birth and history of AD, SDD, ED, and smoking, but not with AD during pregnancy. Conclusions: Examining the previous history of SDD and ED in pregnant women, and SDD, and ED during pregnancy is highly relevant to avoid pre-term birth


Objetivo: Estudiar la relación entre diagnósticos de trastornos afectivos (TA) antes y durante el embarazo, y factores de confusión con prematuridad del neonato. Diseño: Estudio observacional retrospectivo. Emplazamiento: Servicios de atención sexual y reproductiva del Institut Català de la Salut (ICS) en Cataluña, España. Participantes: Embarazadas atendidas con resultado de hijo vivo del 1/1/2012 al 30/10/2015. Intervenciones: Datos recogidos en la base de datos de la historia clínica informatizada. Mediciones: Se recogió los diagnósticos de TA antes y durante el embarazo, meses de gestación y posibles factores de confusión. Se realizó análisis estadístico descriptivo (mediana y rango intercuartílico y frecuencias absoluta y relativa), bivariante (test de Wilcoxon y Chi-cuadrado) y multivariante (regresión logística). Resultados: Ciento dos mil ochenta y seis mujeres presentaban información válida para el estudio. La prevalencia de TA durante el embarazo fue del 3,5% (4,29% en prematuros y 3,46% en a término; p<0,004). Las embarazadas con partos prematuros presentan mayor edad, más tabaquismo, menor tiempo entre embarazos y menor nivel socioeconómico. La prematuridad se asoció a antecedentes previos de trastorno por estrés y disociativo (TED), de ansiedad y obsesivo-compulsivo, de conducta alimentaria (TCA) y uso de antidepresivos. También a abuso de alcohol, tabaco y sustancias psicoactivas; TED, TCA, uso de antipsicóticos y divorcio durante el embarazo. El análisis multivariante confirmó la relación de prematuridad con antecedentes de TA, TED, TCA y tabaquismo, pero no con TA durante el embarazo. Conclusiones: Es importante explorar antecedentes de TED y TA en la embarazada y los TED durante el embarazo, para disminuir la prematuridad


Assuntos
Humanos , Feminino , Gravidez , Transtornos do Humor/complicações , Complicações na Gravidez/psicologia , Trabalho de Parto Prematuro/epidemiologia , Fatores de Risco , Fatores de Confusão Epidemiológicos , Estudos Retrospectivos , Modelos Logísticos , Fatores Socioeconômicos
6.
Artigo em Russo | MEDLINE | ID: mdl-31851169

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of Сytoflavin in the treatment of cognitive and emotional disorders in patients with tension headache. MATERIAL AND METHODS: Fifty patients with tension headache, aged from 18 to 50 years, were studied. The following methods and tests were used: neurological examination, NPRS, STAI, CFQ, RAVLT, TOVA, electroencephalography (routine and spectral analysis). The patients were treated with Сytoflavin. RESULTS: After the treatment, clinical improvement was observed in 62.0% of the patients. A significant decrease in trait anxiety and inattention, as well as an improvement of memory performance were observed. A comparative analysis of neurophysiological results before and after the treatment showed a decrease in the manifestations of dysfunction of nonspecific regulation of the brain. CONCLUSION: The results of this study demonstrate the efficacy of Cytoflavin in the treatment of tension headache and associated emotional and cognitive impairments.


Assuntos
Mononucleotídeo de Flavina , Inosina Difosfato , Transtornos do Humor , Niacinamida , Succinatos , Cefaleia do Tipo Tensional , Adolescente , Adulto , Ansiedade , Cognição , Combinação de Medicamentos , Mononucleotídeo de Flavina/uso terapêutico , Humanos , Inosina Difosfato/uso terapêutico , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos do Humor/tratamento farmacológico , Niacinamida/uso terapêutico , Succinatos/uso terapêutico , Cefaleia do Tipo Tensional/complicações , Cefaleia do Tipo Tensional/tratamento farmacológico , Adulto Jovem
7.
BMC Psychiatry ; 19(1): 320, 2019 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660914

RESUMO

BACKGROUND: Previous research suggests that family caregivers contemplate suicide at a higher rate than the general population. Much of this research has been disease specific and in relatively small samples. This study aimed to compare suicidal thoughts between non-caregivers and informal caregivers of people with a variety of conditions, in a large representative sample, and to identify significant risk factors. METHODS: The general population study NEMESIS-2 (N at baseline = 6646) included 1582 adult caregivers at the second wave (2010-2012) who also participated at the third wave (2013-2015). Suicidal thoughts were assessed over 4 years, with the Suicidality Module of the Composite International Diagnostic Interview 3.0. The presence of suicidal thoughts was estimated and risk factors for suicidal thoughts were assessed with logistic regression analyses adjusted for age and gender. RESULTS: Thirty-six informal caregivers (2.9%) reported suicidal thoughts during the 4 year study period. The difference between caregivers and non-caregivers (3.0%) was not significant. Among caregivers, significant risk factors for suicidal thoughts included being unemployed, living without a partner, having lower levels of social support, having a chronic physical disorder, a mood disorder or an anxiety disorder, and having impaired social, physical and emotional functioning. These risk factors were also found in non-caregivers. No caregiving-related characteristics were associated with suicidal thoughts. CONCLUSION: There was no elevated rate of suicidal thoughts in caregivers and risk factors for suicidal thoughts in caregivers were consistent with risk factors in non-caregivers. No association between caregiving characteristics and suicidal thoughts was found. Caregivers with limited resources and in poorer health might still benefit from prevention and intervention efforts.


Assuntos
Cuidadores/psicologia , Ideação Suicida , Adulto , Idoso , Transtornos de Ansiedade/complicações , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Países Baixos/epidemiologia , Fatores de Risco , Apoio Social
8.
Artigo em Russo | MEDLINE | ID: mdl-31626228

RESUMO

The article presents a literature review on the problem of cognitive deficit in patients with affective disorders. Cognitive deficit in patients with bipolar affective disorder and recurrent depression affects cognitive and executive functions, information processing, and has certain specific features. Specifics of cognitive deficit in patients with affective disorders hampers the use of rehabilitation programs. Consequently, the topic evokes increased interest of specialists and the need for further research.


Assuntos
Transtorno Bipolar , Transtornos Cognitivos , Remediação Cognitiva , Transtornos do Humor , Transtorno Bipolar/complicações , Transtorno Bipolar/terapia , Cognição , Transtornos Cognitivos/complicações , Transtornos Cognitivos/terapia , Humanos , Transtornos do Humor/complicações , Transtornos do Humor/terapia
9.
Pharmacol Res ; 149: 104402, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31536783

RESUMO

Interleukin 6 (IL-6) is a pleiotropic cytokine that plays a role in the neuroendocrine system, insulin resistance, lipid metabolism, vascular disease, mitochondrial activities, neuropsychological behaviour, and also mediates communications between the immune and central nervous system (CNS). Treatment with anti-IL-6 or anti-IL-6R agents seems to alleviate allodynia and hyperalgesia, so it may be a valid option when treating the many conditions involving pathological pain as rheumatoid arthritis.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Fadiga/tratamento farmacológico , Interleucina-6/antagonistas & inibidores , Transtornos do Humor/tratamento farmacológico , Dor/tratamento farmacológico , Artrite Reumatoide/complicações , Artrite Reumatoide/imunologia , Fadiga/complicações , Fadiga/imunologia , Humanos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/imunologia , Dor/complicações , Dor/imunologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
10.
Maturitas ; 128: 1-3, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31561815

RESUMO

Sleep disorders increase in prevalence during the menopausal transition and they constitute a complex phenomenon. Insomnia, the main sleep disorder, can be a primary disorder or it can be secondary to hot flushes (HF), mood disorders, psychosocial factors, medical conditions, and other sleep disturbances, such as obstructive sleep apnoea (OSA) or restless legs syndrome (RLS). Menopausal women complaining of persistent sleep disorders should be referred to a sleep specialist for comprehensive sleep management because unrecognized and untreated sleep disorders can have dramatic health-related consequences. Women suffering from insomnia related to vasomotor symptoms (VMS) can be treated with hormone replacement therapy (HRT). Primary insomnia will be preferentially improved with cognitive behavioural therapy (CBT-I) or with non-benzodiazepine hypnotics or melatonin. CBT-I is a highly efficacious treatment for postmenopausal women with insomnia. Using antidepressants to treat sleep disruption in the absence of depression is not recommended; instead, the United States Food and Drug Administration (FDA) approved paroxetine as the first non-hormonal treatment for HF. Sleep disorders in menopausal women should not be underestimated. It is necessary to diagnose the specific causal disorder and then to provide treatment to improve sleep quality and quality of life.


Assuntos
Terapia Cognitivo-Comportamental , Fogachos/complicações , Menopausa , Transtornos do Humor/complicações , Qualidade de Vida , Transtornos do Sono-Vigília/diagnóstico , Sono , Gerenciamento Clínico , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/terapia
11.
Psychiatr Danub ; 31(Suppl 3): 591-594, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488796

RESUMO

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare monogenic disorder caused by mutations in the NOTCH3 gene. The clinical features are primarily neurological, which include recurrent transient ischaemic attacks, strokes, and migraines. However, psychiatric manifestations which mainly include mood disturbances have also been reported in CADASIL. Manic symptoms and bipolar disorders are rarely documented in CADASIL and existing reports generally lack detailed descriptions of the psychiatric evaluation. We discuss a case of Bipolar Affective Disorder (BD) in a British woman with a family history of CADASIL. This case provides insight into the diagnosis and management of BD as well as the possible underlying aetiologies that should be considered. The similarities between BD and CADASIL in terms of imaging, genetic, and therapeutic aspects raise the possibility of common dysfunctional pathways. BD in CADASIL may warrant greater consideration by both psychiatrists as well as non-psychiatric specialists and further studies are required to understand the pathological significance.


Assuntos
Transtorno Bipolar/complicações , CADASIL/complicações , Transtorno Bipolar/genética , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , CADASIL/genética , CADASIL/fisiopatologia , CADASIL/psicologia , Feminino , Humanos , Transtornos de Enxaqueca/complicações , Transtornos do Humor/complicações , Mutação , Receptor Notch3/genética , Reino Unido
12.
IEEE J Biomed Health Inform ; 23(6): 2302-2316, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31502995

RESUMO

Mood disorders affect more than 300 million people worldwide and can cause devastating consequences. Elderly people and patients with neurological conditions are particularly susceptible to depression. Gait and body movements can be affected by mood disorders, and thus they can be used as a surrogate sign, as well as an objective index for pervasive monitoring of emotion and mood disorders in daily life. Here we review evidence that demonstrates the relationship between gait, emotions and mood disorders, highlighting the potential of a multimodal approach that couples gait data with physiological signals and home-based monitoring for early detection and management of mood disorders. This could enhance self-awareness, enable the development of objective biomarkers that identify high risk subjects and promote subject-specific treatment.


Assuntos
Emoções/fisiologia , Análise da Marcha , Transtornos do Humor/fisiopatologia , Adulto , Idoso , Marcha/fisiologia , Humanos , Transtornos do Humor/complicações , Transtornos do Humor/diagnóstico , Doenças do Sistema Nervoso/complicações , Fenótipo
13.
Psychiatry Res ; 281: 112547, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31494450

RESUMO

Hypersomnia is common in psychiatric disorders, yet there are few self-report measures that adequately characterize this sleep disturbance. The objective of this study was to validate the Hypersomnia Severity Index (HSI), a tool designed to measure severity, distress and impairment of hypersomnia in psychiatric populations. Psychometric properties were evaluated in an undergraduate Scale Development sample (N = 381) and two psychiatric Scale Validation samples: euthymic bipolar participants with a range of sleep complaints (N = 89), and unmedicated unipolar depressed participants (N = 21) meeting operational criteria for hypersomnolence disorder. Exploratory factor analysis and confirmatory factor analysis in the Scale Development and Validation samples, respectively, suggested a two-factor structure representing Hypersomnia Symptoms and Distress/Impairment best fit the data. Convergent validity was established by significant associations with the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and the Sheehan Disability Scale in both samples. Construct validity was further supported by significant correlations between the Scale Validation sample and two weeks of diary- and actigraphy-determined total sleep time and time in bed. A cutoff score of 10 maximally discriminated between those with hypersomnia and those without. The HSI shows promise as a measure of hypersomnia that is commonly seen in psychiatric disorders, and may be of use to both researchers and clinicians. SUPPORT: This work is supported by grants from the American Sleep Medicine Foundation (76-JF-12), the Brain and Behavior Research Foundation (19193), and NIMHK23MH099234 (DTP); National Science Foundation Graduate Research Fellowship Program and Stanford Child Health Research Institute (KAK); and R34MH080958 and R01MH105513 (AGH).


Assuntos
Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Transtornos do Humor/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Psicometria/normas , Índice de Gravidade de Doença , Adulto , Distúrbios do Sono por Sonolência Excessiva/etiologia , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
14.
Psychiatr Hung ; 34(2): 172-182, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417006

RESUMO

An increasing number of studies deal with the potential correspondence between suicidal behaviour and creativity nowadays. Psychobiographical analysis of the life of well known artists may help the better understanding of this phenomenon. In the present study predictive and protective factors of suicide are presented through the case of the well known suicidal poet and writer, Sylvia Plath. The most important predictive factors of suicide in her case are: affective disorder, comorbid anxiety disorder, prior attempt of suicide, and also her seriously affected personality, that mainly appears in her affective dependence. Her life events, both causes and effects of these, are also predisposing suicide. The early loss of her father, ambivalent relation with her mother and her marriage foredoomed to failure are the most significant of them. Although she used to write since her early childhood, the constant fluctuation of her psychological state had serious effect on her ability to write and also her motivation, both being an additional source of stress, due to her performance pressure. The fear of the acceptance of her works could also lay to increased amount of stress and anxiety on her sensitive personality. Her tragical life events, her psychiatric illness and her relentless templets towards herself could cause such a pressing stress, that neither creation, nor motherhood (the most important protective factor for women) could predominate. Neither moving to England, nor her last confessional book, "The Bell Jar" could cure her many kind of wounds, and these factors together lead to the suicide.


Assuntos
Criatividade , Transtornos do Humor/história , Transtornos do Humor/psicologia , Fatores de Proteção , Suicídio/história , Suicídio/psicologia , Transtornos de Ansiedade/complicações , Feminino , História do Século XX , Humanos , Transtornos do Humor/complicações , Mães/psicologia , Motivação , Fatores de Risco , Estresse Psicológico/complicações , Redação/história
15.
Am J Addict ; 28(5): 382-389, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31291042

RESUMO

BACKGROUND AND OBJECTIVES: To identify substance and psychiatric predictors of overdose (OD) in young people with substance use disorders (SUDs) who received treatment. METHODS: We conducted a retrospective review of consecutive medical records of young people who were evaluated in a SUD program between 2012 and 2013 and received treatment. An independent group of patients from the same program who received treatment and had a fatal OD were also included in the sample. OD was defined as substance use associated with a significant impairment in level of consciousness without intention of self-harm, or an ingestion of a substance that was reported as a suicide attempt. t Tests, Pearson's χ2 , and Fisher's exact tests were performed to identify predictors of OD after receiving treatment. RESULTS: After initial evaluation, 127 out of 200 patients followed up for treatment and were included in the sample. Ten (8%) of these patients had a nonfatal OD. Nine patients who received treatment and had a fatal OD were also identified. The sample's mean age was 20.2 ± 2.8 years. Compared with those without OD, those with OD were more likely to have a history of intravenous drug use (odds ratio [OR]: 36.5, P < .001) and mood disorder not otherwise specified (OR: 4.51, P = .01). DISCUSSION AND CONCLUSIONS: Intravenous drug use and mood dysregulation increased risk for OD in young people who received SUD treatment. SCIENTIFIC SIGNIFICANCE: It is important to identify clinically relevant risk factors for OD specific to young people in SUD treatment due to the risk for death associated with OD. (Am J Addict 2019;28:382-389).


Assuntos
Overdose de Drogas/psicologia , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Adolescente , Adulto , Overdose de Drogas/mortalidade , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Estudos Retrospectivos , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tentativa de Suicídio , Adulto Jovem
16.
Codas ; 31(3): e20180111, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31271579

RESUMO

PURPOSE: to analyze the occurrence of psychiatric diagnosis and the use of psychotropics medications in subjects with vestibular complaints and to relate the presence of these conditions to the results of vestibulometry. METHODS: quantitative, observational, cross-sectional study with 131 patients, treated in a university hospital. They were submitted to anamnesis, visual inspection of the external ear canal, static and dynamic balance tests, Foam laser dynamic posturography and Computerized Vectoelectronystagmography. RESULTS: sample composed of 109 women and 22 men, with average age of 55 years and nine months. The most common type of dizziness was vertigo, with the presence of neurovegetative signals. A significant percentage of psychiatric complaint/diagnosis was observed, as well as the use of psychotropic medications, mainly serotonin uptake inhibitors, followed by benzodiazepines. There was a relation between the presence of psychiatric complaints with the female gender, alterations of the static balance and alterations in the Sensorial Organization Test positions III and VI. In the Vectoelectronystagmography, there was a relation between age and the presence of spontaneous nystagmus. CONCLUSION: There was a high occurrence of psychiatric complaint/diagnosis among patients with dizziness, with use of psychotropic medications substantially greater than the general population. The evaluation of postural balance revealed an association between anxiety/depression and alterations visual overload positions in the foam laser dynamic posturography. However, no relationship was found between these conditions and alterations in the Vectoelectronystagmography tests.


Assuntos
Tontura/induzido quimicamente , Transtornos do Humor/tratamento farmacológico , Equilíbrio Postural/efeitos dos fármacos , Psicotrópicos/efeitos adversos , Vertigem/induzido quimicamente , Testes de Função Vestibular/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Psicotrópicos/classificação , Estudos Retrospectivos , Adulto Jovem
17.
Asian J Psychiatr ; 43: 170-176, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31202087

RESUMO

AIM: To compare the symptom profile of catatonia among patients with affective, psychotic and organic disorders. METHODOLOGY: A 46 item catatonia rating scale prepared by combining items from 3 catatonia rating scales, i.e., Bush Francis Catatonia Rating Scale(BFCRS), North off catatonia rating scale and Catatonia rating scale was used. RESULTS: Study included 53, 45 and 42 patients with psychotic disorders, affective disorders and organic catatonia respectively. No significant difference was seen in the prevalence and severity of various catatonic symptoms between patients with psychotic and affective disorders. Compared to participants in the organicity group, participants in the psychotic group had significantly higher prevalence and severity of posturing. There was no difference in the affective and organicity group in terms of frequency and severity of catatonic symptoms. CONCLUSIONS: Patients with organic catatonia do not differ from those with catatonia due to affective and psychotic disorders in terms of prevalence and severity of signs and symptoms of catatonia except for posturing. The present study suggests that catatonic symptoms in patients with various disorders are not just limited to BFCRS and extend beyond the same.


Assuntos
Transtorno Bipolar/fisiopatologia , Encefalopatias/fisiopatologia , Catatonia/etiologia , Catatonia/fisiopatologia , Transtornos do Humor/fisiopatologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtorno Bipolar/complicações , Encefalopatias/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos Psicóticos/complicações , Esquizofrenia/complicações , Adulto Jovem
18.
Turk Psikiyatri Derg ; 30(1): 42-50, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170306

RESUMO

OBJECTIVE: The aim of this study was to evaluate the reliability and validity of the Schedule for Affective Disorders and Schizophrenia for School-Age ChildrenPresent and Lifetime Version, DSM-5 November 2016 -Turkish Adaptation (K-SADS-PL-DSM-5-T).  METHOD: A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability.  RESULTS: The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (κ=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, social anxiety disorder, depressive disorders, disruptive mood dysregulation disorder and attention deficit hyperactivity disorder (κ=0.67-0.80). Interrater reliability was perfect for selective mutism (κ=1.0), substantial for oppositional defiant disorder, disruptive mood dysregulation disorder, attention deficit hyperactivity disorder, depressive disorders and social anxiety disorder (κ=0.63-0.73). Test-retest reliability was almost perfect for autism spectrum disorder (κ=0.82), substantial for attention deficit hyperactivity disorder, oppositional defiant disorder, disruptive mood dysregulation disorder, depressive disorders and generalized anxiety disorder (κ=0.62-0.78).  CONCLUSION: The results of this study show that the K-SADS-PL-DSM-5-T is an effective instrument for diagnosing major childhood psychiatric disorders including selective mutism, disruptive mood dysregulation disorder and autism spectrum disorder which have recently been added to the schedule.


Assuntos
Transtornos do Humor/psicologia , Esquizofrenia/complicações , Adolescente , Serviços de Saúde do Adolescente , Criança , Serviços de Saúde da Criança , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Turquia
19.
Neuropsychology ; 33(5): 711-724, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31144830

RESUMO

OBJECTIVE: It is increasingly recognized that trauma victims, particularly Veterans, have co-occurring psychological and physical conditions that impact cognition, especially the domains of sustained attention and executive functioning. Although previous work has generally attempted to isolate the unique cognitive effects of common combat-related comorbidities, less work has been done to examine how these conditions co-occur, and whether unique cognitive signatures accompany certain clinical combinations. METHOD: To address this gap, we examined how several deployment-related conditions were associated with performance on a well-validated measure of sustained attention (i.e., gradual onset continuous performance task [gradCPT]) and a battery of standard neuropsychological measures in 123 Veterans from the Translational Research Center for TBI and Stress Disorders. Initially, a Principal component analysis was conducted to investigate how comorbid conditions grouped together. RESULTS: Several sustained attention measures from the gradCPT were differentially associated with four unique combinations of trauma-related pathology. Specifically, a somatic component representing the combination of current pain, sleep disturbance, and mild traumatic brain injury was associated with a higher rate of failures of attentional engagement. On the other hand, a comorbid posttraumatic stress disorder (PTSD) and mood disorder component (moodPTSD), as well as a substance use disorder component, were associated with higher rates of inhibitory control failures. Increased attentional instability was associated with moodPTSD as well as an anxiety disorder component. In contrast, the cognitive effects of deployment-related trauma were not observed on standard neuropsychological measures. CONCLUSION: These findings suggest that unique combinations of trauma-related pathology have dissociable effects on sustained attentional control. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/fisiopatologia , Atenção/fisiologia , Concussão Encefálica/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Distúrbios de Guerra/fisiopatologia , Função Executiva/fisiologia , Transtornos do Humor/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Veteranos , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Concussão Encefálica/complicações , Concussão Encefálica/epidemiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Distúrbios de Guerra/complicações , Distúrbios de Guerra/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Testes Neuropsicológicos , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos
20.
World Neurosurg ; 129: e311-e316, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31132486

RESUMO

OBJECTIVE: Previous studies have identified the impact of affective disorders on preoperative and postoperative perception of pain. However, there is a scarcity of data identifying the impact of affective disorders on postdischarge narcotic refills. The aim of this study was to determine whether patients with affective disorders have more narcotic refills after complex spinal fusion for deformity correction. METHODS: The medical records of 121 adult (≥18 years old) spine deformity patients undergoing elective, primary complex spinal fusion (≥5 level) for deformity correction at a major academic institution from 2010 to 2015 were reviewed. Patient demographics, comorbidities, intraoperative and postoperative complication rates, baseline and postoperative patient-reported pain scores, ambulatory status, and narcotic refills were collected for each patient. The primary outcome was the rate of 6-week and 3-month narcotic refills. RESULTS: Of the 121 patients, 43 (35.5%) had a clinical diagnosis of anxiety or depression (affective disorder) (AD n = 43; No-AD n = 78). Preoperative narcotic use was significantly higher in the AD cohort (AD 65.9% vs. No-AD 37.7%, P = 0.0035). The AD cohort had significantly higher pain scores at baseline (AD 6.5 ± 2.9 vs. No-AD 4.7 ± 3.1, P = 0.004) and at the first postoperative pain score reported (AD 6.7 ± 2.6 vs. No-AD 5.6 ± 2.9, P = 0.049). However, there were no significant differences in narcotic refills at 6 weeks (AD 34.9% vs. No-AD 25.6%, P = 0.283) and 3 months (AD 23.8% vs. No-AD 17.4%, P = 0.411) after discharge between the cohorts. CONCLUSIONS: Our study suggests that whereas spinal deformity patients with affective disorders may have a higher baseline perception of pain and narcotic use, the impact of affective disorders on narcotic refills at 6 weeks and 3 months may be minimal after complex spinal fusion.


Assuntos
Transtornos do Humor/complicações , Entorpecentes/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/efeitos adversos , Adulto , Prescrições de Medicamentos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Entorpecentes/administração & dosagem , Percepção da Dor/efeitos dos fármacos , Dor Pós-Operatória/complicações , Estudos Retrospectivos , Doenças da Coluna Vertebral/complicações , Coluna Vertebral/cirurgia
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