Interest of admission clinical and paraclinical examinations for the detection of organic comorbidities in psychiatry

2016 ◽  
Vol 33 (S1) ◽  
pp. S385-S385
Author(s):  
M. Turki ◽  
N. Halouani ◽  
N. Hamza ◽  
R. Naoui ◽  
I. Gassara ◽  
...  
Keyword(s):  
Mental Illnesses ◽  
Clinical Observations ◽  
Somatic Disorder ◽  
Admission Data ◽  
Somatic Comorbidities ◽  
Patients At Risk ◽  
Biological Tests ◽  
Skin Abnormalities ◽  
Somatic Disorders ◽  
Competing Interest

IntroductionSomatic comorbidities in patients with mental disorders have become an important issue. They complicate therapeutic management and aggravate the prognosis.ObjectivesOutline the nature of somatic disorders observed in psychiatry and assess the different interactions between psychiatric pathologies and organic diseases.MethodsWe conducted a descriptive retrospective study including 60 patients hospitalized in a psychiatry department during 2 years (2013 and 2014). We included patients having presented a somatic disorder at their admission. Data collection was based on psychiatric and clinical observations.ResultsAt the admission, somatic examination was abnormal in 53.3% of cases: skin abnormalities 28.3%; blood pressure abnormalities 8.3%. An abnormality of the initial biological tests has been reported in 51.7% of patients: leukocytosis 18.3%; liver test abnormalities 13.3%; hematologic abnormalities 8.3%. The electro-cardiograph was pathologic in 35% of cases. These anomalies have required advices from medical and surgical services: cardiology 33.3%; endocrinology 10%, orthopedics 10%. The relationship between somatic and psychiatric pathology was: a comorbidity: 55%; a side effect of psychotropic drug: 5%; an organic origin of the psychiatric disorder: 6.6% and a somatic disorder secondary to the psychiatric pathology: 10%. In the course of this investigation, 6.6% of patients were transferred urgently to a specialist department, the psychotropic treatment was stopped in 10% of cases, and a therapeutic adjustment was necessary in 6.6% of cases.ConclusionOur study confirms the importance of somatic assessment of patients with mental illnesses. This must be a systematic practice in order to detect in time patients at risk of somatic complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Correlation Between Chronic Somatic Co-morbidities and Prognosis of Major Depressive Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s240-s240
Author(s):  
N. Lucev ◽  
A. Vuk ◽  
I. Simunovic Filipcic ◽  
I. Filipcic
Keyword(s):  
Poor Prognosis ◽  
Treatment Success ◽  
Cross Sectional ◽  
Duration Of Illness ◽  
Co Morbidity ◽  
Wide Range ◽  
Somatic Comorbidities ◽  
Somatic Disorders ◽  
Competing Interest ◽  
Somatic Diseases

IntroductionDepression and somatic disorders are closely interrelated. Depressed mood is recognized to contribute to the development and progression of wide range of somatic diseases, while at the same time somatic diseases may increase the risk of depression. Co-morbidity research still represents huge research and clinical challenge to contemporary psychiatry and medicine.ObjectivesTo check whether the correlation of NSC and poor prognosis of MDD treatment is merely the consequence of age and duration of illness.MethodsWe investigated a cross-sectional sample consisting of 290 psychiatric diagnosed with MDD. Outcome was the number of psychiatric rehospitalizations (NPR) since the first diagnosis of MDD treatment success. Predictor was NSC. Covariates controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of MDD, CGI-severity of MDD at diagnosis, treatment with antidepressants and anti-psychotics.ResultsAfter adjustment for all confounders, mediation analysis revealed insignificant indirect effects of NSC on NPR through patient's age (P = 0.296) and duration of MDD (P = 0.180). Direct effect of NSC was significant and clinically relevant (P < 0.001). Effect of NSC was significantly moderated by duration of MDD (P = 0.019). NSC and NPR were not significantly associated if MDD lasted for less than a year. The more MDD lasted the stronger was correlation of NSC and NPR.ConclusionCorrelation of NSC and poor prognosis of MDD is not a mere consequence of patient's age and duration of illness. To treat MDD effectively we have to treat simultaneously somatic comorbidities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Multidisciplinary approach about contraception in a day hospital of mental health

2017 ◽  
Vol 41 (S1) ◽  
pp. s848-s848
Author(s):  
C.M. Calahorro ◽  
M. Guerrero Jiménez ◽  
B.M. Girela Serrano
Keyword(s):  
Mental Illness ◽  
Reproductive Health ◽  
Mental Illnesses ◽  
Healthy Population ◽  
Day Hospital ◽  
Attitudes And Practices ◽  
Hospital Patients ◽  
Unwanted Pregnancies ◽  
Competing Interest ◽  
Healthy Sexuality

BackgroundWomen with mental illness are a disadvantaged group both in terms of their gender and because of their mental disorders, and they experience serious problems related to reproductive health.The high rates of unplanned and unwanted pregnancies among women with schizophrenia underscore the importance of understanding their attitudes and practices related to family planning. Different studies reveal that even though many sexually active women with serious mental illnesses do not want to become pregnant, they do not use birth control.ObjectivesRelease last data about contraception methods among patients with severe mental illness after doing a bibliographical review. Also reflect present setup in Motril day hospital women patients and their relationship with sexuality and contraception. At the same time we intend to clarify and unify the proceedings on ethical problems respecting subject's autonomy, beneficence, qualification and minors’ protection.MethodsData were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing.ResultsIt was found that female patients with psychiatric disorders had more negative attributes with regard to contraception approach and sexuality compared with a corresponding healthy population.ConclusionsWe reached an agreement about future contraception approaches in Motril day hospital users as part of the global treatment offered in our section.MotrilHospital gynaecology service has facilitated the proceedings for contraceptive subcutaneous implants insertion in those indicated women.Day hospital patients were instructed individually and through group work about healthy sexuality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals First Do No Harm: An Analysis of the Risk Aspects and Side Effects of Clinical Holistic Medicine Compared With Standard Psychiatric Biomedical Treatment

2007 ◽  
Vol 7 ◽  
pp. 1810-1820 ◽  
Author(s):  
Søren Ventegodt ◽  
Isack Kandel ◽  
Joav Merrick
Keyword(s):  
Side Effects ◽  
Psychiatric Treatment ◽  
Treatment Method ◽  
Mental Illnesses ◽  
Holistic Medicine ◽  
Treatment As Usual ◽  
Philosophy Of Life ◽  
Do No Harm ◽  
Comparative Review ◽  
Patients At Risk

Clinical holistic medicine (CHM) is short-term psychodynamic psychotherapy (STPP) complemented with bodywork and philosophical exercises, to be more efficient in treating patients with severe mental and physical illness. STPP has already been found superior to psychiatric treatment as usual (TAU) and thus able to compete with psychiatric standard treatment as the treatment of choice for all non-organic mental illnesses; we have found the addition of bodywork and philosophy of life to STPP to accelerate the process of existential healing and recovery (salutogenesis). In this paper we compare the side effects, suicidal risk, problems from implanted memory and implanted philosophy of CHM with psychopharmacological treatment. Method: Qualitative and quantitative comparative review. Results: In all aspects of risks, harmfulness, and side effects, we have been considering, CHM was superior to the standard psychiatric treatment. The old principle of “first do no harm“ is well respected by CHM, but not always by standard psychiatry. CHM seems to be able to heal the patient, while psychopharmacological drugs can turn the patient into a chronic, mentally ill patient for life. Based on the available data CHM seems another alternative to patients with mental illness. There seem to be no documentation at all for CHM being dangerous, harmful, having side effects of putting patients at risk for suicide. As CHM uses spontaneous regression there is no danger for the patient developing psychosis as, according to some experts, has been seen with earlier intensive psychodynamic methods. CHM is an efficient, safe and affordable cure for a broad range of mental illnesses.

Physiotherapy and Human Relations

2016 ◽  
pp. 67-74
Author(s):  
Donald W. Winnicott
Keyword(s):  
Early Development ◽  
Emotional Development ◽  
The Body ◽  
Human Relations ◽  
Somatic Disorder ◽  
Somatic Disorders ◽  
The Subject ◽  
The Relationship

In this paper on psycho-somatic disorders, Winnicott begins by acknowledging the vastness of the subject. Psycho-somatic disorder merges into the universal problem of the healthy interaction between the psyche and the soma—that is, between the personality of an individual and the body in which the person lives. The relationship between body and mind, role of early development and stages of emotional development are also discussed.

A comprehensive systematic screening protocol for assessment of medical comorbidities in schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S574-S574
Author(s):  
P. Bucci ◽  
E. Durante Mangoni ◽  
P.C. Pafundi ◽  
S. De Simone ◽  
U. Malgeri ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Intraclass Correlation ◽  
Mental Illnesses ◽  
Rater Reliability ◽  
Systematic Screening ◽  
Medical Comorbidities ◽  
Brief Training ◽  
Screening Protocol ◽  
Competing Interest

IntroductionDifficult access and low quality of health care are recognized as factors that may account for the excess deaths widely reported in patients with schizophrenia. As a matter of fact, psychiatrists not always possess adequate competences in the assessment of physical health, while non-psychiatric physicians receive little training in psychiatry and are not prepared to take care of subjects with severe mental illnesses.ObjectivesWe present a comprehensive and systematic algorithm for screening medical comorbidities, conceived to be easy to use for psychiatrists, after a brief training.AimsThe study is aimed to implement an instrument for proper detection and management of physical illnesses in people with schizophrenia.MethodsThe screening protocol, developed by internal medicine specialists, was applied to 15 subjects in two independent assessments, one performed by trainees in psychiatry, after a brief training, and one carried out by one specialist and two trainees in internal medicine. The analysis of the inter-rater reliability was carried out by calculating the Cohen's kappa coefficient and the intraclass correlation coefficient as appropriate.ResultsThe agreement among raters resulted excellent for 61% of items, good for 17%, moderate for 18% and scarce for 4%. The few items showing scarce inter-rater reliability were excluded. The final algorithm is being tested for feasibility in psychiatric settings.ConclusionsThe proposed screening protocol resulted in a suitable tool, showing moderate to excellent inter-rater reliability, that can be used in clinical practice by psychiatrists after a brief training.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Genetic determinants of psychic resilience after a diagnosis of cancer

2017 ◽  
Vol 41 (S1) ◽  
pp. S596-S596
Author(s):  
M. Christensen ◽  
A. Drago
Keyword(s):  
At Risk ◽  
Psychiatric Disorders ◽  
Depressive Disorders ◽  
Adjustment Disorder ◽  
Genetic Determinants ◽  
Co Morbidity ◽  
Patients At Risk ◽  
Diagnosis Of Cancer ◽  
Competing Interest ◽  
Definition Of

IntroductionCo-morbidity between cancer and psychiatric disorders including adjustment disorder, depressive disorders or angst can seriously influence the prognosis and the quality of life of patients.AimThe identification of the psychological and biological profile of patients at risk for such co-morbidity is not yet available. Classical candidate genes such as the BDNF, the 5-HTLPR and genes whose products are involved in inflammatory events have received some attention, but results are inconclusive.Object and methodsIn the present review the association between cancer and psychiatric disorders is reviewed, a focus on the investigation of the Gene X environment and the epigenetic control over the activation of the HPA axis is proposed as a tool to refine the definition of the biologic profile at risk for co-morbidity between psychiatry and cancer.Results and conclusionA number of genes and socio-demographic variables that may influence risk to suffer from a psychiatric disorder after a diagnosis of cancer is identified and discussed. The identification of such biologic and socio-demographic profile is instrumental in the identification of subjects at risk of a double diagnosis, both somatic and psychiatric. An early identification of such profile risk would pave the way to the implementation of early intervention strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attitudes towards help seeking behaviour and professional psychiatric help in Slovenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S183-S184
Author(s):  
S. Roškar ◽  
M. Bračič ◽  
U. Kolar ◽  
N. Konec Juričič ◽  
K. Lekić ◽  
...  
Keyword(s):  
Mental Health ◽  
Help Seeking ◽  
Demographic Data ◽  
Health Indicators ◽  
Mental Illnesses ◽  
Health History ◽  
Mental Health History ◽  
Help Seeking Behaviour ◽  
On Line ◽  
Competing Interest

IntroductionKnowledge about signs and treatment of mental illnesses is often not enough to seek professional help. Hence, it is important to gain understanding of other determinants, i.e. attitudes, stigma, which influence help-seeking behaviour.ObjectivesBased on Ajzen's theory of planned behaviour, we aimed at collecting data of determinants known to be related to behavioural action, in our case help seeking.AimsTo examine how attitudes, stigma and normative believes influence help seeking behaviour and whether these determinants differ in relation to demographic data and mental health indicators of the respondents’ region.MethodsA representative sample of adult Slovene population (n = 594) was recruited via an on-line invitation. They were asked to (i) provide basic demographic data (region, age, gender, mental health history…) and (ii) to complete the inventory of attitudes toward seeking mental health services. The inventory variables (attitudes, knowledge and stigma) were linked to demographic data and mental health indicators in Slovenia.ResultsThe respondents dispose of good knowledge of where and when to seek help either for themselves or others. However, the readiness to seek help was significantly lower, in particular so in men, younger, single persons and respondents from regions with lower mental health indicators. Accordingly, stigma was significantly higher pronounced in the same groups. More than 50% of respondents have already experienced mental distress, however only 25% have sought help.ConclusionsReasons for this “help seeking gap” should be further scrutinized. Future interventions shall be focused on changing attitudes and destigmatization mental health issues.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sociodemographic variables and efficacy study in psychotic patients after 12 months of outpatient treatment with paliperidone palmitate (PP)

2016 ◽  
Vol 33 (S1) ◽  
pp. S546-S546
Author(s):  
P. Manzur Rojas ◽  
P. Botias Cegarra ◽  
M.R. Raposo Hernandez ◽  
M.I. Ibernon Caballero ◽  
A. Sanchez Bahillo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Rating Scale ◽  
Clinical Status ◽  
Cross Sectional Study ◽  
Mental Illnesses ◽  
Sociodemographic Characteristics ◽  
Cross Sectional ◽  
Psychiatric Rating ◽  
Competing Interest ◽  
Psychiatric Rating Scale

IntroductionPsychotic disorders are serious mental illnesses that compromise the quality of life of patients. It is important to know the characteristics of the affected population, seek to improve the adhesion and functionality.ObjectivesTo describe the sociodemographic characteristics of patients treated with Palmitato Paliperidona (PP). Analyze the efficacy variables, adherence to treatment.MethodsCross-sectional study of 15 patients in outpatient follow-up after 12 months of treatment with PP. Sociodemographic characteristics are collected, mean dose of PP, through a mirror study. Scales to measure the functionality, clinical status and attitude towards medication apply: Scale of personal and social functioning (PSP), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI-SI) and attitudes toward Inventory Medication (DAI).ResultsThe sample consists of 15 patients (54% male). 81% are single; 77% live alone and 94% not working. The mean dose of PP is 147 mg/month. DAI shows a good attitude to the treatment (80%). The PSP shows that 22% of patients have serious difficulties in its development. The CGI-SI shows that 67% are moderately sick and the BPRS that 33% of patients have a serious disorder.ConclusionsThe demographic profile of patients after 12 months of treatment with PP coincides with male, unmarried, unemployed, living alone. Most have good adherence. The variables measured by the CGI-SI, BPRS and PSP, displayed moderately ill patients with severe difficulties or marked on their autonomy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

On Becoming Ill: An Exploration of the Concept of “Transition” to a Mental Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S509-S510
Author(s):  
B. Moura
Keyword(s):  
Mental Illness ◽  
Clinical Practice ◽  
Mental Disorder ◽  
Systems Approach ◽  
Mental Illnesses ◽  
Clinical Population ◽  
Longitudinal Models ◽  
Cross Sectional ◽  
Competing Interest ◽  
Models Of Disease

IntroductionAs a general problem in nosology, the moment when one becomes ill may be hard to define. In Psychiatry, the boundaries of disease may be more difficult to establish. In the last decade, we’ve been observing a growing interest in early diagnosis in this field, and the concept of “transition” to a mental illness became an important topic of discussion with implications in clinical practice.ObjectiveTo review different author's models of evolution of symptoms and transition to mental illness and discuss their advantages and limitations in the actual context of Psychiatry research and clinical practice.AimTo increase understanding on the different paradigms of becoming ill and their relevance to present and future psychiatric practice.MethodsNon-systematic review of literature devoted to the creation of models that describe the establishment of a mental disorder.ResultsOne of the first accounts of becoming mentally ill was developed by K. Jaspers within a phenomenological life-history analysis. Nonetheless, a cross-sectional approach to diagnosis has dominated Psychiatry for most of the time. With the advent of early intervention studies, longitudinal models of disease have been emphasized. The concept of a transition to disease was then operationalized but also highly criticized. Recently, McGorry proposed a staging model for psychiatric disorders in continuum with the non-clinical population. Finally, a dynamic systems approach to diagnosis in Psychiatry will be discussed.ConclusionDriven by research in early phases of mental illnesses, current models of disease propose a longitudinal approach that emphasizes the complex and non-linear course of symptom clusters.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment of patients with opioid addiction with different disease duration

2016 ◽  
Vol 33 (S1) ◽  
pp. S302-S302
Author(s):  
N. Khodjaeva ◽  
S. Sultanov
Keyword(s):  
Disease Duration ◽  
Immune Reactivity ◽  
Systematic Observation ◽  
Rehabilitation Care ◽  
Treatment Techniques ◽  
Results Of Treatment ◽  
Somatic Disorders ◽  
Competing Interest ◽  
One Year ◽  
Group 1

To study the characteristics of medical and rehabilitation care for patients with opioid dependence we have investigated 50 patients. All patients on long-term use of opioids were divided into 2 groups. The duration of drug abuse in group 1 ranged from 4 months up to 5 years. In the second group, the duration of dependence was more than 5 years. Patients in the second group of somatic-neurological symptoms were having somatic disorders and organic brain damage. Systematic observation in drug treatment clinics at the place of and maintenance treatment of at least one year was achieved in 8.48% of patients of group 1 and 3.85% of the second group. Consequently, the role of the therapeutic factor in trying to achieve regression syndrome pathological attraction in early stages of the disease, we recognize more productive. Patients of the second group with a large weighting of disease duration was noted clinical abstinence syndrome both by somatic and neurological disorders, as well as by more severe anxiety, dysphoric disorders. These disorders require the inclusion in the scheme of treatment techniques aimed at more effective detoxification and immune reactivity of the organism. Patients of the second group was added to the treatment nootropics and immunomodulators. Analysis of the results of treatment in patients with drug addiction with different disease duration showed significant differences in the effectiveness. In the second group with a duration of more than 5 years of addiction, it is advisable to the treatment nootropics, immunomodulators.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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