A new evidence-based neuropsychological model of suicidal propensity and suicide based in depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S605-S606
Author(s):  
L.-H. Thorell
Keyword(s):  
Neuropsychological Dysfunction ◽  
Apparent Loss ◽  
The Everyday ◽  
Hippocampal Ca3 ◽  
Depressed Person ◽  
Competing Interest ◽  
New Evidence ◽  
The Relationship ◽  
Relevant Factors

IntroductionObjectively validated models of the depressed suicide are lacking. Early observations that electrodermal hyporeactivity was strongly related to suicide in depression required an untraditional statistical approach that was applied on materials from published materials with between themselves totally confirming results.ObjectivesA plausible explanation model of the relationship had to be developed.AimsThe aims were to investigate the nature of electrodermal hyporeactivity and its possible causes and connections to other suicide relevant factors and to formulate a coherent model of the depressed suicide.MethodsPublished materials with in- and outpatients (in total > 900 patients) comprising follow-up of suicide and tests of habituation of the electrodermal response were analysed. Symptomatology, gender, age and other variables were considered and so were knowledge and theories from other scientists.ResultsThe apparent loss of or considerably reduced specific electrodermal orienting (curiosity) responses in future depressed suicide victims showed clear relationships to and clear independence of considered important suicidal factors.ConclusionsLoss of specific orienting responses indicates loss of hippocampal CA3 plasticity. CA3 areas are early and centrally positioned in the information processing of neocortical sensory input supporting the hypothesis of a particular neuropsychological dysfunction disabling normal cognitive and emotional curiosity reactions to everyday events. It is proposed that this dysfunction may make the depressed person ready to leave the everyday life and fearless of imminent pain – a loss of two important barriers against suicide.It seems righteous to propose this basically objectively validated model as a plausible explanation of the depressed suicide.Disclosure of interestThe author has not supplied his declaration of competing interest.

Influence of Gender in Patients Attended in Emergency Rooms for Suicidal Tendencies

2017 ◽  
Vol 41 (S1) ◽  
pp. S95-S95
Author(s):  
B. Mata Saenz ◽  
E. Segura Escobar ◽  
E. Lopez Lavela ◽  
L.-M. Asensio Aguerri ◽  
L. Nuevo Fernandez ◽  
...  
Keyword(s):  
Personality Traits ◽  
Statistical Correlation ◽  
Toxic Substances ◽  
Emergency Rooms ◽  
Logistic Regression Models ◽  
Competing Interest ◽  
And Gender ◽  
The Relationship ◽  
Repeated Visit

IntroductionThe first time when people attempt suicide first contact is critical. Psychiatrists must decide to hospitalize them or follow-up in mental health units and the bases of a doctor-patient relationship are formed.ObjectivesAn analysis of referrals to psychiatry from the emergency room (ER) was developed. Our objective was to discover if there was a statistical correlation between gender and other variables, especially repeated visits and admissions.MethodsOur sample was composed of patients who visited the ER for suicidal tendencies for 20 months. We carried out an observational retrospective study. The variables collected were: age, gender, cause, repeated visit (visit to the ER in the following two months), previous attempts, previous follow-up, method used, use of toxic substances during the attempt, intentionality, referral from the ER, later follow-up and diagnostic impression at the ER.ResultsA total of 620 patients were sampled. The relationship between gender and repeated visit, previous attempts, dysfunctional personality traits, use of substances and later follow-up was found (Chi2). Although the relationship between admissions and gender were not statistically significant, influence by gender (over all in males) can be observed in logistic regression models. As well as, in patients who visited the ER several times, dysfunctional personality traits seem to be the most common but gender marks significant differences between groups.ConclusionsThe data obtained is consistent with those reported in previous studies. To know who the riskier groups are can allow professionals to plan protocols and unify admission criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Impact of Early Nephrology Referral on Mortality and Hospitalization in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Kai Ming Chow ◽  
Cheuk Chun Szeto ◽  
Man Ching Law ◽  
Bonnie Ching-Ha Kwan ◽  
Chi Bon Leung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Mortality ◽  
Univariate Analysis ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
Poor Outcomes ◽  
The Relationship ◽  
Late Referral ◽  
Relevant Factors

Objectives Several studies have examined the possible association between late referral to a nephrologist and mortality on maintenance hemodialysis. However, we lack information on the benefit of early nephrologist referral in patients receiving peritoneal dialysis (PD). Patients and Methods In an inception cohort of 102 consecutive PD patients identified in a single center between 2003 and 2004, we sought to determine whether late nephrologist referral was associated with poor outcomes. The primary end point was all-cause mortality. The effects of early referral to a multidisciplinary low clearance clinic on cardiovascular mortality and length of hospitalization were also evaluated. Results Of 102 incident PD patients, 61 subjects (59.8%) were referred early to the nephrologist (more than 3 months) before dialysis initiation. During the study period of 284.9 patient-years (median follow-up period 36.8 months), 25 patients died, 12 due to cardiovascular causes. Both cardiovascular and all-cause mortality were significantly increased among PD patients with late referral, but the relationship between late referral and all-cause mortality was mitigated substantially by adjusting for relevant factors. In univariate analysis, late nephrology referral was associated with increased cardiovascular mortality, with a hazard ratio of 5.43 (95% confidence interval 1.46 – 20.21, p = 0.012). Annual adjusted days of hospitalization were similar between the early and late nephrology referral groups. Conclusions A comprehensive analysis of incident PD subjects confirmed the significant relationship between late nephrology referral and all-cause and cardiovascular mortality. A causal relationship remains to be established and validated.

Individual Differences in Women's Perceptions of other Women's Dominance

2012 ◽  
Vol 26 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Christopher D. Watkins ◽  
Michelle C. Quist ◽  
Finlay G. Smith ◽  
Lisa M. DeBruine ◽  
Benedict C. Jones
Keyword(s):  
Individual Differences ◽  
Follow Up Studies ◽  
Different Types ◽  
Women’S Perceptions ◽  
New Evidence ◽  
The Relationship ◽  
Physical Dominance

Recent research on men's dominance perception suggests that the extent to which men perceive masculine men to be more dominant than relatively feminine men is negatively correlated with measures of their own dominance. In the current studies, we investigated the relationship between indices of women's own dominance and their perceptions of other women's facial dominance. Women's own height and scores on a dominance questionnaire were negatively correlated with the extent to which they perceived masculine women to be more dominant than relatively feminine women. In follow–up studies, we observed similar individual differences when (i) women separately judged other women's social and physical dominance, suggesting that individual differences in women's dominance perceptions generalize across two different types of dominance judgment and (ii) we assessed the perceivers’ dominance indirectly by using a questionnaire that measures the extent to which women view interactions with other women in competitive terms. These findings present new evidence that the extent to which people perceive masculine individuals to be more dominant than relatively feminine individuals is negatively correlated with measures of their own dominance and suggest that competition and conflict among women may have shaped individual differences in women's dominance perception. Copyright © 2011 John Wiley & Sons, Ltd.

Child obsessive-compulsive disorder presenting with catatonic-like features: Case presentation

2017 ◽  
Vol 41 (S1) ◽  
pp. S446-S446
Author(s):  
V. Kodra ◽  
V. Alikaj ◽  
B. Allkoja ◽  
B. Zenelaj ◽  
D. Sanxhaku
Keyword(s):  
Case Reports ◽  
Brain Mri ◽  
Food Contamination ◽  
Obsessive Compulsive ◽  
Drug Induced ◽  
Case Presentation ◽  
Compulsive Disorder ◽  
Competing Interest ◽  
The Relationship

IntroductionAlthough catatonia was conceptualized as a subtype of schizophrenia, it is now recognized to occur most commonly in the course of other psychiatric disorders, in drug-induced disorders [1] or neurologic conditions [2]. Catatonia is rarely seen together with OCD and there are a limited number of case reports in the literature [3,4].ObjectiveWe describe the case of a 12 year boy who presented in our clinic with mutism, negativism, immobility, social withdrawn, rigid posture, refusal to eat.MethodWe performed a thorough psychiatric diagnostic assessment of the child as well as laboratory tests and MRI of the brain.ResultsThe child's first symptoms appeared 2 years ago: initially the child became socially withdrawn, spent most of time at his room, and became preoccupied with rituals of hand washing, walking back and forth, preoccupations with food contamination, became aggressive if someone would interrupt what he was doing, stopped going at school, and stopped calling his parents “mother” or “father”. Brain MRI showed lateral ventricular asymmetry and suboccipital cyst.ConclusionsThe child was put on therapy with lorazepam and sertraline. His obsessive-compulsive symptoms improved, and the apparent catatonic like features resolved and did not return over follow-up.DiscussionCatatonia is not uncommon among children and adolescents, and the relationship between OCD and catatonia is still misunderstood, but it may be an indicator of the severity of the OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

When schizophrenia leads to terrorism: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s839-s839
Author(s):  
N. Staali
Keyword(s):  
Mental Illness ◽  
Case Report ◽  
Clinical Features ◽  
Mentally Ill ◽  
Personality Type ◽  
Treatment Processes ◽  
Terrorist Organization ◽  
Competing Interest ◽  
The Relationship

BackgroundSome have suggested that terrorists are mentally ill and have used labels such as psychopathic or sociopathic, narcissistic, paranoid, are schizophrenic types, or passive–aggressive. Others have argued that although terrorist actions may seem irrational or delusional to society in general, terrorists in fact, act rationally, and there is no evidence to indicate that they are mentally ill/disordered, psychopathic or otherwise psychologically abnormal.Objective and methodHere we present the case of Mr. A, a 32 year old man diagnosed with schizophrenia, who travelled to Egypt and Syria in attempt to join the ISIS terrorist organization, and discuss the clinical features, treatment processes and two years follow-up of this particular case.ConclusionAs described in some studies, most terrorists do not demonstrate serious psychopathology and there is no single personality type. Thus, the relationship between terrorism and mental illness mostly refers to the question about pathological travel as part of a religious and messianic delirium.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

External Investigators' Follow-Up Intentions When Whistleblowers Report Healthcare Fraud: The Effects of Report Anonymity and Previous Confrontation

2020 ◽  
Vol 32 (2) ◽  
pp. 91-101
Author(s):  
Steven E. Kaplan ◽  
Danny Lanier ◽  
Kelly R. Pope ◽  
Janet A. Samuels
Keyword(s):  
Experimental Study ◽  
Early Detection ◽  
Data Availability ◽  
Medical Provider ◽  
Perceived Credibility ◽  
The Relationship ◽  
Critical Investigation

ABSTRACT Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical, investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions. Data Availability: Data are available upon request.

Characteristics of Different Types of Childhood Violence and the Risk of Revictimization

2019 ◽  
Vol 25 (14) ◽  
pp. 1696-1716 ◽  
Author(s):  
Ida Frugaard Stroem ◽  
Helene Flood Aakvaag ◽  
Tore Wentzel-Larsen
Keyword(s):  
Childhood Abuse ◽  
Telephone Survey ◽  
Regression Analyses ◽  
Multiple Forms ◽  
Different Types ◽  
Children And Young Adults ◽  
Childhood Violence ◽  
Forms Of Violence ◽  
The Relationship

This study investigates the relationship between the characteristics of different types of childhood violence and adult victimization using two waves of data from a community telephone survey (T1) and a follow-up survey, including 505 cases and 506 controls, aged 17-35 years (T2). The logistic regression analyses showed that exposure to childhood abuse, regardless of type, was associated with adult victimization. Exposure to multiple types of abuse, victimization both in childhood and in young adulthood, and recency of abuse increased these odds. Our findings emphasize the importance of assessing multiple forms of violence when studying revictimization. Practitioners working with children and young adults should be attentive to the number of victimization types experienced and recent victimization to prevent further abuse.

Clinical Evaluation of the Variables associated with Treatment Acceptability and Their Relation to Compliance

1992 ◽  
Vol 18 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Thomas M. Reimers ◽  
David P. Wacker ◽  
Linda J. Cooper ◽  
Agnes O. Deraad
Keyword(s):  
Behavior Problem ◽  
Behavior Management ◽  
Positive Reinforcement ◽  
Treatment Acceptability ◽  
Clinic Visit ◽  
Future Research ◽  
Parental Ratings ◽  
Problem Severity ◽  
The Relationship

The authors examined the acceptability ratings of positive reinforcement procedures recommended to parents seen in a pediatric behavior management outpatient clinic. Parental ratings of acceptability were obtained in the clinic and 1, 3, and 6 months following their initial clinic visit. Acceptability variables were examined by group (parents who rated the acceptability of treatments as high vs. low) and by severity (parents who rated their children's behavior problem as severe vs. mild). The relationship between these variables and reported compliance was also examined. Results show that the acceptability variables were useful in differentiating between parents who rated treatments to be more acceptable and parents who rated treatments to be less acceptable. Differences were also observed as a function of behavior problem severity. Significant correlations occurred between acceptability variables and compliance at each of the follow-up points. Results are discussed in relation to the clinical significance of these findings and the impetus they might serve for future research.

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