Psychoses of epilepsy – “Acute attacks of insanity”. What literature says and how we act

2016 ◽  
Vol 33 (S1) ◽  
pp. S630-S630
Author(s):  
N. Echeverría Hernández ◽  
M.D.M. Lázaro Redondo ◽  
F. de la Torre Brasas ◽  
A. Duque Domínguez ◽  
A. Mas Villaseñor ◽  
...  
Keyword(s):  
Seizure Activity ◽  
Published Data ◽  
Potential Association ◽  
End Of Treatment ◽  
Epileptic Patients ◽  
Pubmed Search ◽  
History Of ◽  
Acute Attacks ◽  
Competing Interest ◽  
Patients With Epilepsy

IntroductionPatients with epilepsy seem particularly liable to certain major psychiatric disorders. Prevalence of schizophrenia within an epileptic population varies between 3% and 7% (1% in general population). The aetiology is possibly multifactorial (drugs and neurosurgery).ObjectivesTo study comorbidity between psychoses and epilepsy and management in the literature and in our patients.AimsTo analyze factors that might influence the onset of psychoses within an epileptic population and how this potential association could influence our practice.MethodsPubMed search was conducted with interest in psychoses of epilepsy, pharmacology, and comorbidity. Up to 10 variables related with factors influencing psychotic episodes that required hospital admission in three patients with epilepsy were studied.ResultsUnlike published data, our patients did not have postictal psychoses. All cases had early onset temporal lobe epilepsy with no seizure activity since diagnosis (more than 20 years). No family history of either epilepsy or psychoses. Management included lamotrigine, oxcarbazepine, carbamazepine, zonisamide, and levetiracetam in conventional doses. The psychosis, which comprised affective, schizophrenic, and confusional elements, lasted longer and was more troublesome than psychosis in non-epileptic patients. Response to neuroleptics was poorer than in non-epileptic patients with psychoses. Consultation with Neurology Unit resulted in end of treatment with zonisamide and levetiracetam.ConclusionsLess than perfect evidence suggests the association between psychosis and epilepsy. In our patients, no postictal cases were recorded. Management showed poorer effect of neuroleptics when compared with non-epileptics, and zonisamide and levetiracetam were changed for other drugs with presumably lower association with psychoses.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Schizophreniform Psychosis among Epileptics in a Mental Hospital

1973 ◽  
Vol 123 (573) ◽  
pp. 231-232 ◽  
Author(s):  
K. F. Standage
Keyword(s):  
Mental State ◽  
Mental Hospital ◽  
Psychiatric Interview ◽  
Interview Technique ◽  
Epileptic Patients ◽  
History Of ◽  
Definition Of ◽  
Patients With Epilepsy

Several years have passed since the last study of the psychiatric abnormalities shown by epileptic patients in an English mental hospital (2), during which time detailed information has become available about the development of schizophreniform states in some chronic epileptics (3). This study was undertaken to examine the mental state of patients with epilepsy resident in Bexley Hospital, using a semi-structured psychiatric interview technique (6). The criteria used for the definition of epilepsy were those of Gunn and Fenton (1)—a history of at least three epileptic attacks in a two-year-period, and continuation of anti-convulsant therapy if the period did not immediately precede the time of examination.

Bipolar Disorder in Epilepsy

2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Sivakova ◽  
G. Mazo ◽  
L. Lipatova
Keyword(s):  
Bipolar Disorder ◽  
Scientific Data ◽  
Future Research ◽  
Entire Cohort ◽  
Affective Symptoms ◽  
High Prevalence ◽  
Epileptic Patients ◽  
The Mean ◽  
Competing Interest ◽  
Patients With Epilepsy

IntroductionBipolar disorder (BD) and epilepsy are the chronic recurrent diseases with several similarities in pathogenic mechanisms. There are high prevalence of comorbidity between affective disorders and epilepsy. However, most recent studies focused on association epilepsy with depression, while lack of scientific data about relationship between epilepsy and BD.ObjectivesThis study examined the frequency of bipolar disorder in epileptic patients.AimsTo improve the diagnostic tool for BD in epileptic patients.Materials and methodsWe observed 50 patients with epilepsy (PE). In this study, the symptoms of BD were measured by the Hypomania Checklist-32 (HCL-32).ResultsThe mean age of the entire cohort was 40 (SD = 19.2) years. The proportion of females were 62%. The mean score using HCL-32 were 11.1 (SD = 4.5, range: 3–20) with 17 (34%) scoring above 14, the cut-off points for the basic version of the HCL-32. Among of high score subgroup there were 6 men and 11 women, maximum age was 74 and minimum 19, the mean age of the subgroup were 37 years. The patients 8 out of 17 (47%) received a score of 20 or more (maximum of 37) on the bipolar index that corresponds to ≥ 20% probability BD.ConclusionThe results of the study observed a high prevalence of BD in PE. Future research addressing (1) using of psychiatric examination instruments to assess affective symptoms among PE and (2) treatment management of affective symptoms by antiepileptic drugs might result in better treatment outcomes among patient with comorbidities of BD and PE.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anxiety and undiagnosed pheochromocitoma

2016 ◽  
Vol 33 (S1) ◽  
pp. S362-S362
Author(s):  
C. Cocho Santalla ◽  
C. Sanahuja
Keyword(s):  
Anxiety Disorders ◽  
Urinary Catecholamine ◽  
Potential Source ◽  
Clinical Presentations ◽  
Pubmed Search ◽  
History Of ◽  
Competing Interest ◽  
Manual Review ◽  
Previous Medical History ◽  
Acute Anxiety

IntroductionPheochromocytomas are rare catecholamine-secreting tumours from the adrenal medulla. The clinical presentations may mimic other disorders due to nonspecific symptoms produced by catecholamines in blood.ObjectivesWe report a case of undiagnosed pheochromocytoma in a 29-year-old woman with a two year history of anxiety. We undertook a literature review.MethodsPubMed search using “pheochromocytoma”, “anxiety” as key words. Follow by a manual review of identified publication. We report a case of a 29-year-old with a two-year history of anxiety pharmacologically treated without success. She presents episodes of acute anxiety accompanied, sometimes, by nausea or headache, without high blood pressure. She presented a previous medical history of thyroid carcinoma. The patient was referred to the endocrinology service for thyroid review, postulated as potential source for drug resistance. High catecholamine levels were found and pheochromocytoma diagnosis was confirmed histopathologically.ResultsThe releasing catecholamine in blood can lead to a number of symptoms that can include paroxysmal hypertension, headache, palpitations, anxiety, chest/abdominal pain, nausea. Hypertension may not be the main symptom. These symptoms can be misinterpreted as psychiatric disorders, in particularly anxiety disorders. Elevated urinary catecholamine suggested the diagnosis of pheochromocytoma.ConclusionsPheochromocytoma should be included in the differential diagnosis of anxiety disorders, especially if pharmacological treatment is not effective. The suspected cases should be investigated, even in the absence of hypertension, due to the potential morbidity of untreated pheochromocytoma.Disclosure of interestThe authors have not supplied their declaration of competing interest.

History of diatom studies in sphagnum bogs of Russia and some adjacent countries

2008 ◽  
Vol 42 ◽  
pp. 36-54
Author(s):  
M. S. Kulikovskiy
Keyword(s):  
Published Data ◽  
Sphagnum Bogs ◽  
History Of

Main trends of diatom studies in Sphagnum bogs of Russia and adjacent countries are shown. On the basis of published data, making use of modern taxonomical changes, the taxonomical list of diatoms from the considered Sphagnum bogs is presented.

Update on the Boundaries of the Curly Birch Range

2020 ◽  
pp. 9-21
Author(s):  
L.V. Vetchinnikova ◽  
◽  
A.F. Titov ◽  
◽  
Keyword(s):  
Population Size ◽  
Natural Populations ◽  
Forest Tree ◽  
Published Data ◽  
Population Approach ◽  
Key Factors ◽  
History Of ◽  
Individual Trees ◽  
Karelian Birch

The article reports on the application of the best known principles for mapping natural populations of curly (Karelian) birch Betula pendula Roth var. carelica (Mercklin) Hämet-Ahti – one of the most appealing representatives of the forest tree flora. Relying on the synthesis and analysis of the published data amassed over nearly 100 years and the data from own full-scale studies done in the past few decades almost throughout the area where curly birch has grown naturally, it is concluded that its range outlined in the middle of the 20th century and since then hardly revised is outdated. The key factors and reasons necessitating its revision are specified. Herewith it is suggested that the range is delineated using the population approach, and the key element will be the critical population size below which the population is no longer viable in the long term. This approach implies that the boundaries of the taxon range depend on the boundaries of local populations (rather than the locations of individual trees or small clumps of trees), the size of which should not be lower than the critical value, which is supposed to be around 100–500 trees for curly birch. A schematic map of the curly birch range delineated using this approach is provided. We specially address the problem of determining the minimum population size to secure genetic diversity maintenance. The advantages of the population approach to delineating the distribution range of curly birch with regard to its biological features are highlighted. The authors argue that it enables a more accurate delineation of the range; shows the natural evolutionary history of the taxon (although it is not yet officially recognized as a species) and its range; can be relatively easily updated (e.g. depending on the scope of reintroduction); should be taken into account when working on the strategy of conservation and other actions designed to maintain and regenerate this unique representative of the forest tree flora.

scholarly journals On the Short Time Scale Evolutionary History of the Contact Binary VW Cephei

1998 ◽  
Vol 11 (1) ◽  
pp. 396-396
Author(s):  
I. Pustylnik
Keyword(s):  
Evolutionary History ◽  
Light Curves ◽  
Published Data ◽  
Short Time Scale ◽  
Flare Activity ◽  
Considerable Portion ◽  
History Of ◽  
Contact Binary ◽  
Elongation Phase ◽  
Short Time

We study the short-time evolutionary history of the well-known contact binary VW Cep. Our analysis is based partly on the numerous UBV lightcurves obtained at Tartu Observatory, IUE spectra, and samples from the published data. Special attention is given to the effects of asymmetry of the light curves. A higher degree of asymmetry outside the eclipses along with the significant displacements of the brightness maxima in respect to the elongation phase is interpreted as evidence that a considerable portion of the flaring source is concentrated close to the neck connecting the components. We discuss the nature of asymmetry in terms of possible mass exchange and the flare activity and compare the results of our model computations with the record of orbital period variations over the last 60 years.

scholarly journals Perception about Etiology of Epilepsy and Help-Seeking Behavior in Patients with Epilepsy

2021 ◽  
Author(s):  
Gautam Das ◽  
Samar Biswas ◽  
Souvik Dubey ◽  
Durjoy Lahiri ◽  
Biman Kanti Ray ◽  
...  
Keyword(s):  
Help Seeking ◽  
Tertiary Care ◽  
Epileptic Seizures ◽  
Treatment Seeking ◽  
Professional Help ◽  
Epileptic Patients ◽  
Seeking Behavior ◽  
Tertiary Care Centers ◽  
Patients With Epilepsy

Abstract Objectives Patients with epilepsy and their family have diverse beliefs about the cause of their illness that generally determine their treatment-seeking behavior. In this study, our aim was to find out different beliefs about epilepsy that lead to different help-seeking patterns, which act as barrier to the intended modern medical management of epilepsy. Materials and Methods One hundred and fifty consecutive consenting patients accompanied by a reliable informant/family member fulfilling the International Classification of Epileptic Seizures (ICES), simplified version, were included. Demographic and clinical data of all the eligible subjects was collected. Perceived cause of illness and help-seeking pattern were explored from patient/informant by administering proper instruments. Results Respondents identified varied causes of epilepsy and explored multiple help-seeking options before reaching tertiary care centers. We observed that, generally, epileptic patients/relatives who had belief in causes like supernatural causes sought help from nonprofessional personnel and those attributed their symptom to bodily pathology had professional help-seeking. Conclusions The belief in supernatural causes not being conformed to the biomedical models of the epileptic disorders increases the treatment gap.

Attempted suicide attention at an emergency room: A hospital-based descriptive approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S603-S603
Author(s):  
D. Torres ◽  
G. Martinez-Ales ◽  
M. Quintana ◽  
V. Pastor ◽  
M.F. Bravo
Keyword(s):  
Emergency Room ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Study Results ◽  
History Of ◽  
Competing Interest ◽  
Reported Data ◽  
Medium Cost ◽  
Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anxiety disorders and substance abuse

2016 ◽  
Vol 33 (S1) ◽  
pp. S384-S384
Author(s):  
I. Prieto Sánchez ◽  
M.D.L.C. Ramírez Domínguez ◽  
S. Fernández León ◽  
M. Reina Domínguez ◽  
N. Garrido Torres ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Dual Diagnosis ◽  
Behavioral Problems ◽  
Strong Association ◽  
Epidemiological Studies ◽  
Distinctive Features ◽  
Other Substances ◽  
History Of ◽  
Competing Interest ◽  
Substance Disorder

IntroductionPatients with anxiety disorders are more vulnerable to develop other comorbid conditions. In particular, large epidemiological studies show a strong association between different anxiety disorders and substance use disorders.ObjectivesTo show the prevalence of major anxiety disorders and the consumption of different substances. As well as the particular characteristics of this dual diagnosis and treatments that have proven more effective.MethodsExhaustive review of all the material published on this topic in the recent years.ConclusionsNearly 24% of patients with anxiety disorder suffer from a comorbid substance disorder use in their lifetime (17.9% diagnosis of alcohol abuse or dependence diagnosis and 11.9% of abuse or dependence on other drugs). Dual patients show a number of distinctive features, such as more frequency in males, family history of alcohol or other substances abuse and behavioral problems, early parental loss among others.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comorbid depression and ulcerative colitis – is there a connection?

2017 ◽  
Vol 41 (S1) ◽  
pp. S534-S534
Author(s):  
A. Melada ◽  
I. Krišto-Mađura ◽  
A. Vidović
Keyword(s):  
Ulcerative Colitis ◽  
Psychiatric Treatment ◽  
Psychiatric Symptoms ◽  
Specific Treatment ◽  
Unknown Etiology ◽  
Suicidal Thoughts ◽  
Symptoms Of Depression ◽  
Bidirectional Communication ◽  
History Of ◽  
Competing Interest

Ulcerative colitis (UC) is a subset disorder of inflammatory bowel disease (IBD) with chronic course and symptoms such as fatigue, gastrointestinal pain, fever, etc. IBD is associated with psychological manifestations including depression and anxiety. There is an increased number of studies trying to link these comorbidities. The gut-brain axis is regulated by intestinal microbiota and this bidirectional communication including immune, neural, endocrine and metabolic mechanisms may bring us closer to the answer. The following case concerns a 56-year-old patient with history of major depressive disorder who was in continuous psychiatric care and treated with antidepressants. Several years after the beginning of psychiatric treatment, he was hospitalized for diagnostic examination due to subfebrility of unknown etiology, but with no final somatic diagnosis. After two years he was referred to our department and at administration the patient showed symptoms of depression, anxiety, lack of motivation and suicidal thoughts and tendencies. Subfebrility was still present at that time. His psychopharmacotherapy was revised and there was a slight improvement in mood and behaviour. During outpatient follow-ups the symptoms of depression were still prominent and remission was not achieved even with modulation of antidepressant pharmacotherapy. The following year the patient was diagnosed with UC and started specific treatment after he presented with diarrhea in addition to subfebrility. Subsequently his mood improved, suicidal thoughts were diminished and ultimately remission was achieved. This case suggests that only after UC was being treated the psychiatric symptoms also withdrew which implicates that inflammatory mediators were involved in pathogenesis of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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