Ethnic Immigrant suicide in a Canadian psychiatric service: A case series from 1966–1997

2016 ◽  
Vol 33 (S1) ◽  
pp. s273-s273
Author(s):  
N. Husain ◽  
B. Martin ◽  
M. Husain ◽  
V. Duddu ◽  
I. Sakinofsky ◽  
...  
Keyword(s):  
Psychiatric Service ◽  
Case Series ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Completed Suicide ◽  
Historical Factors ◽  
Universal Approach ◽  
Competing Interest ◽  
Statistics Canada ◽  
Social Demographic

IntroductionSuicide is a major public-health problem in Canada. Data from ‘Statistics Canada’ suggests that there was a 10% increase in suicide rate between the years 1997 and 1999. Studies have found substantial differences in suicide rates (and patterns) amongst ethnic immigrants compared to Canadian-born individuals.AimThe aim of the study was to investigate whether ethnic-immigrant patients differed from Canadian-born patients in their social, demographic, psychiatric and historical associations.MethodsAll registered patients (n = 276) known to have completed suicide from 1966–1997 constituted the study sample. Data were extracted from the written case audits, autopsy and toxicology reports, and medical records.ResultsOf the 276 known cases of suicide, 11 were Afro-Caribbean, 24 were Eastern European, 14 were Asian and 215 were Canadian-born patients. The ethnic-immigrant groups were broadly comparable to the Canadian-born group in terms of the social, demographic, psychiatric and background historical factors (except that the latter had a higher prevalence of alcohol and substance misuse). There were no significant differences between different ethnic immigrant groups themselves.ConclusionsThe most salient implication of the findings are that social, psychiatric and historical associations of mentally ill patients who complete suicide are common across different ethnic immigrant groups, and as such a universal approach to mental health promotion, early identification and treatment would be similarly applicable to patients belonging to all groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluation of Dependence Among Benzodiazepines in Population of Elderly Subjects Followed in Psychiatric Service in Sfax

2017 ◽  
Vol 41 (S1) ◽  
pp. S660-S660
Author(s):  
N. Messedi ◽  
I. Feki ◽  
I. Baati ◽  
R. Sellami ◽  
D. Trigui ◽  
...  
Keyword(s):  
Psychotropic Drugs ◽  
Psychiatric Service ◽  
Public Health Problem ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Competing Interest ◽  
Withdrawal Signs

IntroductionBenzodiazepines (BZD) are the most consumed psychotropic drugs by the elders. This prescription can lead to the dependence which is a major public health problem particularly in this population.ObjectivesTo study the prevalence of dependence of the (BZD) in elderly subjects followed as outpatients and to identify the factors associated with it.MethodsIt was a cross-sectional study of 60 patients aged 65 years and older followed at the psychiatric consultation of the UH Hédi Chaker of Sfax; for 3 months. We used:– Questionnaire containing demographic and clinical data.– The cognitive scale of attachment to benzodiazepines (ECAB), a score ≥ 6 indicates dependence.ResultsThe average age of patients was 67.78 years, with a sex-ratio M/W = 0.46. They were smoking in 58.3% of cases. The most frequent psychiatric disorders were mood disorders (40%) followed by anxiety disorders (13.3%). The absence of diagnosis was observed in 23.3% of cases. A psychotropic drugs were associated with BZD in 86.7%. The most prescripted BZD was lorazépam (90%). Withdrawal signs were present in 90% of cases. The prevalence of BZD dependence has been estimated at 80%.BZD dependence was significantly correlated with smoking (P = 0.00), with psychotropics association (P = 0.04) and with signs of withdrawal (P = 0.001).ConclusionIt appears from our study the importance of BZD dependence in the elderly what it is a source of withdrawal difficulty. So we need make more effort to comply with recommendations regarding the prescription of these molecules.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Alcohol use and bipolar disorder comorbidity: Synthesis and perspectives

2017 ◽  
Vol 41 (S1) ◽  
pp. S470-S470
Author(s):  
A. Dahdouh ◽  
B. Semaoune ◽  
A. Tremey ◽  
L. Samalin ◽  
V. Flaudias ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Alcohol Use ◽  
Dual Diagnosis ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Systematic Screening ◽  
Electronic Search ◽  
Clinical Interest ◽  
Competing Interest ◽  
The Relationship

ObjectiveAlcohol use disorders and bipolar disorder commonly co-occur and both are associated with more pejorative outcomes, thus constituting a major public health problem. We undertook this synthetic review to provide an update on this issue in order to clarify the nature of the relationship between the two disorders, improve clinical outcomes, prevent complications and therefore optimize management of patients.MethodsWe conducted an electronic search by keywords in databases MEDLINE, EMBASE, PsychINFO, published in English and French from January1985 to December 2015.ResultsThe AUD prevalence is important among BD patients in whom the effects of alcohol are more severe. However, in terms of screening, it appears that the comorbidity is not systematically sought. The concept of co-occurrence finds its clinical interest in the development of specific screening and therapeutic strategies. To date, there are only few recommendations about the management of dual diagnosis and the majority of them support “integrated” approaches.ConclusionsRecommendations should emphasize this strong co-occurrence and promote systematic screening and offered integrated cares.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric disorders among asthmatic patients: Literature review

2016 ◽  
Vol 33 (S1) ◽  
pp. S376-S376
Author(s):  
C.A. Moreira ◽  
A.M. Marinho ◽  
L.C. Gil ◽  
M. Bairrão ◽  
L. Queiroz
Keyword(s):  
General Population ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Public Health Problem ◽  
Close Correlation ◽  
Major Public Health Problem ◽  
Psychological Consequences ◽  
Asthmatic Patients ◽  
Pubmed Database ◽  
Competing Interest

IntroductionAsthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.ObjectivesThe authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.AimsTo understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.MethodsThe review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.ResultsCompared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.Discussions/ConclusionsThere is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sociodemographic and clinical profile in elderly suicide victims: 34 autopsy case studies

2017 ◽  
Vol 41 (S1) ◽  
pp. s887-s887
Author(s):  
S. Ellouze ◽  
I. Baati ◽  
W. Ben Amar ◽  
D. Trigui ◽  
W. Abbes ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Suicide Risk ◽  
Public Health Problem ◽  
The Elderly ◽  
University Hospital ◽  
Major Public Health Problem ◽  
Treatment Of Depression ◽  
Competing Interest ◽  
Elderly Suicide

IntroductionThe elderly suicide is a major public health problem that is gaining more and more ground, given the aging population problem. This has rarely been the subject of forensic studies in Tunisia.ObjectivesTo identify the sociodemographic and clinical characteristics of elderly suicide victims over 60 years and to determine what factors might increase suicide risk in this population.MethodsWe conducted a retrospective study on suicide victims aged 60 and over, autopsied in forensic medicine department of the Habib Bourguiba university hospital in Sfax (Tunisia), on a 10-year period (January 2006–December 2015).ResultsWe identified 34 cases with an average age of 66 years. The sex ratio was 2.77. Suicide victims were alone in 38.2% of cases. They were inactive professionally in 32.4% of cases. Almost half of them (44.1%) had a psychiatric history, 40% of depressed pace, 26.7% of bipolar disorder and 13.3% of schizophrenia.Three main factors were identified as precipitating the passage to suicidal act: family conflicts (26.5%), financial difficulties (11.8%) and loss of autonomy (5.9%).Suicide methods were hanging (50%), immolation and drug intoxication (11.8%), hit by train and poisoning (8.8%), jumping from height (5.9%) and drowning (2.9%). In 55.8% of cases, suicide took place at home.ConclusionElderly suicide seems to be a huge but largely preventable public health problem. Its prevention is essentially based on the identification of risk situations and the detection and treatment of depression: major suicide risk factor in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals COVID-19 and Hyperinflammation: Role of Steroid in Mild Disease

2020 ◽  
pp. 18-22
Author(s):  
Jhasaketan Meher ◽  
Manish Kumar Nayak
Keyword(s):  
Immune Response ◽  
Wide Spectrum ◽  
Case Series ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cytokine Storm ◽  
Multiorgan Dysfunction ◽  
Mild Disease ◽  
Persistent Symptoms

Current COVID-19 has become a major public health problem because of its pandemicity, with wide spectrum of disease manifestation. SARS-COV-2 can have a varied clinical manifestation ranging from asymptomatic, mild symptomatic to severe disease like acute respiratory distress syndrome, cytokine storm, and multiorgan dysfunction. It has been described in literature that cytokine storm/hyperinflammation arises as result of dysregulated immune response leading to excessive release of various cytokines which causes multiorgan dysfunction. But there is paucity of literature describing the immune response and hyperinflammation in mild disease which may cause unremitting symptoms. Here we describe a case series of three patients with mild disease, who had persistent symptoms beyond 1 week and managed with low dose steroid after confirming it to be hyperinflammation. So it is imperative to detect the hyperinflammatory phase to halt the disease progression. Also we have discussed the role of immune system and role of steroid in COVID-19.

scholarly journals Sociodemographic and Clinical Characteristics Associated with Suicidal Behaviour and Relationship with a Nurse-Led Suicide Prevention Programme

2020 ◽  
Vol 17 (23) ◽  
pp. 8765
Author(s):  
Judit Pons-Baños ◽  
David Ballester-Ferrando ◽  
Lola Riesco-Miranda ◽  
Santiago Escoté-Llobet ◽  
Jordi Jiménez-Nuño ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Suicide Prevention ◽  
Suicidal Behaviour ◽  
Clinical Characteristics ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Prevention Programme ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Completed Suicide

Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. Aims: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. Methods: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013–2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. Results: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. Conclusion: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.

scholarly journals Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome

2020 ◽  
Vol 12 (3) ◽  
pp. 51-60
Author(s):  
Yudianto Budi Saroyo ◽  
Ali Sungkar ◽  
Rima Irwinda ◽  
Raymond Surya
Keyword(s):  
Dengue Fever ◽  
Platelet Transfusion ◽  
Dengue Infection ◽  
Case Series ◽  
Public Health Problem ◽  
Team Approach ◽  
Major Public Health Problem ◽  
Viral Virulence ◽  
Foetal Outcome ◽  
In Pregnancy

Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. Case illustration: Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. Discussion: Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. Conclusions: The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.

Non-suicidal self-injury in adolescents: A diagnostic and psychopathological approach. A case presentation

2017 ◽  
Vol 41 (S1) ◽  
pp. S450-S450
Author(s):  
M.D. Ortega Garcia ◽  
V. Marti Garnica ◽  
S. Garcia Marin ◽  
C. Martinez Martinez ◽  
R. Gomez Martinez ◽  
...  
Keyword(s):  
Mental Health Center ◽  
Public Health Problem ◽  
Personal Characteristic ◽  
Family Characteristics ◽  
Major Public Health Problem ◽  
Case Presentation ◽  
Self Injury ◽  
Self Harm ◽  
Competing Interest ◽  
First Time

Self-injurious behavior is a major public health problem. An increase in the number of self-injuring adolescents has been observed since the mid-1960s.Description of clinical caseC. is a 14 teenager who comes to a mental health center for the first time a year ago for having numerous self-injuries in the forearm. She says that she cannot avoid doing so in moments of anxiety and that, in addition, when she is hurt she calms down. Throughout the interviews, C. relates that after the death of her best friend in a traffic accident she is alone and with episodes of anxiety.Exploration and complementary testsIt is important to analyze the risk factors of self-injurious behaviors in adolescence such as:– personal characteristic;– psychiatric disorders;– family characteristics;– mass media.DiagnosisDepressive episode (F32).Differential diagnosisIn general, self-injury is considered as a symptom or characteristic of a specific psychiatric disorder. Stereotyped self-injury is characteristic of processes of cognitive deficit of the level of severe and profound mental retardation. Compulsive self-harm involves symptomatic habits such as severe scratching of the skin or already differentiated psychiatric entities, such as trichotillomania, onicofagia or delusional parasitosis… Important psychotic disorder.ConclusionsFollowing the Task Force's criteria, in relation to probably effective therapies, it can be concluded that the therapy based on mentation for adolescents (MBT-A) is the first effective treatment for the treatment of self-harm in adolescents.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Quetiapine XR reduce impulsivity and dissociation in a sample of alcoholic patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S312-S313
Author(s):  
M. Godio ◽  
M. Preve ◽  
N.E. Suardi ◽  
E. Bolla ◽  
R.A. Colombo ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Future Research ◽  
Final Visit ◽  
Major Public Health Problem ◽  
Research Directions ◽  
Quetiapine Xr ◽  
Oral Naltrexone ◽  
Affective Temperament ◽  
Future Research Directions ◽  
Competing Interest

IntroductionAlcohol dependence (AD) is a major public health problem. Currently, three drugs for the treatment of AD have been approved: acamprosate, disulfiram and oral naltrexone. Quetiapine XR is an atypical antipsychotic has been shown to be a promising medication for the treatment of alcoholism [1,2]. The aim of our study is evaluate quetiapine efficacy on impulsivity in a sample of alcoholic patients.MethodA sample of alcoholic patients (n = 40) was assessed at the entrance and 2 months with: SCID-P, Brief-Temps, BIS-11, GSR, BPRS, SCI-DER, and CGI. The medium dosage of quetiapine is 300 mg.ResultsUsing the last observation carried forward, the mean total BIS score decreased from 60.8 at baseline to 40.2 at the final visit (P = .03). More pronounced improvement was observed in motor impulsiveness (P < .03) and attentional impulsiveness (P < .05) compared with non-planning impulsiveness (P = .09). We observed an improvement in SCI-DER total score (P = .02), in particular in derealization (P = .03) and autopsychic depersonalization (P = .04). A mean weight gain of 4.8 kg was observed. There is not significant different related to the different affective temperament.Discussion and conclusionAnalyses revealed a significant effect of Quetiapine XR in improving impulsivity and dissociation, in particular motor and attentional impulsiveness, derealization and autopsychic depersonalization. Moreover, an improvement of dissociative symptoms is probably connected with the blockade of postsynaptic 5-HT1A receptors [3]. Methodological limitations, clinical implications and suggestions for future research directions are considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Paediatric Enteric Fever in Brussels: a case series over 16 years

2021 ◽  
Author(s):  
Valbona Selimaj Kontoni ◽  
Philippe Lepage ◽  
Marc Hainaut ◽  
Véronique Yvette Miendje Deyi ◽  
Wesley Mattheus ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Clinical Symptoms ◽  
Case Series ◽  
Public Health Problem ◽  
Paediatric Population ◽  
Stool Culture ◽  
Teaching Hospitals ◽  
Major Public Health Problem ◽  
Laboratory Findings ◽  
Endemic Areas

Abstract BackgroundEnteric fever (EF) is a major public health problem and a witness of the global health disparities. It is caused by Salmonella enterica serovar typhi (Salmonella ser. Typhi) and Salmonella enterica serovar Paratyphi A,B,C (Salmonella ser. Paratyphi) and is estimated to infect 12-26 million persons yearly.Paediatric data on enteric fever in Europe are scarce. A case series of EF was analysed to describe the clinical presentation, laboratory characteristics and diagnostic challenges identified in a paediatric population in Brussels.MethodsWe performed a retrospective study of all lab-confirmed cases of enteric fever in children aged 0-15 years at two Brussels teaching hospitals, between January 2005 and December 2020. We reviewed age, gender, travel history, consultations before diagnosis, hospitalisation duration, clinical symptoms and laboratory findings.ResultsThere were 34 positive isolates of S.typhi and S.paratyphi: 31 patients had positive blood culture, 1 patient had positive bone drainage, 2 patients had positive stool culture (one was excluded for missing data). There were 20 girls(60%). Median age was 3.5 years (range 5 months to 14 years). Travel to EF endemic areas was present in 55% of patients. Diagnosis was delayed in 80% of children. Eosinopenia was present in 93% of the cohort. The patients had not received any preventive travel education or vaccination.ConclusionsEnteric fever poses diagnostic challenges to clinicians. Eosinopenia in a febrile patient coming from the tropics should raise suspicion of EF. Travelers to endemic areas, should be better educated about EF risks and typhoid fever vaccination must be promoted.

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