Major psychotrauma and social stress–risk factors for the unfavorable course of paranoid schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. s842-s843
Author(s):  
T. Udristoiu ◽  
I. Udristoiu ◽  
F. Militaru ◽  
S. Ristea ◽  
A.G. Vilcea ◽  
...  
Keyword(s):  
Physical Abuse ◽  
Social Stress ◽  
Suicide Attempts ◽  
Paranoid Schizophrenia ◽  
Childhood And Adolescence ◽  
Social Interventions ◽  
Prophylactic Measures ◽  
Endogenous Cortisol ◽  
Icd 10 ◽  
Competing Interest

IntroductionRecent studies in the neurobiology of schizophrenia highlighted the role of neuropsychoendocrine activations as a consequence of psychostress followed by the activation of the HPA axis with an excess of endogenous cortisol. The relation endogenous cortisol–glutamatergic hyperactivation enhances the excito-toxic mechanisms and the cortical-subcortical alterations in schizophrenia.MethodWe conducted a retrospective study on 40 patients, with ages between 25 and 55 years, admitted in the university clinic of Craiova between January 1, 2015 and December 31, 2015 for paranoid schizophrenia according to ICD-10 criteria and with positive history of psychotrauma and physical abuse in childhood and adolescence.ResultsThe frequency of psychotraumas, social stress and physical abuse in our group was significantly higher in women (63.33%), in patients with urban residence (80.00%) and age group 36–45 years (46.67). There was a pattern of residual defectuality reflected by positive symptoms (83.33%), alcohol abuse (80.00%), aggressive behavior (66.67%) and suicide attempts (30.00%). The poor course with minimal social functioning (GAFS < 40; 36.67%) was correlated with a high number of relapses and hospitalizations (> 9 hospitalizations; 43.33%), cognitive deficit (MMSE < 23; 76.67%). The psychosocial factors involved in the pathogenesis and course of schizophrenia were social stress (60.00%), physical abuse in childhood and adolescence (20.00%) and psychotraumas (20.00%).Conclusions.Psychotrauma and physical abuse in childhood and adolescence and during the course of paranoid schizophrenia constitute a risk factor for a poor outcome with cognitive deterioration, aggressive and suicidal behavior that call for prophylactic measures and qualified psycho-social interventions associated to the pharmacological treatments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Childhood Trauma in Bipolar Disorders: Familial and Individual Mediators for Predicting Occurrence and Outcome

2017 ◽  
Vol 41 (S1) ◽  
pp. S28-S28
Author(s):  
B. Etain
Keyword(s):  
Physical Abuse ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Affect Intensity ◽  
The Face ◽  
History Of ◽  
Competing Interest ◽  
Psychotic Features

Childhood trauma is highly prevalent in patients with bipolar disorder (BD) and has been associated to a more severe/complex expression of the disorder. Little is known about the familial and individual factors that can mediate the occurrence of trauma within families but also influence the outcomes of BD. We will present data from two independent samples of patients with BD in order to identify the potential mediators for occurrence and severity/complexity. In a first sample of 371 patients with BD, 256 relatives and 157 healthy controls, we will show that there is a familial resemblance for emotional and physical abuses. Patients’ level of physical abuse was associated with their parental levels of physical abuse, but also with their father's history of alcohol misuse (p < 0.05). Second, in a sub-sample of 270 normothymic patients, we have performed a path-analysis to demonstrate that emotional and physical abuses interacted with cannabis misuse to increase the frequency of psychotic features and delusional beliefs. Finally, in an independent sample of 485 euthymic patients from the FACE-BD cohort we used path-analytic models to show that emotional abuse increased all the assessed affective/impulsive dimensions (p < 0.001). In turn, affect intensity and attitudinal hostility were associated with high risk for suicide attempts (p < 0.001), whereas impulsivity was associated with a higher risk for presence of substance misuse (p < 0.001). These results illustrate that childhood trauma might derive from parental characteristics (own childhood trauma and psychopathology) and increase the severity/complexity of BD through individual dimensions of psychopathology.Disclosure of interestThe author has not supplied his declaration of competing interest.

Vintage mode: Expansive paraphrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S460-S461
Author(s):  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
M. Juncal Ruíz ◽  
G. Pardo de Santayanda Jenaro ◽  
L. Sánchez Blanco ◽  
...  
Keyword(s):  
Functional Performance ◽  
Paranoid Schizophrenia ◽  
Emotional Involvement ◽  
Daily Lives ◽  
Aged Woman ◽  
Icd 10 ◽  
Middle Aged Woman ◽  
First Relapse ◽  
Paranoid Symptoms ◽  
Competing Interest

IntroductionParaphrenia is a poorly defined process whose uncertain origins date back to the German psychiatry mid-nineteenth century. Paraphrenia would be a subtype of schizophrenia characterized by a more benign clinical course in terms of volitional and emotional involvement. Certain types of serious sensoperceptive distortions and paranoid symptoms are characteristics of this clinical variant. Despite its diverse presentation, its chronic development and its presence in the daily lives of the patient, the overall functionality is not deeply affected.ObjectivesTo discuss the validity of this and other clinical processes based on classical clinical descriptions for diagnostic approach of our current patients, in contrast to the common use simplified concept (forgetting in ICD-10 or disappeared in American manuals).Materials and methodsClinical case a middle-aged woman diagnosed with longstanding paranoid schizophrenia who suffered from a highly systemized delusional and hallucinatory syndrome with chronic evolution after a first relapse due to abandonment of treatment, but keeping high functional performance even during phases of partial remission.ConclusionsSchizophrenia presents multiple symptomatic and prognostic paths. Classical authors named these different subtypes. Revisiting these subtypes could be useful as a complementary tool for predicting clinical outcome based on their descriptions, especially in the absence of reliable material instruments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Referrals of patients with schizophrenia to a consultation-liaison psychiatry service

2017 ◽  
Vol 41 (S1) ◽  
pp. s504-s505
Author(s):  
R. Sánchez González ◽  
E. Baillès Lázaro ◽  
S. Herranz Villanueva ◽  
L. Pintor Pérez
Keyword(s):  
Suicide Attempts ◽  
General Medicine ◽  
Liaison Psychiatry ◽  
Medical Specialties ◽  
Psychiatric Units ◽  
Icd 10 ◽  
Consultation Liaison Psychiatry ◽  
Competing Interest ◽  
Psychiatric State ◽  
External Causes

BackgroundThere are few studies specifically investigating the acute treatment procedures of patients with schizophrenia in the context of Consultation-liaison psychiatry (CLP).PurposeDescribe the main clinical features of the referrals of patients with schizophrenia, attended by a general hospital CLP service.MethodsLongitudinal observational and descriptive study, assessing adult inpatients with schizophrenia (DSM-IV-TR criteria) admitted to non-psychiatric units of Hospital Clínic of Barcelona (Spain), who were consecutively referred to our CLP service over a 10-year period (from January 1, 2005, through December 31, 2014).ResultsDuring that period, 9.808 psychiatric consultations were requested. 163 of them (1.8%) concerned patients with schizophrenia. These groups of patients were aged 50.9 ± 15.3 years and 65% were male. A 25.9% of patients had history of suicide attempts and 45.6% presented current psychosocial stressors.Characteristics of referrals Referral sources according to medical specialties are shown in Table 1.The major medical conditions for referral according to ICD-10 categories were: external causes of morbidity (21.5%), infectious diseases (13.5%) and diseases of the digestive system (10.4%).The two most frequent reasons for referral were the assessment of psychopharmacological treatment and/or psychopathological state examination (62%) and suicidal risk/attempt assessment (8.6%).ConclusionsIn our sample, only a 1.8% of all patients for whom psychiatric consultation was requested had a diagnosis of schizophrenia. The most common profile of them was: male, 50 years old, coming from general medicine department due external causes of morbidity and referred to the CLP service because of psychiatric state and/or medication review.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Is the firearm epidemic in the US getting worse?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Tedesco ◽  
K Y C Adja ◽  
F Rallo ◽  
C Reno ◽  
M P Fantini ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
National Level ◽  
Gun Violence ◽  
Public Health Issue ◽  
Western World ◽  
Diagnostic Code ◽  
The Us ◽  
Icd 10 ◽  
Ed Visits ◽  
Annual Decline

Abstract Background The US is the least regulated firearm market in the Western world and firearm violence is a major public health issue. Firearms account for 40,000 deaths in the US annually, which is higher than other high-income countries. Although most of the gun-related deaths in the US are the result of suicide attempts and self-inflicted injuries, nearly 40% of them come from accidents, assaults, or police intervention. Methods We measured the number of non-self-inflicted firearm-related ED visits, by including patients discharged with diagnostic ICD-9-CM (ICD-10 for 2016) codes of accidents, assaults or legal intervention resulting in firearm injuries between 2006-2016. We used data from the Healthcare Cost and Utilization Project (HCUPnet). From the CDC Wide-ranging Online Data for Epidemiologic Research we obtained data on non-suicidal firearm-related deaths over the period 2006-2017. To identify the cause of death we used the ICD-10 codes. Temporal changes of rates of ED visits and deaths were evaluated using Joinpoint Software. Results In 2006 there were a total of 79,998 ED visits with a diagnostic code of firearm-related injury, and this number showed a non-significant 2.7% annual decline between 2006-2013 (p = 0.06) followed by a significant 19.4% annual increase between 2013-2016 (p &lt; 0.05), resulting in 111.305 visits in 2016. The number of non-suicidal firearm-related deaths showed a significant 2.2% annual decline between 2006-2014 (p &lt; 0.05), followed by a significant 10.3% APC (p &lt; 0.05) between 2014-2017. Conclusions Data showed steady rates until 2013 and a striking increasing trend starting from 2013. Firearm-related deaths followed the same trends. Our data show that in the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities. Analysis limitations: we used national-level aggregate data and coding accuracy may be not consistent nationwide. Key messages In the last four detectable years there has been a new concerning wave of gun violence and consequently a higher number of fatalities nationwide. The US firearm related deaths epidemic urges for new policies and preventive measures, such as stricter background checks and restrictions on guns ownership.

scholarly journals National record-linkage study of hospital admissions for schizophrenia in childhood and adolescence in England

2021 ◽  
Author(s):  
Olena Seminog ◽  
Uy Hoang ◽  
Michael Goldacre ◽  
Anthony James
Keyword(s):  
Hospital Admissions ◽  
Population Based ◽  
Linkage Study ◽  
Incidence Rates ◽  
Childhood And Adolescence ◽  
Childhood Onset ◽  
Affective Psychosis ◽  
Health Service Provision ◽  
Childhood Onset Schizophrenia ◽  
Icd 10

Abstract Background There is a lack of information on changes in hospital admission rates for childhood-onset schizophrenia (COS), or on patient characteristics, to inform clinical research and health service provision. Aims To report age- and sex-specific incidence rates of hospital admissions and day patient care for schizophrenia (ICD-10 F20) and non-affective psychosis (ICD-10 F20-29), by year of occurrence and age, in childhood and adolescence. Methods Population-based study using person-linked data for England (available 2001–2016); time-periods in single years and 4-year groups. Results Hospitalised incidence for schizophrenia increased with increasing age, from 0.03 (95% confidence interval (CI) 0.02–0.05) and 0.01 (0–0.01) per 100,000 in, respectively, males and females aged 5–12 years, to 3.67 (3.44–3.91) in males and 1.58 (1.43–1.75) in females aged 13–17 years. There was no gender difference in hospitalised incidence rates in children aged 5–12, but in 13–17 years old, there was a male excess. Rates for schizophrenia were stable over time in 5–12 years old. In ages 13–17, rates for schizophrenia decreased between 2001–2004 and 2013–2016 in males, from 6.65 (6.04–7.31) down to 1.40 (1.13–1.73), and in females from 2.42 (2.05–2.83) to 1.18 (0.92–1.48). The hospitalisation rates for schizophrenia and non-affective psychosis, combined, in 13–17 years old decreased in males from 14.20 (13.30–15.14) in 2001–2004 to 10.77 (9.97–11.60) in 2013–2016, but increased in females from 7.49 (6.83–8.20) to 10.16 (9.38–11.00). Conclusions The study confirms that childhood-onset schizophrenia is extremely rare, with only 32 cases identified over a 15-year period in the whole of England. The incidence of schizophrenia and non-affective psychosis increased substantially in adolescence; however, the marked reduction in the proportion of those diagnosed with schizophrenia in this age group suggests a possible change in diagnostic practice.

A case of rare allele T 126, 30,32 base pairs in a schizophrenic patient: A study case

2016 ◽  
Vol 33 (S1) ◽  
pp. S585-S586
Author(s):  
A.I. Sabau ◽  
P. Cristina ◽  
B. Valerica ◽  
P. Delia Marina
Keyword(s):  
Schizophrenic Patient ◽  
Complex Disease ◽  
Susceptibility Gene ◽  
Rflp Analysis ◽  
Rare Allele ◽  
Base Pairs ◽  
Gene Coding ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionSchizophrenia is a severe and complex disease clinically characterized by disturbed thought processes, delusions, hallucinations and reduced social skills. Gene coding for neregulin 1 (NRG 1) located in 8 p21chromosomeand single nucleotide polymorphism (SNPs) have been identified strongly supporting NRG1 gene as a susceptibility gene for schizophrenia.ObjectiveThe present preliminary study, determines the relationship between polymorphism nucleotide sites (SNPs2) of NRG1 gene and schizophrenia.AimsIdentifying rare allele T of neregulin 1 genein schizophrenic patients.MethodWe analyzed the polymorphism (SNPs2) of NRG1 gene in 20 patients recruited from Psychiatry Department of Emergency Clinical Hospital of Arad diagnosed with schizophrenia according to DSM-5-TM and ICD-10 criteria and 10 healthy controls. From all subjects, we obtained 2 mL of peripheral blood samples. Genomic DNA was extracted using the phenol-chloroform method. Genotyping was performed byPCR-based RFLP analysis for all subjects. The obtained PCR product mixture was completely digested with restriction enzyme, separated on SNP1 and SNP2 agarose gel. We present the case of a 31 years old, male, schizophrenic patient with the SNPs2 polymorphism and rare allele T 126.ResultsIn both groups, common allele G 127 and 60 base pairs was identified but only 2 schizophrenic patients presented rare allele T 126 and 30,32 base pairs.ConclusionsThe polymorphism SNPs2 of NRG1 gene with rare allele T 126 and 30,32 base pairs, may play a role in predisposing an individual to schizophrenia. Further and extended replicating studies with multiple sequencing of NRG1 gene are necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

The Assessment of Social Disability in Persons With a Diagnosis of Mental Disorder. Preliminary Data

2016 ◽  
Vol 33 (S1) ◽  
pp. S448-S449
Author(s):  
T.M. Gondek ◽  
A. Królicka ◽  
B. Misiak ◽  
A. Kiejna
Keyword(s):  
Mental Disorder ◽  
Demographic Factors ◽  
Well Being ◽  
Social Disability ◽  
Inpatient Ward ◽  
Cross Cultural Comparison ◽  
The Social ◽  
Icd 10 ◽  
Competing Interest ◽  
The Relationship

Social disability in persons diagnosed with mental disorder is one of the factors preventing them from achieving the broadly defined well-being, even when appropriate and effective treatment is applied. Improvement in the field of social disability is therefore one of the main challenges for the mental health and social welfare policy makers. The second version of the Groningen Social Disabilities Schedule (GSDS-II) is widely used in the assessment of social disability, however the relationship between its degree and many of the clinical and demographic factors have not been investigated thoroughly enough.The objective of the study is to assess the degree of social disability using GSDS-II as well as to analyze the relationship between the degree of social disability and clinical, social and demographic factors, in patients with a mental disorder diagnosis of F20–F48 according to ICD-10, aged 18–65, in a day ward and an inpatient ward settings.The paper presents the data gathered from a preliminary sample of 20 patients of both genders diagnosed with mental disorders who gave their informed consent to participate in the study, thus comprising 10% of the targeted total study sample.Our study, performed on a larger, targeted sample, will provide a better insight into the social functioning of persons with a burden of mental disorder. A precise presentation of the social disability shall improve the model of care offered to these persons. Any possible parallel studies in other countries, employing analogical methodology, could allow for a cross-national and cross-cultural comparison of the received outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Mental Disorders in Patients with Temporomandibular Pain-dysfunction Syndrome

2017 ◽  
Vol 41 (S1) ◽  
pp. S254-S254
Author(s):  
V. Medvedev ◽  
V. Frolova ◽  
Y. Fofanova
Keyword(s):  
Psychiatric Disorders ◽  
Affective Disorders ◽  
Inform Consent ◽  
Painful Condition ◽  
Schizotypal Personality ◽  
Icd 10 ◽  
Psychometric Method ◽  
Competing Interest ◽  
Depressive Episodes ◽  
Temporomandibular Pain

IntroductionMaxillofacial surgeons and dentists often deal with the phenomenon of temporomandibular pain-dysfunction syndrome–painful condition of maxillofacial area without clear organic pathology. Psychiatric studies of this disorder are almost lacking. The aim of this study was to determine the prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and to define the psychiatric diagnosis (ICD-10).MethodsStudy sample consists of 57 patients (44 women and 13 men) with temporomandibular pain-dysfunction syndrome aged older than 18 years, who gave inform consent. The study used clinical psychopathological, psychometric (HADS, HDRS, State-Trait Anxiety Inventory, Hypochondria Whitley Index, Visual Analog Scale for Pain).ResultsPsychiatric disorders were revealed in 48 patients (84.2%) with temporomandibular pain-dysfunction syndrome–39 women and 9 men aged 18-65 years (mean age 39.6 ± 15.4 years). Affective disorders was diagnosed in 56.3%, personality disorders in 20.8%, schizotypal personality disorder in 12.5% and schizophrenia in 10.4%. Among affective pathology mild and moderate depressive episodes prevailed (59.3%). The severity of pain (VAS) in patients with affective disorders was higher than in patients with other psychiatric conditions.ConclusionThis study shows high prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and proves the feasibility of a psychiatrist participate in the complex treatment of these patients. The use of psychometric method allows to improve the timeliness of the detection of patients who require further clinical psychopathological examination in order to determine the need of pharmacotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Implementation of the national register of suicide attempts as a preliminary strategy for the prevention of suicides in Poland

2017 ◽  
Vol 41 (S1) ◽  
pp. s892-s893
Author(s):  
A. Gmitrowicz ◽  
R. Szmajda ◽  
A. Baran ◽  
I. Makowska ◽  
P. Kropiwnicki
Keyword(s):  
Suicide Attempts ◽  
Independent Predictor ◽  
Population Based ◽  
Death Certificates ◽  
Psychiatric Institutions ◽  
Central Register ◽  
Central Statistical ◽  
Central Statistical Office ◽  
Competing Interest ◽  
Reported Data

Studies show that suicide attempts are a major independent predictor of suicide. Only in some countries of the world, there are national registers of these behaviors. Poland is among the countries where suicide prevention is at the stage of implementation of these strategies. One is the initial diagnosis of the prevalence of suicidal behavior (SB) in selected populations. The aim of the study was to assess the prevalence of SB in Poland on the basis of available databases, including data such as age, sex and mental disorders and the analysis of differentiation of selected indicators of SB.Material and methodsWe analyzed available registers of completed suicides (CS) and suicide attempts (SA), carried out under reporting of the central statistical office (CSO, in the general population, based on death certificates), Police Headquarters (PH, the number of reported SB in the country) and the Institute of Psychiatry and Neurology in Warsaw (IPiN, the number of SB in all psychiatric institutions) and the department of adolescent psychiatry in Łódź (SB among hospitalized youth).Results and conclusionsReported data on dissemination of SB in Poland are incomplete, which may affect the reliability of the assessment of the effectiveness of implemented strategies for the prevention of suicides. The aim should be to create a central register of SB, which will not only gather a well-defined data but also monitor how it is obtained.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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