Evolutionary Aspects of Psychotic Disorders Induced by Cannabis

2017 ◽  
Vol 41 (S1) ◽  
pp. S203-S203
Author(s):  
F. Guermazi ◽  
R. Ennaoui ◽  
N. Halouani ◽  
S. Chouayakh ◽  
J. Aloulou ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Cannabis Use ◽  
University Hospital ◽  
Early Screening ◽  
Effective Strategies ◽  
Competing Interest ◽  
Psychiatric Department ◽  
The University ◽  
Evolutionary Aspects ◽  
Chronic Psychosis

IntroductionCannabis is increasingly used by young people. Its several noxious effects on mental health have become a matter of preoccupation. Although cannabis use may be involved in the etiology of acute psychosis, there has been considerable debate about the association observed with chronic psychosis.Aims(1) To describe the profile of patients with cannabis use disorders (CUD); (2) to determine the evolutionary aspects.MethodsWe proceed with a retrospective and descriptive study conducted among 16 male patients with CUD and hospitalised for the first time in the psychiatric department at the University Hospital Hedi Chaker during the period from 1 January 2012 to 31 December 2014.ResultsAn overwhelming majority of the subjects were single and unemployed. One-third of the users had a stay abroad, the half was incarcerated at least once and one patient was implicated in illegal drugs trade. CUD were associated with specific personality disorders: borderline (18.8%) and antisocial (6.3%) personality. Into at least the 2 years of follow-up, different evolutionary aspects were distinguished. Many of the patients were lost to follow (18.8%). A total restitution of symptoms or a recurrence of the same disorders were observed in 25% of cases. About 56.3% of subjects had a change in diagnosis to either schizophrenia (43.3%) or affective disorder (12.5%).ConclusionThis study showed that cannabis use can be a cause of the emergence of chronic psychosis. This emphasizes the importance of early screening of the vulnerability to psychotic disorder and identify more effective strategies to improve intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Ultra-resistant schizophrenia and potentiation strategies

2017 ◽  
Vol 41 (S1) ◽  
pp. s834-s834 ◽  
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
S. Younes ◽  
A. Bouallagui ◽  
I. Marrag ◽  
...  
Keyword(s):  
Treatment Resistance ◽  
Cost Benefit ◽  
Clinical Excellence ◽  
University Hospital ◽  
Dsm Iv ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department ◽  
The Cost ◽  
The University

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

SHANK3 mutation in consanguineous schizophrenia family in northwest Algeria

2017 ◽  
Vol 41 (S1) ◽  
pp. S595-S596
Author(s):  
A. Dahdouh ◽  
J. Prados ◽  
M. Guipponi ◽  
F. Bena ◽  
W. Adouan ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Rare Variants ◽  
University Hospital ◽  
High Rate ◽  
Common Disease ◽  
Multiplex Family ◽  
Illumina Hiseq ◽  
Genetic Technologies ◽  
Competing Interest ◽  
The University

IntroductionSeveral studies have asserted the existence of a strong and complex genetic component in the determination of psychotic disorders. GWAS studies conducted over the past decade lead to the identification of only a few low effect associations, calling questioning the hypothesis of “common disease – common variants” for a model involving a large number of rare variants.AimsHere, we studied a multigenerational multiplex family with schizophrenia a high rate of consanguinity, located in the northwest of Algeria. This study aims to identify inherited rare variants of schizophrenia using new genetic technologies.MethodsThis family has received complete clinical (DIGS, DSM-IV criteria), genealogical investigations, CNV analysis using CGH Microarray Kit 244 K (Santa Clara, CA) and WES (by GAIIx Illumina/HiSeq 2000) focused in CNV regions, that were performed in the department of genetics in the university hospital of Geneva.ResultsWe identify 11 affected members by psychotic disorders. The main CNVs analysis results found in a schizophrenic member a Del 22q13.33 affecting SHANK3 gene. WES regarding these regions identified a mutation at position 511178000 in SHANK3 gene in all the selected affected relatives.DiscussionSeveral studies have asserted the association of SHANK3 mutations with schizophrenia and autism disorders. This is the first observation of rs511,178,000 in schizophrenia phenotype.ConclusionIn total, this highly informative family have identified new rare genetic variant of schizophrenia. The search for this mutation in wider control population in would be useful to validate these data.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Children’s poisoning profile during the Covid-19 pandemic – Experience of Hassan II University Hospital in Fez, MOROCCO

2021 ◽  
Vol 319 ◽  
pp. 01077
Author(s):  
Amrani Hanchi Sahar ◽  
Hoummani Hasnae ◽  
Mourabiti Hajar ◽  
Chebaibi Mohammed ◽  
Chaouki Sana ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
University Hospital ◽  
Accidental Poisoning ◽  
Pediatric Emergency Department ◽  
Neurological Signs ◽  
Snake Bites ◽  
Scorpion Stings ◽  
The University ◽  
Evolutionary Aspects

Introduction. —The Covid-19 pandemic and the containment situation, has generated enormous risks for children. Indeed, with the closure of schools, children, forced to stay at home, found themselves in permanent contact with dangerous products (drugs, disinfectants, plants) exposing them to accidental poisoning. Objective. —To describe the epidemiological, clinical and evolutionary aspects of the cases of pediatric intoxications in the UHC during the period of Covid-19, in order to assess the repercussions of this pandemic on the profile of these intoxications, in terms of number and incriminated products. Material and method. — This is a retrospective descriptive comparative study of intoxication cases admitted to the pediatric emergency department of the University Hospital of Fez spread over 2 years; from March 1, 2019 to February 2021; comparing intoxications admitted during the period of Covid-19 with the previous year. Results. — The emergency department recorded 132 cases of intoxication during the Covid-19 period (compared to 104 cases in 2019). Fez was always the most concerned city (66.21% against 69.02% in 2019). The cases emanated from the urban environment in (58.78%). The accidental circumstance was the most frequent, with an increase from 77.88% in 2019 to 82.02%. The rate of cases of envenomation that consulted was almost similar; children are more exposed to scorpion stings (73.52%) than snake bites. The analysis of incriminated products was marked by the increase of Caustics (20.38% in 2019 to 24.24% in 2020), and the decrease of pesticides (19.41% in 2019 to 13.63%). The symptomatology was dominated by neurological signs in 25.75% of cases, followed by respiratory disorders (18.18%). The evolution was favorable in 95.46%, and death occurred in 4.54% of cases compared to 3.84% in2019. The Covid-19 pandemic has changed the use of antidotes.

scholarly journals Cardiac Tamponade: Epidemioclinical, Therapeutic and Evolutionary Aspects at the University Hospital of Brazzaville

2021 ◽  
Vol 11 (12) ◽  
pp. 572-582
Author(s):  
Solange Flore Mongo Ngamami ◽  
Armel Landry Batchi-Bouyou ◽  
Evariste Pabingui ◽  
Christian Michel Kouala Landa ◽  
Bertrand Fikahem Ellenga Mbolla ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
University Hospital ◽  
The University ◽  
Evolutionary Aspects

The correlation between mood disorders and suicide attempts for the period 2013–2015 at “Mother Teresa” hospital center, Fatbardha Myslimaj, Psychiatrist, Mirela Gokaj, Deana Rama

2017 ◽  
Vol 41 (S1) ◽  
pp. S564-S564
Author(s):  
F. Myslimaj ◽  
M. Gokaj ◽  
D. Rama
Keyword(s):  
Mood Disorders ◽  
Suicide Attempts ◽  
Mental Illnesses ◽  
University Hospital ◽  
Psychiatric Clinic ◽  
Cry For Help ◽  
Suicidal Attempts ◽  
Competing Interest ◽  
The University ◽  
Hospital Center

BackgroundPeople, who have tried to commit self-injurers or suicidal attempts, refer symptomatic presence of disorders of humor and numerous problems social as factors precipitant to suicidal thoughts and actions. It is important recognition of the signs of suicide and self-inflicting behavior to help prevent suicide.Materials and methodsThe study includes a period of 3 years of cases hospitalized in the psychiatric clinic UHC, since 2013–2015. The data are taken from the records of admissions at the Psychiatric Clinic at the University Hospital Center. Results are grouped and studied issued by mood disorders, sex, age, place of residence and social status.ResultsThe influence of mood disorders is recently estimated very important in causing suicide attempts compared with other mental illnesses, similar values with contemporary literature.ConclusionsThe majority of suicide attempts do not result in death. Many of these efforts are made in a way that makes salvation possible. These efforts are often a cry for help. Suicide is a social phenomenon different cognitive aspect such as ethical, philosophical, legal, psychiatric, etc. Employees of psycho-social care should be informed about this phenomenon and finding the diagnosis, prevention and treatment of suicidal attempts by persons at risk of suicide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide attempts in emergency department

2016 ◽  
Vol 33 (S1) ◽  
pp. S170-S170
Author(s):  
K. Hajji ◽  
I. Marrag ◽  
R. Ben soussia ◽  
L. Zarrouk ◽  
S. Younes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Characteristics ◽  
Suicide Attempts ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Medical Emergency ◽  
Cross Sectional ◽  
Adequate Care ◽  
Competing Interest ◽  
The University

IntroductionThe suicide attempt is a real challenge for the clinician who works at the emergency department in order to identify and propose an adequate care.AimsTo estimate the prevalence of the suicide attempts, to describe the sociodemographic and clinical characteristics and to identify the predictors of recurrence.MethodsOur cross-sectional study was conducted at the medical emergency department of the university hospital of Mahdia and lasted for 12 months. Data were collected using a questionnaire of 51 items exploring the general and clinical characteristics and providing information of the treatment.ResultsAmong the 513 consultants, 90 had attempted suicide (17,5%). We found an average age of 26 years old, a sex-ratio (M/F) of 0,3, a secondary education level (53,3%), an unemployment and a single status (38,9% and 75,6%). The presence of psychiatric personal history and/or suicide attempts was found in 31,1% and 33,3% of cases. Suicide attempts were taken place in all cases at home, between 18 and midnight (43,3%), without premeditation (82,2%), in the presence of triggering factor (95,6%), during the last 3 months of the year (34,4%). In 70,2% of cases, the type of the suicide attempts was a drug intoxication. 67,8% of the suicide attempters regretted and criticized their acts.ConclusionA good assessment of the suicide risk determines the type of intervention that should be established and allows an adequate care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Acute psychotic disorders: Factors related to schizophrenia evolution

2017 ◽  
Vol 41 (S1) ◽  
pp. S186-S186
Author(s):  
R. Ben Soussia ◽  
A. Bouallagui ◽  
I. Marrag ◽  
S. Khouadja ◽  
S. Younes ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Clinical Syndrome ◽  
Recurrence Time ◽  
Male Predominance ◽  
Kaplan Meier ◽  
Prolonged Duration ◽  
History Of ◽  
Competing Interest ◽  
Psychiatric Department

IntroductionAcute psychotic disorders are described as a clinical syndrome characterized by Acuteness of the installation, the intensity and the polymorphism of delirium.AimDescribe the demographic characteristics of a population of patients with an acute psychotic disorder and identify factors correlated with evolution to schizophrenia.MethodsThis is a retrospective, descriptive and analytic study conducted on hospitalized patients in psychiatric department EPS Mahdia for acute psychotic disorder according to DSM-VI-TR criteria. A study of the recurrence time was performed by Kaplan–Meier and Cox test was used to identify factors correlated with evolution to schizophrenia.ResultsOne hundred and eleven patients were collected. The average age of the study population was 27 years, a male predominance was noted (59.5%), 39.6% of patients had family history of psychiatric disorders, including schizophrenic disorders and bipolar disorder were the most common with rates of 63.6 and 18.4% of cases. For our patients, 38.7% progressed to schizophrenia. Four risk factors were significantly predictive of progression to schizophrenia: male gender (P = 0.026), subacute or progressive onset disorders (P = 0.003), partial remission of the disorder (P = 0.023) and the prolonged duration of untreated psychosis (P = 0.027).ConclusionThe evolution of an acute psychotic disorder remains unpredictable. In fact, the severity is related to the risk of developing schizophrenia or mood disorder. Attention is paid in recent years to recognize and seek most precociously as possible factors associated with this evolution.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Antipsychotic-induced hyperprolactinemia

2017 ◽  
Vol 41 (S1) ◽  
pp. S701-S701
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
A. Bouallagui ◽  
I. Marrag ◽  
S. Younes ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Atypical Antipsychotics ◽  
Antipsychotic Agents ◽  
University Hospital ◽  
Therapeutic Assessment ◽  
Assessment And Monitoring ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department

IntroductionAs antipsychotic agents are increasingly used, many patients are at risk for antipsychotic-induced hyperprolactinemia.Aims of the studyEstimate the prevalence of hyperprolactinemia in patients treated by a single antipsychotic and identify the risk factors for its occurrence.MethodsThis is a prospective study carried out at the psychiatric department of psychiatry of university hospital of Mahdia during 24 months. We have included all patients with a follow up and treated by single antipsychotic for at least 12 weeks. A pituitary MRI has been requested for patients with a prolactin level higher than 100 ng/ml.ResultsWe have collected 92 patients. Hyperprolactinemia was found in 34.8% of patients among which 7.6% have had prolactin level greater than 150 ng/ml. Pituitary MRI have revealed 2 cases of macro-adenoma. The decrease of the antipsychotic doses has significantly improved prolactin levels. The switch of antipsychotic with another less inducing hyperprolactnimea has significantly decreased prolactin levels. 7 factors were correlated significantly to hyperprolactinemia: sex (female), substance use, presence of side effects, combination of psychotropic drugs, atypical antipsychotics, type of antipsychotic: Haloperidol and amisulpride, antipsychotic dose greater than 1000 mg Chlorpromazine equivalent.ConclusionHyperprolactinemia must be carefully identified, through a pre-therapeutic assessment and monitoring of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Potential Impact of Recreational Cannabis Legalization on the Prevalence of Cannabis Use Disorder and Psychotic Disorders: A Retrospective Observational Study: L’effet potentiel de la légalisation du cannabis récréatif sur la prévalence du trouble d’utilisation du cannabis et des troubles psychotiques : une étude observationnelle rétrospective

2021 ◽  
pp. 070674372098468
Author(s):  
Catherine Vignault ◽  
Amélie Massé ◽  
David Gouron ◽  
Jacques Quintin ◽  
Khashayar Djahanbakhsh Asli ◽  
...  
Keyword(s):  
Observational Study ◽  
Psychotic Disorders ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cannabis Use ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Cannabis Use Disorder ◽  
Centre Hospitalier Universitaire ◽  
Significant Difference

Objectives: The principal objective of our study was to document the short-term impact of the legalization of recreational cannabis on active cannabis use, cannabis use disorder, and various psychotic disorders. Methods: We carried out a retrospective observational study of patients who were at least 12 years old and who had visited a psychiatrist in the emergency unit of the Centre hospitalier universitaire de Sherbrooke (CHUS). We included all the consultations of this type over a 5-month period, immediately following the legalization of recreational cannabis in Canada. We then divided our population into an adult (over 18) and teenager group (12 to 17) compared the data to the data from consultations made 2 years earlier, using a generalized linear mixed model. Results: We examined consultations in patients over 18 years old in prelegalization ( n = 1,247) and postlegalization ( n = 1,368) groups. We observed a statistically significant increase in the use of cannabis (28.0% to 37.1%; odds ratio [ OR] = 1.81 [1.34 to 2.44], P = 0.00011) as well as an increase in diagnoses of active cannabis use disorder (17.7% to 24.3%; OR = 1.53 [1.13 to 2.08], P = 0.0064). The increase in cannabis use disorder was more prominent among patients between 18 and 24 years old (17.3% to 25.9%; OR = 2.27 [1.17 to 4.40], P = 0.015). We observed no statistically significant difference in terms of psychotic disorder diagnoses (27.4% to 29.2%; OR = 1.17 [0.84 to 1.63], P = 0.35)]. Conversely, we identified a greater proportion of patients who had a personality disorder diagnosis in the postlegalization period (39.6% to 44.9%; OR = 1.35 [1.02 to 1.80], P = 0.038). Examination of pediatric (under 18 years old) consultations revealed no statistically significant differences. Conclusion: Although an affirmative conclusion is tentative, the current findings suggest a first link between the legalization of cannabis in Canada and increased diagnoses of cannabis use disorder, as well as cannabis use in general among patients in a university hospital psychiatric emergency department.

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