A child with Pica. A case presentation

2017 ◽  
Vol 41 (S1) ◽  
pp. S449-S449
Author(s):  
M.D. Ortega Garcia ◽  
M.V. Marti Garnica ◽  
S. Garia Marin ◽  
C. Martinez Martinez ◽  
R. Gomez Martinez ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Developmental Disorder ◽  
Toxic Substances ◽  
Single Test ◽  
Case Presentation ◽  
Blood Biochemical ◽  
Competing Interest

Description/clinical caseA. is a 10-year-old girl of Moroccan origin appearing in pediatric specialist of A.P repeatedly by unspecific stomachache, nausea and vomiting. After several visits to the same reason for consulting an exploratory interview alone with the patient in that regard that “sometimes when calms nervous scratching the walls and eating them” is performed. The mother says intrafamily difficulties. Information reported by the patient's mother confirms next visit also providing pictures on the wall of your room is returned. Referral to child and adolescent mental health is decided.Exploration/complementary testsThere is no single test for pica. It is carried out systematic blood, biochemical (iron, zinc, lead…) to assess toxic substances and nutritional levels. Abdominal Rx. Both normal.DiagnosisPica (F98.3).Differential diagnosisIngestion of nutrients can occur in the course of other mental disorders (for example, a pervasive developmental disorder, schizophrenia), mental retardation, in the Kleine–Levin syndrome… In these cases, should only be established an additional diagnosis of pica if the feeding behavior is sufficiently severe to warrant independent clinical attention.ConclusionsPica disorder has been studied by pediatricians, gynecologists, dermatologists, psychiatrists, psychologists, nutritionists, anthropologists, etc., which has been interpreted as a conduct disorder, food, mental illness, poverty, hunger… but really the cause it is unknown. Although morbidity and mortality is unknown and difficult to study, include poisonings, parasitosis and surgical abdomen as serious complications. Finally, like all other eating disorders, the overall management of this entity requires the coordinated intervention of various professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Study of Patient's Perspective of Schizophrenia Using Emic Perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s249-s249
Author(s):  
D. Sanyal ◽  
D. Das
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Help Seeking ◽  
Cultural Perspective ◽  
Faith Healer ◽  
Mental Health Specialist ◽  
Health Specialist ◽  
Help Seeking Behaviour ◽  
Competing Interest ◽  
Emic Perspective

IntroductionKnowledge about how patients perceive mental illness and how it possibly influences help seeking behaviour is important in development of proper plan for mental health reform.ObjectiveThis study planned to study disease related perception, first help seeking behaviour and stigma among schizophrenia patients admitted at a hospital.Aims(1) To know about patient's view regarding the problems; (2) attempt to predict help seeking behaviour.MethodsFifty-one patients suffering from schizophrenia according to DSM-5 and fit to be interviewed were assessed using EMIC (Explanatory Model Interview Catalogue) to get emic (insider or person's own cultural) perspective of disease related perception, help seeking behaviour and stigma.ResultsTerms used to describe their illness included “depression” (21.6%), “mental” (17.6%) “matha kharap” (9.8%). Most common perceived cause was stress (25.5%) and sorcery (23.5). Mental health specialist was visited by 27.5% Faith healer consultation was high (29.4%). Stigma score was higher with marriage related issues and social isolation. Using exhaustive CHAID analysis, it was found that patients with negative themes as disease name like “matha kharap” (loosely meaning crazy) are more likely to visit faith healers, while patients naming the condition with some medical related term like depression were more likely to visit mental health specialist.ConclusionClearly perception of patients regarding mental illness and its causation varies greatly from the way psychiatrists’ viewpoint and this perception is likely to influence help seeking behaviour. Understanding these issues is likely to enable better patient awareness and proper formulation of plans to address mental health issues.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Owning the brand of psychiatry

2017 ◽  
Vol 41 (S1) ◽  
pp. S740-S740
Author(s):  
A. Peters
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
New Zealand ◽  
Public Space ◽  
Medical Training ◽  
The Public ◽  
Community Information ◽  
Zealand College ◽  
Competing Interest ◽  
Promotion Campaigns

In Australia and New Zealand, conversations around mental health are playing out in the public space with increasing frequency. Mental health promotion campaigns and organizations are embraced by mainstream and other forms of media, and supported by government. Whilst public knowledge of mental illness is increasing, the profile of psychiatrists as leaders and medical experts in mental illness is a more difficult brand to sell. With a somewhat tarnished history behind us, the modern evidence-based practice of psychiatry is not always at the forefront of public impression. Furthermore, in Australia, more than half of the population (56%) is unaware that psychiatrists have undertaken medical training as a doctor. This presentation will outline Royal Australian and New Zealand college of psychiatrists (RANZCP) action to improve community information about psychiatry, psychiatrists and treatment experiences.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s899-s899 ◽  
Author(s):  
D. Banerjee ◽  
G. Desai ◽  
P.S. Chandra
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Seeking Help ◽  
Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Impact on personal growth and environment conservation self-perception in a volunteering program with adults with severe mental illness (SMI)

2016 ◽  
Vol 33 (S1) ◽  
pp. s280-s281
Author(s):  
D. Cabezas Sánchez ◽  
A. Ramírez Macías ◽  
J. Sáiz Galdós
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Personal Growth ◽  
Well Being ◽  
Control Group ◽  
Green Area ◽  
Significant Difference ◽  
Competing Interest ◽  
The Impact ◽  
The City

Introduction“Viaje del Parnaso” is a volunteering project developed at the Day Center Aranjuez2 (CD2) for helping adults with SMI to get a satisfactory and responsible occupation through their implication in a volunteering work in the community, while involved in the maintenance of a green area in the city of Aranjuez.Objectives/aimsThe aim of this study was to evaluate the impact of the project on the volunteers’ lives in terms of personal growth and environment conservation and compare its results with non-volunteers also attended at the CD2.MethodsThe project was carried once a week during 45 weeks. 11 volunteers participated on the project, plus 5 non-volunteers were considered as cuasi-control group. The instruments applied were an item on “environment conservation” and 2 subscale items of “Personal Growth” from the Ryff Scales of psychological well-being. Measures were applied at baseline, 6 and 12 months after.ResultsSignificant differences were found on the environment conservation item between volunteers at baseline and 6 months after (P < 0.05). Results also revealed a significant difference (P < 0.05) between volunteers and non-volunteers at both variables (“environment conservation” and “Personal Growth”) in baseline and 6 months after treatment.ConclusionsThe data from this study suggest that a volunteering program seems to be an effective intervention for bringing about improvements in well-being of people with SMI, and also for increasing their environmental awareness. These improvements may also help to change the stigma of SMI reinforcing mental health patient's contributions to society.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Mental Health Stigma: What's Been Done? Where to Go?

2017 ◽  
Vol 41 (S1) ◽  
pp. s245-s245
Author(s):  
P. Macedo ◽  
M. Silva ◽  
A. Fornelos ◽  
A.R. Figueiredo ◽  
S. Nunes
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Life ◽  
Social Inclusion ◽  
Psychiatric Patients ◽  
Mental Health Stigma ◽  
Public Stigma ◽  
Negative Consequences ◽  
People With Mental Illness ◽  
Competing Interest

IntroductionNegative attitudes towards psychiatric patients still exist in our society. Persons suffering from mental illness frequently encounter public stigma and may internalize it leading to self-stigma. Discrimination occurs across many aspects of economic and social existence. It may represent a barrier for patients to receive appropriate care. Many anti-stigma campaigns have been taken to decrease people's prejudice, but its effects are not well documented.ObjectivesTo characterize anti-stigma initiatives and its effects on diminishing negative consequences of stigma.MethodsBibliographical research using PubMed using the keywords “stigma” and “mental illness”.ResultsDespite several approaches to eradicate stigma, it shows a surprising consistency in population levels. It was expected that focus on education would decrease stigma levels. The same was expected following concentration on the genetic causation of pathology. Most studies have revealed that education has little value and endorsing genetic attributions has led to a greater pessimism on the efficacy of mental health services, sense of permanence and guilty feelings within the family.ConclusionPublic stigma has had a major impact on many people with mental illness, especially when leading to self-stigma, interfering with various aspects in life, including work, housing, health care, social life and self-esteem. As Goffman elucidated, stigma is fundamentally a social phenomenon rooted in social relationships and shaped by the culture and structure of society. Social inclusion has been pointed as a potential direction of change.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Autism-plus spectrum disorders: Interfaces with psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S356-S356
Author(s):  
I. Peixoto ◽  
R. Velasco Rodrigues ◽  
C. Marques
Keyword(s):  
Autism Spectrum Disorder ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Psychotic Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Case Vignette ◽  
The Face ◽  
Competing Interest ◽  
Definition Of

IntroductionDespite categorical differentiation, autistic and psychotic disorders are historically related diagnostic entities and there is still much controversy regarding their limits and developmental course. Particularly in children, the presence of idiosyncratic fears, difficulties in the social sphere and thought disorder are important factors in the differential diagnosis. There are some research-derived clinical constructs that operationalize symptomatology aiming to highlight the interfaces and the overlap between such disorders. Their clinical implications can be extremely relevant in the face of the limits of current nosology.ObjetivesTo phenomenologically describe differentiating parameters and high-risk clinical profiles for the development of psychosis in children with autism spectrum disorder.MethodsSelective review of the literature in PubMed (MEDLINE). Illustration with a clinical case vignette.ResultsThe clinical case reflects well the difficulties posed in the differential diagnosis due to the multiple interfaces between autism and psychosis. Constructs such as “multiple complex developmental disorder” or “multidimensionally impaired syndrome” allow a clearer and more practice-friendly characterization of such individuals.ConclusionThe constelation of symptoms identified in these criteria may become useful through the definition of subgroups of autism spectrum disorder individuals with complex psychopathology. Studies in this regard are still scarce, but the validation and reproduction of the positive results observed in the near future can help optimize the clinical approaches in these children.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Best practices in perinatal mental health for mothers with severe mental illness

2017 ◽  
Vol 41 (S1) ◽  
pp. 911-911
Author(s):  
L. Howard
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Best Practices ◽  
Perinatal Period ◽  
Current Evidence ◽  
Pharmacological Treatments ◽  
Profound Impact ◽  
Competing Interest

Perinatal mental disorders are common and can have a profound impact on women and their families. This session will briefly review the epidemiology of disorders in the perinatal period and current evidence on pharmacological and non-pharmacological treatments. The role of the psychiatrist in helping women in their decision-making on treatment will be discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.

Upper Extremity Anomalies

2019 ◽  
pp. 203-210
Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry
Keyword(s):  
Valproic Acid ◽  
Differential Diagnosis ◽  
Upper Extremity ◽  
Clinical Case ◽  
Background Information ◽  
Amniotic Band ◽  
Case Presentation ◽  
Vascular Disruption ◽  
Common Causes ◽  
Malformation Syndromes

This chapter reviews background information about the incidence, epidemiology, genetics, and other anomalies associated with common congenital anomalies of the upper extremity. The discussion reviews the differential diagnosis of transverse, longitudinal (amelia, radial, ulnar), intercalary (phocomelia), and central (split hand/foot) defects of the radius and ulna and combined upper and lower extremity defects. The chapter summarizes common causes of upper extremity anomalies, including amniotic band disruption sequence, teratogenic agents (misoprostol, thalidomide, valproic acid), vascular disruption, chromosome anomalies, and Mendelian congenital malformation syndromes, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with Holt–Oram syndrome.

Behavioral disorders in emergencies. Differential diagnosis and treatment

2017 ◽  
Vol 41 (S1) ◽  
pp. S465-S465 ◽  
Author(s):  
S.M. Bañón González ◽  
N. Ogando Portilla ◽  
M.G. García Jiménez ◽  
R. Álvarez García ◽  
F. García Sánchez
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Behavioral Disorders ◽  
Clinical Case ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Oppositional Defiant ◽  
Competing Interest ◽  
Epidemiological Characteristics ◽  
The Impact

IntroductionThe clinical case has been submitted because it presents a number of difficulties in diagnosis. After seven psychiatric hospitalizations, it does not present a definitive diagnosis, poor prognosis and multiple relapses.ObjectivesBoth analyze clinical, psychopathological and epidemiological characteristics of behavioral disorders in relation to a clinical case and review causes, incidence, prevalence, diagnostic, therapeutic tools and the importance of an appropriate differential diagnosis to reach a correct therapeutic approach.MethodsReview of the impact literature for the last five years concerning behavioral disorders: prevalence, incidence, pathogenesis and its relationship with psychiatric disorders encoded in DSM-V.ResultsIt is evident that the patient has behavioral disorders and psychotic symptoms in the context of cocaine intoxication. Although sometimes the dose of cocaine has been very small and probably not justifies in all cases a toxic psychosis, it is true that withdrawal periods have been short; therefore difficult to assess. Also mania-like symptoms have been discussed because the patient has an increased activity, dysphoric mood, anxiety and decreased need for sleep.ConclusionsResponse to treatment and hyperactivity, impulsivity and inattention characteristics make us consider the diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD). ADHD in adults and adolescents have significant comorbidity with substance abuse, particularly cocaine, amphetamines and psychostimulants, also alcohol, tobacco and cannabis, and with other psychiatric disorders: oppositional defiant, personality (especially cluster B: antisocial, etc), anxiety (generalized anxiety, phobias, panic..), affective or eating disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Differences in attitudes towards mental illness and psychiatry among medical students, before and after the academic course of psychiatry

2016 ◽  
Vol 33 (S1) ◽  
pp. s218-s219
Author(s):  
M. Pascucci ◽  
M. La Montagna ◽  
E. Stella ◽  
A. De Angelis ◽  
P. Parente ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Medical Students ◽  
Perceived Discrimination ◽  
Psychiatric Patients ◽  
First Year Students ◽  
Before And After ◽  
Social Restriction ◽  
Empathy Quotient ◽  
Competing Interest

BackgroundStigma towards mental illness and psychiatry have a major impact on psychiatric patients’ quality of life; in particular, prejudicial beliefs make it more difficult for future doctors to send patients to mental health services, leading to a delay of necessary care.AimsOur aim is to evaluate the stigma towards mental illness and psychiatry, in a sample of Italian medical students. We studied the differences between the first-year students who have not attended the academic course in psychiatry, compared to the senior students who have attended the psychiatric lectures.MethodsWe tested 113 medical students, using the following questionnaires:– Attitudes Towards Psychiatry (ATP 30);– Community Attitudes Towards Mental Ill (CAMI);– Perceived Discrimination Devaluation Scale (PDD), to assess the discrimination towards mental illness perceived in society;– Baron-Cohen's Empathy Quotient (EQ), to measure empathy.ResultsAmong the 113 students, 46 have already attended the academic course of psychiatry and CAMI scores were less stigmatizing as total score (P = 0.014) and in authoritarianism subscale (P = 0.049), social restriction (P = 0.022) and ideology of mental health in the community (P = 0.017). However, there were no statistically significant differences in empathy, perceived discrimination in the society and stigmatization of psychiatry.ConclusionsThe 67 students who have not attended the academic course of psychiatry are more stigmatizing, considering psychiatric patients as inferior people that require coercive attitudes, socially dangerous and that should be treated faraway from the community. Studying psychiatry is therefore useful to reduce, in the future doctors, these prejudices toward mentally ill patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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