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.

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.

Seven Years Of Occupational Psychiatry In A Portuguese Universitary Hospital

2016 ◽  
Vol 33 (S1) ◽  
pp. S487-S487
Author(s):  
L. Sousa ◽  
A. Antunes ◽  
L. Bastos
Keyword(s):  
Common Mental Disorders ◽  
Clinical Information ◽  
Work Organizations ◽  
Institutional Level ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Competing Interest ◽  
The Individual ◽  
Anxiety Depression ◽  
Mental Health Policies

IntroductionOccupational psychiatry is the field of psychiatry that focuses on work, its importance in the lives of individuals and work organizations. It gained visibility in the 2000 decade, after the creation of the Academy of Occupational and Organizational Psychiatry. Following that trend, occupational psychiatry outpatient started in 2008 at Hospital de Santa Maria.ObjectiveTo describe the structure and functioning of that project; to characterize the population that has been referred to this subspecialty, as well as the main motives for referral; and to highlight some paradigmatic cases that deserve special attention.AimsCall attention to the importance of occupational psychiatry at the individual and institutional level.MethodsAll the patients ever referred to the occupational psychiatry consultation were considered for the analysis. Clinical information was obtained through medical records and interviews with the patients. Bibliographic research was conducted through the PubMed in the Medline library.ResultsIn our hospital, the prototype patient referred to occupational psychiatry is a middle-aged woman working as a medical assistant. The most frequent motives for referral were related to difficulties in accomplishing job duties and definite psychiatric diagnosis corresponded more often to the common mental disorders (anxiety, depression and adjustment disorders). At the institutional level, the initiative was received with great enthusiasm.ConclusionsAs Freud stated “To Love and work are the cornerstone of our humanness”, in line with that we consider that occupational psychiatry should be taken as a priority in what concerns to mental health policies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A middle aged woman with isolated ACTH deficiency associated with transient GH deficiency

2014 ◽  
Author(s):  
Michelle Mangual ◽  
Jose Hernan-Martinez ◽  
Monica Santiago ◽  
Carlos Figueroa ◽  
Rafael Trinidad ◽  
...  
Keyword(s):  
Gh Deficiency ◽  
Middle Aged ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Aged Woman ◽  
Middle Aged Woman

scholarly journals P.005 Lisdexamfetamine precipitated pathological gambling

2018 ◽  
Vol 45 (s2) ◽  
pp. S17-S17 ◽  
Author(s):  
F Chaudhary ◽  
A Hirsch ◽  
W MacPherson ◽  
J Nayati
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Nucleus Accumbens ◽  
Pathological Gambling ◽  
Risk Taking ◽  
Gambling Behavior ◽  
Hyperactivity Disorder ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
History Of ◽  
Mental Status Examination

Background: Lisdexamfetamine has not heretofore been reported to cause pathological gambling. Such a case is presented. Methods: A middle-aged woman, without past interest in gambling, gaming, or risk taking behavior, with childhood history of attention deficit hyperactivity disorder presented with difficulty focusing and concentrating. Lisdexamfetamine was started at 20 mg daily and gradually escalated due to lack of efficacy. At 70 mg daily, she began binging on sweets and gambling all day, every day at nearby riverboats, which she had never frequented previously. Upon reduction to 60 mg daily, the gambling resolved. Ritalin 20 mg every morning and 50 mg every afternoon was used without gambling reoccurrence. Results: Mental Status Examination: Alert, cooperative and oriented x 3 with good eye contact. Euthymic, without mania, thoughts logical and goal directed. Conclusions: Enhanced dopamine in the nucleus accumbens may induce hedonic activities including gambling, binging on sweets, or sexual activity (Moore et al. 2014). Lisdexamfetamine has been described to induce mania, and pathological gambling may have been an isolated manifestation of early mania. In those who have recently begun lisdexamfetamine, query should be made regarding change in gambling behavior and in those who are pathologically gambling, investigation should be entertained as to whether they are taking lisdexamfetamine.

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