scholarly journals Psychiatric morbidity preceding psychotic and non-psychotic depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 670-670
Author(s):  
S.D. Østergaard ◽  
P.T. Dinesen ◽  
G. Petrides ◽  
S. Skadhede ◽  
P. Munk-Jørgensen ◽  
...  
Keyword(s):  
Psychiatric Morbidity ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Psychiatric Diagnoses ◽  
Central Research ◽  
Psychotic Depression ◽  
Psychopharmacological Treatment ◽  
Research Register ◽  
Icd 10 ◽  
History Of

IntroductionPsychotic depression differs significantly from non-psychotic depression in many aspects. These differences comprise etiology, severity, treatment response and prognosis.Objectives/aimsThe aim of the study was to assess the diversity of the psychiatric morbidity preceding psychotic and non-psychotic depression.MethodsDanish, register-based, nationwide cohort study. Subjects were all Danish residents assigned with an ICD-10 diagnosis of severe depression with- (F32.3 and F33.3) or without (F32.2 and F33.2) psychotic symptoms between January 1st 1994 and December 31st 2007. Psychiatric diagnoses preceding the severe depression were assessed through the Danish Psychiatric Central Research Register. It was investigated whether patients with psychotic depression had a history of more diverse/severe psychiatric morbidity and a different use of psychopharmacological drugs prior to index, compared to their non-psychotic counterparts.ResultsThe study included 29,254 subjects with severe depression. Of these, 9,768 patients (33%) were of the psychotic subtype while 19,576 (67%) were non-psychotic.Patients with the psychotic depressive subtype had a psychiatric history involving more and longer admission, more diverse diagnoses and a different pattern of psychopharmacological treatment compared to their non-psychotic counterparts. The results indicate, that psychotic depression may be more related to the bipolar/schizophrenia/psychosis spectrum than to the depression/anxiety spectrum.ConclusionsThe results add to a growing body of literature proving fundamental differences between psychotic- and non-psychotic severe depression. This should be considered in the upcoming revisions of the current diagnostic classifications.

Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression

2014 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Kimiya Nakamura ◽  
Junichi Iga ◽  
Naoki Matsumoto ◽  
Tetsuro Ohmori
Keyword(s):  
Bipolar Disorder ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Primary Disorder ◽  
Icd 10 ◽  
History Of ◽  
Physical Diseases ◽  
The Stability ◽  
Psychotic Features ◽  
Depressive Episodes

ObjectiveSevere depression may be a risk factor for diagnostic conversion into bipolar disorder (BD), and psychotic depression (PD) has been consistently associated with BD. The aims of the present study were to investigate the stability of the diagnosis of severe depression and the differences between PD and non-psychotic severe depression (non-PD), as well as to assess the effectiveness of electroconvulsive therapy (ECT).MethodsPatients who were hospitalised for severe depression (diagnosed according to ICD-10) both with and without psychotic symptoms (n=89; mean age=55.6 years, SD=13.9) from 2001 to 2010 were retrospectively assessed.ResultsBy the 75th month of follow-up assessments, 11(12.4%) patients had developed BD. Among these 11 converters, nine had developed BD within 1 year after admission. Only sub-threshold hypomanic symptoms were significantly related to developing BD. The number of depressive episodes and history of physical diseases were significantly increased in non-PD compared with PD patients, whereas ECT was significantly increased in PD compared with non-PD patients. There was a significant association between length of stay at the hospital and the number of days between admission and ECT.ConclusionSub-threshold hypomanic symptoms may represent a prodrome of BD or an indicator of an already manifest phenotype, especially in older patients, which suggests cautious use of antidepressants. In severe depression, non-PD may often occur secondary to physical diseases and patients may experience increased recurrences compared with PD patients, which may be a more ‘primary’ disorder and often requires ECT treatments. ECT is effective for severe depression regardless of the presence of any psychotic feature; the earlier ECT is introduced, the better the expected treatment outcome.

Trends in the psychopharmacological treatment of bipolar disorder: a nationwide register-based study

2015 ◽  
Vol 28 (2) ◽  
pp. 75-84 ◽  
Author(s):  
Louise Bjørklund ◽  
Henriette Thisted Horsdal ◽  
Ole Mors ◽  
Søren Dinesen Østergaard ◽  
Christiane Gasse
Keyword(s):  
Bipolar Disorder ◽  
Atypical Antipsychotics ◽  
Tricyclic Antidepressants ◽  
Treatment Guidelines ◽  
Treatment Patterns ◽  
Central Research ◽  
Cross Sectional ◽  
Psychopharmacological Treatment ◽  
Research Register ◽  
Disorder Treatment

ObjectiveIn bipolar disorder, treatment with antidepressants without concomitant use of mood stabilisers (antidepressant monotherapy) is associated with development of mania and rapid cycling and is therefore not recommended. The present study aimed to investigate the psychopharmacological treatment patterns in bipolar disorder over time, with a focus on antidepressant monotherapy.MethodsCohort study with annual cross-sectional assessment of the use of psychotropic medications between 1995 and 2012 for all Danish residents aged 10 years or older with a diagnosis of bipolar disorder registered in the Danish Psychiatric Central Research Register. Users of a given psychotropic medication were defined as individuals having filled at least one prescription for that particular medication in the year of interest.ResultsWe identified 20 618 individuals with bipolar disorder. The proportion of patients with bipolar disorder using antidepressants, atypical antipsychotics and anticonvulsants increased over the study period, while the proportion of patients using lithium, typical antipsychotics and benzodiazepines/sedatives decreased. The proportion of patients treated with antidepressant monotherapy decreased from 20.5% in 1997 to 12.1% in 2012, and among antidepressant users, the proportion in monotherapy decreased from 47.7% to 23.9%, primarily driven by a decrease in the use of tricyclic antidepressants.ConclusionThe results show an increase in the proportion of patients with bipolar disorder being treated with antidepressants in the period from 1997 to 2012. However, in accordance with international treatment guidelines, the extent of antidepressant monotherapy decreased during the same period.

scholarly journals A Case of Psychosis Due to Acute Hypocalcemia From Hypoparathyroidism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A172-A173
Author(s):  
Joseph Theressa Nehu Parimi ◽  
John Chen Liu ◽  
Rajani Gundluru ◽  
Sowjanya Naha ◽  
Timur Gusov ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Case Reports ◽  
Severe Depression ◽  
Altered Mental Status ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Organic Psychosis ◽  
Neuropsychiatric Manifestations ◽  
History Of ◽  
Gait Abnormalities

Abstract A 61-year-old female with past medical history of depression, hypoparathyroidism (hypoPtH), and hypothyroidism had disappeared from her home and was found wandering a few hours away with persecutory delusions, visual and auditory hallucinations. Serum calcium (Ca) was 6.3 mg/dL (range 8.6–10.2), albumin 3.7 g/dL (range 3.5–5.2) and ionized Ca 0.89 mmol/L (range 1.12–1.30). She was admitted and treated with Ca and calcitriol. Work-up for altered mental status was negative except for hypocalcemia (hypoCa) and scattered bilateral basal ganglia calcifications (BGC) with cortical and subcortical frontal lobe calcifications on CT. Psychiatry diagnosed delirium due to hypoCa. Acute psychosis resolved once Ca levels improved. Diagnosis of idiopathic hypoPtH was in 1997. Her regimen included Ca citrate 1500mg daily and 10 mcg of Forteo twice daily. She had skipped her medications for at least 2 days prior to presentation. Her medical records revealed that she was seen for severe depression, progressive gait abnormalities, slowed movements, and imbalance, in 2015. CT scan and MRI brain showed BGC. Her son gave a history of multiple admissions for psychosis, violence, delusions with agitation, and wandering at times when the patient was hypoCa, which was diagnosed as schizophrenia. Neuropsychiatric disturbances are commonly associated with hypercalcemia. Review of literature found a few case reports of psychosis and hypoPtH 1,2 BGC is common in hypoPtH. Psychotic symptoms due to BGC include auditory hallucinations, delusions of influence, paranoid states, and complex perceptual distortions.3,5 HypoCa is associated with cognitive impairment. Neurological manifestations tend to improve with Ca correction, but psychiatric symptoms do not improve substantially.4,5 Further studies are needed in hypoPtH with BGC to appropriately diagnose organic psychosis. This is important in management of the vicious cycle of psychiatric illness leading to noncompliance resulting in psychosis. Prevention of BGC will play a key role. References: 1. Finan M, Axelband J. This is your brain on calcium: psychosis as the presentation of isolated hypoparathyroidism. Am J Emerg Med. 2014;32:945.e1-4. 2. Ang AW, Ko SM, Tan CH. Calcium, magnesium, and psychotic symptoms in a girl with idiopathic hypoparathyroidism. Psychosom Med. 1995;57:299–302. 3. Burns K, Brodaty H. Fahr’s disease and psychosis. In: Sachdev PS, Keshavan MS, editors. Secondary schizophrenia. Cambridge: Cambridge University; 2010. p. 358–66. 4. Maiti A, Chatterjee S. Neuropsychiatric manifestations and their outcomes in chronic hypocalcaemia. J Indian Med Assoc. 2013;111:174–7. 5. Amara A, Novais C, Coelho M, Silva A, Curral R, Brandao I, Torres A. Organic psychosis due to hypoparathyroidism in an older adult: a case report. Braz. J. Psychiatry; 2016; 38(4)

Annual incidence of cannabis-induced psychosis, other substance-induced psychoses and dually diagnosed schizophrenia and cannabis use disorder in Denmark from 1994 to 2016

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Carsten Hjorthøj ◽  
Maria Oku Larsen ◽  
Marie Stefanie Kejser Starzer ◽  
Merete Nordentoft
Keyword(s):  
Dual Diagnosis ◽  
Incidence Rates ◽  
Cannabis Use ◽  
Psychiatric Diagnoses ◽  
Cannabis Use Disorder ◽  
Central Research ◽  
Dually Diagnosed ◽  
Research Register ◽  
Incident Cases ◽  
Over Time

Abstract Background Worldwide, cannabis is the most used illegal substance, and the use of cannabis has increased over the years. An increase in the level of tetrahydrocannabinol (THC) in cannabis has also been seen. It is currently unclear whether this has led to an increase in the incidence of cannabis-induced psychosis. We aimed to investigate (1) the development of incidence of cannabis-induced psychosis over time compared with other substance-induced psychoses and (2) the development of incident cases of cannabis-induced psychosis over time compared with dual diagnosis defined as schizophrenia and a cannabis use disorder. Method Data on psychiatric diagnoses were extracted from the Danish Psychiatric Central Research Register and summarized per year as both absolute incidence (number of cases) and incidence rates per 100 000 person years. Results The incidence rate of cannabis-induced psychosis increased steadily from 2.8 per 100 000 person years in 2006 to 6.1 per 100 000 person years in 2016. There was a corresponding increase in dual diagnosis with schizophrenia and cannabis use disorder, but a decrease in alcohol-induced psychosis. The data showed no trend in the other substance-induced psychosis investigated in this thesis. Conclusion The increase in cannabis-induced psychosis follows both the increase in the level of THC in cannabis, and the increase in cannabis use. The change in diagnostic practice does not appear to explain the increase in incidence of cannabis-induced psychosis.

scholarly journals Cognitive approach to depression and suicidal thinking in psychosis

2000 ◽  
Vol 177 (6) ◽  
pp. 516-521 ◽  
Author(s):  
Max Birchwood ◽  
Zaffer Iqbal ◽  
Paul Chadwick ◽  
Peter Trower
Keyword(s):  
Negative Symptoms ◽  
De Novo ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Positive Symptoms ◽  
Psychotic Depression ◽  
Acute Psychosis ◽  
Concomitant Increase ◽  
Cognitive Approach ◽  
Icd 10

BackgroundDepression in schizophrenia is a rather neglected field of study, perhaps because of its confused nosological status. Three course patterns of depression in schizophrenia, including post-psychotic depression (PPD), are proposed.AimsWe chart the ontogeny of depression and psychotic symptoms from the acute psychotic episode over a 12-month period and test the validity of the proposed course patterns.MethodOne hundred and five patients with ICD–10 schizophrenia were followed up on five occasions over 12 months following the acute episode, taking measures of depression, positive symptoms, negative symptoms, neuroleptic exposure and side-effects.ResultsDepression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms.ConclusionsThe results provided support for the validity of two of the three course patterns of depression in schizophrenia, including PPD. Post-psychotic depression occurs de novo without concomitant change in positive or negative symptoms.

scholarly journals COVID-19 Encephalopathy in the Context of Psychiatric Comorbidity: Case Report and Diagnostic Pitfalls

2020 ◽  
Author(s):  
David Benrimoh ◽  
Vincent Jetté Pomerleau ◽  
Majed A. Alharbi ◽  
Louis Pinard ◽  
Leon Tourian
Keyword(s):  
Serotonin Syndrome ◽  
Psychiatric Comorbidity ◽  
Clinical Course ◽  
Psychotic Symptoms ◽  
Rehabilitation Services ◽  
Repeated Treatment ◽  
Psychotic Depression ◽  
Stiff Person Syndrome ◽  
History Of ◽  
Diagnostic Pitfalls

We present the case of likely COVID-19 associated encephalopathy in a male in his early 50s with a history of non-psychotic depression and personality disorder who presented with delirium, new psychotic symptoms and who developed paratonia and obtundation. After initial questions of neuroleptic malignant syndrome, serotonin syndrome, and stiff person syndrome were decided to not be supported by the clinical picture, conservative management and the repeated treatment of a co-ocurring mastoiditis led to improvement of mental status, regained ability to walk and speak, though a dysexecutive syndrome was left when patient was discharged to rehabilitation services. We explore the role the patient's psychiatric comorbidity had in terms of both his clinical course and the decisions and diagnostic considerations of the various treating teams involved.

scholarly journals Nepalese psychiatric patients with armed-conflict related stressors

1970 ◽  
Vol 9 (2) ◽  
pp. 67-72 ◽  
Author(s):  
DR Shakya ◽  
N Lamichhane ◽  
PM Shyangwa ◽  
R Shakya
Keyword(s):  
Armed Conflict ◽  
Psychiatric Patients ◽  
Psychiatric Morbidity ◽  
Political Conflict ◽  
Stressful Events ◽  
Psychotic Symptoms ◽  
Common Diagnosis ◽  
Icd 10 ◽  
The One ◽  
Relationship Of

Introduction: Psychiatric disorders have long been associated with bio-psycho-social factors. The relationship of stressful events with the etiology and the course of mental illness have similarly been much considered. Among different types of conflicts, armed political is the one under which many countries including Nepal have been reeled directly. This study aims to evaluate the psychiatric morbidity profile of patients with the stressors related to the then ongoing political conflict in Nepal. Methods: This is a hospital based, descriptive study with convenient sampling method carried out in Department of Psychiatry, B P Koirala Institute of Health Sciences. The diagnosis was based on Chapter V (F) of ICD- 10. Results: Among 50 subjects, there were 36 males and 14 females. More than half of the subjects were of productive age. During the war period, more than half had been affected directly; physically and or psychologically while other halves indirectly. Nearly all subjects had biological/ somatic symptoms, followed by anxiety and psychotic symptoms. Two cases (4%) presented with attempted suicide. Affective disorders were the most common diagnosis among the subjects with conflict related stressors. Conclusion: Many of the mentally ill people had significant political stressor in current day Nepal. Hence, as described in the literature, it is a risk factor. Keywords: armed conflict; conflict related stressor; psychiatric disorder; Nepal. DOI: http://dx.doi.org/10.3126/hren.v9i2.4975 Health Renaissance 2011: Vol.9 (No.2): 67-72

scholarly journals CLINICAL PROFILE AND PSYCHIATRIC MORBIDITY IN PATIENTS WITH DELIBERATE SELF-HARM

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Yogesh Motwani ◽  
Shobha Nair ◽  
Aditi Chaudhari ◽  
Kaustubh Mazumdar
Keyword(s):  
Psychiatric Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Demographic Data ◽  
Psychiatric Morbidity ◽  
Deliberate Self Harm ◽  
Icd 10 ◽  
History Of ◽  
Case Files ◽  
Self Harm

Background: It requires detailed research to understand the psychopathology behind DSH attempts. Apart from social factors, psychiatric disorders and individual coping mechanisms can contribute to DSH. This study will be helpful in knowing the prevalence of psychiatric morbidity in these patients. Aims and Objectives: To study the Psychiatric morbidity in patients with DSH. Materials and Methods: This is a retrospective, descriptive study including 42 patients who had history of DSH and were referred to psychiatry department of BARC Hospital, Mumbai. Patients who were below 45 years of age at the time of DSH and above 18 years at the time of study were included. Their socio-demographic data were collected, psychiatric diagnosis were noted from the case files, personality disorders were evaluated using ICD-10 IPDE. Data were analysed using descriptive and analytic statistical methods. Results: 42.86% of the population was diagnosed as having psychiatric disorder. Most common disorder was depression. 7.14% of the patients were diagnosed as having borderline personality disorder. Conclusions: Depression was the most common psychiatric disorder found in our study. Key words: Deliberate self-harm, psychiatric disorders, personality disorders.

scholarly journals Interrelation of clinical-anamnestic, medical-biological and neurocognitive characteristics of maladaptation in remission as a component of pathopersonological transformations in patients with schizoaffective disorder

2020 ◽  
pp. 68-74
Author(s):  
Mykola Khomitskyi
Keyword(s):  
Schizoaffective Disorder ◽  
Pathological Process ◽  
Psychotic Symptoms ◽  
Neurocognitive Deficits ◽  
Psychoactive Substances ◽  
Psychopharmacological Treatment ◽  
Icd 10 ◽  
Rehabilitation Measures ◽  
Neurological Pathology

The aim of the study was to study the interrelation between clinical, medical, biological and neurocognitive characteristics of maladaptation (as a component of pathopersonological transformations) in patients with schizoaffective disorder in remission. On the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia, Ukraine) 102 persons with the established diagnosis of “schizoaffective disorder” were examined. Diagnosis was per formed according to the International ICD-10. The mandatory criteria for inclusion in the study were the presence of a condition of clinical remission with reduction of psychotic symptoms and the absence of severe somatic and neurological pathology, abuse of psychoactive substances. The main methods of the study were clinical psychopathological, psychodiagnostical, clinical-anamnestic and clinical-cathamnestic as well as medi cal and statistical analysis. The study established the presence and regularities of conjugation of clinical, medical, biological, and neurocognitive characteristics of maladaptation (as a component of pathopersonological transformations) in patients with schizoaffective disorder in remission. The structure of neurocognitive deficits in schizoaffective disorder in remission is related to the clinical type of the disease, the sex, the duration of the pathological process, and the characteristics of psychopharmacological treatment. The established regularities emphasize the importance of neurocognitive disorders in the structure of pathopersonological transformations and can be used in the formation of the system of diagnostic and treatment and rehabilitation measures to improve the quality of differential diagnosis and to carry out preventive and therapeutic rehabilitation measures to reduce the level of social maladaptation of patients with schizoaffective disorder. Keywords: schizoaffective disorder, clinic, neurocognition, social maladaptation, pathopersonalogical transformations

Prevalence of Psychiatric Diagnoses and Psychiatric Consultation Service Utilization on Inpatient Medical Units

2021 ◽  
pp. 107839032110055
Author(s):  
Bianca Reis ◽  
Jenny Hsin-Chun Tsai
Keyword(s):  
Health Care ◽  
Psychiatric Disorders ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Adult Patients ◽  
Psychiatric Diagnoses ◽  
Psychiatric Consultation ◽  
Consultation Service ◽  
Icd 10 ◽  
Delivery Models

OBJECTIVE This practice improvement project sought to determine the prevalence of psychiatric diagnoses among patients admitted to a community hospital’s inpatient medical units and which diagnoses were serviced by the hospital’s psychiatric consultation service. METHOD Electronic medical record data on adult patients of five medical units admitted with a psychiatric condition between October 1, 2019, and December 31, 2019, were used. Psychiatric ICD-10 ( International Classification of Diseases, 10th Revision) codes and diagnosis names extracted were categorized into seven major diagnostic groups. A total of 687 adult patients with 82 psychiatric ICD-10 codes were analyzed using descriptive statistics. RESULTS Substance-related and addictive disorders were the most prevalent psychiatric diagnoses. Ninety-six percent ( n = 658) of patients residing on medical floors with psychiatric disorders were hospitalized for a principal medical problem. Seventy-three cases received psychiatric consultations during their stay. Sixty percent ( n = 44) of those cases had psychiatric disorders from two or more diagnostic categories. CONCLUSIONS Multidisciplinary, team-based health care delivery models that include a psychiatric nurse can provide an effective approach to treat patients in community hospitals with multiple psychiatric and medical comorbidities. Hospitals could take a significant role in providing substance use disorder treatment and equipping medical nurses with training to competently care for patients with psychiatric disorders on medical units. Further research into the prevalence and impact of patients with co-occurring and multiple psychiatric diagnoses in community hospitals is needed to implement effective health care delivery models and provide appropriate treatment options in the community.

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