Voluntary and involuntary admissions with schizoaffective disorder: do they differ from schizophrenia?

2020 ◽  
pp. 1-8
Author(s):  
A. Feeney ◽  
E. Umama-Agada ◽  
A. Curley ◽  
C. Anamdi ◽  
M. Asghar ◽  
...  
Keyword(s):  
Clinical Features ◽  
Schizoaffective Disorder ◽  
Psychotic Symptoms ◽  
Involuntary Admission ◽  
Services Research ◽  
Acute Psychiatry ◽  
Affective Symptoms ◽  
Catchment Areas ◽  
Admission Status ◽  
Biological Differences

Objectives: Schizoaffective disorder and schizophrenia are common presentations to psychiatry services. Research to date has focussed on hypothesised biological differences between these two disorders. Little is known about possible variations in admission patterns. Our study compared demographic and clinical features of patients admitted voluntarily and involuntarily with diagnoses of schizoaffective disorder or schizophrenia to three psychiatry admission units in Ireland. Methods: We studied all admissions to three acute psychiatry units in Ireland for periods between 1 January 2008 and 31 December 2018. We recorded demographic and clinical variables for all admissions. Voluntary and involuntary admissions of patients with schizoaffective disorder were compared to those with schizophrenia. Results: We studied 5581 admissions to the study units for varying periods between January 2008 and December 2018, covering a total of 1 976 154 person-years across the 3 catchment areas. The 3 study areas had 218.8, 145.5 and 411.2 admissions per 100 000 person-years, respectively. Of the 5581 admissions over the study periods, schizoaffective disorder accounted for 5% (n = 260) and schizophrenia for 17% (n = 949). Admissions with schizoaffective disorder were significantly more likely to be female and older, and less likely to have involuntary admission status, compared to those with schizophrenia. As first admissions were not distinguished from re-admissions in this dataset, these findings merit further study. Conclusions: Admissions with a schizoaffective disorder differ significantly from those with schizophrenia, being, in particular, less likely to be involuntary admissions. This suggests that psychotic symptoms might be a stronger driver of involuntary psychiatry admission than affective symptoms.

Cocaine Dependence Produce Psychiatric Symptoms - a Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Stankovic ◽  
S. Vucetic-Arsic ◽  
S. Alcaz ◽  
J. Cvejic
Keyword(s):  
Clinical Features ◽  
Male Patient ◽  
Psychiatric Symptoms ◽  
Cocaine Dependence ◽  
Psychotic Symptoms ◽  
Personal Contact ◽  
Outpatient Unit ◽  
Special Hospital ◽  
First Time ◽  
The Brain

Aim:We want to present a polymorphic clinical features like: hallutinations, paranoid ideas, agitation and violence as a result of prolonged cocaine intranasal consumption.Methods:We exposed a 30-year old male patient with ICD-X diagnostic criteria for cocaine dependence (intranasal consumption) that treated in the outpatient unit of Special Hospital of Addicitons, Belgrade, Serbia from April to July 2008. We used the medical records, psychical examination, psychiatric interwievs, standard blood sampling and cocaine urine detections sample (positive).Results:Observations a specific and polymorphic clinical features with presence of psychotic symptoms after cocaine consumptions in our male patient, for the first time after 5 years of cocaine dependence: auditory hallucinations (two- voice speakers), paranoid persecution ideas and suspiciousness, agitation with appearance of vegetative symptomatology (palpitations, sweating, pupil dilatation), extremely violence behavior to other people, complete social reductions (“armed to the outside world”, refused any personal contact and isolated from friends and family, permanent outdoor checking). There was an intensive fear too and impaired judgment.Conclusions:Permanent cocaine consumption can result with produce a numerous of psychiatric symptoms and syndromes as our experience does. It is similar to the findings of other studies and papers reviewed. It is suppose that cocaine has numerous effects on important neurotransmitters in the brain, such as increase as well as the release of dopamine and it related with aggressiveness, hallucinations and other psychiatric symptoms.

Behavioural and psychological symptoms of dementia

2020 ◽  
pp. 247-258
Author(s):  
Rianne van der Linde ◽  
Tom Dening
Keyword(s):  
Quality Of Life ◽  
Environmental Factors ◽  
Psychological Symptoms ◽  
Symptom Clusters ◽  
Psychotic Symptoms ◽  
Mixed Group ◽  
People With Dementia ◽  
Affective Symptoms ◽  
Behavioural And Psychological Symptoms

The term: ‘behavioural and psychological symptoms of dementia’ (BPSD) refers to a mixed group of phenomena. BPSD are the non-cognitive features of dementia and include depression, anxiety, psychotic symptoms, apathy, irritability, aggression, and sleep and eating problems. They occur in around 80% of people with dementia at some stage, several of them becoming more frequent as dementia progresses. Some BPSD, notably apathy, are very persistent. BPSD often limit the person’s quality of life and can be stressful for carers. Causes of BPSD include biological, psychological, social, and environmental factors. This chapter explores how they are assessed and measured, and how they may usefully grouped together in symptom clusters. Usually four symptom groups are found: affective symptoms, psychosis, hyperactivity, and euphoria. However, these are not always consistent and in particular apathy does not consistently belong in one group. Approaches to management of BPSD are outlined.

Course and symptom and functional correlates of passivity symptoms in schizophrenia: an 18-year multi-follow-up longitudinal study

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ellen S. Herbener ◽  
Martin Harrow
Keyword(s):  
Longitudinal Study ◽  
Schizoaffective Disorder ◽  
Similar Rate ◽  
Psychotic Symptoms ◽  
Work Functioning ◽  
Index Hospitalization ◽  
Persecutory Delusions ◽  
Work Impairment ◽  
Time Information

Abstract Background Change in the experience of oneself may lay the groundwork for the development of additional hallucinations and delusions in individuals with schizophrenia. However, to date, the course and symptom and functioning correlates of passivity symptoms (cf. thought insertion, thought withdrawal) have not been measured consistently over long periods of time. Information on the course and correlates of passivity symptoms is essential for developing models of their contribution to schizophrenic illness. Method Eighty-two individuals diagnosed with schizophrenia or schizoaffective disorder were recruited at an index hospitalization and reassessed at three or more follow-ups over the following 18 years. Results The results indicate that a small group of participants report passivity symptoms at all follow-ups, many reported passivity symptoms at some follow-ups, and the majority of individuals never reported passivity symptoms. The prevalence of passivity symptoms was similar to that for delusions of reference and persecutory delusions. Notably, when individuals did experience passivity symptoms, they also had a greater number of additional psychotic symptoms than individuals without passivity symptoms. Further, the presence of passivity symptoms was associated with work impairment at some assessments. Conclusions Passivity symptoms present episodically, at a similar rate as delusions of reference and persecutory delusions, and when present, they are associated with having a higher number of additional psychotic symptoms, as well as having some impact on work functioning. These results suggest that passivity symptoms may increase vulnerability to additional psychotic symptoms and greater work impairment.

Lifetime presence of psychotic symptoms in bipolar disorder is associated with less favorable socio-demographic and certain clinical features

2017 ◽  
Vol 76 ◽  
pp. 169-176 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Giulia Camuri ◽  
Laura Cremaschi ◽  
Cristina Dobrea ◽  
Massimiliano Buoli ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Features ◽  
Psychotic Symptoms

CBT for a Person With Schizophrenia: Systematic Desensitization for Phobias Led to Positive Symptom Improvement

2005 ◽  
Vol 33 (2) ◽  
pp. 249-254 ◽  
Author(s):  
Robert Dudley ◽  
Jaime Dixon ◽  
Douglas Turkington
Keyword(s):  
Successful Treatment ◽  
Specific Phobia ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Symptom Improvement ◽  
Systematic Desensitization ◽  
Antipsychotic Medications ◽  
Affective Symptoms ◽  
Effect Of Treatment

Affective symptoms are often present and under-treated in schizophrenia. This case study reports the effect of treatment of a specific phobia and associated avoidance on the psychotic symptoms of a patient with medication resistant schizophrenia. The treatment of the specific phobia and agoraphobia followed a traditional systematic desensitization procedure. The successful treatment of the phobias led to improvements in psychotic symptoms. Previously, the client had only a limited response to a number of antipsychotic medications including clozapine but responded well to a traditional systematic desensitization program that produced positive consequences for the psychotic symptomatology. The clinical and theoretical aspects of this case are discussed.

scholarly journals Factors Associated With Involuntary Psychiatric Hospitalization of Youths in China Based on a Nationally Representative Sample

2020 ◽  
Vol 11 ◽  
Author(s):  
Feng Geng ◽  
Feng Jiang ◽  
Rachel Conrad ◽  
Tingfang Liu ◽  
Yuanli Liu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Children And Adolescents ◽  
Representative Sample ◽  
Psychiatric Hospitalization ◽  
Psychiatric Hospitals ◽  
Psychotic Symptoms ◽  
Involuntary Admission ◽  
Primary Reason ◽  
Nationally Representative ◽  
Reason For Admission

Objective: This nationally representative sample investigates demographic, diagnostic and clinical features associated with both voluntary and involuntary psychiatric hospitalization among children and adolescents psychiatrically hospitalized in China.Method: As part of an official national survey, 41 provincial tertiary psychiatric hospitals in China were selected. Data from 196 children and adolescents who were discharged from these psychiatric hospitals from March 19 to 31, 2019 were retrieved and analyzed.Results: 1. Psychotic symptoms, depressive symptoms and self-injury/suicide were the most common reasons of admission. Girls were significantly likely to be admitted due to depressive symptoms, whereas boys were more likely to be admitted due to aggressive behaviors. 2. The overall rate of involuntary admission was 32.1% (N = 63). Compared to patients who were admitted voluntarily, those who were admitted involuntarily had lower GAF scores on admission, were older, were more likely to present with psychotic symptoms, manic symptoms or aggressive behavior as primary reason for admission, were less likely to present with depressive symptoms, had a significantly longer length of stay, were more likely to be diagnosed with schizophrenia and were less likely to be diagnosed as depressive disorder. 3. A logistic regression showed that depressive symptom as primary reason for admission was significantly associated with voluntary admission (OR = 0.159, p < 0.001), along with two other factors: age (p < 0.01) and a lower GAF score at admission (p < 0.001) were significantly associated with involuntary admission.Conclusion: The rate of involuntary psychiatric hospitalization among children and adolescents is higher in China than in other regions. Developing more specific and more operational criteria to guide involuntary psychiatric admission for child and adolescent patients is of urgency and great importance to ensure appropriate treatment of these patients and protect their rights.

Association study of tryptophan hydroxylase-2 gene in schizophrenia and its clinical features in chinese han population

2011 ◽  
Vol 26 (S2) ◽  
pp. 1535-1535
Author(s):  
C. Zhang ◽  
Z.Z. Li ◽  
Y. Shao ◽  
Y.R. Fang
Keyword(s):  
Clinical Features ◽  
Case Control Study ◽  
Tryptophan Hydroxylase ◽  
Case Control ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Tryptophan Hydroxylase 2 ◽  
Functional Polymorphisms ◽  
Schizophrenic Patients ◽  
Control Study

IntroductionSchizophrenia is a chronic and severe mental illness which is characterized by the development of various detrimental clinical features, and its etiology still remains unknown. Based on the evidence from neurobiological and pharmacological research, dysfunctions in central serotonergic transmission may be involved in the development of schizophrenia. Tryptophan hydroxylase 2 (TPH2), a newly identified isoform of tryptophan hydroxylase (the rate limiting enzyme in the biosynthesis of serotonin), regulates the brain-specific serotonin synthesis.ObjectivesTo further clarify the role of TPH2 in the development of schizophrenia.AimWe performed a case-control study to examine the association of the TPH2 gene with schizophrenia and its clinical features.MethodsWe genotyped three putative functional polymorphisms (rs4570625, rs7305115 and rs4290270) within the gene and carried out a case-control study consisting of 304 schizophrenia patients and 362 healthy subjects. The severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS).ResultsThe frequencies of genotypes and alleles of rs4570625, rs7305115 and rs4290270 did not differ significantly between schizophrenic patients and controls. However, the PANSS positive symptom subcore was significantly associated with rs4570625 (P = 0.022).ConclusionThese results suggest that rs4570625 of TPH2 may play an important role in the development of positive symptoms in Han Chinese schizophrenic patients.

Symptoms of Psychoses

1995 ◽  
Vol 166 (2) ◽  
pp. 236-240 ◽  
Author(s):  
Toshinori Kitamura ◽  
Yuji Okazaki ◽  
Akira Fujinawa ◽  
Masahiro Yoshino ◽  
Yomishi Kasahara
Keyword(s):  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Current Knowledge ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Affective Symptoms ◽  
Five Factors ◽  
Thought Disorders ◽  
Positive And Negative Symptoms

BackgroundThe literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.MethodThe symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.ResultsFactor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.ConclusionThese results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.

Benefit of Clomipramine-quetiapine Combination in Obsessive-compulsive Disorder with Non Response to Serotonin Selective Reuptake Inhibitors. Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Marian ◽  
B. Ionescu ◽  
D. Ghinea ◽  
N. Alina
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Case Series ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Work Related ◽  
Affective Symptoms

Background:Patients who suffer of obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. the condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning.Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as adjuvant to antidepressant medication have proven to be effective in several case series and pilot clinical trials.The objective of this case was to evaluate the effectiveness of clomipramine-quetiapine combination in OCD refractory to serotonin selective reuptake inhibitors treatment patient.Method:23 years unemployed male was diagnosed with OCD after 1 year from onset and received 3 trials with serotonin selective reuptake inhibitors at therapeutical doses, without any improvement and even more with worsening of affective associated symptoms. We managed this case by using a tricyclic antidepressant (clomipramine up to 100 mg/day) with an atypical antipsychotic (quetiapine up to 200 mg/day). We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Hamilton Depression rating Scale (HDRS) at baseline, weekly for the first 2 months and monthly after (follow up 2 years).Results:Patient achieved a very fast and sustained improvement both in obsessive-compulsive and affective symptoms, which provided a very good social and work rehabilitation.Conclusion:Clomipramine-quetiapine combination may be a benefit for OCD refractory to serotonin selective reuptake inhibitors and a safe strategy.

Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH)

2015 ◽  
Vol 34 (1) ◽  
pp. 13-18
Author(s):  
B. Masood ◽  
S. O’Ceallaigh ◽  
T. Thekiso ◽  
M. Nichol ◽  
P. Kowalska-Beda ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Involuntary Admission ◽  
Clinical Predictors ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
Admission Status ◽  
Act Assessment

BackgroundFew studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained.AimsThis study aimed to describe all involuntary admissions to St Patrick’s University Hospital (SPUH) (2011–2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.MethodsAll uses of Mental Health Act 2001 within SPUH 2011–2013 were identified. All uses of Section 23(1) during 2011 were reviewed and relevant documents/case-notes examined using a pro forma covering clinical data, factors recognized to influence involuntary admissions and validated scales were used to determine diagnoses, insight, suicide and violence risk.ResultsOver 2011–2013, 2.5–3.8% of all admissions were involuntary with more detained after use of Section 23(1) than Section 14(2). The majority of initiations of Section 23(1) did not result in an involuntary admission (72%), occurred out of hours (52%) and many occurred early after admission (<1 week, 43%). Initiation of Section 23(1) by a consultant psychiatrist (p=0.001), suicide risk (p=0.03) and lack of patient insight into treatment (p=0.007) predicted conversion to involuntary admission.ConclusionThis study predicts a role for patient insight, suicide risk and consultant psychiatrist decision making in the initiation of Mental Health Act assessment of voluntary patients. Further data describing the involuntary admissions process in an Irish setting are needed.

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