A nationwide study on delirium in psychiatric patients from 1995 to 2011

2013 ◽  
Vol 26 (4) ◽  
pp. 234-239 ◽  
Author(s):  
Anne Sofie Lundberg ◽  
Niels Okkels ◽  
Lea Nørgreen Gustafsson ◽  
Janne Tidselbak Larsen ◽  
Lisbeth Uhrskov Sørensen ◽  
...  

ObjectivesDelirium shares symptoms with some mental illnesses. This may lead to misdiagnosis of delirium in psychiatric patients and a risk of inadequate management. Moreover, literature on delirium in psychiatric patients is sparse. The aim was to analyse possible changes in the diagnostic incidence of delirium in psychiatric patients from 1995 to 2011, and to investigate the patients with regard to sex, age, and type of patient.MethodsAll first time ever diagnoses of delirium among psychiatric patients were identified in the nationwide Danish Psychiatric Central Research Register (DPCRR) from 1995 to 2011. The delirium diagnoses include (1) delirium unspecified, (2) delirium with dementia, and (3) drug-related delirium, all in accordance with International Classification of Diseases-10. The incidence rates were age standardised.ResultsA total of 15 680 persons diagnosed with delirium for the first time were identified in the DPCRR between 1995 and 2011. The total incidence rate of delirium has decreased, reaching 8.4/1000 person-years in 2011. In 2011, 2.6% of the demented patients were diagnosed with delirium with dementia. Diagnosis of delirium is significantly more common in men, and the three groups of delirium showed a characteristic age distribution.ConclusionOur incidences were markedly lower when compared with previous studies. This suggests a possible underdiagnosis of delirium in psychiatric hospitals and should be investigated further, as delirium is a serious state and identifying the syndrome is important for sufficient treatment.

2017 ◽  
Vol 42 (7) ◽  
pp. 673-677 ◽  
Author(s):  
J. Nordenskjöld ◽  
M. Englund ◽  
C. Zhou ◽  
I. Atroshi

The prevalence and incidence of doctor-diagnosed Dupuytren’s disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren’s disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren’s disease; the prevalence among men was 1.35% and among women 0.5%. Of all people diagnosed, 56% had received treatment (87% fasciectomy). In 2013, the incidence of first-time doctor-diagnosed Dupuytren’s disease among men was 14 and among women five per 10,000. The annual incidence among men aged ⩾50 years was 27 per 10,000. Clinically important Dupuytren’s disease is common in the general population. Level of evidence: III


Author(s):  
Kurian Jose ◽  
Christoday R. J. Khess. ◽  
N. A. Uvais

Background: Marital quality is considered as a significant part of social well-being. Poor marital quality adversely affects physical and mental health as well as the overall quality of life. Moreover, it can significantly affect the course of alcohol dependance syndrome. The aim this study was to compare the marital quality among patients with alcohol dependance syndrome who are admit-ted for the first time and patients with alcohol dependance syndrome (ADS) who are admitted for multiple times.Methods: The sample consisted of each 30 patients with alcohol dependance syndrome who are admitted for the first time and patients with alcohol dependance syndrome who are admitted for multiple times, diagnosed as per international classification of diseases-10 diagnostic criteria for research. The sample population was evaluated using Severity of Alcohol Dependence Questionnaire and The Marital Quality Scale. The data was analysed using SPSS-16.0.Results: The severity of alcohol dependance was found to be significantly higher in the repeatedly hospitalised group when compared to first time admitted patients with ADS (p<0.01). The repeatedly hospitalised patients are found to be having significantly poor Marital Quality in the domains of Understanding, Rejection, Satisfaction, Affection, Despair, Decision Making, Dominance, Self-Disclosure, Trust and Role Functioning, when compared to first time admitted patients (p<.001).Conclusions: How problem use of alcohol affect marital quality is not settled in research till date, though most of the studies suggest a negative correlation. There are contradictory hypotheses regarding the effects of alcohol use on marital quality. Our study showed that patients with severe degrees alcoholism and who are admitted repeatedly have poor marital quality when compared to patients with lesser severity of alcoholism and admitted for the first time in Indian context.


Author(s):  
Stephen J. Glatt ◽  
Stephen V. Faraone ◽  
Ming T. Tsuang

The diagnosis of schizophrenia cannot be made based on the results of an ob­jective diagnostic test or laboratory measure, though we and others are working towards this. Instead, clinicians diagnose schizophrenia based on behaviour and psychopathology (including the symptoms described in the previous chapter). These require the subjective interpretation of clinicians, but they can be as­sessed reliably. The definitions of major mental illnesses used by clinicians are presented in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (in the United States) and the World Health Organization’s International Classification of Diseases (ICD) in other countries. These def­initions are updated from time to time to reflect gains in knowledge, or to reflect modern thinking on the similarities and differences between certain disorders. From one edition to the next, some diagnoses are revised, some are added, and some vanish altogether, only to be replaced or absorbed under other diagnoses. The diagnostic criteria for schizophrenia as defined by the most recent version of the DSM (DSM- 5) include the presence of two or more of the following symptoms: delusions, hallucinations, disorganized speech, disorganized or cata­tonic behaviour, and negative symptoms. At least one of the two must be delu­sions, hallucinations, or disorganized speech, while the second symptom type required for diagnosis could be any of the remaining four criteria. The require­ment of delusions, hallucinations, or disorganized speech maintains the resem­blance of the modern- day diagnosis to that first described by the clinician Emil Kraepelin over a century ago. Kraepelin’s discovery that schizophrenia is marked by a chronic and gradually worsening course is seen in modern- day criteria as well. A DSM-5 diagnosis of schizophrenia requires continuous signs of illness for at least 6 months, during which the individual must show at least 1 month of active symptoms (less if well treated). The diagnosis also requires social or work deterioration over a signifi­cant amount of time. Lastly, the diagnosis requires that the observed symptoms are not due to some other medical condition, including other psychiatric disorders such as bipolar disorder or major depressive disorder.


2009 ◽  
Vol 138 (5) ◽  
pp. 677-682 ◽  
Author(s):  
K. D. SIRCAR ◽  
E. BANCROFT ◽  
D. M. NGUYEN ◽  
L. MASCOLA

SUMMARYHospital discharge reports have provided data for studies of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft-tissue infection (SSTI) studies. This analysis determined the sensitivity and positive predictive value of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code combinations to calculate hospitalization incidence rates, representativeness of a set of three ICD-9-CM codes to define MRSA SSTI, and hospitalization incidence rate trends for paediatric MRSA SSTIs in Los Angeles County (LAC). Using 133 cases from 31 hospitals, we found that the set of three ICD-9-CM codes used to define laboratory-confirmed cases had one of the highest positive predictive values (49%). There was no difference in age and race between those categorized using three codes vs. other code combinations. A dramatic increase in paediatric MRSA SSTI cases occurred in LAC during 1998–2006. We conclude that this combination of codes may be used to determine the rise of MRSA SSTIs in paediatric populations.


Author(s):  
Aina Faus-Bertomeu ◽  
Rosa Gómez-Redondo

A pesar del conocimiento acumulado sobre mortalidad y longevidad se hace imprescindible conocer con mayor profundidad la cuarta fase de la Transición Epidemiológica en la que se encuentra España, como otros países de su entorno, para anticipar la emergencia de un nuevo escalón en la Transición Sanitaria así como su impacto social en los años venideros. Para ello, se precisa del análisis de datos de mortalidad por  causas de muerte con el objeto de seguir su evolución y cambios. No obstante la codificación de las causas de muerte se interrumpe con las sucesivas revisiones a la Clasificación Internacional de Enfermedades (CIE). Por ello, se utiliza la metodología de la reconstrucción de causas de muerte propuesta por France Meslé y Jacques Vallin (1988, 1996), de aplicación en la comunidad científica de los países que forman parte de la red internacional Mortality, Divergence and Causes of Death (MODICOD) y en la que las autoras participan en representación de España. El presente trabajo describe las fases de dicho protocolo y lo ejemplifica con los datos de causas de muerte españolas para el periodo 1980- 2012, reconstruyendo las series entre la CIE-9 y la CIE-10. Los resultados obtenidos garantizan el seguimiento de 6.902 rúbricas de causas de muerte continuas y homogeneizadas que por primera vez se establece a nivel de desagregación del cuarto dígito de la CIE-10 configurándose como un instrumento metodológico en el análisis demográfico-epidemiológico.Despite the accumulated knowledge about mortality and longevity, it is essential to know in the depth of the fourth phase of the Epidemiological Transition in which Spain, like other neighboring countries, is in to anticipate a new step in the Health Transition as well as its impact in the coming years. In this context, the analysis of the data of the causes of death is necessary in order to follow its evolution and changes. However, the codification of causes of death is interrupted by the successive revisions to the International Classification of Diseases and Related Health Problems (ICD). For this reason, the methodology of the reconstruction of causes of death proposed by France Meslé and Jacques Vallin (1988, 1996) is used and applied in the countries that are part of the international network Mortality, Divergence and Causes of Death (MODICOD) and in which the authors participate in representation of Spain. The present work describes the phases of this protocol and exemplifies it with the date of Spanish causes of death for the period 1980 to 2015, reconstructing series between ICD-9 and ICD-10. The results obtained ensuring the monitoring of 6,902 rubrics of continuous and homogenized causes of death at a fourth digit level of the ICD-10, which for the first time is established at a level of the fourth digit of the ICD-10, that are configured as a demographic-epidemiological methodological instrument.


1988 ◽  
Vol 152 (S1) ◽  
pp. 38-43 ◽  
Author(s):  
J. E. Mezzich

As work proceeds on the development of the Tenth Revision of the International Classification of Diseases (ICD-10) widespread interest has been expressed in the preparation of a multiaxial diagnostic schema for psychiatric patients. In consideration of this task, the present paper briefly notes pertinent international experience on multiaxial diagnosis, the discernible purposes of this approach, design requirements, and a specific multiaxial proposal.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. DiFranza

Aims:The risk factors for trying a cigarette are well known, however we were interested in the factors that determine which youths become addicted to nicotine once they have tried it.Method:To investigate this we followed a cohort of 1246 students (mean baseline age of 12.2 years) over 4 years. Subjects underwent 11 interviews during which we assessed 45 risk factors, measured diminished autonomy over tobacco with the Hooked On Nicotine Checklist, and evaluated tobacco dependence using the International Classification of Diseases-10th revision. Cox proportional hazards models were used.Results:Among 217 youths who had inhaled from a cigarette, the loss of autonomy over tobacco was predicted by feeling relaxed the first time inhaling from a cigarette (adJusted Hazard Ratio (HR)=3.26; 95% CI, 1.95-5.46; P< .001) and depressed mood (HR=1.29; 1.09-1.54; P=.004). Tobacco dependence was predicted by feeling relaxed (HR=2.43; 1.27-4.65; P=.007), familiarity with Joe Camel (HR=2.19; 1.11-4.32; P=.02), novelty seeking (HR=1.56; 1.06-2.29; P=.02), and depressed mood (HR=1.17; 1.04-1.30; P=.007).Conclusion:Once exposure to nicotine had occurred, remarkably few risk factors for smoking consistently contributed to individual differences in susceptibility to the development of dependence. An experience of relaxation in response to the first dose of nicotine was the strongest predictor of both dependence and lost autonomy. This association was not explained by trait anxiety or many other psychosocial factors. These results are discussed in relation to the theory that addiction is initiated by the first dose of nicotine.


2018 ◽  
Vol 107 (2) ◽  
pp. 172-179 ◽  
Author(s):  
L. Kavaja ◽  
A. Malmivaara ◽  
T. Lähdeoja ◽  
V. Remes ◽  
R. Sund ◽  
...  

Background and Aims: Shoulder capsular surgery is nowadays usually performed arthroscopically, and the proportion of arthroscopic method has rapidly increased during the last two decades. We assessed the incidence of shoulder capsular surgery procedures in Finland between 1999 and 2008. Material and Methods: We gathered the shoulder capsular surgery procedures for all kinds of shoulder instability in Finland between 1999 and 2008 from National Hospital Discharge Register and limited the patient material to include only certain diagnosis (International Classification of Diseases, 10th Edition) and Nordic Medico-Statistical Committee procedure code combinations. We analyzed the data in the whole country, between different age groups, and in university hospital districts. Results: The total incidence of shoulder capsular surgery procedures in Finland increased from 17 to 33 per 100,000 person-years. The incidence of arthroscopic procedures increased from 11 to 30 per 100,000 person-years and the proportion of arthroscopic procedures increased from 63% to 92% between years 1999 and 2007. The incidence of shoulder capsular surgery procedures increased on average around 90% in almost all age groups and particularly in the older age groups. We observed no significant geographical variation between university hospital districts. Conclusion: The incidence of shoulder capsular surgery procedures increased on average round 90% in almost all age groups. It seems to be difficult to support the rapidly increased rates of shoulder capsular surgery procedures or the arthroscopic method based on scientific evidence. While also older patients are treated with shoulder capsular surgery, well-defined indications for surgical intervention are needed so that the operations are conducted for the symptomatic patients benefitting most regardless of patients’ age.


2018 ◽  
Vol 12 (2) ◽  
pp. 56 ◽  
Author(s):  
Zahra Tolou Ghamari ◽  
Farhad Tadayon ◽  
Hamid Mazdak

Background: Liver cancer remains to grow worldwide. We aimed to describe the period prevalence (PP) and incidence rates (Irs) for liver cancer in Isfahan Province that is located in the center of Iran and ranked as the third province in terms of population.Methods: Information related to the Surveillance, Epidemiology, and End Results; (SEER) was collected from the Isfahan Cancer Registry. Period prevalence (PP) was calculated per 100,000 people. The cancer sites studied were defined according to the International Classification of Diseases (ICD-O; Third Edition) and recorded by topography code (C22).Result: Among all registered liver cancer patients, 57% of the 920 cases were male. The mean age of the patients was 65.9 ± 16.8 years. Reported age in 13% of the patients was less than 50 years and as high as 84% were in between 50 to 90 years. With a total PP of 18.5 per 100,000 people, this value was 24.4% higher in males when compared to females (16.8 vs. 20.9). In the previous years, incidences were 3.9 (2011-2012), 5.3 (2012-2013), 4.9 (2013-2014) and 4.2 (2014-2015) per 100,000 people. There were 89% reported deaths among the total population.Conclusion: The PP for liver cancer in male population was approximately 24.4% higher than females. There was a 7.7% increase in the Irs over the study period. Further study toward estimation of the proportion of the causes of liver cancer and deaths due to infection of hepatitis B and C virus, exposure to aflatoxin, alcohol drinking and smoking seem to be advantageous. Therefore, the plan of healthcare system should focus on greater effort toward strategic evidence-based pharmacotherapy in Isfahan province/Iran.


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