Special Populations

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S3) ◽  
pp. 36-42 ◽  
Author(s):  
Joseph Zohar ◽  
Leah Fostick ◽  
Donald W. Black ◽  
Juan J. Lopez-Ibor
Keyword(s):  
Psychiatric Disorders ◽  
Treatment Response ◽  
Primary Care Physicians ◽  
Clinical Symptoms ◽  
Public Health Problem ◽  
World Health ◽  
Elderly Persons ◽  
Late Adolescent ◽  
Compulsive Disorder ◽  
Comorbid Psychiatric Disorders

AbstractObsessive-compulsive disorder (OCD) is a formidable public health problem, rated by the World Health Organization as one of the top 20 most disabling diseases.The shame and secrecy associated with OCD, as well as the lack of recognition of its characteristic symptoms, particularly by primary care physicians, hinders appropriate diagnosis and treatment. Most adults with OCD report a late adolescent or early adulthood onset, yet OCD can occur throughout the life span. Pre-school children have been known to develop the disorder, as have elderly persons. OCD can cause considerable distress and disability; for example, children may fall behind in their education, and adults can become housebound. Comorbid psychiatric disorders have become an area of intense interest. Comorbid depression for example, is frequently the symptom that leads the individual to seek treatment. Patients with schizophrenia frequently develop obsessions and compulsions, and these symptoms are associated with a poorer outcome. The role of second-generation antipsychotics merits further study in the treatment of this subset of patients. An important step toward delineating specific subgroups within the OCD-schizophrenia axis may be the use of endophenotypic markers. Unfortunately, many patients with OCD will have a less than optimal treatment response. Poor treatment response is associated with serious social disability, but there are few clues to guide clinicians in predicting treatment response in patients with OCD, in terms of specific demographic variables, clinical symptoms, or the presence of comorbid psychiatric disorders.

scholarly journals Mental and Behavioural Disorders of Childhood and Adolescence: An Observational Study

2021 ◽  
pp. 189-194
Author(s):  
Shyamanta Das ◽  
Soumitra Ghosh ◽  
Dhrubajyoti Bhuyan ◽  
Hiranya Saikia ◽  
Hiranya Kumar Goswami ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Developmental Disorders ◽  
World Health ◽  
Childhood And Adolescence ◽  
Behavioural Disorders ◽  
Compulsive Disorder ◽  
Oppositional Defiant ◽  
Type 3 ◽  
Disorder Type

Background: There is overlap of symptoms in psychiatric disorders, especially in mental and behavioural disorders of childhood and adolescence. Half of all lifetime psychiatric disorders tend to arise by age 14 years and three fourths of them arise by age 24 years. Aim: To study the various types of mental and behavioural disorders of childhood and adolescence, and to find out comorbidities within and across the types. Methods: An observational cross-sectional study was carried out over a period of one year in the psychiatry department of a tertiary care general hospital. The psychiatric diagnoses according to the World Health Organization’s (WHO) tenth revision of the International Statistical Classification of Health and Related Problems (ICD-10) were categorised into type 1 (depression, anxiety, obsessive-compulsive disorder, and somatoform disorder), type 2 (attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder), type 3 (mental retardation, developmental disorders of speech and language, and scholastic skills, and pervasive developmental disorders). Descriptive statistics was used with frequency and percentage. Results: Total sample size was 137. Children and adolescents were almost equally distributed. Boys were more than girls. Type 3 disorders were maximum. Adolescents had mostly type 1 disorders. Children had mostly type 3 disorders. Girls had almost same number of type 1 and type 3 disorders. Boys had mostly type 3 disorders. Within group comorbidity was mostly with type 3 disorders. Across group comorbidity was highest in type2-type 3 disorders. Conclusion: Mental and behavioural disorders in childhood and adolescence do vary according to age and sex, and their recognition will help in the early diagnosis and proper management.

Healthy living and smart choices - A project for developing a web-based Turkish obesity treatment program

2016 ◽  
Vol 33 (S1) ◽  
pp. S390-S390
Author(s):  
C. Hepdurgun ◽  
H. Elbi ◽  
Ş. Pırıldar ◽  
F.L. Saygılı ◽  
M.O. Ünalır ◽  
...  
Keyword(s):  
Treatment Program ◽  
Primary Care Physicians ◽  
Behavioral Treatment ◽  
Public Health Problem ◽  
World Health ◽  
Major Public Health Problem ◽  
Healthy Weight ◽  
Behavioral Strategies ◽  
Web Based ◽  
The World

IntroductionObesity is a major public health problem in the world and getting obesity under control is one of the most important goals of the World Health Organization. Cognitive behavioral therapy techniques are helpful for adjusting lifestyle to stay at a healthy weight range. Success of web-based programs which designed with evidence-based behavioral strategies has been proven with different studies. However, a web-based program suitable for Turkish culture and eating habits is still missing.ObjectivesPrimary objective of this project is to develop and test a web-based obesity behavioral treatment program in collaboration with experienced academicians from different disciplines.AimsThe aim of this project is to develop a program which will help Turkish primary care physicians in treating and tracking obesity patients.MethodThe web-based program will include a 12-week-long core behavioral program. Participants will be asked to record their daily dietary intakes and automatic feedback will be given by the system. Weekly behavioral training videos will be available during the core program. As participants watch the videos and record their daily intakes, they will get instant awards such as virtual diet-coin which they will be able to spend for gifts such as low calorie recipes. One hundred obese patients (with body mass index greater than 30 kg/m2) will be recruited to evaluate the effectiveness of the program. The changes in their blood pressures, body weights and waist circumferences will be recorded.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Attention Deficit Hyperactivity Disorder and Psychiatric Comorbidities

2020 ◽  
Vol 9 (1) ◽  
pp. 27-34
Author(s):  
Mengühan Araz Altay ◽  
Işık Görker ◽  
Begüm Demirci Şipka ◽  
Leyla Bozatlı ◽  
Tuğçe Ataş
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Primary Care Physicians ◽  
Psychiatric Comorbidity ◽  
Psychiatric Comorbidities ◽  
Comorbid Psychiatric Disorders ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant ◽  
And Gender

Aim: This study aims to obtain current information on the clinical features of attention deficit hyperactivity disorder cases, comorbid psychiatric disorders and psychiatric drug use. Methods: All patients between the ages of 6 and 18 years who were admitted to our outpatient clinic and diagnosed with attention deficit hyperactivity disorder were included in the study. The files of the patients were examined and their demographic characteristics, symptoms, psychiatric diagnoses and drug profiles were recorded. The pattern of the psychiatric disorders accompanied by attention deficit hyperactivity disorder cases and the differences according to age and gender were analyzed. The differences were determined in patients with psychiatric comorbidity compared to those without. Result: The mean age of the 777 patients included in the study was 11.1±2.94 and 76.6% were boys. 60.9% of attention deficit hyperactivity disorder patients had comorbid psychiatric disorders. The most common psychiatric comorbidities were specific learning disability (23.6%), oppositional defiant disorder (12.9%) and conduct disorder (12.1%). There was no difference between the genders in terms of the incidence of psychiatric comorbidities. The rate of psychiatric comorbidity was significantly higher in adolescents than in children. A psychotropic medication was used in 86.4% of the cases and psychotropic polypharmacy was present in 31.5%. The rate of polypharmacy was significantly higher in the group with psychiatric comorbidity. Conclusion: Attention deficit hyperactivity disorder is frequently accompanied by other psychiatric disorders and the psychiatric comorbidity leads to a more complicated clinical profile. Approximately one-third of attention deficit hyperactivity disorder patients have psychiatric polypharmacy and these patients should be carefully monitored. Primary care physicians who are frequently confronted with attention deficit hyperactivity disorder cases should be careful about psychiatric comorbidities. Keywords: Child psychiatry, attention deficit hyperactivity disorder, mental disorders, Family practice

scholarly journals Pathogenesis of Onchocercal Keratitis (River Blindness)

1999 ◽  
Vol 12 (3) ◽  
pp. 445-453 ◽  
Author(s):  
Laurie R. Hall ◽  
Eric Pearlman
Keyword(s):  
Inflammatory Response ◽  
Clinical Symptoms ◽  
Corneal Stroma ◽  
Public Health Problem ◽  
Experimental Models ◽  
World Health ◽  
River Blindness ◽  
Anterior Portion ◽  
Immunological Mechanisms ◽  
Interstitial Keratitis

SUMMARY Onchocerciasis is a major cause of blindness. Although the World Health Organization has been successful in reducing onchocerciasis as a public health problem in parts of West Africa, there remain an estimated 17 million people infected with Onchocerca volvulus, the parasite that causes this disease. Ocular pathology can be manifested in any part of the eye, although disease manifestations are frequently characterized as either posterior or anterior eye disease. This review focuses on onchocerca-mediated keratitis that results from an inflammatory response in the anterior portion of the eye and summarizes what is currently known about human disease. This review also describes studies with experimental models that have been established to determine the immunological mechanisms underlying interstitial keratitis. The pathogenesis of keratitis is thought to be due to the host inflammatory response to degenerating parasites in the eye; therefore, the primary clinical symptoms of onchocercal keratitis (corneal opacification and neovascularization) are induced after injection of soluble O. volvulus antigens into the corneal stroma. Experimental approaches have demonstrated an essential role for sensitized T helper cells and shown that cytokines can regulate the severity of keratitis by controlling recruitment of inflammatory cells into the cornea. Chemokines are also important in inflammatory cell recruitment to the cornea, and their role in onchocerciasis is being examined. Further understanding of the molecular basis of the development of onchocercal keratitis may lead to novel approaches to immunologically based intervention.

scholarly journals An IoT-Based Glucose Monitoring Algorithm to Prevent Diabetes Complications

2020 ◽  
Vol 10 (3) ◽  
pp. 921
Author(s):  
Francisco Valenzuela ◽  
Armando García ◽  
Erica Ruiz. ◽  
Mabel Vázquez ◽  
Joaquín Cortez ◽  
...  
Keyword(s):  
Critical Condition ◽  
Moving Average ◽  
Glucose Monitoring ◽  
Public Health Problem ◽  
World Health ◽  
Elderly Persons ◽  
Glucose Levels ◽  
Normal Limits ◽  
Health Organization ◽  
The Impact

Diabetes mellitus (DM) is a metabolic disorder characterized by blood glucose levels above normal limits. The impact of this disease on the population has increased in recent years. It is already a public health problem worldwide and one of the leading causes of death. Recently, several proposals have been developed for better and regular monitoring of glucose. However, theses proposals do not discard erroneous readings and they are not able to anticipate a critical condition. In this work, we propose an algorithm based on the double moving average supported by an IoT architecture to prevent possible complications in elderly patients. The algorithm uses historical readings to construct a series. Given a number of periods, it is possible to calculate averages of different subsets and trends for the next periods and, in this way, the prognosis is obtained. With the prognosis, it is possible to notify the doctor and relatives in advance about a possible critical condition in the patient. The aim of our work is to validate the architecture and prognosis algorithm used for elderly persons. Tests of the algorithm and the architecture were performed with different readings and it was shown that the system generated corresponding notifications before the glucose values were higher than those defined by the WHO (World Health Organization), thus avoiding unnecessary alarms.

scholarly journals Brain Versus Blood: A Systematic Review on the Concordance Between Peripheral and Central Kynurenine Pathway Measures in Psychiatric Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Katrien Skorobogatov ◽  
Livia De Picker ◽  
Robert Verkerk ◽  
Violette Coppens ◽  
Marion Leboyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychiatric Disorders ◽  
Treatment Response ◽  
Clinical Symptoms ◽  
Psychiatric Patients ◽  
Kynurenine Pathway ◽  
Primary Objective ◽  
Original Research ◽  
Psychiatric Illnesses ◽  
Predictive And Prognostic Biomarker

ObjectiveDisturbances in the kynurenine pathway have been implicated in the pathophysiology of psychotic and mood disorders, as well as several other psychiatric illnesses. It remains uncertain however to what extent metabolite levels detectable in plasma or serum reflect brain kynurenine metabolism and other disease-specific pathophysiological changes. The primary objective of this systematic review was to investigate the concordance between peripheral and central (CSF or brain tissue) kynurenine metabolites. As secondary aims we describe their correlation with illness course, treatment response, and neuroanatomical abnormalities in psychiatric diseases.MethodsWe performed a systematic literature search until February 2021 in PubMed. We included 27 original research articles describing a correlation between peripheral and central kynurenine metabolite measures in preclinical studies and human samples from patients suffering from neuropsychiatric disorders and other conditions. We also included 32 articles reporting associations between peripheral KP markers and symptom severity, CNS pathology or treatment response in schizophrenia, bipolar disorder or major depressive disorder.ResultsFor kynurenine and 3-hydroxykynurenine, moderate to strong concordance was found between peripheral and central concentrations not only in psychiatric disorders, but also in other (patho)physiological conditions. Despite discordant findings for other metabolites (mainly tryptophan and kynurenic acid), blood metabolite levels were associated with clinical symptoms and treatment response in psychiatric patients, as well as with observed neuroanatomical abnormalities and glial activity.ConclusionOnly kynurenine and 3-hydroxykynurenine demonstrated a consistent and reliable concordance between peripheral and central measures. Evidence from psychiatric studies on kynurenine pathway concordance is scarce, and more research is needed to determine the validity of peripheral kynurenine metabolite assessment as proxy markers for CNS processes. Peripheral kynurenine and 3-hydroxykynurenine may nonetheless represent valuable predictive and prognostic biomarker candidates for psychiatric disorders.

Family Accommodation in OCD

2017 ◽  
Author(s):  
Kristin Koller ◽  
Eli R. Lebowitz
Keyword(s):  
Psychiatric Disorders ◽  
Treatment Response ◽  
Empirical Research ◽  
Clinical Course ◽  
Treatment Programs ◽  
Obsessive Compulsive ◽  
Family Accommodation ◽  
Compulsive Disorder ◽  
The Impact

The impact of psychiatric disorders often goes beyond the affected individual, extending to family members, partners, and close friends. This is certainly true in obsessive-compulsive disorder (OCD). Clinical experience and empirical research have long shown that relatives of individuals with OCD commonly become involved in the symptoms of the disorder, through a process known as family accommodation. Family accommodation has important implications for the conceptualization, clinical course, and treatment of OCD. This chapter provides a brief review of family accommodation in OCD and its implications for the disorder’s clinical course. It also addresses the role of family accommodation in treatment response and highlights some novel interventions that have incorporated a focus on family accommodation in OCD treatment programs.

Patients profile with obsessive-compulsive disorder attending to psychiatric emergency department

2011 ◽  
Vol 26 (S2) ◽  
pp. 976-976
Author(s):  
M.J. Mota Rodríguez ◽  
A. Pampin Alfonso ◽  
J. Portillo Díez ◽  
P. De Usabel Guzmán ◽  
M. Pérez García
Keyword(s):  
Emergency Department ◽  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Rural Areas ◽  
Anxiety Symptoms ◽  
Psychiatric Emergency ◽  
Psychiatric Evaluation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Comorbid Psychiatric Disorders

IntroductionPrevalence of obsessive-compulsive disorder (OCD) in general population is 2–3%. This high prevalence is not often reflected in number of assitances to Emergency Department. There are few studies that analyze the characteristics of OCD patients assisting to psychiatric emergency services.ObjectiveTo establish the profile of these patients, determining aswell their type of emergency assistance, time distribution and why they relapse. We used the SPSS 17 package.MethodsA retrospective and descriptive study of attendances at the Psychiatry Emergency Department of Hospital Clínico Universitario de Santiago de Compostela in a sample of patients fitting the ICD-10 criteria for OCD diagnosis (n = 45). Time period: from 9TH July 2007 to 26TH September 2010.ResultsFrom 5091 attendances at the Psychiatry Emergency Department, 45 patients had an OCD diagnosis (57.8% women), with a mean age of 33.31 ± 11.58 years. 68.9% came from rural areas. 44.4% had comorbid psychiatric disorders.68.9% came by own initiative. In 28.9% the consultation was anxiety, 15.6% obsessive symptoms and 11% affective symptoms. 13.3% were admitted to a psychiatric ward.There was lower attendance between 0:00–08:00 AM and on Fridays. The months with more attendance were August and September.12% had more than one assitance, 85.7% were women with anxiety symptoms (38%) and with personality disorder as the most frequent comorbid diagnosis.ConclusionsPatient's profile: “33 years old female from countryside, presenting anxiety symptoms, who comes only once and by own initiative. Doesn’t have comorbid psychiatric disorders. After the psychiatric evaluation she is discharged to outpatient's psychiatric follow-up”.

scholarly journals The Therapeutic Effect of Electroconvulsive Therapy in Obsessive-Compulsive Disorder Patients: A Quasi-Experimental Study

2021 ◽  
Vol 0 (0) ◽  
pp. 1-23
Author(s):  
Seyed Gholamreza Noorazar ◽  
◽  
Somayyeh Emamizad ◽  
Ali Fakhari-Dehkharghani ◽  
◽  
...  
Keyword(s):  
Experimental Study ◽  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Electroconvulsive Therapy ◽  
P Value ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Comorbid Psychiatric Disorders ◽  
Quasi Experimental

Background: Electroconvulsive therapy (ECT) is demonstrated to be an effective treatment in some psychiatric disorders. It is postulated ECT should primarily be considered for patients with treatment-resistant obsessive-compulsive disorder (OCD) in the context of major depression. Therefore, we aimed to evaluate the efficacy of ECT in OCD patients without comorbid psychiatric disorders. Methods: This quasi-experimental study was conducted on 12 adult patients with severe OCD (Yale-Brown test score above 25) and no comorbid psychiatric disorders referred to a tertiary care hospital for psychiatric disorders. Treatment was administered three times a week for up to three to four weeks (a minimum of 8 sessions and a maximum of 12 sessions). We completed the Yale-Brown test for all the patients exactly before ECT, on the exact day after applying ECT, and two months after the final ECT session in order to evaluate the effect of therapy. Results: Yale-Brown score of patients significantly decreased after the ECT sessions from 28.08 ± 2.50 to 17.17 ± 3.78 (P-value, 0.043). After treatment, the severity of OCD improved in all patients and reduced to mild and moderate levels in 4 (33.3%) and 8 (66.7%) patients, respectively. After two months the mean Yale-Brown score slightly increased to 18.08 ±1.62 (P-value, 0.125) and the severity of OCD in all 12 patients (100%) became moderate. Nevertheless, in none of them, the Yale-Brown score increased up to the baseline value in this period. None of the patients developed significant side effects during/after ECT sessions. Conclusion: ECT was a safe and effective therapeutic strategy for patients with treatment-resistant OCD with no comorbid psychiatric disorders in our study. However, further randomized controlled trials are required to validate the efficacy of ECT for OCD treatment before implementing it into routine clinical practice.

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