An Analysis of 17 Catatonic Patients Diagnosed With Neuroleptic Malignant Syndrome

CNS Spectrums ◽  
2000 ◽  
Vol 5 (7) ◽  
pp. 58-65 ◽  
Author(s):  
Denise A. C. White ◽  
Ashley H. Robins
Keyword(s):  
Single Dose ◽  
Mental Disorders ◽  
Medical Treatment ◽  
Neuroleptic Malignant Syndrome ◽  
Creatine Phosphokinase ◽  
Predisposing Factor ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Before And After ◽  
Neuroleptic Administration

AbstractThis study was conducted to show that catatonia is a predisposing factor for neuroleptic malignant syndrome (NMS) and to review the nosological relationship between catatonia and NMS. Seventeen consecutive cases of NMS were analyzed prospectively with reference to clinical and investigative findings before and after exposure to a neuroleptic. The series comprised eight males and nine females, ranging in age from 18 years to 65 years. Prior to neuroleptic exposure, all patients exhibited features compatible with criteria for catatonia (mutism/excitement) according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised, (DSM-III-R). Following neuroleptic administration (single dose in nine cases), patients deteriorated into a febrile, rigid, and obtunded state accompanied by autonomic dysfunction and raised creatine phosphokinase levels. These features were consistent with a diagnosis of NMS. Neuroleptics were discontinued and supportive medical treatment instituted. Benzodiazepines were beneficial in eight cases in relieving stupor, but bromocriptine and dantrolene were generally ineffective. In all patients diagnosed with NMS in the authors' series, catatonia was an invariable prodromal state. It appears that the administration of a neuroleptic intensified the preexisting catatonic state and precipitated a malignant variant of the disorder, which is currently recognized as NMS. The authors, therefore, challenge the separate nosological status of NMS and catatonia and suggest that these syndromes are part of a unitary pathophysiological disorder.

Is Lorazepam a Treatment for Neuroleptic Malignant Syndrome?

CNS Spectrums ◽  
2000 ◽  
Vol 5 (7) ◽  
pp. 54-57 ◽  
Author(s):  
Andrew Francis ◽  
Sanjay Chandragiri ◽  
Syed Rizvi ◽  
Monika Koch ◽  
Georgios Petrides
Keyword(s):  
Mental Disorders ◽  
Hospital Admission ◽  
Neuroleptic Malignant Syndrome ◽  
Recovery Time ◽  
Clinical Signs ◽  
Fourth Edition ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm Iv ◽  
Research Criteria

AbstractThe authors assessed the ability of lorazepam and other benzodiazepines to affect the course of neuroleptic malignant syndrome (NMS). Records of inpatients who met both stringent research criteria and criteria under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) (n=11) or DSM-IV criteria alone (n=5)for NMS were identified. All received lorazepam or related benzodiazepines within 24 hours of NMS onset or hospital admission. The records were reviewed for resolution of clinical signs NMS. Rigidity and fever abated within 24—48 hours, while secondary features of NMS were relieved within 64 hours. These results compared favorably with prior reports of 5-day to 10-day recovery periods. Benzodiazepine administration appeared to be well tolerated. Lorazepam and related benzodiazepines may reduce recovery time in NMS.

scholarly journals Early detection of an atypical presentation of neuroleptic malignant syndrome: A case report

2017 ◽  
Vol 7 (3) ◽  
pp. 137-142
Author(s):  
P. Brittany Vickery ◽  
Lindsy Meadowcraft ◽  
Stephen B. Vickery
Keyword(s):  
Case Report ◽  
Mental Disorders ◽  
Neuroleptic Malignant Syndrome ◽  
Dopamine Antagonist ◽  
Atypical Presentation ◽  
Diagnostic Features ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Neurologic Emergency ◽  
Rapid Conversion

Abstract Neuroleptic malignant syndrome (NMS), which is considered a neurologic emergency, is believed to be caused by exposure to dopamine antagonist or withdrawal from a dopamine agonist. This article reports a case of suspected atypical NMS in a patient following rapid conversion of ziprasidone to risperidone without titration. While the initial presentation did not fully meet the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic features, a sequential treatment strategy was initiated and the patient appropriately responded to antipsychotic cessation in addition to combination therapy with dantrolene and bromocriptine. Neuroleptic malignant syndrome diagnostic criteria, treatment, and prognosis are discussed.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Validación de la escala de sintomas somáticos (SSS-8) en pacientes de una zona rural en Ecuador

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Mercy García ◽  
Ernestina Tamami ◽  
Giovanni Rojas-Velasco ◽  
Carolina Posso ◽  
Galo Sánchez del Hierro ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Somatic Symptom ◽  
Symptom Scale ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Calidad De Vida ◽  
Dsm V ◽  
Scale 8

Introducción.- Los síntomas somáticos causan malestar y afectan la calidad de  vida de los pacientes, incrementando la frecuencia del uso de los servicios de salud. En Ecuador no existe un instrumento validado que evalúe somatización. La escala Somatic Symtom Scale-8 (SSS-8), es un instrumento usado como medida de referencia en the Diagnostic and Statistical Manual of Mental Disorders(DSM-V), para evaluar la carga de síntomas somáticos, validada en inglés y adaptada culturalmente a los idiomas alemán y japonés. Objetivos.- En esta investigación el propósito fue validar la escala “Somatic Symptom Scale-8” y determinar sus propiedades métricas. Métodos.- Investigación descriptiva y transversal en la que se realizó la validación de la herramienta clínica SSS-8 en 401 pacientes en la consulta externa del hospital Pedro Vicente Maldonado, desde mayo a julio de 2017. Para el análisis de datos se utilizaron los programas estadísticos SPSS versión 23, Latent gold y EpiDat 3.1. Resultados.- El grupo mayoritario fue de 30 a 47 años, con ligero predominio del sexo masculino (con 52,6%) sobre el femenino (47,4%). El SSS-8 mostró adecuadas propiedades métricas (alfa de Cronbach de 0,73). Mediante este análisis se obtuvo que, los pacientes que respondieron: algo, bastante o muchísimo en las dimensiones sentirse cansado, dolor de cabeza, dolor de brazos y dolor de espalda; tenían un 99% de probabilidades de presentar somatización. Conclusiones.- En este estudio, el SSS-8 demostró ser una herramienta útil para evaluar los síntomas somáticos en pacientes que acuden a consulta externa, ya que presentó buenas propiedades métricas: consistencia interna elevada, buena validez y una apropiada capacidad discriminativa.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

scholarly journals Use of empathy in psychiatric practice: Constructivist grounded theory study

BJPsych Open ◽  
2017 ◽  
Vol 3 (1) ◽  
pp. 26-33 ◽  
Author(s):  
James Ross ◽  
Chris Watling
Keyword(s):  
Grounded Theory ◽  
Mental Disorders ◽  
Major Elements ◽  
Qualitative Theory ◽  
Constructivist Grounded Theory ◽  
Psychiatric Practice ◽  
Teaching Approaches ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Iterative Coding

BackgroundPsychiatry has faced significant criticism for overreliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and medications with purported disregard for empathetic, humanistic interventions.AimsTo develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches.MethodThis study used constructivist grounded theory methodology to ask (a) ‘How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?’ and (b) ‘How do psychiatrists learn and teach the skills of empathetic engagement?’ The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data.ResultsThis constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional.ConclusionsParticipants were described by empathy-based interventions which are presented in a theory of ‘empathetic engagement’. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice.

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