Easing the Burden of Panic Disorder: Comorbidity, Diagnosis, and Implications for Treatment

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S12) ◽  
pp. 5-11 ◽  
Author(s):  
David Baldwin
Keyword(s):  
Panic Disorder ◽  
Correct Diagnosis ◽  
Somatic Symptoms ◽  
High Rate ◽  
Increased Risk ◽  
Medical Consultations ◽  
Substance Abuse Disorders ◽  
The Individual ◽  
Medical Morbidity

AbstractPanic disorder (PD) is typically a distressing, chronic, and recurrent mental disorder associated with a high rate of comorbidity with other mood, anxiety, and substance abuse disorders, increased risk of medical morbidity and mortality, and marked impairment of functioning and reduced quality of life. Most patients with PD first seek treatment in emergency room or general practice settings. In the overwhelming majority of cases, PD patients present with primarily somatic symptoms, many of which are common to medical illnesses. It is, therefore, not surprising that PD is often misdiagnosed and that patients with this disorder often spend years seeking treatment and undergoing costly and unnecessary tests and medical consultations before receiving a correct diagnosis. Better diagnosis and treatment of PD to achieve remission and prevent relapse has the potential to reduce the burden of this illness to the individual and society.

Mental health in the workplace

2011 ◽  
Vol 26 (S2) ◽  
pp. 694-694 ◽  
Author(s):  
H.Ø. Sørensen ◽  
P. Munk-Joergensen
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Psychiatric Symptoms ◽  
Correct Diagnosis ◽  
Mental Illnesses ◽  
The Public ◽  
Need For Treatment ◽  
Increased Risk ◽  
The Individual

IntroductionDepression and simple phobia are the most prevalent mental illnesses among employees leading to an increased number of sick days, decreased social and professional function, job satisfaction, quality of life and increased risk of loss of work.Around 25% of the working population is affected by psychiatric symptoms in a way that is painful to the individual, but not of such severity that is qualifies as a genuine disease.Untreated and not early identified these cases could lead to actual mental illness.Moreover, less than half of those currently suffering from depression are provided with the correct diagnosis in general practice, and less the half, diagnosed correctly, receive the proper medical treatment.ObjectivesTo identify, treat and thereby interrupt pre-existing cases of mental illness in the workplace. To prevent worsening of minor cases of psychiatric illness and symptomatic cases not considered a genuine disease.AimsTo develop models for early tracing and treatment of mental illness in the workplace with consequent improved health status and quality of life for the individual and improved economy for the workplace and the public.MethodsThis intervention study includes larger companies with more than 100 employees in the Region of North Denmark.The study design is a before-after study using self-reporting questionnaires as a basis for identification of cases of mental illness and follow-up of treatment. The study uses clinical interview and examination for determining the need for treatment.ResultsResults not yet available.

scholarly journals The Canadian Migraine Forum

2007 ◽  
Vol 34 (4) ◽  
pp. s1-s26
Keyword(s):  
Correct Diagnosis ◽  
Health Related Quality ◽  
The Public ◽  
The Family ◽  
Related Quality ◽  
Health Related ◽  
Degree Of Disability ◽  
The Individual ◽  
The Impact

ABSTRACT:The goal of the Canadian Migraine Forum was to work towards improving the lives of Canadians with migraine by reducing their migraine-related disability. This paper reviews the epidemiology and diagnosis of migraine, and the effects of migraine on health related quality of life. Many patients with migraine do not consult a physician for their headaches, and when they do they often do not receive a correct diagnosis. The discussion at the Forum concluded that better education, both for physicians and the public, on issues relating to migraine was a necessary step in improving migraine diagnosis. The degree of disability caused by migraine is often not recognized by society, and can be substantial for individuals with migraine. Once again, education of the public and of the health professionals who see these patients is key, so that the best migraine management can be instituted to minimize the impact of migraine on the individual, the family, and society at large.

Quetiapine withdrawal: A systematic review

2020 ◽  
pp. 000486742096569
Author(s):  
Katherine Monahan ◽  
Jaimie Cuzens-Sutton ◽  
Dan Siskind ◽  
Steve Kisely
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Case Reports ◽  
Somatic Symptoms ◽  
Individual Case ◽  
Clinical Implications ◽  
Psychoactive Substance ◽  
Psychoactive Medication ◽  
The Individual

Objective: Withdrawal from psychoactive medication such as quetiapine is a well-documented phenomenon. Despite the extensive use of quetiapine, there have been few studies into the presence of discontinuation symptoms. We therefore performed a systematic review of published literature for evidence of quetiapine withdrawal or symptoms associated with discontinuation. Methods: We searched PubMed, Embase, CINAHL, Medline, Web of Science, PsycINFO for articles containing the terms ‘Quetiapine’ AND ‘withdraw$’ OR ‘discontinue$’. We included all study types that reported on somatic withdrawal symptoms and had no language restrictions. We excluded studies where there was withdrawal from multiple medications or any other psychoactive substance, or where the only symptoms were psychological such as rebound psychosis or craving. Results: We included 13 papers, all of which were individual case reports. The quality of the individual case reports was sub-optimal, as assessed by the CARE Case Report Guidelines. There was an association between rapid cessation of quetiapine and onset of somatic symptoms such as nausea, vomiting, agitation, restlessness, diaphoresis, irritability, anxiety, dysphoria, sleep disturbance, insomnia, tachycardia, hypertension and dizziness. Three studies also reported the onset of a withdrawal dyskinesia characterised by abnormal choreiform movements as well as confusion and speech disturbance in some cases. However, these findings were limited by the number and quality of case reports identified. Conclusion: Discontinuation symptoms are an uncommon side effect of quetiapine cessation, which may have clinical implications. Clinicians should therefore be alert to the possibility of quetiapine withdrawal in individuals who present with somatic symptoms or choreiform movements. However, large prospective studies are required to clarify this association.

scholarly journals Dietary behaviors Are Associated with Excessive Daytime Sleepiness

2019 ◽  
Author(s):  
majid ghayour-mobarhan ◽  
Sayyed Saeid Khayyatzadeh ◽  
Farzad Rahmani ◽  
Maryam Masoudifar ◽  
Gordon A Ferns ◽  
...  
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Cross Sectional Study ◽  
Dietary Behaviors ◽  
High Rate ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Increased Risk ◽  
Snack Consumption ◽  
The Individual

Abstract Background Excessive daytime sleepiness (EDS) is a common sleep abnormality among adolescents, and is reported to be associated with increased risk of morbidity and mortality. Multiple factors have been associated with EDS, especially life style. This study aimed to explore the relationships between dietary behaviors and EDS.Methods A total of 988 Iranian adolescent girls aged between 12-18 years old were recruited this cross-sectional study. A Persian translation of the Epworth Sleepiness Scale (ESS) was used to determine the presence of EDS. A pre-validated questionnaire was used for the assessment of dietary behaviors. To investigate the association between diet-related practices and the prevalence of EDS, we applied logistic regression analysis.Results The subjects who consumed a major meal three times daily had a 0.56 lower odds for EDS than the individual who consumed a single major meal (OR: 0.44; P = 0.01). Individuals with a ‘high-rate of food chewing’ were less likely to have EDS (OR: 0.55; P = 0.03). Compared with those who consumed fried or spicy foods daily, individuals who never consumed fried (OR: 1.8; P = 0.02) or spicy foods (OR: 1.71; P = 0.01) had a greater risk for EDS. In addition, there were direct associations between meal regularity and intra-meal fluid intake with EDS in an adjusted models. Neither in the crude nor in the adjusted models, were there significant associations between breakfast intake and frequency of snack consumption with EDS.Conclusions The findings of our study show the importance of diet-related practices in determining EDS. Prospective intervention studies are required to confirm these results.

scholarly journals Results of chalazion cryosurgery with an increased risk of complications

2021 ◽  
Vol 6 (6-1) ◽  
pp. 181-189
Author(s):  
A. N. Steblyuk ◽  
V. E. Gunter ◽  
V. N. Khodorenko ◽  
E. V. Bykova ◽  
R. A. Avakimyan ◽  
...  
Keyword(s):  
Functional State ◽  
Titanium Nickelide ◽  
Heat Removal ◽  
High Rate ◽  
Pathological Conditions ◽  
Effi Ciency ◽  
Increased Risk ◽  
Complicated Course ◽  
New Generation

Background. At an appointment with an ophthalmologist, patients with pathological conditions of the eyelids are often dissatisfi ed with the effectiveness of the traditional surgical treatment.The aim: assessment of the functional state of the eye adnexa after cryodestruction of the chalazion with an increased risk of complications using modern cryosurgical equipment.Material and methods. Clinical studies were carried out in 254 patients (277 eyes) with chalazion, including a complicated course of the disease, with cryodestruction of the chalazion using an autonomous cryoapplicator made of porous-permeable titanium nickelide.Results. Cryosystems of the new generation, in comparison with the well-known industrial cryoapparatus, diff er in new properties. They can signifi cantly improve the quality of cryotherapy in surgery due to a clearer localization of cryotherapy and a high rate of heat removal from the surface of altered tissues without damaging the surrounding tissues. Depending on the size of the pathological formation, the duration of the exposure, the frequency of repetitions of the applications during the session, the regression of the chalazion occurred within 1–1.5 months with the preservation of the integrity of the intermarginal space and the functional state of the eyelid.Conclusion. Analysis of the data obtained indicates a high clinical and cosmetic effi ciency of cryosurgery of the eyelid chalazion using an autonomous cryoapplicator made of porous-permeable titanium nickelide.

scholarly journals Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3671
Author(s):  
Flaminia Coluzzi ◽  
Monica Rocco ◽  
Rula Green Gladden ◽  
Pietro Persiani ◽  
Laurel A. Thur ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Childhood Leukemia ◽  
Analgesic Drugs ◽  
Off Label ◽  
Increased Risk ◽  
Leukemia Diagnosis ◽  
Ongoing Pain ◽  
The Individual

Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments. Pain management in children is often inadequate because of difficulties in pain assessment, different indications across countries, and the lack of specific pediatric trials. Analgesic drugs are often prescribed off-label to children by extrapolating information from adult guidelines, with possible increased risk of adverse events. Optimal pain management should involve a multidisciplinary team to ensure assessment and interventions tailored to the individual patient.

scholarly journals M129. PATTERNS OF CHILDHOOD TEMPERAMENT ARE ASSOCIATED WITH ADULT PSYCHOTIC DISORDER IN A PROSPECTIVE COHORT STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S184-S184
Author(s):  
Mary Clarke ◽  
Ross Brannigan ◽  
Antti Tanskanen ◽  
Matti Huttunen ◽  
Finbarr Leacy ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Skills Training ◽  
Logistic Regression Models ◽  
School Based ◽  
Regulatory Strategies ◽  
Increased Risk ◽  
Psychosis Risk ◽  
School Based Interventions ◽  
The Individual

Abstract Background Childhood temperament has previously been shown to be associated with mood and anxiety disorders later in life. Studies have also suggested possible links between childhood temperament and later psychosis. Aim To investigate the association between childhood temperament and its individual component factors, measured at age 5, and later psychiatric disorders including psychosis. Methods Using a sample from a Finnish birth cohort (N=1014), we used logistic regression models to examine associations between maternal reported childhood temperament at age 5, and later psychiatric diagnoses, ascertained through linkage with the Finnish Hospital Discharge Register. Results Individuals with a childhood temperament rated as difficult at age 5 had almost 5-times the odds of developing a psychotic disorder in adulthood compared to those with a temperament rated as average by their mothers (OR = 4.91, 95% CI = 1.51 – 15.91). The individual temperament factors of approach withdrawal, adaptability and quality of mood were each independently associated with later psychotic disorder while different temperament components were associated with increased risk of mood disorders. Discussion Early childhood temperament could be used in combination with other early life indicators to identify those at greatest risk for the development of psychosis later in life, and to inform the implementation of early interventions such as parent-training programs and school-based interventions to support children in developing more adaptive behavioural and self-regulatory strategies. Additionally, intervening early in a child’s life to support more optimal temperament development, such as better adaptability to new stressful situations through specific skills training, could be a viable target for early intervention to reduce psychosis risk.

scholarly journals Representativeness of Radiologically Guided Fine-Needle Aspiration Biopsy of Bone Lesions

Sarcoma ◽  
2002 ◽  
Vol 6 (2) ◽  
pp. 61-68 ◽  
Author(s):  
Veli Söderlund ◽  
Edneia Tani ◽  
Henryk Domanski ◽  
Andris Kreicbergs
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
High Rate ◽  
Bone Lesions ◽  
Fine Needle ◽  
Increased Risk ◽  
Needle Aspiration Biopsy

The consistency of the cellular yield as obtained by radiologically guided fine-needle aspiration biopsy (FNAB) was investigated in 29 cases with bone lesions. Aspirates from three different sites of the same lesion were analysed randomly and independently by two cytologists unaware of the clinical and radiological findings.The series was grouped cytologically into four categories: (1) benign, (2) sarcoma, (3) other malignancy, (4) non-conclusive. A lesion was considered cytologically homogenous, when all three aspirates were identically categorised. Among 29 lesions, 13 and 12, respectively, were assessed as homogeneous by the two cytologists. In the remaining lesions, heterogeneity almost exclusively pertained to the mixture of conclusive and non-conclusive aspirates. An alternative diagnosis was suggested in one case by each cytologist. Comparison of the two cytologists' assessments showed that 21 cases were compliant, i.e., no inter-observer difference in 63 out of 87 aspirates. In the remaining eight cases (24 aspirates), non-compliance was mainly due to differences between the cytologists in the ratio of conclusive versus non-conclusive aspirates. Only the analysis of one and the same aspirate resulted in two different diagnoses. A correct diagnosis was given by the cytologists in 22 and 23 cases, incorrect in two and non-conclusive in five and four, respectively.Our cytological study of bone lesions, albeit limited, suggests that true tumour heterogeneity is rare. The non-compliance between the two cytologists and the diagnostic difficulties should mainly be attributed to the blind, random approach of the study.The main problem of FNAB pertains to the high rate of non-conclusive aspirates.This, however, does not entail an increased risk of incorrect diagnosis, but rather prompts repeat FNAB.

Semi-automated methods for 3-D reconstruction of macromolecular complexes

1995 ◽  
Vol 53 ◽  
pp. 42-43
Author(s):  
B. Carragher ◽  
M. Whittaker
Keyword(s):  
Three Dimensional ◽  
Time Saving ◽  
Macromolecular Complexes ◽  
Symmetry Properties ◽  
Dimensional Reconstruction ◽  
Experienced Operator ◽  
Projection Images ◽  
The Individual ◽  
Natural Symmetry

Techniques for three-dimensional reconstruction of macromolecular complexes from electron micrographs have been successfully used for many years. These include methods which take advantage of the natural symmetry properties of the structure (for example helical or icosahedral) as well as those that use single axis or other tilting geometries to reconstruct from a set of projection images. These techniques have traditionally relied on a very experienced operator to manually perform the often numerous and time consuming steps required to obtain the final reconstruction. While the guidance and oversight of an experienced and critical operator will always be an essential component of these techniques, recent advances in computer technology, microprocessor controlled microscopes and the availability of high quality CCD cameras have provided the means to automate many of the individual steps.During the acquisition of data automation provides benefits not only in terms of convenience and time saving but also in circumstances where manual procedures limit the quality of the final reconstruction.

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