Rewriting the history of psychiatric diagnosis hurts women, and activism can end it

2014 ◽  
Author(s):  
Paula Caplan
Keyword(s):  
Psychiatric Diagnosis ◽  
History Of

Risk Factors for Severe Neuropsychiatric Toxicity in Patients Receiving Interferon Alfa-2b and Low-Dose Cytarabine for Chronic Myelogenous Leukemia: Analysis of Cancer and Leukemia Group B 9013

2000 ◽  
Vol 18 (6) ◽  
pp. 1301-1308 ◽  
Author(s):  
Martee L. Hensley ◽  
Bercedis Peterson ◽  
Richard T. Silver ◽  
Richard A. Larson ◽  
Charles A. Schiffer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Myelogenous Leukemia ◽  
Psychiatric Diagnosis ◽  
Interferon Alfa ◽  
Myelogenous Leukemia ◽  
Recombinant Interferon ◽  
History Of ◽  
Neuropsychiatric Toxicity ◽  
Group B ◽  
Leukemia Group

PURPOSE: Recombinant interferon alfa-2b (rIFNα2b) is a standard therapy for chronic myelogenous leukemia (CML). Severe neuropsychiatric toxicity has been described in patients receiving rIFNα2b, although the frequency of and the risk factors for developing this toxicity are not well described. The purpose of this study was to identify predictors for the development of severe neuropsychiatric toxicity in CML patients receiving rIFNα2b-based therapy. PATIENTS AND METHODS: From a prospective cohort of 91 Philadelphia chromosome–positive, previously untreated, chronic-phase CML patients treated on Cancer and Leukemia Group B (CALGB) 9013, a phase II trial of rIFNα2b plus cytarabine, the following were recorded at baseline: age, sex, race, pretreatment history of neurologic or psychiatric diagnosis, spleen size, blood counts, and peripheral blast count. Best response to treatment, rIFNα2b cumulative dose, dose duration, and dose-intensity were recorded during follow-up. Severe neuropsychiatric toxicity was defined as grade 3 or 4 events, according to CALGB expanded common toxicity criteria. Univariate and multivariate logistic regression analyses were used to identify variables that were associated with the development of severe neuropsychiatric toxicity. RESULTS: Severe neuropsychiatric toxicity developed in 22 patients (24.0%; 95% confidence interval [CI], 15.2% to 32.8%). Toxicity resolved after withdrawal of treatment in all patients. Five of six patients developed recurrence of symptoms with rechallenge. Twelve (63%) of 19 patients with a pretreatment neurologic or psychiatric diagnosis developed severe neuropsychiatric toxicity, as compared with 10 (14%) of 72 patients without a pretreatment neurologic or psychiatric diagnosis (P = .001), resulting in a relative risk of 4.55 (95% CI, 2.33 to 8.88) for developing severe neuropsychiatric toxicity. No other variables were independently associated with the development of neuropsychiatric toxicity. CONCLUSION: CML patients with a pretreatment history of a neurologic or psychiatric diagnosis are at significantly increased risk of developing severe neuropsychiatric toxicity during therapy with rIFNα2b plus cytarabine. Monitoring for neuropsychiatric symptoms and avoiding rechallenge are recommended measures for such patients receiving rIFNα2b-based therapy.

Predictors of Improvement in Tardive Dyskinesia Following Discontinuation of Neuroleptic Medication

1990 ◽  
Vol 157 (4) ◽  
pp. 585-592 ◽  
Author(s):  
William M. Glazer ◽  
Hal Morgenstern ◽  
Nina Schooler ◽  
Cathy S. Berkman ◽  
Daniel C. Moore
Keyword(s):  
Tardive Dyskinesia ◽  
Outcome Measures ◽  
Psychiatric Diagnosis ◽  
Psychiatric Illness ◽  
Model Fitting ◽  
First Year ◽  
Neuroleptic Medication ◽  
Younger Age ◽  
Noticeable Improvement ◽  
History Of

Forty-nine chronic psychiatric out-patients (ten were schizophrenic) with tardive dyskinesia (TD) were examined monthly for a mean of 40 weeks (range 1–59 months) after discontinuation of neuroleptic medication. Complete and persistent reversibility of TD was rare (2%), but many patients showed noticeable improvement in movements within the first year of discontinuation, which was sometimes interrupted by psychological relapse. Using three separate outcome measures and appropriate model-fitting techniques for each, we identified several predictors of improvement in TD, including an affective or schizoaffective psychiatric diagnosis, chronic (over 20 years) psychiatric illness, being employed, younger age, and increased neuroleptic dose before discontinuation. Consistent findings emerging from these analyses suggest that the type and history of psychiatric illness affect the course of TD.

scholarly journals Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study

2015 ◽  
Vol 45 (13) ◽  
pp. 2781-2791 ◽  
Author(s):  
K. L. Musliner ◽  
B. B. Trabjerg ◽  
B. L. Waltoft ◽  
T. M. Laursen ◽  
P. B. Mortensen ◽  
...  
Keyword(s):  
Psychiatric Diagnosis ◽  
Affective Disorders ◽  
Age Groups ◽  
Unipolar Depression ◽  
Parental Psychopathology ◽  
Incidence Rates ◽  
Psychiatric Diagnoses ◽  
Parental History ◽  
History Of ◽  
The Impact

BackgroundDepression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups.MethodWe established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or ‘other’ psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions.ResultsParental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p < 0.0001; paternal: IRR 1.68, p < 0.0001) and inpatient (maternal: IRR 1.99, p < 0.0001; paternal: IRR 1.83, p < 0.0001) depression relative to no parental history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29–3.96 in the youngest age group to 1.53–1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51–1.90).ConclusionsParental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

scholarly journals Introduction: Disordered Mood as Historical Problem

2020 ◽  
pp. 1-33
Author(s):  
Åsa Jansson
Keyword(s):  
Nineteenth Century ◽  
Psychiatric Diagnosis ◽  
Medical Statistics ◽  
New Model ◽  
The Core ◽  
Psychological Medicine ◽  
History Of

Abstract The introduction situates the narrative of this book—the reconceptualisation of melancholia in nineteenth-century psychiatry—firstly in the context of current attempts to ‘resurrect’ melancholia as a psychiatric diagnosis, secondly in relation to the history of melancholia more broadly, and finally in the context of past and present debates about classification in psychiatry. The core argument of the book is briefly outlined: in the nineteenth century, melancholia was reconfigured as a modern biomedical disorder of emotion. Two developments in particular were foundational to this new model of melancholia. The first was the uptake of physiological language and concepts into psychological medicine. The second was the institutionalisation of medical statistics together with a standardisation of asylum recording practices.

scholarly journals Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy

2021 ◽  
Vol 17 (3) ◽  
Author(s):  
Massimiliano Beghi ◽  
Riccardo Brandolini ◽  
Laura Biondi ◽  
Claudia Corsini ◽  
Carlo Fraticelli ◽  
...  
Keyword(s):  
Observational Study ◽  
Psychiatric Disorder ◽  
Emergency Room ◽  
Psychiatric Disorders ◽  
Psychiatric Diagnosis ◽  
Psychiatric Evaluation ◽  
Longitudinal Observational Study ◽  
Emilia Romagna Region ◽  
History Of ◽  
The Difference

The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.

Anxiety and depression symptoms among sub-fertile women, women pregnant after infertility treatment, and naturally pregnant women

2017 ◽  
Vol 45 ◽  
pp. 212-219 ◽  
Author(s):  
L. Salih Joelsson ◽  
T. Tydén ◽  
K. Wanggren ◽  
M.K. Georgakis ◽  
J. Stern ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Psychiatric Diagnosis ◽  
Depression Scale ◽  
Infertility Treatment ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Unhealthy Lifestyle ◽  
History Of ◽  
Fertile Women

AbstractBackground:Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally.Methods:Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms.Results:The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise < 2 h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09–1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04–1.49).Conclusions:Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis.

scholarly journals ACUTE PERFORMANCE ON A VESTIBULAR AND OCULAR MOTOR SCREENER AND RECOVERY FOLLOWING CONCUSSION

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0013
Author(s):  
Scott O. Burkhart ◽  
Christine Ellis ◽  
Troy M. Smurawa
Keyword(s):  
Psychiatric Diagnosis ◽  
Descriptive Statistics ◽  
Acute Injury ◽  
Ocular Motor ◽  
Motor Impairments ◽  
Certified Athletic Trainers ◽  
Symptom Provocation ◽  
History Of ◽  
Recovery Group ◽  
Recovery Groups

Background: Concussion injuries are synonymous with vestibular impairments and symptoms include dizziness, impaired balance, and problems with gaze stability (Covassin et al., 2014). Common ocular motor impairments after a concussion include convergence/accommodative insufficiencies and saccadic dysfunction (Mucha et al., 2014). Vestibular and ocular motor impairments have been linked to worse outcomes following concussion (Pearce et al., 2015), including prolonged recovery (Corwin et al., 2015). The purpose of the current study was to determine which VOMS impairments were linked with longer recovery. Methods: Pediatric patients diagnosed with concussion (n = 131) presenting to an outpatient concussion clinic within 7 days from their initial date of injury were administered a standardized version of the VOMS. Patients were administered the VOMS by certified athletic trainers educated and trained on administration. The VOMS consists of nine measures and was validated by the University of Pittsburgh (Mucha et al., 2014) as a symptom provocation measure with a symptom rating of 0-10 with convergence measured in centimeters, and scores of 6 cm or greater being indicative of abnormal. Demographic, acute injury, and baseline values were summarized using descriptive statistics. Point estimates and 95% confidence intervals were calculated for all end points. Results: 131 patients with a mean age of 13.5 + 2.4 completed the VOMS within 7 days (mean = 3.2 + 1.7) of a diagnosed concussion. The sample was evenly divided by gender (52.7% male, 47.3% female). Patients were grouped by recovery time: <14 days (n = 19, 14.5%) 15-28 days (n = 64, 48.9%), and 29-120 days (n = 48, 36.6%). In the <14 day recovery group, 5.2% (n = 2) reported a history of concussion, 15.8% (n = 3) reported a history of migraine, and 5.2% (n = 2) reported a history of psychiatric diagnosis. In the 15-28 day recovery group, 21.9% (n = 14) reported a history of concussion, 9.4% (n = 6) reported a history of migraine, and 6.5% (n = 4) reported a history of psychiatric diagnosis. In the 29-120 day recovery group, 25% (n = 12) reported a history of concussion, 25% (n = 12) reported a history of migraine, and 6.25% (n = 3) reported a history of psychiatric diagnosis. Descriptive statistics for baseline VOMS symptoms were recorded for the <14 day recovery group; headache (mean = 1 + 1.49, CI = 0.7 -1.3), dizziness (mean = 0.2 + 0.5, CI = 0.1-0.3), nausea (mean = 0 + 0, CI = 0-0), and fogginess (mean = 0.9 + 1.5, CI = 0.5 -1.3), for the 15-28 day recovery group; headache (mean = 3.3 + 2.4, CI = 3-3.6), dizziness (mean = 1.5 + 1.9, CI = 1.3 -1.7), nausea (mean = 0.8 + 1.7, CI = 0.6 -1), and fogginess (mean = 1.7 + 2.2, CI = 1.4-2), for the 29-120 day recovery group; headache (mean = 4.4 + 2.2, CI = 4.1-4.7), dizziness (mean = 1.9 + 2.2, CI = 1.6-2.2), nausea (mean = 1.4 + 2.2, CI = 1.1 -1.7), and fogginess (mean = 2.4 + 2.9, CI = 2-2.8). VOMS convergence in centimeters across trials for the <14 day recovery group; T1 (mean = 2.6 + 2.4, CI = 2.1-3.1), T2 (mean = 3.4 + 2.4, CI = 2.9-3.9), and T3 (mean = 3.8 + 2.5, CI = 3.2-4.4), for the 15-29 day recovery group; T1 (mean = 3.9 + 3.9, CI = 3.4-4.4), T2 (mean = 4.8 + 4.2, CI = 4.3-5.3), and T3 (mean = 5.3 + 5.1, CI = 4.7-5.9), for the 29-120 day recovery group; T1 (mean = 6.9 + 5.2, CI = 6.1-7.7), T2 (mean = 8.3 + 1.8, CI = 7.4-9.2), and T3 (mean = 9.6 + 2.1, CI = 8.6-10.6). VOMS symptom provocation increase of +2 and +3 from baseline were totaled for each recovery group. Abnormal convergence greater than 6 cm on any trial was totaled for each group. Percentages for all 3 recovery groups with symptom provocation of +2, +3, and abnormal convergence were calculated. In the <14 day recovery group, 21% had a +2 symptom provocation on at least one symptom, 16% had a +3 symptom increase on at least one symptom, and 16% had abnormal convergence greater than 6 cm on at least one convergence trial. 11% of the <14 day recovery group had a +2, +3, increase and abnormal convergence greater than 6 cm. In the 15-29 day recovery group, 69% had a +2 symptom provocation on at least one symptom, 34% had a +3 symptom increase on at least one symptom, and 38% had abnormal convergence greater than 6 cm on at least one convergence trial. 13% of the 15-29 day recovery group had a +2, +3, increase and abnormal convergence greater than 6 cm. In the 29-120 day recovery group, 85% had a +2 symptom provocation on at least one symptom, 60% had a +3 symptom increase on at least one symptom, and 58% had abnormal convergence greater than 6 cm on at least one convergence trial. 38% of the 29-120 day recovery group had a +2, +3, increase and abnormal convergence greater than 6 cm. Conclusion: The current study identified symptom provocation of +2 and +3 as well as abnormal convergence greater than 6 cm were the most synonymous with recovery across the three recovery groups. Clinicians should consider these findings in providing recommendations and discussing anticipated recovery with patients. Further research is needed to determine more definitive parameters when predicting recovery following concussion.

The Medical Recommendation for Psychiatric Remands into Prison—The Hong Kong Scene

1981 ◽  
Vol 21 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Bernard W. K. Lau
Keyword(s):  
Hong Kong ◽  
Mentally Ill ◽  
Psychiatric Diagnosis ◽  
Mentally Disordered ◽  
The Public ◽  
Younger Age ◽  
History Of ◽  
Psychiatric Staff ◽  
Reception Centre ◽  
Medical Recommendation

A review is presented of all the remand cases who were referred from the courts to the psychiatric staff of the Psychiatric Observation Unit in the Lai Chi Kok Reception Centre, Prisons Department, Hong Kong Government. Altogether 607 defendants were assessed during the 24-month period and reports were furnished which indicated the psychiatric diagnosis, medical recommendation and fitness to plead of each case. It is noted that over half of the remands were not mentally disordered and a psychiatric diagnosis was possible in less than half of the sample. Most of the cases belonged to the younger age group, namely 19–39, which is compatible with the finding of schizophrenia in the majority of the mentally ill remands. A considerable number of them had a history of previous psychiatric contact. The nature of the offences varied and they involved those against the person, the property and the public order. In comparison, the schizophrenics committing offences against the person of a non-sexual nature formed the largest sub-group. On the whole, the schizophrenics were most frequently remanded for psychiatric examination, most likely to be recommended for a medical disposal and almost certainly allowed to benefit from the treatment proposed. Factors associated with positive or negative as well as accepted or rejected recommendation were discussed. Special consideration was given to some of the problems concerning the treatment orders which are peculiar to Hong Kong.

scholarly journals Violence, stigma and psychiatric diagnosis: the effects of a history of violence on psychiatric diagnosis

2006 ◽  
Vol 30 (7) ◽  
pp. 254-256 ◽  
Author(s):  
Tom Clark ◽  
Renarta Rowe
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Diagnosis ◽  
Bipolar Affective Disorder ◽  
Clinical Implications ◽  
Clinical Vignettes ◽  
Diagnostic Decision ◽  
History Of ◽  
History Of Violence ◽  
The Uk ◽  
Diagnostic Decision Making

Aims and MethodThe aim of the study was to investigate whether psychiatrists consider that patients with schizophrenia present a greater risk of violence than patients with other forms of mental illness. Two pairs of clinical vignettes were devised. In each pair, one contained a history of violence and one did not. One vignette was mailed to each of 2000 consultant psychiatrists in the UK. Respondents were asked to give a preferred diagnosis. Rates of diagnosis of bipolar disorder, schizoaffective disorder and schizophrenia were compared within vignette pairs.ResultsFor each pair of vignettes, the rate of diagnosis of schizophrenia was higher (33 v. 21.5%, P=0.008 and 44.4 v. 32.1%, P=0.011), and the rate of diagnosis of bipolar disorder was lower (44.2 v. 62.6%, P<0.0005 and 34.9 v. 49.3%, P=0.004), among those who received the vignette containing a history of violence.Clinical ImplicationsA history of violence may lead to an increased likelihood of receiving a diagnosis of schizophrenia as opposed to bipolar affective disorder. This bias in diagnostic decision-making may affect the treatment received by a patient and may perpetuate and exacerbate the stigma associated with a diagnosis of schizophrenia.

Dual diagnosis (DD) at first admission (FA) in three different periods: An epidemiological study

2011 ◽  
Vol 26 (S2) ◽  
pp. 589-589
Author(s):  
P. Zeppegno ◽  
M. Porro ◽  
A. Lombardi ◽  
A. Feggi ◽  
E. Torre
Keyword(s):  
Dual Diagnosis ◽  
Psychiatric Diagnosis ◽  
Medical Records ◽  
Psychiatric Illness ◽  
Progressive Increase ◽  
Legal Issues ◽  
Drug Abusers ◽  
Affective Psychosis ◽  
Adequate Treatment ◽  
History Of

IntroductionDD represents a common issue in clinical practice, with relevant effects on symptoms, course and treatment of disease. It's often associated with negative outcome as a greater severity of symptoms and resistance to drug treatment.ObjectivesTo assess how the characteristics (sociodemographic, clinical and related to substance abuse) of patients discharged with DD have changed taking into account the FA occurred in three different five-year periods (1990–1994, 2000–2004, 2005–2009). We also compared the characteristics of patients discharged with only psychiatric diagnosis with those of patients with DD to look for possible risk factors for abuse among people with psychiatric illness.MethodsWe conducted a retrospective study of medical records of patients at FA to our Institute in three different periods. We divided the patients discharged with DD from those discharged with only psychiatric diagnosis.ResultsAmong the FA occurred in the periods examined we noticed an increase of DD cases (12% from 1990 to 1994, 21% 2000–2004, 28% 2005–2009). The incidence of each diagnosis was changed in several years, but each time the diseases more represented remain schizophrenic or affective psychosis and personality disorders. Alcohol is the most widely used psychotropic drug in each period. There is also a progressive increase in the abuse of cannabis, cocaine and in the incidence of multi-drug abusers. Compared with patients discharged with only a psychiatric diagnosis, patients with DD were more frequently:male, younger, unmarried, unemployed, with legal issues, grown up in a family with serious problems, and history of etero-aggressive episodes.ConclusionsDue to continued increase in cases of DD, we want to highlight the importance of early identification of cases of comorbidity in order to provide adequate treatment and support.

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