Psychiatric Disorders in Juveniles: Challenges in Assessment and Differential Diagnosis

2010 ◽  
Author(s):  
Robyn Inaba ◽  
Nancy Fowler
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders

Insomnias

2012 ◽  
pp. 933-938
Author(s):  
Colin A. Espie ◽  
Delwyn J. Bartlett
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Differential Diagnosis ◽  
Sleep Disturbance ◽  
Psychiatric Disorders ◽  
Current Understanding ◽  
Health Concern ◽  
Sleep Disruption ◽  
Poor Sleep ◽  
Evidence Based

Most people's experiences of poor sleep are memorable, because sleeplessness and its daytime consequences are unpleasant. There are those, however, for whom insomnia is the norm. Persistent and severe sleep disturbance affects at least one in 10 adults and one in five older adults, thus representing a considerable public health concern. Sleep disruption is central to a number of medical and psychiatric disorders, and insomnia is usually treated by general practitioners. Therefore differential diagnosis is important, and respiratory physicians, neurologists, psychiatrists, and clinical psychologists need to be involved. The purpose of this chapter is to summarize current understanding of the insomnias, their appraisal, and treatment. Particular emphasis will be placed upon evidence-based practical management.

scholarly journals Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders

Brain ◽  
2020 ◽  
Vol 143 (6) ◽  
pp. 1632-1650 ◽  
Author(s):  
Simon Ducharme ◽  
Annemiek Dols ◽  
Robert Laforce ◽  
Emma Devenney ◽  
Fiona Kumfor ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Social Cognition ◽  
Psychiatric Disorders ◽  
Frontotemporal Dementia ◽  
Clinical Assessment ◽  
Rating Scales ◽  
Diagnostic Delay ◽  
Autism Spectrum ◽  
Compulsive Disorder

Abstract The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5–6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal Dementia was recently established to determine the current best clinical practice and set up an international collaboration to share a common dataset for future research. The goal of the present paper was to review the existing literature on the diagnosis of bvFTD and its differential diagnosis with primary psychiatric disorders to provide consensus recommendations on the clinical assessment. A systematic literature search with a narrative review was performed to determine all bvFTD-related diagnostic evidence for the following topics: bvFTD history taking, psychiatric assessment, clinical scales, physical and neurological examination, bedside cognitive tests, neuropsychological assessment, social cognition, structural neuroimaging, functional neuroimaging, CSF and genetic testing. For each topic, responsible team members proposed a set of minimal requirements, optimal clinical recommendations, and tools requiring further research or those that should be developed. Recommendations were listed if they reached a ≥ 85% expert consensus based on an online survey among all consortium participants. New recommendations include performing at least one formal social cognition test in the standard neuropsychological battery for bvFTD. We emphasize the importance of 3D-T1 brain MRI with a standardized review protocol including validated visual atrophy rating scales, and to consider volumetric analyses if available. We clarify the role of 18F-fluorodeoxyglucose PET for the exclusion of bvFTD when normal, whereas non-specific regional metabolism abnormalities should not be over-interpreted in the case of a psychiatric differential diagnosis. We highlight the potential role of serum or CSF neurofilament light chain to differentiate bvFTD from primary psychiatric disorders. Finally, based on the increasing literature and clinical experience, the consortium determined that screening for C9orf72 mutation should be performed in all possible/probable bvFTD cases or suspected cases with strong psychiatric features.

Psychosis in patients with systemic lupus erythematosus

2011 ◽  
Vol 26 (S2) ◽  
pp. 895-895
Author(s):  
S. Yelmo Cruz ◽  
V. Barrau Alonso ◽  
M. Salinas Muñoz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Lupus Erythematosus ◽  
Oral Prednisone ◽  
Systemic Lupus ◽  
Cns Lupus ◽  
Positive Ratio ◽  
Low Levels ◽  
Blood Brain Barrier Damage

IntroductionSystemic Lupus Erythematosus (SLE) can affect central nervous system (CNS), leading to neurological and/or psychiatric disorders. The use of corticosteroids for the management of SLE may induce psychiatric disorders.ObjectivesDifferential diagnosis of the origin of psychosis in patients with SLE (CNS lupus vs. induced by corticosteroid therapy).Methods and resultsA 22 year old female patient presented asthenia, oral bleeding, epistaxis, metrorrhagia, bicytopenia, hypoalbuminemia, low complement, with anti-DNA > 300, ANA, IgG Anticardiolipin, Anti-Sm, anti-RNP, anti-Ro, Anti-La and Anti-Histone positive.A diagnosis of SLE was made. She presented also diffuse grade IV nephritis. There were administered 3 iv 6-methylprednisolone pulse therapies (750 mg/day) with a cycle of cyclophosphamide. Subsequently she continued with oral prednisone 60 mg/day. Four days after the end of the pulses, the patient developed anxiety, suspicion, injury delusions, auditory hallucinations and behavioral disinhibition. A MRI was normal. Risperidone was started up to 6 mg/day and oral prednisone was tapered. After a progressive improvement she was discharged.ResultsCorticosteroids induce psychiatric disorders in 3–10% of patients. Low levels of complement, hypoalbuminemia and a positive ratio (≥ 9) of albumin in CSF x103/serum albumin are indicators of blood brain barrier damage and psychosis induced by corticosteroids. The presence of ac Antiribosoma P, ac antineuronals, MRI or EEG abnormals suggest the diagnosis of CNS lupus (lupus psychosis)ConclusionsDifferential diagnosis between lupus psychosis vs. psychosis induced by corticosteroids is complicated. In case of doubt, some authors advocate increasing the dose of steroids and awaiting a clinical response. Others advocate rapid tapering and stopping steroids.

Fatigue in Neurological, Psychiatric, and Medical Conditions

2006 ◽  
Vol 12 (5) ◽  
pp. 758-759
Author(s):  
Sara J. Swanson
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Empirical Data ◽  
Central Fatigue ◽  
Neural Mechanisms ◽  
Scientific Study ◽  
Medical Conditions ◽  
Cognitive Neuropsychology ◽  
Cognitive Correlates ◽  
The Brain

Fatigue as a Window to the Brain, John DeLuca (Ed.). 2005. Cambridge, MA: The MIT Press, 336 pp., $55.00 (HB).Fatigue is ubiquitous and falls within the purview of several specialties, including neurology, psychiatry, neuropsychology, endocrinology, rheumatology, and immunology. As Simon Wessely points out in the Foreword of Fatigue as a Window to the Brain, fatigue has been virtually overlooked as an area of scientific study, because it is difficult to measure and, as a symptom, rarely aids in differential diagnosis. John DeLuca's edited book is part of the Issues in Clinical and Cognitive Neuropsychology series edited by Jordan Grafman. This is an ambitious book that examines the multidimensional and multifactorial nature of the neurobiology of central fatigue. This book advances the reader's understanding of the neural mechanisms of fatigue through review and integration of empirical data on fatigue and its cognitive correlates in neurological, medical, and psychiatric disorders.

Prevalence of Psychiatric Disorders among Patients Investigated for Occupational Asthma. An Overlooked Differential Diagnosis?

2013 ◽  
Vol 187 (9) ◽  
pp. 926-932 ◽  
Author(s):  
Kim L. Lavoie ◽  
Maryann Joseph ◽  
Helene Favreau ◽  
Catherine Lemiere ◽  
Manon Labrecque ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Occupational Asthma

Behavioral disorders in emergencies. Differential diagnosis and treatment

2017 ◽  
Vol 41 (S1) ◽  
pp. S465-S465 ◽  
Author(s):  
S.M. Bañón González ◽  
N. Ogando Portilla ◽  
M.G. García Jiménez ◽  
R. Álvarez García ◽  
F. García Sánchez
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Behavioral Disorders ◽  
Clinical Case ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
Oppositional Defiant ◽  
Competing Interest ◽  
Epidemiological Characteristics ◽  
The Impact

IntroductionThe clinical case has been submitted because it presents a number of difficulties in diagnosis. After seven psychiatric hospitalizations, it does not present a definitive diagnosis, poor prognosis and multiple relapses.ObjectivesBoth analyze clinical, psychopathological and epidemiological characteristics of behavioral disorders in relation to a clinical case and review causes, incidence, prevalence, diagnostic, therapeutic tools and the importance of an appropriate differential diagnosis to reach a correct therapeutic approach.MethodsReview of the impact literature for the last five years concerning behavioral disorders: prevalence, incidence, pathogenesis and its relationship with psychiatric disorders encoded in DSM-V.ResultsIt is evident that the patient has behavioral disorders and psychotic symptoms in the context of cocaine intoxication. Although sometimes the dose of cocaine has been very small and probably not justifies in all cases a toxic psychosis, it is true that withdrawal periods have been short; therefore difficult to assess. Also mania-like symptoms have been discussed because the patient has an increased activity, dysphoric mood, anxiety and decreased need for sleep.ConclusionsResponse to treatment and hyperactivity, impulsivity and inattention characteristics make us consider the diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD). ADHD in adults and adolescents have significant comorbidity with substance abuse, particularly cocaine, amphetamines and psychostimulants, also alcohol, tobacco and cannabis, and with other psychiatric disorders: oppositional defiant, personality (especially cluster B: antisocial, etc), anxiety (generalized anxiety, phobias, panic..), affective or eating disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Electroencephalography in Catatonic Disorders Due to General Medical Conditions and Psychiatric Disorders

CNS Spectrums ◽  
1998 ◽  
Vol 3 (2) ◽  
pp. 57-61 ◽  
Author(s):  
Brendan T. Carroll ◽  
Harold W. Goforth ◽  
Nashaat N. Boutros ◽  
Theodore J. Anfinson ◽  
Lisa Werner
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Medical Condition ◽  
Case Reports ◽  
Case Series ◽  
Ohio State University ◽  
State University ◽  
Review Of The Literature ◽  
General Medical Condition ◽  
The Ohio State University

AbstractIn an effort to aid the clinician in the differential diagnosis of catatonic states, we assessed the nature of electroencephalography (EEG) findings in both medical and psychiatric forms of catatonia. An exhaustive review of the literature on catatonia due to a general medical condition (CDGMC) was performed in addition to a prospective review of catatonic patients at The Ohio State University Neuwpsychiatric Facility.A total of 105 patients had documented, specific clinical and EEG information, with neurologic conditions accounting for 82.8% of case reports. Results from the case series of 31 episodes of catatonia indicate that there is an increased likelihood of diffuse slowing in patients with CDGMC versus psychiatric catatonia. Given the observed rate of abnormalities, EEG is an important but underutilized tool in the differential diagnosis of catatonic disorders.

Sign in / Sign up

Export Citation Format

Share Document