scholarly journals Abnormalities of confidence in psychiatry: an overview and future perspectives

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Monja Hoven ◽  
Maël Lebreton ◽  
Jan B. Engelmann ◽  
Damiaan Denys ◽  
Judy Luigjes ◽  
...  
Keyword(s):  
Decision Making ◽  
General Population ◽  
Psychiatric Disorders ◽  
Symptom Severity ◽  
Positive Relationship ◽  
Psychiatric Symptoms ◽  
Current Knowledge ◽  
Future Perspectives ◽  
Psychiatric Symptomatology ◽  
Underlying Processes

Abstract Our behavior is constantly accompanied by a sense of confidence and its’ precision is critical for adequate adaptation and survival. Importantly, abnormal confidence judgments that do not reflect reality may play a crucial role in pathological decision-making typically seen in psychiatric disorders. In this review, we propose abnormalities of confidence as a new model of interpreting psychiatric symptoms. We hypothesize a dysfunction of confidence at the root of psychiatric symptoms either expressed subclinically in the general population or clinically in the patient population. Our review reveals a robust association between confidence abnormalities and psychiatric symptomatology. Confidence abnormalities are present in subclinical/prodromal phases of psychiatric disorders, show a positive relationship with symptom severity, and appear to normalize after recovery. In the reviewed literature, the strongest evidence was found for a decline in confidence in (sub)clinical OCD, and for a decrease in confidence discrimination in (sub)clinical schizophrenia. We found suggestive evidence for increased/decreased confidence in addiction and depression/anxiety, respectively. Confidence abnormalities may help to understand underlying psychopathological substrates across disorders, and should thus be considered transdiagnostically. This review provides clear evidence for confidence abnormalities in different psychiatric disorders, identifies current knowledge gaps and supplies suggestions for future avenues. As such, it may guide future translational research into the underlying processes governing these abnormalities, as well as future interventions to restore them.

scholarly journals Abnormalities of confidence in psychiatry: an overview and future perspectives.

2018 ◽  
Author(s):  
Monja Hoven ◽  
Maël Lebreton ◽  
Jan Engelmann ◽  
Damiaan Denys ◽  
Judy Luigjes ◽  
...  
Keyword(s):  
Decision Making ◽  
General Population ◽  
Psychiatric Disorders ◽  
Symptom Severity ◽  
Positive Relationship ◽  
Psychiatric Symptoms ◽  
Current Knowledge ◽  
Future Perspectives ◽  
Psychiatric Symptomatology ◽  
Underlying Processes

Our behavior is constantly accompanied by a sense of confidence and its’ precision is critical for adequate adaptation and survival. Importantly, abnormal confidence judgments that do not reflect reality may play a crucial role in pathological decision-making typically seen in psychiatric disorders. In this review, we propose abnormalities of confidence as a new model of interpreting psychiatric symptoms. We hypothesize a dysfunction of confidence at the root of psychiatric symptoms either expressed subclinically in the general population or clinically in the patient population.Our review reveals a robust association between confidence abnormalities and psychiatric symptomatology. Confidence abnormalities are present in subclinical/prodromal phases of psychiatric disorders, show a positive relationship with symptom severity, and appear to normalize after recovery. In the reviewed literature, the strongest evidence was found for a decline in confidence in (sub)clinical OCD, and for a decrease in confidence discrimination in (sub)clinical schizophrenia. We found suggestive evidence for increased/decreased confidence in addiction, depression/anxiety, respectively.Confidence abnormalities may help to understand underlying psychopathological substrates across disorders, and should thus be considered transdiagnostically. This review provides clear evidence for confidence abnormalities in different psychiatric disorders, identifies current knowledge gaps and supplies suggestions for future avenues. As such, it may guide future translational research into the underlying processes governing these abnormalities, as well as future interventions to restore them.

scholarly journals Acute hydrocephalus secondary to meningioma with psychiatric symptoms as initial manifestation

2018 ◽  
Vol 5 (3) ◽  
pp. 32
Author(s):  
Marta Valentim ◽  
Iván Cadena Velez ◽  
Catarina Teles Neto ◽  
Sónia Almeida ◽  
Ana Gameiro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Psychiatric Disorders ◽  
Neurological Disorders ◽  
Psychiatric Symptoms ◽  
Correct Diagnosis ◽  
Medical Emergency ◽  
Psychiatric Symptomatology ◽  
Initial Manifestation ◽  
Acute Hydrocephalus

Background: Psychiatric disorders are often difficult to evaluate and sometimes have negative connotations associated. That could be a reason to ignore the correct diagnosis of underlying neurological diseases.Case report: We present a case report of a patient with psychiatric symptomatology, where during the study in the Emergency Department an acute hydrocephalus secondary to a massive meningioma was evidenced.Conclusions: This case exemplifies how psychiatric symptoms, often devalued by the physician, may be the first manifestation of serious neurological disorders, as well as being associated with a medical emergency, as in this case was the acute hydrocephalus.

Depression and Anxiety Symptom Severity and Psychiatric Disorders in Children with Chronic Idiopathic Urticaria

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Herguner ◽  
I. Ozyildirim ◽  
G. Kilic
Keyword(s):  
Psychiatric Disorders ◽  
Trait Anxiety ◽  
Symptom Severity ◽  
Child Behavior Checklist ◽  
Anxiety Symptom ◽  
Psychiatric Symptoms ◽  
Chronic Idiopathic Urticaria ◽  
School Age Children ◽  
Depression And Anxiety ◽  
Pediatric Allergy

Aim:Chronic idiopathic urticaria (CIU) is a frequently occurring disease that seems to be associated with a number of psychological factors. This study aims to determine the frequency of psychiatric disorders and to assess the depression and anxiety symptom severity in a group of children with chronic idiopathic urticaria (CIU).Method:The study group included 30 children, ranging in age from 8 to 16 years, with CIU who attended to the Pediatric Allergy Clinic of the Istanbul Faculty of Medicine and 30 healthy subjects matched for age and sex. The psychiatric disorders were evaluated by using Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). State-Trait Anxiety Inventory (STAI), Children’s Depression Inventory (CDI) and Child Behavior Checklist (4-18) were used to examine the levels of depression and anxiety.Results:The K-SADS-PL revealed a psychiatric diagnosis in 63% of the patients. In terms of the distribution of psychiatric diagnoses, the most frequently occurring diagnosis was anxiety disorders (33%), namely simple phobia (21%) and social anxiety disorder (18%). State anxiety scores were significantly higher in children with CIU than controls but not trait anxiety and depression scores. No significant relationships were found between urticaria activity score, duration of illness, age onset and depression and anxiety scores.Conclusion:Psychiatric disorders were frequent in the group children with CIU. Clinicians should be more aware of accompanying psychiatric symptoms in this group of cases.

EEG in Psychiatric Disorders

2017 ◽  
Author(s):  
Andres M. Kanner ◽  
Adriana Bermeo-Ovalle
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Diagnostic Yield ◽  
Clinical Manifestations ◽  
Psychiatric Symptomatology ◽  
Correct Treatment ◽  
Iatrogenic Complications ◽  
Different Types ◽  
Proper Diagnosis ◽  
Eeg Recordings

Psychiatric symptoms are not restricted to primary psychiatric disorders and are relatively frequent in medical and neurological disorders. They may represent the clinical manifestations of these disorders, of a comorbid psychiatric disorder, or of iatrogenic complications of pharmacological and/or surgical therapies. Clearly, proper diagnosis is of the essence to provide the correct treatment. Electroencephalographic (EEG) studies are used on a regular basis to identify a potential organic cause of psychiatric symptomatology. This chapter reviews the diagnostic yield of EEG recordings in psychiatric symptomatology associated with primary psychiatric disorders, with neurological and medical conditions, and in particular with epilepsy, and provides suggestions on the optimal use of the different types of EEG recordings in clinical practice.

Doping in sports – conscious lack of interest or ethical Everest?

2017 ◽  
Vol 65 (4) ◽  
Keyword(s):  
Decision Making ◽  
General Population ◽  
Medical Setting ◽  
Doping In Sports ◽  
Physician Relationship ◽  
Pharmaceutical Agents ◽  
Similar Development ◽  
Level Performance ◽  
Elite Sports ◽  
Support Decision Making

Within a clinical sports medical setting the discussion about doping is insufficient. In elite-sports use of pharmaceutical agents is daily business in order to maintain the expected top-level performance. Unfortunately, a similar development could be observed in the general population of leisure athletes where medical supervision is absent. As a sports physician you are facing imminent ethical questions when standing in between. Therefore, we propose the application of a standardised risk score as a tool to promote doping-prevention and launch the debate within athlete-physician-relationship. In the longterm such kind of risk stratification systems may support decision-making with regard to «protective» exclusion of sporting competition.

The Value of Neuroimaging Techniques in the Translation and Transdiagnostic Validation of Psychiatric Diagnoses - Selective Review

2020 ◽  
Vol 20 (7) ◽  
pp. 540-553 ◽  
Author(s):  
Anna Todeva-Radneva ◽  
Rositsa Paunova ◽  
Sevdalina Kandilarova ◽  
Drozdstoy St. Stoyanov
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Medical Science ◽  
Self Report ◽  
Current Status ◽  
Diagnostic Tools ◽  
Main Concept ◽  
Directional Change ◽  
The Mind ◽  
Neuroimaging Techniques

: Psychiatric diagnosis has long been perceived as more of an art than a science since its foundations lie within the observation, and the self-report of the patients themselves and objective diagnostic biomarkers are lacking. Furthermore, the diagnostic tools in use not only stray away from the conventional medical framework but also remain invalidated with evidence-based concepts. However, neuroscience, as a source of valid objective knowledge has initiated the process of a paradigm shift underlined by the main concept of psychiatric disorders being “brain disorders”. It is also a bridge closing the explanatory gap among the different fields of medicine via the translation of the knowledge within a multidisciplinary framework. : The contemporary neuroimaging methods, such as fMRI provide researchers with an entirely new set of tools to reform the current status quo by creating an opportunity to define and validate objective biomarkers that can be translated into clinical practice. Combining multiple neuroimaging techniques with the knowledge of the role of genetic factors, neurochemical imbalance and neuroinflammatory processes in the etiopathophysiology of psychiatric disorders is a step towards a comprehensive biological explanation of psychiatric disorders and a final differentiation of psychiatry as a well-founded medical science. : In addition, the neuroscientific knowledge gained thus far suggests a necessity for directional change to exploring multidisciplinary concepts, such as multiple causality and dimensionality of psychiatric symptoms and disorders. A concomitant viewpoint transition of the notion of validity in psychiatry with a focus on an integrative validatory approach may facilitate the building of a collaborative bridge above the wall existing between the scientific fields analyzing the mind and those studying the brain.

Neurobiological Reward-Related Abnormalities Across Mood Disorders

2019 ◽  
pp. 222-238
Author(s):  
Alexis E. Whitton ◽  
Michael T. Treadway ◽  
Manon L. Ironside ◽  
Diego A. Pizzagalli
Keyword(s):  
Decision Making ◽  
Mood Disorders ◽  
Treatment Strategies ◽  
Reward Processing ◽  
Reward Learning ◽  
Symptom Presentation ◽  
Psychiatric Symptomatology ◽  
Symptom Dimensions ◽  
Psychotherapeutic Interventions ◽  
Primary Focus

This chapter provides a critical review of recent behavioral and neuroimaging evidence of reward processing abnormalities in mood disorders. The primary focus is on the neural mechanisms underlying disruption in approach motivation, reward learning, and reward-based decision-making in major depression and bipolar disorder. Efforts focused on understanding how reward-related impairments contribute to psychiatric symptomatology have grown substantially in recent years. This has been driven by significant advances in the understanding of the neurobiology of reward processing and a growing recognition that disturbances in motivation and hedonic capacity are poorly targeted by current pharmacological and psychotherapeutic interventions. As a result, numerous studies have sought to test the presence of reward circuit dysfunction in psychiatric disorders that are marked by anhedonia, amotivation, mania, and impulsivity. Moreover, as the field has increasingly eschewed categorical diagnostic boundaries in favor of symptom dimensions, there has been a parallel rise in studies seeking to identify transdiagnostic neural markers of reward processing dysfunction that may transcend disorders. The thesis of this chapter is twofold: First, evidence indicates that specific subcomponents of reward processing map onto partially distinct neurobiological pathways. Second, specific subcomponents of reward processing, including reward learning and effort-based decision-making, are impaired across different mood disorder diagnoses and may point to dimensions in symptom presentation that possess more reliable behavioral and neural correlates. The potential for these findings to inform the development of prevention and treatment strategies is discussed.

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