scholarly journals COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Qin Xie ◽  
Fang Fan ◽  
Xue-Peng Fan ◽  
Xiao-Jiang Wang ◽  
Ming-Jian Chen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Clinical Characteristics ◽  
Psychotic Disorders ◽  
Psychiatric Inpatient ◽  
Adjustment Disorder ◽  
Mental Illnesses ◽  
Control Group ◽  
Clinical Diagnoses ◽  
Inpatient Settings ◽  
First Onset

Abstract Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.

scholarly journals Clinical characteristics and sociodemographic features of psychotic major depression

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  
Keyword(s):  
Family History ◽  
Major Depression ◽  
Clinical Characteristics ◽  
Missing Values ◽  
Psychotic Disorders ◽  
Mental Health Center ◽  
Psychiatric Diseases ◽  
First Onset ◽  
History Of ◽  
Psychotic Major Depression

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.

scholarly journals Traditional faith healers as referral sources: A hospital-based descriptive study

2018 ◽  
Vol 7 (2) ◽  
pp. 46-50
Author(s):  
D.K. Thapa ◽  
N. Lamichhane ◽  
S. Subedi
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Descriptive Study ◽  
Mental Illnesses ◽  
General Observation ◽  
Cross Sectional ◽  
Faith Healer ◽  
Common Notion

Introduction: Mental illnesses are commonly linked with a higher disability and burden of disease than many physical illnesses. But despite that fact, it is a general observation that a majority of patients with mental disorder never seek professional help. To elaborate further, the widely prevalent magico-religious beliefs associated with mental illness and lower literacy, poses significant social obstacles in seeking appropriate health care for psychiatric patients. In general, mental illness is seen as related to life stresses, social or family conflicts and evil spirits and the concept of biological causes of mental illness is rare even among the educated. The idea that illness and death are due to malevolent spirits is common notion that is shared practically by all level of society from the so-called primitive to modern industrialized societies, thus indicating the strong influences of cultural background. When there is a magico- religious concepts of disease causation, there is tendency to consult indigenous healers. Therefore, the patients with mental illness often either visit or are taken to faith healers by their relatives. The objective of the study was to determine the various psychiatric cases that were referred by the traditional faith healers to the authors. Material and Method: This is a cross- sectional, hospital- based descriptive study, conducted at the Psychiatric outpatient department of Pokhara Om Hospital, Pokhara, Kaski, Nepal for the period of one year, from June 2016 to May 2017. The total of 35 cases, referred by the traditional faith healers was included in the study. Subjects of any age, any gender, any literacy level, any caste, from any locality and religious background were included in the study after their consent. Subjects who refused to consent were not included in the study. The psychiatric diagnosis was based on the complete history and examination and ICD- 10 DRC criteria. Results: Though the sample size is small, it is interesting to note that patients with various kinds of mental disorders were referred by traditional faith healers. There were patients suffering from neurotic disorders, psychotic disorders, mood disorders, seizure, substance use disorder, intellectual disability etc seeking the treatment from traditional faith healers. Among the cases referred, predominantly were female and neurotic cases. Most patients were educated. Conclusion: The study shows that patients with various mental disorders visit traditional faith healer. This area surely requires further in-depth look as traditional faith healers can be an important source of referral of psychiatric patients.

Mental Health: Overview

2013 ◽  
Author(s):  
Catherine G. Greeno
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Social Workers ◽  
Service Sector ◽  
Psychotic Disorders ◽  
Health Sector ◽  
Work Relationships ◽  
Classification Systems ◽  
Mental Illnesses ◽  
Substance Abuse Disorders

Mental illnesses are very common; more than one-quarter of people will develop a mental illness during their lifetime. Mental illnesses are associated with substantial disability in work, relationships, and physical health, and have been clearly established as one of the leading causes of disability in the developing, as well as the industrialized world. Mental disorders are common in every service sector important to social workers, and affect outcomes in every service sector. Mental disorders are strongly associated with poverty worldwide, and are common and often unrecognized in the general health sector, child welfare, and criminal justice settings, among others. Basic information about mental health is thus important to all social workers. Information about classification systems and major categories of mental illnesses, including depression, anxiety, psychotic disorders, and substance abuse disorders, is presented. The service system for mental disorders is badly underdeveloped, and most people who need treatment do not receive it. There is an increasing body of evidence demonstrating effective treatments, and policy is moving toward requiring that treatments offered be evidence based. This is a period of a great explosion of knowledge about mental health, and we can expect considerable advances in the coming years.

Referential thinking and severe mental disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1212-1212 ◽  
Author(s):  
L. Peris-Mencheta Puch ◽  
M.C. Senín-Calderón ◽  
E. Fernández-Jiménez ◽  
S. Fuentes-Márquez ◽  
M. Valdés-Diaz ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Public Hospital ◽  
Psychotic Disorders ◽  
Correlation Method ◽  
Adjustment Disorder ◽  
Clinical Severity ◽  
Clinical Samples ◽  
Cross Sectional ◽  
Clinical Center ◽  
Cross Sectional Design

AntecedentsIn a previous study (Senín-Calderón et al., 2010) we observed that the REF scale of referential thinking (Lenzenweger et al., 1997) didn’t discriminate among different mental disorders.Objectives and hypothesesWe try to verify if self-references in various disorders are related to the severity of psychopathology (patients from public hospital and a private clinical). We predict that there will be differences between patients and controls, but not between the clinical samples. Psychotic disorders will be characterized by a significantly greater presence of self-references.MethodsParticipants: 287 subjects, 47 patients from a private clinical center, 57.4% women (mean age = 35.02, SD = 12.69), 30 patients from a public hospital, 53.3% women (38.36 years, SD = 9.53), and 210 controls selected from the general population, 50.5% women (33.80 years, SD = 11.79). Cross-sectional design, correlation method. All analysis were accepted at p < .05.ResultsThere are significant differences in self-references between patients and controls in frequency (t (285) = 2.33, p = . 021) and intensity (t (83.98) = 3.59, p = . 001). No significant differences between patients groups (p>.05) (REF-intensity without homogeneity, p < .05). No significant differences in self-references between types of diagnoses except psychotic patients versus adjustment disorder (frequency and intensity).ConclusionsSelf-references are highlighted in psychosis but, with the exception of adjustment disorders, doesn’t discriminate between personality, mood or anxiety disorders. Differences are more related to the clinical severity (BPRS) than with referential thinking.

scholarly journals Development of a Digital Content-Free Speech Analysis Tool for the Measurement of Mental Health and Follow-Up for Mental Disorders: Protocol for a Case-Control Study

10.2196/13852 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e13852
Author(s):  
Peter Tonn ◽  
Yoav Degani ◽  
Shani Hershko ◽  
Amit Klein ◽  
Lea Seule ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental State ◽  
Mental Illnesses ◽  
Speech Analysis ◽  
Controlled Study ◽  
Control Group ◽  
Analysis Tool ◽  
Big 5 ◽  
Software Analysis

Background The prevalence of mental disorders worldwide is very high. The guideline-oriented care of patients depends on early diagnosis and regular and valid evaluation of their treatment to be able to quickly intervene should the patient’s mental health deteriorate. To ensure effective treatment, the level of experience of the physician or therapist is of importance, both in the initial diagnosis and in the treatment of mental illnesses. Nevertheless, experienced physicians and psychotherapists are not available in enough numbers everywhere, especially in rural areas or in less developed countries. Human speech can reveal a speaker’s mental state by altering its noncontent aspects (speech melody, intonations, speech rate, etc). This is noticeable in both the clinic and everyday life by having prior knowledge of the normal speech patterns of the affected person, and with enough time spent listening to the patient. However, this time and experience are often unavailable, leaving unused opportunities to capture linguistic, noncontent information. To improve the care of patients with mental disorders, we have developed a concept for assessing their most important mental parameters through a noncontent analysis of their active speech. Using speech analysis for the assessment and tracking of mental health patients opens up the possibility of remote, automatic, and ongoing evaluation when used with patients’ smartphones, as part of the current trends toward the increasing use of digital and mobile health tools. Objective The primary objective of this study is to evaluate measurements of participants' mental state by comparing the analysis of noncontent speech parameters to the results of several psychological questionnaires (Symptom Checklist-90 [SCL-90], the Patient Health Questionnaire [PHQ], and the Big 5 Test). Methods In this paper, we described a case-controlled study (with a case group and one control group). The participants will be recruited in an outpatient neuropsychiatric treatment center. Inclusion criteria are a neurological or psychiatric diagnosis made by a specialist, no terminal or life-threatening illnesses, and fluent use of the German language. Exclusion criteria include psychosis, dementia, speech or language disorders in neurological diseases, addiction history, a suicide attempt recently or in the last 12 months, or insufficient language skills. The measuring instrument will be the VoiceSense digital voice analysis tool, which enables the analysis of 200 specific speech parameters, and the assessment of findings using psychometric instruments and questionnaires (SCL-90, PHQ, Big 5 Test). Results The study is ongoing as of September 2019, but we have enrolled 254 participants. There have been 161 measurements completed at timepoint 1, and a total of 62 participants have completed every psychological and speech analysis measurement. Conclusions It appears that the tone and modulation of speech are as important, if not more so, than the content, and should not be underestimated. This is particularly evident in the interpretation of the psychological findings thus far acquired. Therefore, the application of a software analysis tool could increase the accuracy of finding assessments and improve patient care. Trial Registration ClinicalTrials.gov NCT03700008; https://clinicaltrials.gov/ct2/show/NCT03700008 International Registered Report Identifier (IRRID) PRR1-10.2196/13852

Lymphocytes with Fas-receptors of readiness to apoptosis in non-psychotic mental disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S743-S743
Author(s):  
V. Nikitina ◽  
T.P. Vetlugina ◽  
O.A. Lobacheva ◽  
V.A. Rudnitsky ◽  
M.M. Axenov
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Relative Number ◽  
Adjustment Disorder ◽  
Absolute Number ◽  
Control Group ◽  
Becton Dickinson ◽  
Competing Interest ◽  
Clinical Verification ◽  
Organic Personality Disorder

IntroductionApoptosis is a complex physiological process of the organism which supports cellular homeostasis, provides important aspects of development and functioning of the immune system. In various pathological conditions the process of apoptosis can be impaired that leads to decrease or increase in pro-apoptotic activity.Materials and methodsWe conducted investigation of relative and absolute number of CD3+CD95+–lymphocytes in groups of patients with adjustment disorders (n = 90), PTSD (n = 100), organic emotionally labile (asthenic) disorder (n = 232), organic personality disorder (n = 93). Clinical verification was conducted according to ICD–10. Control group included 190 practically healthy persons. Fas protein (CD95) expression on CD3 lymphocytes surfaces was detected using flow cytometry. Cytometric measurements were conducted on flow cytofluorimeter FacsCalibur (Becton Dickinson, US).ResultsIn the control group relative number of CD95+–lymphocytes was 11.6%, absolute–0.21 × 109/L. In all examined patients as compared with control the reliable increase both in relative and absolute number of lymphocytes of CD3+CD95+–phenotype was identified. So, in persons with adjustment disorder content of this indicator made 17.0% and 0.28 × 109/L (Р = 0.0015), in PTSD–18.0% and 0.33 × 109/L (Р = 0.0007) and in patients with organic asthenic disorder–19.0% and 0.32 × 109/L (Р = 0.0048), respectively. The highest content in blood of CD3+–lymphocytes, expressing on the surface of membrane the basic marker of apoptosis CD95 is observed in patients with organic personality disorder: 26.0% and 0.44 × 109/L (Р = 0.0003).ConclusionIn case of intensification of psychopathological symptoms especially in persons with non-psychotic organic mental disorders a receptor-mediated signaling pathway of apoptosis is activated – process of programmed cell death.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches

2008 ◽  
Vol 13 (6) ◽  
pp. 1-7
Author(s):  
Norma Leclair ◽  
Steve Leclair ◽  
Robert Barth
Keyword(s):  
Mental Disorders ◽  
Behavioral Disorders ◽  
Psychotic Disorders ◽  
Behavioral Disorder ◽  
Behavioral Impairment ◽  
Central Nervous System Damage ◽  
Brain Functioning ◽  
Sixth Edition ◽  
Diagnostic And Statistical Manual ◽  
Mental And Behavioral Disorders

Abstract Chapter 14, Mental and Behavioral Disorders, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines a process for assessing permanent impairment, including providing numeric ratings, for persons with specific mental and behavioral disorders. These mental disorders are limited to mood disorders, anxiety disorders, and psychotic disorders, and this chapter focuses on the evaluation of brain functioning and its effects on behavior in the absence of evident traumatic or disease-related objective central nervous system damage. This article poses and answers questions about the sixth edition. For example, this is the first since the second edition (1984) that provides a numeric impairment rating, and this edition establishes a standard, uniform template to translate human trauma or disease into a percentage of whole person impairment. Persons who conduct independent mental and behavioral evaluation using this chapter should be trained in psychiatry or psychology; other users should be experienced in psychiatric or psychological evaluations and should have expertise in the diagnosis and treatment of mental and behavioral disorders. The critical first step in determining a mental or behavioral impairment rating is to document the existence of a definitive diagnosis based on the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The article also enumerates the psychiatric disorders that are considered ratable in the sixth edition, addresses use of the sixth edition during independent medical evaluations, and answers additional questions.

Substance Abuse in Older Psychiatric Inpatients

2017 ◽  
Vol 63 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Tilman Wetterling ◽  
Klaus Junghanns
Keyword(s):  
Substance Abuse ◽  
Substance Abusers ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Severe Withdrawal ◽  
Psychiatric Inpatient Treatment ◽  
Clinical Diagnoses ◽  
Multiple Substance ◽  
Icd 10 ◽  
Substance Abuse Disorders

Abstract. Aim: This study investigates the characteristics of older patients with substance abuse disorders admitted to a psychiatric department serving about 250.000 inhabitants. Methods: The clinical diagnoses were made according to ICD-10. The data of the patients with substance abuse were compared to a matched sample of psychiatric inpatients without substance abuse as well as to a group of former substance abusers with long-term abstinence. Results: 19.3 % of the 941 patients aged > 65 years showed current substance abuse, 9.4 % consumed alcohol, 7.9 % took benzodiazepines or z-drugs (zolpidem and zopiclone), and 7.0 % smoked tobacco. Multiple substance abuse was rather common (30.8 %). About 85 % of the substance abusers had psychiatric comorbidity, and about 30 % showed severe withdrawal symptoms. As with the rest of the patients, somatic multimorbidity was present in about 70 % of the substance abusers. Remarkable was the lower rate of dementia in current substance abusers. Conclusion: These results underscore that substance abuse is still a challenge in the psychiatric inpatient treatment of older people.

The relationship between brain structure and general psychopathology in preadolescents

2020 ◽  
Author(s):  
Louise Mewton ◽  
Briana Lees ◽  
Lindsay Squeglia ◽  
Miriam K. Forbes ◽  
Matthew Sunderland ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Surface Area ◽  
Brain Structure ◽  
Parental Education ◽  
Mental Illnesses ◽  
General Psychopathology ◽  
Control Approach ◽  
Cortical Volume ◽  
Subcortical Regions ◽  
The Relationship

Categorical mental disorders are being recognized as suboptimal targets in clinical neuroscience due to poor reliability as well as high rates of heterogeneity within, and comorbidity between, mental disorders. As an alternative to the case-control approach, recent studies have focused on the relationship between neurobiology and latent dimensions of psychopathology. The current study aimed to investigate the relationship between brain structure and psychopathology in the critical preadolescent period when psychopathology is emerging. This study included baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study® (n = 11,721; age range = 9-10 years; male = 52.2%). General psychopathology, externalizing, internalizing, and thought disorder dimensions were based on a higher-order model of psychopathology and estimated using Bayesian plausible values. Outcome variables included global and regional cortical volume, thickness, and surface area. Higher levels of psychopathology across all dimensions were associated with lower volume and surface area globally, as well as widespread and pervasive alterations across the majority of cortical and subcortical regions studied, after adjusting for sex, race/ethnicity, and parental education. The relationships between general psychopathology and brain structure were attenuated when adjusting for cognitive functioning. There was evidence of a relationship between externalizing psychopathology and frontal regions of the cortex that was independent of general psychopathology. The current study identified lower cortical volume and surface area as transdiagnostic biomarkers for general psychopathology in preadolescence. The widespread and pervasive relationships between general psychopathology and brain structure may reflect cognitive dysfunction that is a feature across a range of mental illnesses.

STUDY ON THE EFFECT OF THE CATGUT-EMBEDDING METHOD COMBINING WITH HERBAL MEDICINE ON THE TREATMENT OF SCIATICA BY WIND-COLD-DAMP ARTHRALGIA

2014 ◽  
pp. 206-215
Author(s):  
Huu Tham Nguyen ◽  
Thi Tan Nguyen
Keyword(s):  
Herbal Medicine ◽  
Traditional Medicine ◽  
Clinical Characteristics ◽  
Day Treatment ◽  
Patient Treatment ◽  
Control Group ◽  
Controlled Trials ◽  
Study Group ◽  
Moderate Pain ◽  
Embedding Method

Objectives: To investigate clinical characteristics of patients with sciatica in Traditional Medicine Hospital in Thua Thien Hue province; To evaluate the effectiveness of the catgut-embedding method combining with herbal medicine on the treatment of sciatica by wind-cold-damp arthralgia. Subjects and Methods: Patients diagnosed with sciatica by wind-cold-damp arthralgia in-patient treatment in Traditional Medicine Hospital in Thua Thien Hue province. Methods: Clinical and controlled trials, a survey of 72 patients, which were divided into 2 groups: The study group: 36 patients: receiving treatment by catgut-embedding and herbal medicine; The control group: 36 patients: only use herbal medicine. 28-day treatment period. Patients were assessed at admission (T0), after 14 days (T14), after 28 days of treatment (T28). Results: After 28 days of treatment: no severity both 2 groups. The study group fell to 8.3% moderate pain, mostly mild pain (91.7%); the control group was 44.4% moderate pain, mild 55.6%.The catgut-embedding method does not cause any side effects. Key words: catgut-embedding method, sciatica by wind-cold-damp arthralgia

Sign in / Sign up

Export Citation Format

Share Document