Neuropsychiatric Complications after Stroke

2021 ◽  
Vol 41 (01) ◽  
pp. 085-100
Author(s):  
Katlyn Nemani ◽  
Lindsey Gurin
Keyword(s):  
Stress Disorder ◽  
Brain Dysfunction ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Stroke Event ◽  
Compulsive Disorder ◽  
Physiological Consequence ◽  
Neuropsychiatric Complications ◽  
Evidence Based Guidelines

AbstractNeuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive–compulsive disorder, and psychosis are less commonly encountered but potentially highly debilitating conditions that may be underrecognized. Early identification and treatment may mitigate functional impairment and improve quality of life. Evidence-based guidelines from the general population are often relied upon to guide treatment. Further research is needed to understand and tailor treatment of these disorders in the poststroke population.

Sex Differences in Anxiety Disorders

2019 ◽  
pp. 404-432
Author(s):  
Teresa A. Piggott ◽  
Alexandra N. Duran ◽  
Isha Jalnapurkar ◽  
Tyler Kimm ◽  
Stephanie Linscheid ◽  
...  
Keyword(s):  
Sex Differences ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Stress Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Considerable Research ◽  
Psychosocial Influences ◽  
Psychiatric Conditions ◽  
The Impact

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

scholarly journals Mindfulness-based and acceptance-based programmes in the treatment of obsessive–compulsive disorder: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050329
Author(s):  
Johannes Julian Bürkle ◽  
Johannes Caspar Fendel ◽  
Stefan Schmidt
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Obsessive Compulsive Disorder ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

IntroductionCognitive–behavioural therapy (CBT) with exposure and response prevention is the recommended standard for the treatment of obsessive–compulsive disorder (OCD). However, a high proportion of patients refuse this treatment, do not respond or relapse shortly after treatment. Growing evidence suggests that mindfulness-based and acceptance-based programmes (MABPs) are an effective option for the treatment of OCD. This systematic review and meta-analysis will examine the effectiveness of MABPs in treating OCD. We also aimed to explore potential moderators of the programmes’ effectiveness.Methods and analysisWe will systematically search MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and Cochrane Register of Controlled Trials (no language restrictions) for studies that evaluate the effect of MABPs on patients with OCD. We will conduct backward and forward citation searches of included studies and relevant reviews and contact corresponding authors. The primary outcome will be pre-post intervention change in symptom severity. A secondary outcome will be change in depressive symptoms. Two reviewers will independently screen the records, extract the data and rate the methodological quality of the studies. We will include both controlled and uncontrolled trials. Randomised controlled trials will be meta-analysed, separately assessing between-group effects. A second meta-analysis will assess the within-group effect of all eligible studies. We will explore moderators and sources of heterogeneity such as the specific programme, study design, changes in depressive symptoms, hours of guided treatment, control condition and prior therapy (eg, CBT) using metaregression and subgroup analyses. We will perform sensitivity analyses using follow-up data. A narrative synthesis will also be pursued. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the quality of the evidence.Ethics and disseminationEthical approval is not required. Results will be published in peer-reviewed journals and presented at international conferences.

Extended-release fluvoxamine and improvements in quality of life in patients with obsessive-compulsive disorder

2010 ◽  
Vol 51 (4) ◽  
pp. 373-379 ◽  
Author(s):  
Lorrin M. Koran ◽  
Daniel Bromberg ◽  
Carl S. Hornfeldt ◽  
John C. Shepski ◽  
Shirley Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Extended Release ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Quality of Life in Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2000 ◽  
Vol 5 (S4) ◽  
pp. 37-39 ◽  
Author(s):  
Dan J. Stein ◽  
Andrea Allen ◽  
Julio Bobes ◽  
Jane L. Eisen ◽  
M. L. Figuera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
World Economy ◽  
Negative Impact ◽  
General Medicine ◽  
Psychiatric Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Occupational Function

AbstractThe construct of quality of life (QOL), which has both subjective and objective components, has gained increasing importance in psychiatric research for several important reasons, not the least being the current importance of pharmacoeconomic issues. Obsessive-compulsive disorder (OCD) has been suggested to be the worlds 10th most disabling disorder, and pharmacoeconomic studies have indicated that its cost to the world economy runs into the billions of dollars. The use of QOL scales derived from general medicine and other areas of psychiatry has demonstrated the enormous negative impact of OCD on several domains, including occupational function, social function, and family function. Further work to ascertain the extent of changes in QOL during treatment of OCD is necessary.

Surgery and Radiosurgery in Autism: A Retrospective Study in 10 Patients

2021 ◽  
pp. 1-10
Author(s):  
Cristina V. Torres ◽  
Nuria Martínez ◽  
Marcos Ríos-Lago ◽  
Monica Lara ◽  
Juan Alvarez-Linera ◽  
...  
Keyword(s):  
Autism Spectrum ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Compulsive Disorder ◽  
Radiofrequency Lesions

<b><i>Introduction:</i></b> A subgroup of patients with autism spectrum disorder (ASD) show self or heteroaggression, dyscontrol episodes, and others are of obsessive-compulsive disorder (OCD) profile; some of them are resistant to medical and behavioural treatment. We describe the long-term outcome in a group of these patients, treated with radiofrequency brain lesions or combined stereotactic surgery and Gamma Knife (GK) radiosurgery. <b><i>Methods:</i></b> We reviewed the medical records of 10 ASD patients with pathological aggressiveness and OCD, who had undergone radiofrequency lesions and/or radiosurgery with GK in our institution. <b><i>Results:</i></b> The 10 patients had a significant reduction of their symptoms (PCQ 39.9 and 33, OAS 11.8 and 5, CYBOCS-ASD 30.4 and 20), preoperatively and in the last follow-up, respectively; <i>p</i> &#x3c; 0.005 (in all cases), although all but 2 needed more than 1 treatment to maintain this improvement. <b><i>Conclusions:</i></b> We observed a marked improvement in behaviour, quality of life, and relationship with the environment in all our 10 patients after the lesioning treatments, without long-lasting side effects.

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