scholarly journals Trends in consultations for schizophrenia and non-affective psychoses in Italian emergency departments during and after the 2020 COVID-19 lockdown

2021 ◽  
Author(s):  
Matteo Balestrieri ◽  
Paola Rucci ◽  
Davide Amendola ◽  
Miki Bonizzoni ◽  
Giancarlo Cerveri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicidal Ideation ◽  
Psychiatric Disorders ◽  
Hospital Emergency Department ◽  
Schizophrenia Spectrum Disorders ◽  
Hospital Emergency ◽  
Consultation Rate ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Sedative Agents

Abstract Aims To analyse the hospital emergency department (HED) consultations for schizophrenia-spectrum disorders in nine Italian hospitals during the 2020 lockdown and post-lockdown periods, compared to the equivalent periods in 2019. Methods Characteristics of consultations, patients, and drug prescriptions were analysed. Joinpoint models were used to identify changes in the weekly trend of consultations. Results During the 2020 lockdown the overall number of HED consultations for schizophrenia decreased by 40.7% and after the lockdown by 12.2% compared with 2019. No difference was found in the proportion of consultations that led to GHPU admissions or compulsory admissions. Suicidality rates did not differ across the two years, with the exception of ideations and plans (+5.9%) during the post-lockdown period. We found an increase in benzodiazepine prescriptions in 2020 during the lockdown and post-lockdown periods (+10.6% and +20.8%, respectively), and a decrease of prescriptions for short-acting sedative agents in the post-lockdown period (-7.9%). An increase in the weekly trend of consultations occurred from March 11-17 (week 11) to June 26-June 30 (week 26). As a result, the initial gap in the number of consultations between the two years cancelled out at the end of June. Conclusions HED consultation rate for schizophrenia-spectrum disorders declined consistent with that of other psychiatric disorders. In the post-lockdown period the growth of suicidal ideation/planning and increase in the prescriptions of anxiolytic-sedating drugs may foreshadow that for some schizophrenia patients the exit from the lockdown period is not liberating, but rather a source of agitation or perturbation.

Living conditions of patients with schizophrenia spectrum disorders in the region of ‘Tâmega e Sousa’ (Portugal)

2020 ◽  
pp. 002076402096253
Author(s):  
Rui Barranha ◽  
Tânia Teixeira ◽  
João Quarenta ◽  
Orlando von Doellinger
Keyword(s):  
Observational Study ◽  
Psychiatric Disorders ◽  
Social Exclusion ◽  
Market Integration ◽  
Professional Status ◽  
Schizophrenia Spectrum Disorders ◽  
Cross Sectional ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Clinical Records

Background: Schizophrenia spectrum disorders (SSD) are the most impairing psychiatric disorders and are a major cause of social exclusion. Despite that, there are only two studies published assessing the socioeconomic characteristics of SSD patients living in Portugal. Aims: The purpose of this study is to assess the degree of social and family support for SSD patients living in the region of ‘Tâmega e Sousa’, in northern Portugal. Method: We conducted a cross-sectional observational study using patients under home-based care provided by the Department of Psychiatry and Mental Health of Centro Hospitalar do Tâmega e Sousa. We retrieved sociodemographic data from clinical records. The study was approved by the Hospital Ethics Committee. Results: Our sample consists on 67 patients with SSD, mostly men (74.6%). Although the majority was single (69.2%) and childless (85.7%), only a minority lived alone (21.2%). In relation to their professional status, only 5.0% were employed and 78.3% got a disability pension. Among the patients that lived accompanied, 68% lived with their parents or grandparents, and a quarter lived with family members affected by psychiatric disorders. Conclusions: These findings highlight the dependence of SSD patients on their family’s support. Lack of labour market integration, economic dependence and difficulty establishing stable relationships further aggravate their social exclusion. Although our results are consistent with a previous observational study held in Portugal, our patients display a worse functional status. Even considering the possible patient selection bias, there is evidence supporting the need for more investment in psychosocial rehabilitation that should take into account the sociodemographic idiosyncrasies of this Portuguese region.

Controversy Over the Diagnosis of ‘Cannabis-Induced Psychosis’

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Arendt
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Treatment ◽  
Subsequent Treatment ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Familial Predisposition ◽  
Schizophrenia Spectrum ◽  
Icd 10 ◽  
Dsm Iv ◽  
Spectrum Disorders

Background:Both the ICD-10 and the DSM-IV operate with a diagnosis of cannabis-induced psychotic disorder. Despite this, the diagnosis is controversial.A number of studies have shown that cannabis can induce short-lived psychotic symptoms, and that this could depend on factors such as genetic predisposition. To qualify for a diagnosis of ‘cannabis-induced psychosis’, however, the symptoms must last for at least 48 hours according to the ICD-10. This diagnosis has traditionally been regarded as benign, but this is based on a very limited number of studies.Methods:We have conducted two studies based on Danish treatment registers. Firstly, all patients who had received psychiatric treatment for cannabis-induced psychosis were followed for at least 3 years to determine the rate of subsequent treatment for schizophrenia-spectrum disorders. Secondly, familial predisposition for psychiatric disorders among subjects treated for cannabis-induced psychosis and schizophrenia was compared using competing risk analyses.Results:Schizophrenia spectrum disorders were diagnosed in 44.5% of the 535 subjects included in the first study. New psychotic episodes of any type were diagnosed in 77.2% and 47.1% received a diagnosis of schizophrenia spectrum disorders more than a year after the cannabis-induced psychosis.Those who develop cannabis-induced psychosis and schizophrenia spectrum disorders both show elevated levels of predisposition for schizophrenia, other psychotic conditions, and other psychiatric disorders in first-degree relatives. In general, the level of predisposition is of similar magnitude in individuals treated for cannabis-induced psychosis and schizophrenia.Conclusion:Cannabis-induced psychosis could be an early sign of schizophrenia rather than a distinct clinical entity.

Clinical Aspects of Psychiatric Disorders

2017 ◽  
Author(s):  
Neha Gupta ◽  
Ajay Shah ◽  
Kamalika Roy ◽  
Varma Penumetcha ◽  
Mark Oldham
Keyword(s):  
Psychiatric Disorders ◽  
Disruptive Behavior ◽  
Behavior Disorders ◽  
Somatic Symptom ◽  
Depressive Disorders ◽  
Clinical Aspects ◽  
Schizophrenia Spectrum Disorders ◽  
Addictive Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

In this chapter, clinical aspects of major psychiatric disorders listed in the DSM5 including intellectual-disability, attention-deficit and disruptive behavior disorders, substance-related and addictive disorders, schizophrenia spectrum disorders, bipolar and related disorders, depressive disorders, anxiety disorders, somatic symptom and related disorders are reviewed

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