Long-standing overt ventriculomegaly in adulthood with primary presentation of psychiatric disturbance

Abstract Purpose Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners’ mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). Methods APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England’s household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. Results One participant in seventy had been in prison (1.4%; 95% CI 1.1–1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02–3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. Conclusions Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.

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ICU admissions: Consequences after discharge

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738020932613 ◽

2020 ◽

Vol 13 (9) ◽

pp. 550-556

Author(s):

Minal Karavadra ◽

Ricky Bell

Keyword(s):

Intensive Care ◽

Cognitive Decline ◽

Intensive Care Units ◽

Critically Ill ◽

Critically Ill Patients ◽

Psychiatric Disturbance ◽

Intensive Care Department ◽

Previous Level ◽

The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

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Madness, virtue, and ecology: A classical Indian approach to psychiatric disturbance

History of the Human Sciences ◽

10.1177/0952695120982242 ◽

2021 ◽

pp. 095269512098224

Author(s):

Chakravarthi Ram-Prasad

Keyword(s):

Mental Illness ◽

Human Subject ◽

Philosophical Anthropology ◽

First Century ◽

The Other ◽

Third Century ◽

Psychiatric Disturbance ◽

Indian Medical ◽

The Subject ◽

Moral Relationship

The Caraka Saṃhitā (ca. first century BCE–third century CE), the first classical Indian medical compendium, covers a wide variety of pharmacological and therapeutic treatment, while also sketching out a philosophical anthropology of the human subject who is the patient of the physicians for whom this text was composed. In this article, I outline some of the relevant aspects of this anthropology – in particular, its understanding of ‘mind’ and other elements that constitute the subject – before exploring two ways in which it approaches ‘psychiatric’ disorder: one as ‘mental illness’ ( mānasa-roga), the other as ‘madness’ ( unmāda). I focus on two aspects of this approach. One concerns the moral relationship between the virtuous and the well life, or the moral and the medical dimensions of a patient’s subjectivity. The other is about the phenomenological relationship between the patient and the ecology within which the patient’s disturbance occurs. The aetiology of and responses to such disturbances helps us think more carefully about the very contours of subjectivity, about who we are and how we should understand ourselves. I locate this interpretation within a larger programme on the interpretation of the whole human being, which I have elsewhere called ‘ecological phenomenology’.

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Mood symptoms Associated with CADASIL Syndrome: A Case Report

CNS Spectrums ◽

10.1017/s1092852920002278 ◽

2021 ◽

Vol 26 (2) ◽

pp. 144-144

Author(s):

Asad Shaikh ◽

Joel Idowu

Keyword(s):

Case Report ◽

Clinical Symptoms ◽

Psychiatric Symptoms ◽

Small Vessel Disease ◽

Altered Mental Status ◽

Hereditary Disease ◽

African American Female ◽

Psychiatric Disturbance ◽

Rare Type ◽

Parietal Lobes

AbstractObjectiveTo discuss the psychiatric symptoms that are associated with CADASIL syndrome Abstract Cerebral:Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare type of hereditary disease involving the small cerebral vessels. The clinical symptoms are various and include recurrent ischemic strokes, migraine with aura, seizures with epilepsy, psychiatric problems such as mood disturbances, and progressive cognitive decline leading to dementia. This disease needs awareness amongst the psychiatrists even though it is discussed much more in neurology literature. Psychiatric symptoms are seen in 20–41% of patients with CADASIL syndrome (1, 2). Psychiatric symptoms are actually the initial presentation in 15% of the cases. (3) The psychiatric disturbance most reported are mood disturbances (9–41%) especially depression. Here a 42-year-old African American female was brought to the hospital emergency room after she was found wandering in the streets. Psychiatry was consulted for altered mental status. Upon evaluation by the psychiatric consult service she was only oriented to person, depressed, anxious and complaining of headaches. Initial CT scan showed marked small vessel disease and old lacunar infarcts in the basal ganglia and right corona radiata. Magnetic Resonance Imaging (MRI) of the brain showed acute infarcts in the right posterior frontal and right parietal lobes along with old infarcts. Her symptoms and findings on imaging were consistent with CADASIL syndrome. Once the diagnosis was confirmed and prior records were obtained patient was resumed on an antidepressant and anxiolytic.ConclusionThe purpose of this case report was to discuss psychiatric symptoms associated with CADASIL syndrome. Although there has been research showing a relationship between vascular disease and depression, a review of the literature suggests that there needs to be more research done to explore other psychiatric disturbances that may be seen with this syndrome. Psychiatric symptoms that are untreated can have the potential to further impact the quality of life therefore psychiatrists need to be aware of this syndrome in order to treat these patients promptly.References1 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0778-8 2 http://dx.doi.org/10.32474/OJNBD.2018.01.000101 3 https://pdfs.semanticscholar.org/47f6/5952ee3c5dcf2a61345f704914b17fa8dc0d.pdf

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Trail Making Test Performance in Relation to Certain Experimenter, Test and Subject Variables

Perceptual and Motor Skills ◽

10.2466/pms.1964.19.1.199 ◽

1964 ◽

Vol 19 (1) ◽

pp. 199-206 ◽

Cited By ~ 18

Author(s):

Oscar A. Parsons ◽

Harriet I. Maslow ◽

Freda Morris ◽

J. Peter Denny

Keyword(s):

Test Performance ◽

Screening Test ◽

Poor Performance ◽

Trail Making Test ◽

Psychiatric Disturbance ◽

The Poor ◽

Subject Variables ◽

Trail Making ◽

The Brain ◽

Order Of Administration

The Trail Making Test, previously reported highly effective in differentiating brain-damaged from non-brain-damaged Ss, was administered to 21 brain-damaged Ss and 63 non-brain-damaged Ss. Since the latter Ss performed at a level indistinguishable from that of the brain-damaged Ss, several studies were designed in an attempt to “explain” the poor performance of the non-brain-damaged Ss. The possible effects of behavioral agitation, anxiety, examiner differences, facility with letters of the alphabet, order of administration, and ego-involvement were investigated. Only anxiety was found to be significantly related to performance. However, in other analyses age, education, vocabulary, and degree of psychiatric disturbance were significantly related to performance. Until these variables are considered in the scoring system, it seems unlikely that the TMT will be effective as a general screening test for brain-damage.

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