scholarly journals Postpartum psychosis in a non-native language–speaking patient: A perspective on language barriers and cultural competency

2019 ◽  
Vol 32 (3) ◽  
pp. e100077 ◽  
Author(s):  
Tatsuhiko Naito ◽  
Justin Chin ◽  
Jun Lin ◽  
Pritesh J Shah ◽  
Christine M Lomiguen
Keyword(s):  
Language Barriers ◽  
Rapid Onset ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Cultural Considerations ◽  
Speaking Patient ◽  
The Usa ◽  
Postpartum Psychiatric Disorders ◽  
English Speaking ◽  
Psychotic Features

Postpartum psychosis is a condition characterised by rapid onset of psychotic symptoms several weeks after childbirth. Outside of its timing and descriptions of psychotic features, minimal research exists due to its relative rarity (1 to 2 per 1000 births in the USA), with greater emphasis on postpartum sadness and depression. With the existing literature, cultural differences and language barriers previously have not been taken into consideration as there are no documented cases of postpartum psychosis in a non–English-speaking patient. Correctly differentiating postpartum psychosis from other postpartum psychiatric disorders requires adeptly evaluating for the presence of psychotic symptoms with in-depth history taking. Here, we present a case of postpartum psychosis in a Japanese-speaking only patient, with an associated clinical course and culturally appropriate approach to treatment. A review of postpartum psychosis and language/cultural considerations are also discussed, with attention on the Japanese concept of ‘Satogaeri bunben’.

scholarly journals A-072 Neuropsychological Case Study of Behavioral Variant Frontotemporal Neurocognitive Disorder​ in a Vietnamese Woman in a Community Health Setting

2020 ◽  
Vol 35 (6) ◽  
pp. 864-864
Author(s):  
Naylor J ◽  
O'Donnell N ◽  
Hans N ◽  
Berry S ◽  
Uzuncan T
Keyword(s):  
Community Health ◽  
Evaluation Process ◽  
Receptive Language ◽  
Low Literacy ◽  
Language And Culture ◽  
Cultural Considerations ◽  
Diffuse Atrophy ◽  
English Speaking ◽  
Psychotic Features

Abstract Objective Behavioral variant frontal temporal dementia (bvFTD) is characterized by progressive changes in behavior, personality, and cognition. Little is published on the presentation in non-English-speaking populations. Here is the case of a neuropsychological evaluation in a community health setting where language and cultural considerations were salient. Method A 73-year-old, right-handed, monolingual Vietnamese widowed female homemaker with five years of education and low literacy, was referred after gradual personality changes over five years caused family tension and a need for increased monitoring. History includes cardiovascular disease, hypertension, hypercholesterolemia, cholestatic hepatitis, and depression with remitting psychotic features and suicidal ideation. Neuroimaging shows right temporal encephalomalacia and mild diffuse atrophy commensurate with age. Results A bilingual phone interpreter was used. Test findings revealed low scores across all but two tasks (visuospatial processing speed, recognition memory). Several confrontation naming items were unknown to the patient or culturally irrelevant, per interpreter. Interview with an English-speaking daughter revealed declines in behavior and social comportment (e.g., unsympathetic, demanding, rigid, repetitive, disorganized, compulsive shopping and gaming, confabulatory) and modest declines in activities of daily living. Presentation was notably childlike, overly affectionate, “grabby”, insistent, restless, with poor conversational turn-taking (with interpreter), but generally intact expressive and receptive language. BvFTD was diagnosed. Conclusions Addressing needs of a diverse, multi-cultural population in a community health setting can present significant challenges. This case study highlights the importance of non-psychometric sources of data, including history, observation, and collateral interviews, along with consideration of education, language, and culture on the evaluation process and case conceptualization.

Experiences of Karen refugees with traditional and western medicine in the USA

2018 ◽  
Vol 14 (4) ◽  
pp. 387-399
Author(s):  
Natalie R. Wodniak
Keyword(s):  
New York ◽  
Health Insurance ◽  
Traditional Medicine ◽  
Traditional Practices ◽  
Content Type ◽  
Large Populations ◽  
The Usa ◽  
English Speaking ◽  
Karen Refugees ◽  
Us Cities

Purpose The purpose of this paper is to further understand the medical experiences of Karen refugees who have been resettled to the USA. It examines the use of traditional medicine throughout the transition from Burma to the USA, as well as refugees’ experiences in the American healthcare system. This study aims to identify shortcomings in refugees’ access to preferred methods of healthcare. Design/methodology/approach Interviews were conducted with 39 Karen refugees in 3 US cities with large populations of refugees from Burma – Fort Wayne, Indiana; Amarillo, Texas; and Buffalo, New York. Participants were asked questions about their healthcare experiences in Burma and the USA, their use of traditional medicine in both countries and their satisfaction with medical care in the USA. Findings Nearly all interviewees reported using traditional medicine in Burma, but only six felt able to continue to use traditional methods in the USA. Most participants had positive experiences with healthcare in America, but 15 expressed dissatisfaction with obtaining health insurance and confusion over its coverage. Findings also indicate that refugees do not feel that traditional practices are accepted in the USA. Research limitations/implications Due to the language barrier, a phone interpreter was used for non-English-speaking participants, which may have affected proper understanding or clarity of answers. Practical implications This study brings to attention the need to improve refugee healthcare by encouraging traditional practices and assisting refugees with obtaining health insurance. Originality/value This paper identifies the importance of analyzing the accessibility of various forms of healthcare, including traditional medicine, to refugees in the USA.

scholarly journals CADASIL syndrome (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) presenting as psychosis

2018 ◽  
Vol 31 (3) ◽  
pp. e100017 ◽  
Author(s):  
Dheerendra Kumar Mishra ◽  
Aman Kishore ◽  
Vijay Niranjan
Keyword(s):  
Autosomal Dominant ◽  
Small Vessel Disease ◽  
Significant Proportion ◽  
Psychotic Symptoms ◽  
Behavioural Disturbance ◽  
Monogenic Form ◽  
Recurrent Strokes ◽  
Spectrum Disorders ◽  
Psychotic Features ◽  
Subcortical Infarct

Cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) is the most common monogenic form of cerebral small-vessel disease characterised by recurrent strokes. Behavioural disturbance also presents in a significant proportion of subjects as neurotic spectrum disorders and psychotic features are rarely reported. In this case report, we highlight a 32-year-old man with CADASIL syndrome, who had overt psychotic symptoms with neurological signs later on.

scholarly journals Case Report: Severe Adolescent Major Depressive Syndrome Turns Out to Be an Unusual Case of Anti-NMDA Receptor Encephalitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander Moldavski ◽  
Holger Wenz ◽  
Bettina E. Lange ◽  
Cathrin Rohleder ◽  
F. Markus Leweke
Keyword(s):  
Cognitive Deficits ◽  
Psychiatric Symptoms ◽  
Previous History ◽  
Rapid Onset ◽  
Depressive Syndrome ◽  
Psychotic Symptoms ◽  
Major Depressive ◽  
Abnormal Movements ◽  
Nmdar Encephalitis ◽  
Initial Symptoms

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a neuroinflammatory condition mediated by autoantibodies against the GluN1 subunit of the receptor. Clinically, it is characterized by a complex neuropsychiatric presentation with rapidly progressive psychiatric symptoms, cognitive deficits, seizures, and abnormal movements. Isolated psychiatric manifestations of anti-NMDAR encephalitis are rare and usually dominated by psychotic symptoms. We present a case of an 18-year-old female high school student—without a previous history of psychiatric disorders—with a rapid onset severe depressive syndrome. Surprisingly, we found pleocytosis and anti-NMDAR autoantibodies in the cerebrospinal fluid (CSF), despite an otherwise unremarkable diagnostic workup, including blood test, clinical examination, and cranial magnetic resonance imaging (MRI). After intravenous immunoglobulins treatment, a complete remission of the initial symptoms was observed. In a follow-up 5 years later, the young woman did not experience any relapse or sequelae. Anti-NMDAR encephalitis can present in rare cases as an organic disorder with major depressive symptoms without distinct concomitant psychotic or neurological symptoms. A clinical presentation such as a rapid onset of symptoms, distinct disturbance in the thought process, restlessness, and cognitive deficits should prompt screening for NMDAR- and other neural autoantibodies to rule out this rare but debilitating pathology.

scholarly journals The Speech Act of Complimenting as Part of the Ukrainian, Russian and English-Speaking Communities: Ukraine and the USA

2019 ◽  
Author(s):  
Anzhelika Solodka ◽  
Luis Perea
Keyword(s):  
Cultural Values ◽  
Speech Acts ◽  
Native Speakers ◽  
The United States ◽  
Personal Appearance ◽  
The Usa ◽  
On Line ◽  
Native Speakers Of English ◽  
English Speaking ◽  
Language Context

Compliments as speech acts have the reflection and expression of cultural values. Many of the values reflected through compliments are personal appearance, new acquisitions, possessions, talents and skills. It is especially important in linguistic interaction between people. This research aims to analyze the speech acts of complimenting in Ukrainian and American cultures in order to use them for teaching pragmatics second language (L2) students. Defining the ways of complimenting in Ukrainian, Russian and American English help to avoid misunderstandings and pragmatic failures. This study uses a method of ethnomethodology. Speach acts are studied in their natural contexts. To carry out this research native speakers of English in the United States and native speakers of Russian and Ukrainian from all over Ukraine were interviewed on-line. The analysis was made on the data that included: 445 Russian, 231 Ukrainian and 245 English compliments. Results of this study show how native speakers tend to compliment people: syntactical structure of expressions, cultural lexicon, attributes praised and language context. It has implications for teaching English to Ukrainians and for teaching Russian and Ukrainian to speakers of English. Knowing how to use speech acts allows the speaker to have pragmatic competence. Upon completion of the data analysis on the current study, further information on deeper analysis in terms of semantics and metaphorical language can be provided.

An Exploratory Retrospective Evaluation of Ropinirole-Associated Psychotic Symptoms in an Outpatient Population Treated for Restless Legs Syndrome or Parkinson's Disease

2009 ◽  
Vol 43 (9) ◽  
pp. 1426-1432 ◽  
Author(s):  
Steven C Stoner ◽  
Megan M Dahmen ◽  
Mignon Makos ◽  
Jessica W Lea ◽  
Lora J Carver ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Receptors ◽  
Restless Legs Syndrome ◽  
Dopamine Agonists ◽  
Dual Therapy ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Restless Legs ◽  
Psychotic Features

Background: Traditional treatment approaches for the management of restless legs syndrome (RLS) and Parkinson's disease (PD) include the use of medications that either directly or indirectly increase dopamine levels. In turn, a potential adverse event that could be expected is the development or exacerbation of psychiatric-related symptoms. Objective: To evaluate and describe the incidence of psychosis and associated behavioral features in patients taking ropinirole for RLS or PD. Methods: Patients were identified from a computerized database search of outpatients being treated with ropinirole for 1 of 2 medical conditions: PD or RLS. Data were collected in a retrospective manner from 95 patients who were tracked over the course of their therapy to determine whether psychosis or associated behavioral symptoms developed as a result and whether an intervention was needed to adjust ropinirole dosing or if additional medications had to be added to control features associated with psychosis. Results: A total of 284 patients being treated for RLS or PD were identified; of this group, 95 patients were identified as being treated for PD or RLS with ropinirole. Of the 95 patients being treated with ropinirole, 13 developed psychotic features that required therapeutic intervention with either the use of an antipsychotic or dose adjustment of ropinirole. PD patients included in this study were numerically more likely to develop psychotic features compared with RLS patients; however, the difference was not statistically significant (p = 0.122). The results do suggest that this risk is increased when ropinirole is used as part of a dual therapy approach with dopamine agonists in the treatment of either PD or RLS (p = 0.003). Discussion: Dopamine agonists have long been used as preferred treatment in the management of PD and RLS. When treating either PD or RLS in the psychiatric population, the concern arises that increased activity at dopamine receptors may induce or exacerbate psychiatric features. A potential clinical concern with the use of ropinirole is the potential for patients to develop psychiatric features, although there are few data available to demonstrate whether stimulation of targeted individual dopamine receptors is linked to the development or exacerbation of psychotic features. It is also undetermined whether concurrent antipsychotic treatment provides any protective benefit against psychosis, especially in patients already being treated for psychotic symptoms. Conclusions: Our findings suggest that ropinirole may play a role in inducing or exacerbating psychosis and its associated features, although a number of confounding variables prevent the determination of a clear association and suggest that further investigation is warranted in controlled clinical trials.

Postpartum psychosis—important clues to the aetiology of mood disorders

2014 ◽  
Author(s):  
Ian Jones
Keyword(s):  
Mood Disorder ◽  
Psychotic Disorders ◽  
Perinatal Period ◽  
Acute Onset ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Research Strategies ◽  
Pregnancy And Childbirth ◽  
Unipolar Disorder ◽  
Disturbance Of Consciousness

It is of great regret that although corresponding with him at the start of my research career, I never met Channi Kumar face to face. His work, however, as evidenced by this book, remains an important influence on our field. I share his belief in the ‘maternal brain as a model for investigating mental illness’ (Kumar 2001), and this conviction has underlined much of my research. In this chapter I will discuss the concept of postpartum psychosis (PP), explore what we know about the relationship of these episodes to other mood and psychotic disorders, and consider research strategies aimed at understanding the nature of the postpartum trigger. I will argue that the nosological confusion surrounding this condition has been unhelpful and that it is time, perhaps, to consider whether we should revive postpartum psychosis as a diagnostic concept. Episodes of mood disorder in relation to pregnancy and childbirth are very common. In our group we have recently examined the history of perinatal episodes in over 1,500 women with mood disorder who have participated in our genetic studies and find that approximately two thirds of parous women, with both bipolar and unipolar disorder, have experienced a significant mood episode in the perinatal period (Di Florio et al. 2013). PP refers to some of the most severe forms of postpartum psychiatric disorder. Although the boundaries of this condition are not easy to define, the core concept is the acute onset of a manic or affective psychosis in the immediate postpartum period. Depending on the definition employed, the incidence is approximately 1 in 1,000 deliveries (Jones et al. 2010). Women may go from being very well to severely ill within hours. Affective (mood) symptoms, both elation and depression, are prominent, as is a disturbance of consciousness marked by an apparent confusion, bewilderment, or perplexity. As the name suggests, psychotic phenomena occur, with delusions and hallucinations prominent. Some women with severe manic episodes, but who do not show psychotic symptoms, may receive the diagnosis, although it is also possible to reserve the label for those women with frank psychotic presentations.

Postpartum Psychosis

2020 ◽  
pp. 39-50
Author(s):  
Nikole Benders-Hadi
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Elevated Risk ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Poor Sleep ◽  
Activity Levels ◽  
History Of ◽  
Infant Hospitalization ◽  
Increased Activity

This chapter on postpartum psychosis notes that the risk of postpartum psychosis in the general population is very rare at less than 1%. In a mother with a known history of schizophrenia, this risk increases to 25%. Psychotic symptoms appearing postpartum may also be evidence of a bipolar disorder. The presence of elevated mood, increased activity levels and energy, poor sleep, and a family history of manic episodes all increase the likelihood that a bipolar disorder is present. Women with a personal or family history of a bipolar disorder are at an elevated risk of developing a mania or depression with psychotic symptoms postpartum. Postpartum psychosis due to any cause is a psychiatric emergency and treatment should be initiated early and aggressively to ensure the safety of mother and infant. Hospitalization and/or separation of the baby and mother may be necessary. The use of medication to treat schizophrenia or bipolar disorder during pregnancy may decrease the risk of a postpartum psychosis. With appropriate postpartum medication and support, the majority of women experiencing postpartum psychosis recover well and the risk of recurrent psychotic symptoms can be greatly reduced.

scholarly journals The Symptom and Domain Structure of Psychotic Disorders: A Network Analysis Approach

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Victor Peralta ◽  
Gustavo J Gil-Berrozpe ◽  
Julián Librero ◽  
Ana Sánchez-Torres ◽  
Manuel J Cuesta
Keyword(s):  
Graphical Models ◽  
Network Structure ◽  
Sampling Method ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Central Position ◽  
Cluster Solution ◽  
Clinical Variables ◽  
Global Strength ◽  
Psychotic Features

Abstract Little is understood about the symptom network structure of psychotic disorders. In the current study, we aimed to examine the network structure of psychotic symptoms in a broad and transdiagnostic sample of subjects with psychotic disorders (n = 2240) and to determine whether network structure parameters vary across demographic, sampling method and clinical variables. Gaussian graphical models were estimated for 73 psychotic symptoms assessed using the Comprehensive Assessment of Symptoms and History. A 7-cluster solution (reality distortion, disorganization, catatonia, diminished expressivity, avolition/anhedonia, mania, and depression) best explained the underlying symptom structure of the network. Symptoms with the highest centrality estimates pertained to the disorganization and, to a lesser extent, negative domains. Most bridge symptoms pertained to the disorganization domain, which had a central position within the network and widespread connections with other psychopathological domains. A comparison of networks in subgroups of subjects defined by premorbid adjustment levels, treatment response, and course pattern significantly influenced both network global strength and network structure. The sampling method and diagnostic class influenced network structure but not network global strength. Subgroups of subjects with less densely connected networks had poorer outcomes or more illness severity than those with more densely connected networks. The network structure of psychotic features emphasizes the importance of disorganization symptoms as a central domain of psychopathology and raises the possibility that interventions that target these symptoms may prove of broad use across psychopathology. The network structure of psychotic disorders is dependent on the sampling method and important clinical variables.

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