scholarly journals Stroke and Disorders of Consciousness

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Zikrija Dostović ◽  
Dževdet Smajlović ◽  
Ernestina Dostović ◽  
Omer Ć. Ibrahimagić
Keyword(s):  
Mental Disorders ◽  
Glasgow Coma Scale ◽  
Disorders Of Consciousness ◽  
National Institutes Of Health ◽  
Severe Stroke ◽  
Statistical Manual ◽  
Coma Scale ◽  
Diagnostic And Statistical Manual ◽  
Disturbance Of Consciousness

Objectives. To determine the severity of stroke and mortality in relation to the type of disturbance of consciousness and outcome of patients with disorders of consciousness. Patients and Methods. We retrospectively analyzed 201 patients. Assessment of disorders of consciousness is performed by Glasgow Coma Scale (Teasdale and Jennet, 1974) and the Diagnostic and Statistical Manual of Mental Disorders (Anonymous, 2000). The severity of stroke was determined by National Institutes of Health Stroke Scale (Lyden et al., 2011). Results. Fifty-four patients had disorders of consciousness (26.9%). Patients with disorders of consciousness on admission (P<0.001) and discharge (P=0.003) had a more severe stroke than patients without disturbances of consciousness. Mortality was significantly higher in patients with disorders of consciousness (P=0.0001), and there was no difference in mortality in relation to the type of disturbance of consciousness. There is no statistically significant effect of specific predictors of survival in patients with disorders of consciousness. Conclusion. Patients with disorders of consciousness have a more severe stroke and higher mortality. There is no difference in mortality and severity of stroke between patients with quantitative and qualitative disorders of consciousness. There is no statistically significant effect of specific predictors of survival in patients with disorders of consciousness.

scholarly journals Course and Recognition of Poststroke Delirium

Stroke ◽  
2020 ◽  
Author(s):  
Robert Fleischmann ◽  
Sina Warwas ◽  
Tina Andrasch ◽  
Rhina Kunz ◽  
Carl Witt ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Odds Ratio ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
National Institutes Of Health ◽  
Screening Tools ◽  
Neurological Deficits ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Confusion Assessment

Background and Purpose: Poststroke delirium (PSD) is an independent predictor of unfavorable outcome. Despite its individual and socioeconomic burden, its frequency, clinical course, and routine detection remain unresolved. This study aimed to assess psychometric properties of established delirium screening tools and investigate the natural course of PSD. Methods: This study investigated patients presenting with high-risk transient ischemic attacks or ischemic stroke within 24 hours during a 3-month period. Twice-daily screenings for PSD were done using the confusion assessment method, nursing delirium scale, and rapid delirium assessment, and evaluated for noninferiority against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. We investigated demographic and stroke characteristics as predictors of PSD, neurological deficits as predictors of false screening results, and conducted a simulation study to estimate the best timing to identify PSD. Results: We enrolled 141 patients (73.8±10.4 years of age, 61 female) with a mean National Institutes of Health Stroke Scale score of 6.4±6.5. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based PSD incidence was 39%, which manifested within 24 hours in 25% and 72 hours in almost all cases. The confusion assessment method was the only screening tool noninferior to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ratings providing a sensitivity of 82% and specificity of 80%. Age (odds ratio, 1.07 [1.02–1.13] per year, P =0.004) and National Institutes of Health Stroke Scale (odds ratio, 1.24 [1.15–1.34] per point, P <0.001) were predictors of PSD. False-positive screening results were associated with stroke-induced disorientation (odds ratio, 6.1 [3.2–11.61], P <0.001) and neglect (odds ratio, 2.17 [1.22–3.87], P =0.008). Simulations revealed that one in 4 cases is missed with less than daily screenings. Conclusions: PSD is a common complication of stroke and transient ischemic attack. Detection is challenged by confounding effects such as focal neurological deficits and the necessity for at least daily screenings. Future studies are required to investigate implementation of these findings in clinical routine. REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03930719.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Validación de la escala de sintomas somáticos (SSS-8) en pacientes de una zona rural en Ecuador

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Mercy García ◽  
Ernestina Tamami ◽  
Giovanni Rojas-Velasco ◽  
Carolina Posso ◽  
Galo Sánchez del Hierro ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Somatic Symptom ◽  
Symptom Scale ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Calidad De Vida ◽  
Dsm V ◽  
Scale 8

Introducción.- Los síntomas somáticos causan malestar y afectan la calidad de  vida de los pacientes, incrementando la frecuencia del uso de los servicios de salud. En Ecuador no existe un instrumento validado que evalúe somatización. La escala Somatic Symtom Scale-8 (SSS-8), es un instrumento usado como medida de referencia en the Diagnostic and Statistical Manual of Mental Disorders(DSM-V), para evaluar la carga de síntomas somáticos, validada en inglés y adaptada culturalmente a los idiomas alemán y japonés. Objetivos.- En esta investigación el propósito fue validar la escala “Somatic Symptom Scale-8” y determinar sus propiedades métricas. Métodos.- Investigación descriptiva y transversal en la que se realizó la validación de la herramienta clínica SSS-8 en 401 pacientes en la consulta externa del hospital Pedro Vicente Maldonado, desde mayo a julio de 2017. Para el análisis de datos se utilizaron los programas estadísticos SPSS versión 23, Latent gold y EpiDat 3.1. Resultados.- El grupo mayoritario fue de 30 a 47 años, con ligero predominio del sexo masculino (con 52,6%) sobre el femenino (47,4%). El SSS-8 mostró adecuadas propiedades métricas (alfa de Cronbach de 0,73). Mediante este análisis se obtuvo que, los pacientes que respondieron: algo, bastante o muchísimo en las dimensiones sentirse cansado, dolor de cabeza, dolor de brazos y dolor de espalda; tenían un 99% de probabilidades de presentar somatización. Conclusiones.- En este estudio, el SSS-8 demostró ser una herramienta útil para evaluar los síntomas somáticos en pacientes que acuden a consulta externa, ya que presentó buenas propiedades métricas: consistencia interna elevada, buena validez y una apropiada capacidad discriminativa.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

scholarly journals Use of empathy in psychiatric practice: Constructivist grounded theory study

BJPsych Open ◽  
2017 ◽  
Vol 3 (1) ◽  
pp. 26-33 ◽  
Author(s):  
James Ross ◽  
Chris Watling
Keyword(s):  
Grounded Theory ◽  
Mental Disorders ◽  
Major Elements ◽  
Qualitative Theory ◽  
Constructivist Grounded Theory ◽  
Psychiatric Practice ◽  
Teaching Approaches ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Iterative Coding

BackgroundPsychiatry has faced significant criticism for overreliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and medications with purported disregard for empathetic, humanistic interventions.AimsTo develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches.MethodThis study used constructivist grounded theory methodology to ask (a) ‘How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?’ and (b) ‘How do psychiatrists learn and teach the skills of empathetic engagement?’ The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data.ResultsThis constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional.ConclusionsParticipants were described by empathy-based interventions which are presented in a theory of ‘empathetic engagement’. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice.

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