Psychiatry is essential for now but might eventually disappear (although this is unlikely to happen any time soon)

2021 ◽  
pp. 103985622110481
Author(s):  
Brendan D Kelly
Keyword(s):  
Mental Illness ◽  
Nmda Receptor ◽  
Physical Health ◽  
Psychological Functioning ◽  
Psychiatric Symptoms ◽  
Mental Illnesses ◽  
Positive Development ◽  
Biological Basis ◽  
Fine Grained ◽  
Nmda Receptor Encephalitis

Objective: To provide an overview of specific aspects of historical and possible future trajectories of psychiatry. Conclusions: Psychiatric treatments alleviate suffering, promote physical health, and are associated with increased longevity. As the biological underpinnings of mental illnesses are slowly uncovered, they generally cease to be primarily part of psychiatry (e.g. epilepsy, anti-NMDA receptor encephalitis). If this process continues, the biological basis of all symptom-based ‘mental illnesses’ might be described, and psychiatry absorbed into neurology and other disciplines. This will be a positive development if it provides better treatment for mental illness and psychiatric symptoms in other conditions, which is psychiatry’s sole concern. Psychiatry’s own survival as a distinct discipline is irrelevant if other disciplines can do the job better, possibly in collaboration. Given the tiny impact of neuroscience on psychiatry to date, the disappearance of psychiatry is unlikely to occur anytime soon, if ever. It is possible that human psychological functioning and psychiatric suffering are sufficiently complex and changeable as to defy complete, fine-grained, neuroscientific explanation. This would leave a role for psychiatry indefinitely, treating the immensely disabling, biologically unexplained clusters of symptoms that we currently call ‘mental illnesses’, increasingly in collaboration with, or absorbed within, other disciplines in medicine.

Frequency and temporal sequence of clinical features in adults with anti-NMDA receptor encephalitis presenting with psychiatric symptoms

2018 ◽  
Vol 49 (16) ◽  
pp. 2709-2716 ◽  
Author(s):  
Ronald J. Gurrera
Keyword(s):  
Nmda Receptor ◽  
Clinical Features ◽  
Psychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Signs And Symptoms ◽  
Nmda Receptor Encephalitis ◽  
Nmdar Encephalitis ◽  
Unexplained Fever ◽  
Study Inclusion

AbstractBackgroundAnti-NMDA receptor (NMDAr) encephalitis is the most common autoimmune encephalitis in adults. It mimics psychiatric disorders so often that most patients are initially referred to a psychiatrist, and many are misdiagnosed. Without prompt and effective treatment, patients are likely to suffer a protracted course with significant residual disability, or death. This study focuses on the frequency and chronology of salient clinical features in adults with anti-NMDAr encephalitis who are likely to be first evaluated by a psychiatrist because their presentation suggests a primary psychiatric disorder.MethodsA systematic search of PubMed and EMBASE databases identified published reports of anti-NMDAr encephalitis associated with prominent behavioral or psychiatric symptoms. After eliminating redundancies, the frequencies and relative timing of clinical features were tabulated. Signs and symptoms were assigned temporal ranks based on the timing of their first appearance relative to the first appearance of other signs and symptoms in each patient; median ranks were used to compare temporal sequencing of both individual features and major symptom domains.ResultsTwo hundred thirty unique cases (185 female) met study inclusion criteria. The most common features were seizures (60.4%), disorientation/confusion (42.6%), orofacial dyskinesias (39.1%), and mutism/staring (37.4%). Seizures, fever, and cognitive dysfunction were often the earliest features to emerge, but psychiatric features predominated and sequencing varied greatly between individuals.ConclusionsClinicians should consider anti-NMDAr encephalitis when new psychiatric symptoms are accompanied by a recent viral prodrome, seizures or unexplained fever, or when the quality of the psychiatric symptoms is unusual (e.g. non-verbal auditory hallucinations).

Peer Support Shows Promise in Helping Persons Living with Mental Illness Address Their Physical Health Needs

2008 ◽  
Vol 27 (2) ◽  
pp. 21-36 ◽  
Author(s):  
Ann Bates ◽  
Vivien Kemp ◽  
Mohan Isaac
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Health ◽  
Peer Support ◽  
Western Australia ◽  
Public Mental Health ◽  
Support Service ◽  
Mental Illnesses ◽  
Health Needs ◽  
People With Mental Illness

The physical health of individuals with long-term mental illnesses has long been of concern. In Western Australia, the overall mortality rate from preventable causes of people living with mental illness was reported to be 2.5 times greater than that of the general population. A trial peer support service was initiated to assist people with mental illness to attend to their physical health needs. This paper presents the planning, implementation, and results of this collaborative initiative involving nongovernment agencies, the public mental health service, consumers of mental health services, and the University of Western Australia.

scholarly journals Anti-NMDAR Encephalitis: Higher Suspicious Needed for Earlier Diagnosis (Case Report, Literature Review and Diagnostic Criteria)

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Chanaka Amugoda ◽  
Noushin Chini Foroush ◽  
Hamed Akhlaghi
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Nmda Receptor ◽  
Psychiatric Symptoms ◽  
Health Assessment ◽  
Young Patients ◽  
Psychotic Episode ◽  
Acute Psychosis ◽  
Nmda Receptor Encephalitis ◽  
Immune Mediated

Background. Auto-immune mediated anti-NMDA receptor encephalitis is a very common delayed diagnosed encephalitis which predominately affecting young population. Objectives. This encephalitis is relatively unknown amongst emergency physicians and a majority of patients are admitted to psychiatric wards before their diagnosis is confirmed and appropriate treatments are commenced. We reported a case of a 22-year-old female presented to our emergency department with acute psychiatric symptoms. She was initially diagnosed with first presentation of acute psychosis and was hospitalised under mental health act. further assessment in the emergency department identified possible an organic cause for her acute psychosis and she was later admitted under medical team after her mental health assessment order was revoke. Several days later, her CSF result was positive with anti-NMDA receptor anti-bodies. Appropriate treatments were instituted leading to her full recovery. Conclusion. This case was the first confirmed anti-NMDA receptor encephalitis in our emergency department. It highlights the importance of thorough assessment of psychiatric presentations to emergency departments and consideration of auto-immune medicated encephalitis as one of the differential diagnosis in young patients presenting with first acute psychotic episode.

scholarly journals Metabolic phenotyping reveals a potential link between elevated faecal amino acids, diet and symptom severity in individuals with severe mental illness

2021 ◽  
Author(s):  
Jack Jansma ◽  
Rogier van Essen ◽  
Bartholomeus C.M. Haarman ◽  
Anastasia Chrysovalantou Chatziioannou ◽  
Jenny Borkent ◽  
...  
Keyword(s):  
Amino Acids ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Symptom Severity ◽  
Psychiatric Symptoms ◽  
Mental Illnesses ◽  
Therapeutic Interventions ◽  
Schizophrenia Spectrum Disorders ◽  
Potential Link ◽  
The Brain

The brain-gut axis is increasingly recognized as an important contributing factor in the onset and progression of severe mental illnesses such as schizophrenia spectrum disorders and bipolar disorder. This study investigates associations between levels of faecal metabolites identified using 1H-NMR, clinical parameters, and dietary components of forty-two individuals diagnosed in a transdiagnostic approach to have severe mental illness. Faecal levels of the amino acids; alanine, leucine, and valine showed a significant positive correlation with psychiatric symptom severity as well as with dairy intake. Overall, this study proposes a diet-induced link between the brain-gut axis and the severity of psychiatric symptoms, which could be valuable in the design of novel dietary or therapeutic interventions to improve psychiatric symptoms.

scholarly journals A 24-Year-Old Female With Anti-NMDA Receptor Encephalitis: A Case Report.

2020 ◽  
Author(s):  
Antoine Steeman ◽  
Ionut-Adrian Andriescu ◽  
Guy Mazairac
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nmda Receptor ◽  
Psychiatric Symptoms ◽  
Delayed Diagnosis ◽  
Young Patients ◽  
Tumour Resection ◽  
Female Ratio ◽  
Nmda Receptor Encephalitis ◽  
Initial Symptoms

Abstract Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a form of autoimmune encephalitis with paraneoplastic and nonparaneoplastic origin. Patients with this disease usually arrive at the intensive care unit without any diagnosis or with complications as a result of a delayed diagnosis. This disease is not well known and is underdiagnosed. Due to the variability of the initial symptoms and the lack of knowledge regarding these symptoms, anti-NMDA receptor encephalitis is not only underdiagnosed but also can be misdiagnosed as viral encephalitis or other pathologies. Anti-NMDA receptor encephalitis preferentially affects children (from 8 months) and young adults, and it has a male/female ratio of 1/4. In case of clinical suspicion, electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) are useful. The diagnosis is confirmed by the detection of IgG antibodies directed against NMDA receptors in serum and CSF. Treatment for this disease includes immunosuppression and tumour resection when indicated.Case presentation: We report the case of a 24-year-old female admitted to the emergency room following the onset of acute confusion. Due to the rapid deterioration of consciousness and swallowing disorders, the patient was transferred to the intensive care unit. On day 23 after presentation, MRI suggested autoimmune limbic encephalitis. Serologic and CSF results were positive for anti-NMDA antibodies. After IV methylprednisolone therapy and plasmapheresis and a second line therapy with corticosteroid therapy and mycophenolic acid, the patient’s clinical condition gradually improved.Conclusions: Anti-NMDA receptor encephalitis typically occurs in young patients with no history of acute psychiatric symptoms. The possibility of this pathology should be taken into account before diagnosing a patient with a psychiatric illness.

scholarly journals Psychiatric Symptoms of Patients With Anti-NMDA Receptor Encephalitis

2020 ◽  
Vol 10 ◽  
Author(s):  
Wei Wang ◽  
Le Zhang ◽  
Xiao-Sa Chi ◽  
Li He ◽  
Dong Zhou ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Psychiatric Symptoms ◽  
Nmda Receptor Encephalitis

scholarly journals The social adjustment of people with severe mental illness in São Paulo, Brazil

2005 ◽  
Vol 27 (4) ◽  
pp. 309-314 ◽  
Author(s):  
André Gulinelli ◽  
Lilian R C Ratto ◽  
Paulo Rossi Menezes
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Social Functioning ◽  
Social Adjustment ◽  
Psychiatric Symptoms ◽  
Sao Paulo ◽  
Mental Illnesses ◽  
São Paulo ◽  
The Social

OBJECTIVE: To investigate the social adjustment of individuals with severe mental illness living in the community in a large urban center of a developing country, and the characteristics associated with poor social functioning. METHOD: A cross-sectional study was performed in the city of Sao Paulo. Eligible subjects were residents of a defined geographic area, aged between 18 and 65, with a diagnosis of functional psychosis who had had contact with any public psychiatric service during a defined period. Structured assessments were used to obtain information on social-demographic characteristics, diagnosis (ICD-10), psychiatric symptoms (PANSS), and social adjustment (DAS). RESULTS: One hundred and eighty-eight subjects were included, of whom, 120 (63.8%) had some degree of impairment in social functioning. The most frequently affected areas of social functioning were work performance and sexual role. Twenty-four patients (12.8%) showed poor or very poor social adjustment in the month prior to the interview. Negative symptoms, number of previous admissions and general symptoms showed statistically significant associations with global social adjustment scores. CONCLUSIONS: The proportion of patients showing any degree of impairment in social adjustment was as high as in more developed societies. In order to successfully implement the new mental health policy in Brazil, better provision of community-based mental health services for those with severe mental illnesses is needed.

Mental health in the workplace

2011 ◽  
Vol 26 (S2) ◽  
pp. 694-694 ◽  
Author(s):  
H.Ø. Sørensen ◽  
P. Munk-Joergensen
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Psychiatric Symptoms ◽  
Correct Diagnosis ◽  
Mental Illnesses ◽  
The Public ◽  
Need For Treatment ◽  
Increased Risk ◽  
The Individual

IntroductionDepression and simple phobia are the most prevalent mental illnesses among employees leading to an increased number of sick days, decreased social and professional function, job satisfaction, quality of life and increased risk of loss of work.Around 25% of the working population is affected by psychiatric symptoms in a way that is painful to the individual, but not of such severity that is qualifies as a genuine disease.Untreated and not early identified these cases could lead to actual mental illness.Moreover, less than half of those currently suffering from depression are provided with the correct diagnosis in general practice, and less the half, diagnosed correctly, receive the proper medical treatment.ObjectivesTo identify, treat and thereby interrupt pre-existing cases of mental illness in the workplace. To prevent worsening of minor cases of psychiatric illness and symptomatic cases not considered a genuine disease.AimsTo develop models for early tracing and treatment of mental illness in the workplace with consequent improved health status and quality of life for the individual and improved economy for the workplace and the public.MethodsThis intervention study includes larger companies with more than 100 employees in the Region of North Denmark.The study design is a before-after study using self-reporting questionnaires as a basis for identification of cases of mental illness and follow-up of treatment. The study uses clinical interview and examination for determining the need for treatment.ResultsResults not yet available.

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