Effect of Marriage on Pre-existing Psychoses: A Convenient or Futile Solution for Severe Mental Disorders?

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.

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Clinical, epidemiological and autoimmune associations in childhood vitiligo in Qatar

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200594 ◽

2020 ◽

Vol 6 (2) ◽

pp. 151

Author(s):

Haya Al Mannai ◽

Mohamed Allam ◽

Hassan Riad

Keyword(s):

Family History ◽

Autoimmune Diseases ◽

Age Of Onset ◽

Positive Family History ◽

Thyroid Peroxidase ◽

Base Line ◽

Adult Onset ◽

Prognostic Features ◽

History Of ◽

The Mean

Background: Childhood vitiligo although clinically similar to adult onset vitiligo but it has distinct clinical, epidemiological and prognostic features compared to adult onset vitiligo.Methods: This is a retrospective study that was carried out on 85 pediatric patients up to age of 18 years old with the diagnosis of vitiligo, where the clinical and epidemiological data including clinical type of vitiligo, family history of autoimmune diseases like thyroid disorders and diabetes mellitus and laboratory results including anti-thyroid peroxidase antibodies (anti-TPO antibodies), anti-parietal cell antibodies, antinuclear antibodies (ANA), Vitamin D and Vitamin B12 were retrieved from the files of these patients.Results: The mean age of the children affected by vitiligo was 10.4 years, the mean age of onset of vitiligo was 5.4 years, 54 (63.5%) percent were girls and 31 (36.5%) were boys. A positive family history of vitiligo was found in 44.7% of the participants, family history of DM was found in 64.7% of patients and family history of thyroid disease was found in 32.9% of the participants. The prevalence of thyroid autoimmunity was found to be in 22.4% of total participants.Conclusions: Childhood vitiligo has distinct clinical features, more common family history for autoimmune diseases and thyroid autoantibodies rather than overt clinical diseases, which raise the necessity to perform a routine initial immunological and thyroid screening in children with vitiligo and to repeat them at annual bases if there were abnormal values at base line or strong family history.

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MON-252 Pituitary Tumor Apoplexy Presenting with Acute Psychosis

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1517 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Maria Mercedes Pineyro ◽

Patrica Agüero ◽

Florencia Irazusta ◽

Claudia Brun ◽

Paula Duarte ◽

...

Keyword(s):

Psychiatric Disorders ◽

Pituitary Tumor ◽

Psychiatric Treatment ◽

Psychiatric Symptoms ◽

Mental Illnesses ◽

Psychotic Symptoms ◽

Acute Psychosis ◽

Sellar Mass ◽

History Of ◽

Pituitary Tumor Apoplexy

Abstract Background: Pituitary tumors (PT) can present with neuropsychiatric symptoms. It has been associated with hormonal changes, as well as extension of the tumor to the diencephalon. Psychopathology has been reported in up to 83% in Cushing Disease (CD) and 35% in acromegaly (ACR). Psychiatric disorders (depression, anxiety and psychosis) have been reported up to 77% in CD and 63% in ACR. We present a rare case of a patient presenting with acute psychosis and a PT apoplexy. Case: A 27 year-old Caucasian female with a PMH of primary hypothyroidism presented with a 15-day history of delusions. She had delusional ideas on the subject of harm and prejudice, persecutory and mystical-religious. The mechanism was mainly intuitive and interpretive with false acknowledgments. She also had sleep disturbance, death ideation and subacute alteration of consciousness. There was no history of substance abuse or psychiatric disorders. She did not report headaches, visual disturbances, symptoms of hormone hypersecretion or hypopituitarism. She had regular menses on BCP. She had no family history of mental illnesses. Physical exam revealed reluctance, latency in responses and bradypsychia. She did not have acromegalic or cushingoid features. She was diagnosed with acute psychosis with atypical features so a brain CT was performed, which showed a sellar mass. Pituitary MRI revealed a sellar mass measuring 15x12x13 mm, with suprasellar extension, optic chiasm compression, hyperintense on T1- and hypointense on T2-weighted imaging compatible with subacute hemorrhage. She was treated with neuroleptics and benzodiazepines. Lab work revealed high prolactin (PRL) (114ng/dl), and normal 8 AM cortisol, FT4, LH, FSH and IGF-1 levels. Repeated PRL was 31,6 ng/dl after changing psychiatric treatment to aripiprazole. Her psychiatric symptoms improved. We postulate a diagnosis of PT apoplexy that presented with acute psychosis. In relation to the nature of the PT we postulate a non functioning pituitary adenoma (NFA) or a partial resolution of a prolactinoma after apoplexy. A follow up MRI is pending. Discussion: Infrequently, psychiatric symptoms may be the primary manifestation of brain tumors. Patients with PT have been reported to have altered quality of life, reduced coping strategies, increased prevalence of psychopathological alterations and maladaptive personality disorders. In addition, they can present with psychotic symptoms, mostly reported with hormone excess (GH and cortisol). Psychiatric symptoms such as anxiety and neurosis have been reported in NFA and prolactinomas. However, it is not clear a higher prevalence of psychiatric illnesses in these tumors. To our knowledge this is the first case of a pituitary tumor apoplexy presenting with acute psychosis. Conclusion: Psychiatric symptoms can be the first manifestation of PT, so atypical presentations should warrant further workup with brain imaging.

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A brief history of the criminalization of mental illness

CNS Spectrums ◽

10.1017/s1092852920000103 ◽

2020 ◽

Vol 25 (5) ◽

pp. 638-650 ◽

Cited By ~ 2

Author(s):

Joel A. Dvoskin ◽

James L. Knoll ◽

Mollie Silva

Keyword(s):

Mental Health ◽

United States ◽

Mental Illness ◽

Community Mental Health ◽

Mental Disorders ◽

The United States ◽

Mental Illnesses ◽

The People ◽

History Of ◽

Serious Mental Illnesses

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.

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Cannabis use and age of diagnosis of schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2009.01.002 ◽

2009 ◽

Vol 24 (5) ◽

pp. 282-286 ◽

Cited By ~ 31

Author(s):

Gisela Sugranyes ◽

Itziar Flamarique ◽

Eduard Parellada ◽

Immaculada Baeza ◽

Javier Goti ◽

...

Keyword(s):

Age Of Onset ◽

Peak Frequency ◽

Cannabis Use ◽

First Episode ◽

Antipsychotic Treatment ◽

Episode Psychosis ◽

Schizophrenic Patients ◽

Age Of Diagnosis ◽

History Of ◽

Post Hoc

AbstractBackground and objectivesObservational studies have reported earlier onset of psychosis in schizophrenic patients with a history of cannabis use. Earlier age of onset of schizophrenia has been associated with a poorer outcome. We aimed to examine whether cannabis use determined an earlier onset of schizophrenia in a sample of first episode patients, in an area with one of Europe's highest rates of cannabis use.Methods116 subjects with first episode psychosis and subsequent diagnosis of schizophrenia (after a 12-month follow-up) were included Age at first antipsychotic treatment (A1T) was used as proxy for age of psychosis onset, and acted as dependent variable for the statistical analysis. Cannabis use was evaluated retrospectively, and divided into three groups according to peak frequency (never, sporadic/frequent, daily).Results46 (39.7%) subjects had never used cannabis, 23 (19.9%) had done so sporadically/frequently, and 47 (40.5%) daily. A1T differed between the three groups (mean, in years and [SD]: 27.0 [4.94]; 25.7 [4.44] and 24.5 [4.36]; p = 0.033) and diminished as cannabis use increased (linear tendency; p = 0.009). Post-hoc analysis showed that cannabis use (irrespective of frequency) was significantly associated with decrease in A1T (p = 0.033), as shown by the first contrast [1 −1/2 −1/2]. Post-hoc contrast showed that cannabis users had a significantly lower age of onset of psychosis (mean decrease, in years: 1.93; CI (confidence interval) 95%: 0.17–3.70; p = 0.033).ConclusionsCannabis use was significantly associated with a decrease in age of onset of schizophrenia. Age of onset of the disease correlated with frequency of cannabis use.

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Post-stroke psychosis: how long should we treat?

Trends in Psychiatry and Psychotherapy ◽

10.1590/2237-6089-2015-0090 ◽

2017 ◽

Vol 39 (2) ◽

pp. 144-146 ◽

Cited By ~ 2

Author(s):

Maria do Céu Ferreira ◽

Célia Machado ◽

Beatriz Santos ◽

Álvaro Machado

Keyword(s):

Low Dose ◽

Rare Complication ◽

Acute Onset ◽

Psychotic Symptoms ◽

Antipsychotic Treatment ◽

Antipsychotic Therapy ◽

Post Stroke ◽

History Of ◽

One Year

Abstract Objective: To describe a rare case of a patient who developed psychotic symptoms after a right stroke that disappeared with antipsychotic treatment, but appears to need low-dose maintenance antipsychotic therapy. Case description: A 65-year-old man presented at the psychiatric emergency service with a history of persistent delusional jealousy, visual illusions and agitation with onset about 1 month after a right posterior cerebral artery ischemic stroke. These symptoms only disappeared with therapeutic dosages of an antipsychotic drug (3 mg/day of risperidone). At 2-year follow-up, he no longer had delusional activity and the antipsychotic treatment was gradually discontinued over the following year. However, 1 week after full cessation, the patient once more became agitated and suspicious and was put back on risperidone at 0.25 mg/day, resulting in rapid clinical remission. One year after the return to low-dose risperidone, the patient's psychopathology is still under control and he is free from psychotic symptoms. Comments: Psychosis is a relatively rare complication after stroke. To our knowledge, no cases of post-stroke psychosis that apparently require continuous low-dose antipsychotic treatment have been reported to date. Our case suggests that low-dose maintenance antipsychotic therapy may be needed for certain patients with post-stroke psychosis, especially for those with risk factors and non-acute onset.

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Prevalence of Psoriasis Vulgaris and Its Associated Risk Factors in Pakistan

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i43b32585 ◽

2021 ◽

pp. 390-395

Author(s):

Syeda Ujala Sohail ◽

Nasima Iqbal ◽

Ashok Kumar ◽

Sarwath Fatimee ◽

Ayesha Khan ◽

...

Keyword(s):

Risk Factors ◽

Standard Deviation ◽

Family History ◽

Psoriasis Vulgaris ◽

Age Of Onset ◽

Strong Association ◽

Positive Family History ◽

P Value ◽

History Of ◽

Associated Risk Factors

Aim: To find out the prevalence of psoriasis vulgaris and its associated risk factors. Study Design: Descriptive cross-sectional. Place and Duration of Study: Study was conducted at Rawalpindi Leprosy Hospital during January 2019 to December 2019. Methodology: The diagnosed cases of Psoriasis Vulgaris (PsV) were included in the study. All the patients were investigated on the basis of an in depth Performa. The Performa include all the relevant clinical and family history of the patient along with the personal details. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 20. All the numerical variables were presented as mean with standard deviation while categorical data as frequency and percentages. The association of risk factors with the Psoriasis was calculated by using the Chi-square test. p-value less than 0.05 was considered as significant. Results: Mean age with standard deviation of patients was 34.7±14. Most of the diagnosed patients were male and below 40 years of age, only 4.2% cases were having positive family history of Psoriasis and found significant correlation. The frequency of onset of symptoms in adolescent was more as compared to childhood i.e. 95.3% and 4.7% respectively. Majority of psoriasis cases (65.3%) were from non-smoker group and having strong association with smoking. The frequency of arthritis among psoriasis patients was 23.7% and majority of the patients, who developed arthritis were those having age <40 year and were suffering from psoriasis since 5-10 years. Conclusion: Current study concluded that Psoriasis vulgar is having higher prevalence rate among male and below 40 years of age group. The results also suggested a strong association of severity of psoriasis with certain risk factors including family history, age of onset of symptoms, smoking and arthritis.

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Effect of substance misuse in early psychosis

The British Journal of Psychiatry ◽

10.1192/s0007125000297791 ◽

1998 ◽

Vol 172 (S33) ◽

pp. 134-136 ◽

Cited By ~ 72

Author(s):

Jean Addington ◽

Donald Addington

Keyword(s):

Quality Of Life ◽

Substance Use ◽

Negative Symptoms ◽

Substance Misuse ◽

Age Of Onset ◽

Past History ◽

Psychotic Symptoms ◽

First Episode ◽

History Of

Background Studies examining the temporal relationship between substance use and the onset of psychotic symptoms in schizophrenia are inconclusive.Method Three groups of out-patients with schizophrenia were compared on onset of illness, symptoms and quality of life. Fifty-one subjects had no past or present history of substance misuse, 29 subjects had a history of past substance misuse occurring around the onset of their illness, and 33 subjects were currently misusing substances.Results Current substance misusers had poorer quality of life scores and less negative symptoms than the non-users. Those who had a past history of substance misuse had a significantly earlier age of onset than those with no substance use.Conclusions Attention should be paid to substance misuse present at the first episode. Treatment for schizophrenia should begin even though a diagnosis of drug-induced psychosis cannot be ruled out.

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Natural History of Migraine in Childhood

Cephalalgia ◽

10.1046/j.1468-2982.2000.00083.x ◽

2000 ◽

Vol 20 (6) ◽

pp. 573-579 ◽

Cited By ~ 43

Author(s):

MA Hernandez-Latorre ◽

M Roig

Keyword(s):

Natural History ◽

Prophylactic Treatment ◽

Clinical Course ◽

Age Of Onset ◽

Statistical Significance ◽

Positive Family History ◽

Phenotypic Expression ◽

Clinical Evolution ◽

History Of ◽

Prospective Longitudinal

Epidemiological studies have shown that 3–7% of the paediatric population suffer from migraine. Despite this high prevalence little has been published about the natural history of migraine or of its prognosis. The objectives of this study were: (i) to outline the natural history of migraine in childhood; and (ii) to identify early predictors of an unfavourable clinical evolution. A prospective, longitudinal, 10-year follow-up study was conducted of the clinical evolution of 181 paediatric patients with migraine. Data analysis was performed by statistical significance and logistic regression tests. In our study 24.3% of children with migraine had their onset before age 6 years and another 57% between 6 and 10 years of age. A positive family history of migraine was recorded in 77.5%. Eighty-eight percent of patients followed a favourable clinical course. The remaining 12% of patients had to be placed on prophylactic treatment owing to the increasing of their headache. Of all parameters investigated, the age of onset was the only statistically significant predictor of an unfavourable clinical evolution. We conclude: (i) most patients with migraine headache starting in childhood do not require prophylactic treatment; (ii) the earlier the disease begins the more likely is an unfavourable clinical course; (iii) genetic factors play an important role in the phenotypic expression of the disease; (iv) our study suggests the existence, at least, of two different populations among childhood migraine patients.

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Study on the impact of family history of diabetes among type 2 diabetes mellitus patients in an urban area of Kancheepuram district, Tamil Nadu

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20174819 ◽

2017 ◽

Vol 4 (11) ◽

pp. 4151 ◽

Cited By ~ 1

Author(s):

Geetha A. ◽

Gopalakrishnan S. ◽

Umadevi R.

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Family History ◽

Age Of Onset ◽

Positive Family History ◽

Study Group ◽

Family History Of Diabetes ◽

History Of ◽

Study Participants

Background: Type 2 diabetes mellitus (T2DM) is a commonly occurring chronic non communicable disease. Family history of diabetes is one of the important non modifiable risk factor for occurrence of the disease. This study was done to assess the percentage of positive family history of diabetes among T2DM patients and its association with age of onset and complications of diabetes. Methods: This is a descriptive cross sectional study done in an urban health training centre of a medical college. Using purposive sampling technique, 215 diabetic patients were selected as study participants. Data collection was done by structured questionnaire. Data analysis was done using SPSS 17. Results: Among the study participants, 62.3% were females. The mean age of the participants was 56.08±10.04. Nearly 68.8% of T2DM patients had family history of Diabetes, among them 25.1% of them had diabetic mother and 15.3% had diabetic father. Among the study group of T2DM patients, 51.6% had diabetic complications. The family history of diabetes with age of onset and complications had statistically significant association among the study group. Conclusions: This study shows that persons with positive family history of diabetes are more prone to early onset of diabetes and developing complications. So appropriate behavioural changes and modification must be practiced to delay or prevent the occurrence of the disease. Early diagnosis and treatment is a must to prevent the complications in the vulnerable people.

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Prevalence and Characteristics of Obsessive-Compulsive Disorder Among Urban Residents in Wuhan During the Stage of Regular Control of Coronavirus Disease-19 Epidemic

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.594167 ◽

2020 ◽

Vol 11 ◽

Author(s):

Yage Zheng ◽

Ling Xiao ◽

Yinping Xie ◽

Huiling Wang ◽

Gaohua Wang

Keyword(s):

Family History ◽

Mental Disorders ◽

Obsessive Compulsive Disorder ◽

Psychiatric Comorbidity ◽

Sleep Latency ◽

Positive Family History ◽

Epidemic Control ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

History Of

Background: Coronavirus disease-19 (Covid-19) is one of the most devastating epidemics in the 21st century, which has caused considerable damage to the physical and mental health of human beings. Despite a few regions like China having controlled the epidemic trends, most countries are still under siege of COVID-19. As the emphasis on cleaning and hygiene has been increasing, the problems related to obsessive-compulsive disorder (OCD) may appear.Objective: This study was designed to investigate the prevalence of OCD in the urban population in Wuhan during the stage of regular epidemic control and prevention. Meanwhile, characteristics and risk factors for OCD were also explored.Method: Five-hundred and seventy residents in urban areas of Wuhan were recruited using the snowball sampling method to complete questionnaires and an online interview from July 9 to July 19, 2020. Collected information encompassed socio-demographics, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, Social Support Rating Scale (SSRS) scores and Pittsburgh Sleep Quality Index(PSQI) values.Results: Three months after lifting the quarantine in Wuhan, the prevalence of OCD was 17.93%. About 89% of OCD patients had both obsessions and compulsions, while 8% had only obsessions and 3% had only compulsions. Top 3 common dimensions of obsessions were miscellaneous (84.0%), aggressive (76.6%), and contamination (48.9%), and of compulsions were miscellaneous (64%), checking (51.7%), and cleaning/washing/repeating (31.5%). The unmarried were more vulnerable to OCD than the married (p < 0.05, odds ration = 1.836). Students had 2.103 times the risk of developing OCD than health care workers (p < 0.05). Those with positive family history of OCD and other mental disorders (p < 0.05, odds ration = 2.497) and presence of psychiatric comorbidity (p < 0.05, odds ration = 4.213) were also at higher risk. Each level increase in sleep latency increased the risk of OCD to 1.646 times (p < 0.05).Conclusion: In the background of regular epidemic control, the prevalence of OCD was high, and the symptoms were widely distributed. Obsessions often accompanied compulsions. Being single and a student, positive family history of OCD and other mental disorders, presence of psychiatric comorbidity, and longer sleep latency were predictors of OCD. Early recognition and detection of these issues may help to intervene in OCD.

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