Predictors of Improvement in Tardive Dyskinesia Following Discontinuation of Neuroleptic Medication

1990 ◽  
Vol 157 (4) ◽  
pp. 585-592 ◽  
Author(s):  
William M. Glazer ◽  
Hal Morgenstern ◽  
Nina Schooler ◽  
Cathy S. Berkman ◽  
Daniel C. Moore
Keyword(s):  
Tardive Dyskinesia ◽  
Outcome Measures ◽  
Psychiatric Diagnosis ◽  
Psychiatric Illness ◽  
Model Fitting ◽  
First Year ◽  
Neuroleptic Medication ◽  
Younger Age ◽  
Noticeable Improvement ◽  
History Of

Forty-nine chronic psychiatric out-patients (ten were schizophrenic) with tardive dyskinesia (TD) were examined monthly for a mean of 40 weeks (range 1–59 months) after discontinuation of neuroleptic medication. Complete and persistent reversibility of TD was rare (2%), but many patients showed noticeable improvement in movements within the first year of discontinuation, which was sometimes interrupted by psychological relapse. Using three separate outcome measures and appropriate model-fitting techniques for each, we identified several predictors of improvement in TD, including an affective or schizoaffective psychiatric diagnosis, chronic (over 20 years) psychiatric illness, being employed, younger age, and increased neuroleptic dose before discontinuation. Consistent findings emerging from these analyses suggest that the type and history of psychiatric illness affect the course of TD.

Neuroleptic Malignant Syndrome Superimposed on Tardive Dyskinesia

1987 ◽  
Vol 150 (1) ◽  
pp. 104-105 ◽  
Author(s):  
John J. Haggerty ◽  
B. Steven Bentsen ◽  
Gregory M. Gillette
Keyword(s):  
Tardive Dyskinesia ◽  
Neuroleptic Malignant Syndrome ◽  
Neuroleptic Medication ◽  
History Of ◽  
Proper Diagnosis

A 30-year-old man with a 3-year history of tardive dyskinesia developed a neuroleptic malignant syndrome while having reserpine and lithium; his symptoms worsened following three doses of neuroleptic medication and improved with bromocriptine. The pre-existing dyskinesia made the presentation confused, and delayed proper diagnosis.

The Expression of Schizophrenia, Affective Disorder and Vulnerability to Tardive Dyskinesia in an Extensive Pedigree

1988 ◽  
Vol 153 (3) ◽  
pp. 376-381 ◽  
Author(s):  
John L. Waddington ◽  
Hanafy A. Youssef
Keyword(s):  
Family History ◽  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Affective Disorder ◽  
Psychiatric Illness ◽  
Late Onset ◽  
Psychiatric Morbidity ◽  
Neuroleptic Treatment ◽  
History Of

The demography, psychiatric morbidity, and motor consequences of long-term neuroleptic treatment in the 14 children born to a father with a family history of chronic psychiatric illness and a mother with a late-onset affective disorder resulting in suicide are documented. Twelve siblings lived to adulthood, nine of whom were admitted to a psychiatric hospital in their second or third decade, and required continuous in-patient care; five remaining in hospital, with long-term exposure to neuroleptics, had chroniC., deteriorating, schizophrenic illness and emergence of movement disorder. Two siblings showed no evidence of psychosis but developed a late-onset affective disorder. The implications for the issues of homotypia, vulnerability to involuntary movements, and interaction with affective disorder are discussed.

Predictors of Readmission Following Outpatient Treatment for Alcohol Use Disorder

2020 ◽  
Vol 55 (3) ◽  
pp. 291-298
Author(s):  
Emmanuel Mangkornkaew Hansen ◽  
Anna Mejldal ◽  
Anette Søgaard Nielsen
Keyword(s):  
Alcohol Use ◽  
Outpatient Treatment ◽  
Psychiatric Illness ◽  
Alcohol Use Disorder ◽  
Addiction Severity Index ◽  
Drop Out ◽  
Younger Age ◽  
History Of ◽  
Index Treatment

Abstract Aims To identify predictors of readmission to outpatient treatment for alcohol use disorder (AUD) with a view to identifying underlying mechanisms for preventing relapse. Methods A consecutive clinical cohort of 2130 AUD outpatients treated between 1 January 2006 and 1 June 2016 was studied. Data were collected by means of the Addiction Severity Index upon treatment entry and at discharge. Outcome measures were readmission to outpatient treatment and time to readmission. Potential predictors were tested for significance using Cox Proportional Hazards multivariate analysis. Results A total of 22% were readmitted during the follow-up time. Patients readmitted within 1 year of treatment conclusion differed significantly from those not readmitted on age, cohabitation status and completion status of index treatment. Significant predictors of readmission during follow-up time were younger age (hazard ratio (HR) = 0.99, 95% confidence interval (CI), 0.98–1.00), history of psychiatric illness (HR = 1.24, 95% CI, 1.02–1.50), drop-out from index treatment (HR = 1.41, 95% CI, 1.15–1.72) and length of index treatment (HR = 1.02, 95% CI, 1.00–1.04). Conclusion Premature drop-out from treatment, a history of psychiatric illness, younger age and longer treatment episodes appear to be the most important predictors of readmission.

scholarly journals Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia

2019 ◽  
Vol 18 (2) ◽  
pp. 252-259
Author(s):  
Raihan Hassan ◽  
Maryam Mohd Zulkifli ◽  
Imran Ahmad ◽  
Siti Suhaila MohdYusoff
Keyword(s):  
Family History ◽  
Outpatient Clinic ◽  
Psychiatric Illness ◽  
Medical Science ◽  
High Body Mass Index ◽  
Medical Illness ◽  
Obese Patients ◽  
Factors Associated ◽  
Younger Age ◽  
History Of

Introduction: Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic. Methods: This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses. Results: The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91–0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32–10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18–8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49–21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01–1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33–19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70–15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03–20.7). Conclusion: Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.252-259

scholarly journals Psychiatric Illness and Mortality in Hospitalized ESKD Dialysis Patients

2019 ◽  
Vol 14 (9) ◽  
pp. 1363-1371 ◽  
Author(s):  
Paul L. Kimmel ◽  
Chyng-Wen Fwu ◽  
Kevin C. Abbott ◽  
Marva M. Moxey-Mims ◽  
Susan Mendley ◽  
...  
Keyword(s):  
Psychiatric Diagnosis ◽  
Psychiatric Illness ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
First Year ◽  
Psychiatric Diagnoses ◽  
Elderly Adults ◽  
Dialysis Patients ◽  
Proportional Hazards Regression ◽  
Adults And Children

Background and objectivesLimited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice.Design, setting, participants, & measurementsWe examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models.ResultsIn the first ESKD year, 72% of elderly adults, 66% of adults and 64% of children had at least one hospitalization. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis. The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and organic disorders/dementias in elderly adults. Prevalence of hospitalizations with psychiatric diagnoses increased over time across groups, primarily from secondary diagnoses. 19% of elderly adults, 25% of adults and 15% of children were hospitalized with a secondary psychiatric diagnosis. Hazards ratios of all-cause death were higher in all dialysis adults hospitalized with either primary (1.29; 1.26 to 1.32) or secondary (1.11; 1.10 to 1.12) psychiatric diagnoses than in those hospitalized without psychiatric diagnoses.ConclusionsHospitalizations with psychiatric diagnoses are common in pediatric and adult ESKD patients, and are associated with subsequent higher mortality, compared with hospitalizations without psychiatric diagnoses. The prevalence of hospitalizations with psychiatric diagnoses likely underestimates the burden of mental illness in the population.

The Nithsdale Schizophrenia Surveys X: Obstetric Complications, Family History and Abnormal Movements

1992 ◽  
Vol 160 (6) ◽  
pp. 799-805 ◽  
Author(s):  
Robin G. McCreadie ◽  
David J. Hall ◽  
Ian J. Berry ◽  
Lesley J. Robertson ◽  
James I. Ewing ◽  
...  
Keyword(s):  
Family History ◽  
Tardive Dyskinesia ◽  
Psychiatric Illness ◽  
Obstetric Complications ◽  
Degree Relative ◽  
Drug Induced ◽  
Abnormal Movements ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
History Of

Obstetric histories of 54 schizophrenic patients and 114 siblings were obtained from their mothers and scored using the Obstetric Complications Scale. There was no statistically significant difference in the proportion of schizophrenic patients (35%) and siblings (29%) who had at least one definite obstetric complication. There was no evidence that schizophrenic patients with a history of obstetric complications were less likely to have a first-degree relative with a history of psychiatric illness leading to in-patient care. Schizophrenic patients with a history of obstetric complications were more likely to have drug-induced Parkinsonism. There was a trend for tardive dyskinesia to be more common in those schizophrenic patients with no obstetric complications but a family history of schizophrenia.

The Medical Recommendation for Psychiatric Remands into Prison—The Hong Kong Scene

1981 ◽  
Vol 21 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Bernard W. K. Lau
Keyword(s):  
Hong Kong ◽  
Mentally Ill ◽  
Psychiatric Diagnosis ◽  
Mentally Disordered ◽  
The Public ◽  
Younger Age ◽  
History Of ◽  
Psychiatric Staff ◽  
Reception Centre ◽  
Medical Recommendation

A review is presented of all the remand cases who were referred from the courts to the psychiatric staff of the Psychiatric Observation Unit in the Lai Chi Kok Reception Centre, Prisons Department, Hong Kong Government. Altogether 607 defendants were assessed during the 24-month period and reports were furnished which indicated the psychiatric diagnosis, medical recommendation and fitness to plead of each case. It is noted that over half of the remands were not mentally disordered and a psychiatric diagnosis was possible in less than half of the sample. Most of the cases belonged to the younger age group, namely 19–39, which is compatible with the finding of schizophrenia in the majority of the mentally ill remands. A considerable number of them had a history of previous psychiatric contact. The nature of the offences varied and they involved those against the person, the property and the public order. In comparison, the schizophrenics committing offences against the person of a non-sexual nature formed the largest sub-group. On the whole, the schizophrenics were most frequently remanded for psychiatric examination, most likely to be recommended for a medical disposal and almost certainly allowed to benefit from the treatment proposed. Factors associated with positive or negative as well as accepted or rejected recommendation were discussed. Special consideration was given to some of the problems concerning the treatment orders which are peculiar to Hong Kong.

Dual diagnosis (DD) at first admission (FA) in three different periods: An epidemiological study

2011 ◽  
Vol 26 (S2) ◽  
pp. 589-589
Author(s):  
P. Zeppegno ◽  
M. Porro ◽  
A. Lombardi ◽  
A. Feggi ◽  
E. Torre
Keyword(s):  
Dual Diagnosis ◽  
Psychiatric Diagnosis ◽  
Medical Records ◽  
Psychiatric Illness ◽  
Progressive Increase ◽  
Legal Issues ◽  
Drug Abusers ◽  
Affective Psychosis ◽  
Adequate Treatment ◽  
History Of

IntroductionDD represents a common issue in clinical practice, with relevant effects on symptoms, course and treatment of disease. It's often associated with negative outcome as a greater severity of symptoms and resistance to drug treatment.ObjectivesTo assess how the characteristics (sociodemographic, clinical and related to substance abuse) of patients discharged with DD have changed taking into account the FA occurred in three different five-year periods (1990–1994, 2000–2004, 2005–2009). We also compared the characteristics of patients discharged with only psychiatric diagnosis with those of patients with DD to look for possible risk factors for abuse among people with psychiatric illness.MethodsWe conducted a retrospective study of medical records of patients at FA to our Institute in three different periods. We divided the patients discharged with DD from those discharged with only psychiatric diagnosis.ResultsAmong the FA occurred in the periods examined we noticed an increase of DD cases (12% from 1990 to 1994, 21% 2000–2004, 28% 2005–2009). The incidence of each diagnosis was changed in several years, but each time the diseases more represented remain schizophrenic or affective psychosis and personality disorders. Alcohol is the most widely used psychotropic drug in each period. There is also a progressive increase in the abuse of cannabis, cocaine and in the incidence of multi-drug abusers. Compared with patients discharged with only a psychiatric diagnosis, patients with DD were more frequently:male, younger, unmarried, unemployed, with legal issues, grown up in a family with serious problems, and history of etero-aggressive episodes.ConclusionsDue to continued increase in cases of DD, we want to highlight the importance of early identification of cases of comorbidity in order to provide adequate treatment and support.

scholarly journals Neuroleptic usage in a community mental handicap unit

1993 ◽  
Vol 17 (11) ◽  
pp. 657-660 ◽  
Author(s):  
Richard J. Harvey ◽  
Sherva E. Cooray
Keyword(s):  
Tardive Dyskinesia ◽  
Psychiatric Diagnosis ◽  
General Public ◽  
Mentally Handicapped ◽  
Neuroleptic Medication ◽  
Mental Handicap ◽  
Television Documentary ◽  
Handicapped People ◽  
Legal Grounds

Increasing concern has been expressed in the psychiatric literature and general press about the use of neuroleptic medication for the treatment of behaviour disturbance in the mentally handicapped (Buck & Sprague, 1989). The issue was highlighted in a television documentary (Public Eye, BBC2, 1 May 1992) which reported a number of cases of tardive dyskinesia in mentally handicapped people who had been treated with neuroleptics. The programme, although taking a characteristically slanted view, will have made an impression on relatives, patients and the general public. It was also intimated that British families may be preparing to test the legal grounds for prescribing these drugs to the mentally handicapped, particularly where there is no formal psychiatric diagnosis.

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