Suicidal Ideation as a Presenting Complaint

1991 ◽  
Vol 159 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Christopher J. Hawley ◽  
David V. James ◽  
Paul L. Birkett ◽  
David S. Baldwin ◽  
Marian J. De Ruiter ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Psychiatric Service ◽  
Previous History ◽  
Depressive Illness ◽  
The Other ◽  
Criminal Record ◽  
History Of ◽  
Self Harm ◽  
One Year ◽  
A Prospective Study

A prospective study was conducted of all referrals to the emergency psychiatric service of an inner-London hospital over one year. There were 53 individuals who presented with the specific and spontaneous complaint of suicidal ideation without any accompanying act of self-harm. The main diagnoses in this group were personality disorders (40%) and alcohol dependence (15%); only 13% were suffering from depressive illness. Members of the group differed from the other 369 presenters to the service in that they were less likely to be accorded a diagnosis of a defined mental illness, twice as likely to have a criminal record, and more likely to have a previous history of deliberate self-harm. A quarter of the suicidal complainants were admitted to hospital following assessment.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

COVID-19 WITH RHINO-ORBITO-CEREBRAL MUCORMYCOSIS : A SUDDEN SURGE

2021 ◽  
pp. 130-133
Author(s):  
Seema Patel ◽  
A. Z. Nitnaware ◽  
R. T. Pawar ◽  
Ashish Keche ◽  
Tanvi Rekhade
Keyword(s):  
Diabetes Mellitus ◽  
Early Diagnosis ◽  
Prospective Study ◽  
Previous History ◽  
Diagnosis And Treatment ◽  
Temporal Association ◽  
Concomitant Infection ◽  
History Of ◽  
A Prospective Study

Recently an increase in the incidence of mucormycosis is noticed in COVID-19 cases. The main aim of this study is to present our experience of rhino-orbito-cerebral mucormycosis in COVID-19 patients and thereby aid its early diagnosis and treatment. This is a prospective study of 12 cases diagnosed as Rhino-orbito-cerebral mucormycosis . Presentation of mucormycosis in COVID-19, their temporal association and outcome of treatment was studied. Pre-existing comorbidities were seen in 91.67% patients, Diabetes Mellitus (83.33%). Previous history of COVID-19 infection and treatment for the same in 41.67% cases, concomitant infection in 16.67% and asymptomatic undiagnosed covid (antibodies positive) was detected in 41.67%. All patients showed improvement in general and nasal condition (100%). Early diagnosis is must.

scholarly journals Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Lars-Gunnar Lundh ◽  
Margit Wångby-Lundh ◽  
My Paaske ◽  
Stina Ingesson ◽  
Jonas Bjärehed
Keyword(s):  
Risk Factor ◽  
Depressive Symptoms ◽  
Longitudinal Design ◽  
Community Sample ◽  
Deliberate Self Harm ◽  
Self Image ◽  
Bidirectional Relationship ◽  
Self Harm ◽  
One Year ◽  
A Prospective Study

The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness.

Predictors of Outcome Following Brief Psychodynamic-Interpersonal Therapy for Deliberate Self-Poisoning

2003 ◽  
Vol 37 (5) ◽  
pp. 532-536 ◽  
Author(s):  
Elspeth Guthrie ◽  
Navneet Kapur ◽  
Kevin Mackway-Jones ◽  
Carolyn Chew-Graham ◽  
James Moorey ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Usual Care ◽  
Severe Depression ◽  
Post Treatment ◽  
Prior History ◽  
Predictors Of Outcome ◽  
Interpersonal Therapy ◽  
History Of ◽  
Self Harm ◽  
Severity Of Depression

Background: We found that brief psychodynamic-interpersonal therapy was more helpful than usual care in deliberate self-poisoning patients, and resulted in reduced suicidal ideation and repetition of self-harm in the 6 months post-treatment. Here, we explore which baseline factors predicted outcome following treatment. Method: Patients presenting to an emergency department with deliberate self-poisoning were randomly assigned to brief psychodynamic-interpersonal therapy (PIT) or usual care. Severity of suicidal ideation 6 months post-treatment was used as the main outcome measure. Sociodemographic features and baseline psychological measures were used as predictor variables. Univariate and regression analyses were used to identify predictors of outcome for the whole group and for those who received psychotherapy. Results: Principal predictors for the psychotherapy group were baseline severity of depression and a prior history of self-harm. For the group as a whole predictors were severity of suicidal ideation, anxiety and prior history of self-harm. Conclusions: Four session PIT for deliberate self-poisoning is effective in reducing suicidal ideation in patients with less severe depression, no prior history of self-harm, and who have not consumed alcohol with the overdose. Extended therapy may be indicated for those with more severe depression.

scholarly journals The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Ceyda Sarıal ◽  
Abdulhamıt Tayfur ◽  
Beyza Kap ◽  
Dılara Donder ◽  
Ozum Melıs Ertuzun ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Previous History ◽  
Control Group ◽  
Balance Test ◽  
Balance Tests ◽  
Volleyball Players ◽  
History Of ◽  
One Year ◽  
The Right ◽  
The Impact

Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05). Conclusion: Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.

Correlation of abnormal upper tract cytology and tumor histology in patients who have undergone a nephroureterectomy for urothelial carcinoma with disease recurrence in the bladder.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 288-288
Author(s):  
Einar Freyr Sverrisson ◽  
Timothy Kim ◽  
Patrick Espiritu ◽  
Wade Jeffers Sexton ◽  
Julio Pow-Sang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Previous History ◽  
Tumor Grade ◽  
Disease Recurrence ◽  
Intravesical Therapy ◽  
Prior History ◽  
Upper Tract ◽  
History Of ◽  
One Year ◽  
Bladder Recurrence

288 Background: 15-50% of patients with upper tract urothelial carcinomas (UTUC) will have a bladder recurrence. Abnormal upper tract cytology (UTC) is an indicator of higher grade tumors but has not been associated with bladder recurrence. We were interested in investigating the role of UTC as a predictor of bladder cancer recurrences in patients with no prior history of bladder cancer presenting with UTUC. Methods: Of 67 patients who had an UTC collected prior to their nephroureterectomy (NU) in 2004-2012, we identified 17 patients with a recurrent disease in the bladder who met the criteria of having no previous history of bladder cancer at the time of their NU. UTC and histology were reviewed and analyzed with the bladder pathology data. Positive or suspicious cytology was defined as abnormal and atypical or reactive as benign. Results: 15 (88%) of 17 patients (11 men and 6 women) who met our criteria were diagnosed with bladder cancer within one year after their NU (average 7.5 months (range 2-26)). 10 (59%) of 17 patients had abnormal UTC with a calculated sensitivity and specificity of 59% and 22%, respectively. 7 (70%) of 10 patients with abnormal UTC compared to 5 (71%) of 7 patients with benign cytology had high grade (HG) bladder cancer (p=1.0). Muscle invasive tumors were found in 5 (29%) of 17 patients and 3 (60%) of those had abnormal UTC. All six women had HG bladder cancer compared to 6 of 10 men (p=0.23). HG tumors were slightly more common in the bladder compared to the upper tract (75% vs 65%, p=0.70) and 14 (87.5%) of 16 bladder tumors had the same tumor grade in the upper tract. Conclusions: Abnormal UTC is a poor predictor of bladder recurrence in patients with a history of UTUC. The majority of patients who developed bladder recurrence presented within one year from NU with HG disease which underscores the importance of aggressive surveillance and the consideration of prophylactic intravesical therapy at the time of NU in this patient cohort.

Termination of Pregnancy and Psychiatric Morbidity

1995 ◽  
Vol 167 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Anne C. Gilchrist ◽  
Philip C. Hannaford ◽  
Peter Frank ◽  
Clifford R. Kay
Keyword(s):  
Social Factors ◽  
Psychiatric Illness ◽  
Unplanned Pregnancy ◽  
Psychiatric Morbidity ◽  
Previous History ◽  
Termination Of Pregnancy ◽  
Factors Associated ◽  
Confounding Variables ◽  
History Of ◽  
Self Harm

BackgroundWe investigated whether reported psychiatric morbidity was increased after termination of pregnancy compared with other outcomes of an unplanned pregnancy.MethodThis was a prospective cohort study of 13 261 women with an unplanned pregnancy. Psychiatric morbidity reported by GPs after the conclusion of the pregnancy was compared in four groups: women who had a termination of pregnancy (6410), women who did not request a termination (6151), women who were refused a termination (379), and women who changed their minds before the termination was performed (321).ResultsRates of total reported psychiatric disorder were no higher after termination of pregnancy than after childbirth. Women with a previous history of psychiatric illness were most at risk of disorder after the end of their pregnancy, whatever its outcome. Women without a previous history of psychosis had an apparently lower risk of psychosis after termination than postpartum (relative risk RR = 0.4, 95% confidence interval CI = 0.3–0.7), but rates of psychosis leading to hospital admission were similar. In women with no previous history of psychiatric illness, deliberate self-harm (DSH) was more common in those who had a termination (RR 1.7, 95%CI 1.1–2.6), or who were refused a termination (RR 2.9, 95%CI 1.3–6.3).ConclusionsThe findings on DSH are probably explicable by confounding variables, such as adverse social factors, associated both with the request for termination and with subsequent self-harm. No overall increase in reported psychiatric morbidity was found.

scholarly journals Death Ideation and Suicidal Ideation in a Community Sample Who Do Not Meet Criteria for Major Depression

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Jinhui Joo ◽  
Seungyoung Hwang ◽  
Joseph J. Gallo
Keyword(s):  
Suicidal Ideation ◽  
Social Withdrawal ◽  
Community Sample ◽  
General Health Questionnaire ◽  
Population Based ◽  
Depressive Illness ◽  
Major Depressive ◽  
Lifetime History ◽  
History Of

Abstract. Background: Suicide is strongly associated with depression, but many without depression have thoughts of death. Aims: To characterize persons who did not meet criteria for depressive illness but endorsed death ideation or suicidal ideation over the course of a 10-year follow-up. Method: Subjects included 753 participants of the Baltimore sample of the Epidemiologic Catchment Area Program, a population-based 10-year follow-up survey, who neither met criteria for major depressive disorder nor reported death or suicidal ideation in 1994. Results: Persons with death ideation or suicidal ideation in 2004 were generally distressed as measured by the General Health Questionnaire. At baseline, both groups endorsed difficulty with concentration, feeling unhappy, and taking things hard. Functional problems such as social withdrawal were endorsed by both groups. Those with suicidal ideation had a longer lifetime history of social phobia. Persons with death ideation did not use more health services but sought help from persons in their social network. Conclusion: Thoughts of death are associated with distress even in persons who do not have depressive illness. This group of persons may have subclinical depressive symptoms that will not be detected by depression screening. Detection of these persons will require broadening our concept of persons at risk.

scholarly journals Problem-Based Review: Paracetamol Overdose

2011 ◽  
Vol 10 (4) ◽  
pp. 212-215
Author(s):  
Tom Heaps ◽  
Keyword(s):  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Past History ◽  
Previous History ◽  
Past Medical History ◽  
Minute Period ◽  
Normal Diameter ◽  
History Of ◽  
Self Harm ◽  
History Of Depression

A 29-year old male presents to the emergency department 1h after an overdose of cocodamol. He admits to taking approximately 60 x 8/500mg tablets, with alcohol, over a 20 minute period. He has a past history of depression, treated by his GP with citalopram 20mg OD. He has no previous history of deliberate self-harm. His past medical history is otherwise unremarkable and he is not on any additional medications. He drinks approximately 40 units of alcohol per week. Physical examination is unremarkable, his pupils are normal diameter and his Glasgow Coma Scale is 15. He weighs 82kg.

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