scholarly journals Feigned psychosis revisited –a 20 year follow up of 10 patients

1996 ◽  
Vol 20 (11) ◽  
pp. 666-669 ◽  
Author(s):  
Martin Humphreys ◽  
Alan Ogilvie
Keyword(s):  
Case Note ◽  
Psychotic Symptoms ◽  
Psychotic Illness ◽  
Retrospective Case ◽  
Long Term Follow Up ◽  
Initial Episode ◽  
Changes Over Time ◽  
Over Time

Feigned psychosis, although rare, presents considerable diagnostic problems in clinical psychiatric practice. Long-term follow up data are lacking. A retrospective case note study was undertaken of 10 patients described in a previous paper, published in 1970, on the simulation of psychosis. The computerised diagnostic instrument OPCRIT was applied to both index episode and lifetime occurrence of symptoms. All 10 patients were found to have had a major psychotic illness based on lifetime symptoms at 20 year follow-up by DSM–III–R criteria. Eight had met such criteria at the time of the initial episode. Diagnosis in patients thought to be feigning psychotic symptoms changes over time and major mental illness is likely to emerge which may be schizophrenic or affective. The term feigned psychosis should be abandoned and more attention given to why symptoms are accepted as genuine in some cases but not others.

scholarly journals Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary
Keyword(s):  
Case Series ◽  
Surgical Reconstruction ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Retrospective Case ◽  
Penile Fracture ◽  
Case Series Study ◽  
Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

scholarly journals Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus

2012 ◽  
Vol 1 (1) ◽  
pp. 22-25
Author(s):  
Paraskevi G Zotta ◽  
Diamantis D Almaliotis ◽  
George D Kymionis ◽  
Vasilios F Diakonis ◽  
Kostas A Moschou ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Retrospective Case ◽  
Time Intervals ◽  
Long Term Follow Up ◽  
Collagen Cross Linking ◽  
Corneal Collagen

ABSTRACT Purpose To determine the long-term alterations of corneal thickness, along with topographic outcomes, after corneal collagen cross-linking treatment (CXL) for keratoconus. Materials and methods In this retrospective case series, 46 patients (52 eyes), 32 males and 14 females, with progressive keratoconus were included. All eyes underwent CXL in accordance with the standard protocol (Dresden) for the treatment of their ectatic corneal disorder between January 2006 and June 2007. Pachymetric and topographic outcomes were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months postoperatively. Results Mean follow-up was 28.08 ± 8.39 months (range, from 12 to 36 months). A statistically significant decline in corneal pachymetric values (at the thinnest location) when compared with preoperative values (467.65 ± 41.08 µm) was demonstrated at 1 (437.63 ± 50.57 µm), 3 (439.08 ± 52.27 µm), 6 (449.37 ± 52.73 µm), 12 (449.63 ± 83.53 µm) and 24 (459.97 ± 47.32 µm) months after CXL (p < 0.05, for all mentioned time intervals). Return to preoperative pachymetric values (469.52 ± 40.52 µm) was revealed 36 months post-CXL (p > 0.05). With respect to topographic (flat and steep keratometric values, keratoconus index), no statistically significant differences between preoperative and all postoperative intervals were found (p > 0.05, for all values for all time intervals). Conclusion Corneal pachymetric values reduce significantly up to 24 months after CXL treatment, while a return to preoperative values was revealed 36 months after the procedure. No significant changes’ concerning topographic outcomes was demonstrated after CXL, indicating stability of these parameters. How to cite this article Zotta PG, Almaliotis DD, Kymionis GD, Diakonis VF, Moschou KA, Karampatakis VE. Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):22-25.

scholarly journals T214. ANTIPSYCHOTIC TREATMENT PATTERNS AND EFFECTS DURING THE EARLY YEARS AMONG 316 NEWLY DIAGNOSED PATIENTS WITH SCHIZOPHRENIA FROM THE OPUS TRIAL

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S314-S314
Author(s):  
Nikolai Albert ◽  
Karl Ole Köhler-Forsberg ◽  
Carsten Hjorthøj ◽  
Merete Nordentoft
Keyword(s):  
Early Intervention ◽  
Medical Treatment ◽  
Relapse Rate ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Follow Up Studies ◽  
Long Term Follow Up

Abstract Background In studies investigating the relapse rate of psychotic symptoms in patients diagnosed with schizophrenia there is a discrepancy between discontinuation studies finding a relapse rate up to 90% after discontinuation of antipsychotic medication and long-term follow-up studies finding approx. 30% of patients living without antipsychotic medication and psychotic symptoms. Long-term follow-up studies often have multiple follow-up assessments, but little is known about the use of medication in the intervals between the follow-up points. While register studies can follow large cohorts of patients, they are unable to investigate psychopathology and level of functioning in patients who discontinue their medication. In this study we use data from a clinical cohort with information on participants symptoms and functioning and combine them with register data on the individual participants prescriptions and hospitalizations. Methods The present study represents a combination of a clinical study from early intervention settings and register-based information on antipsychotic drug use and hospital contacts. For the present study, patients were included 18 months into their 24 months early intervention treatment and followed up 3 ½ year later. At baseline and follow-up we performed clinical assessments with all patients and via the Danish National Hospital Register and the Danish National Prescription Register, we had complete nationwide information for all patients identifying all redeemed prescriptions for antipsychotic drugs from 6 to 42 months after inclusion into the study. Based on medication information from the Danish National Prescription Register, we divided participants in the following four groups: 1) Non-users, 2) compliant on medication, 3) stopped but resumed later with medication, and 4) stopped with medication. Results Of the 316 participants included in this study 94.3% had I diagnosis of schizophrenia. In the 3 years preceding the 5 years follow-up 28.2% did not redeem any prescriptions for antipsychotics drugs while 21.2% discontinued their treatment during the follow-up, 20.9% discontinued their treatment but resumed later and 29.7% remained in stable treatment. At the 5 years follow-up the 30.3% of the Never-users where in competitive employment, the mean psychotic symptom score were 1.4 SD (1.4) and negative symptoms 1.1 SD (0.9). Whiles these results were worse for patients Compliant on medication (17%, 1.9 SD (1.3), 1.8 SD (1.0)), Stopped but resumed medication (10.6%, 22.4 SD (1.4), 1.5 SD (1.0)) and Stopped medication (17%, 1.6 SD (1.3), 1.3 SD (1.0)), respectively. Of the Never-user 23.6% were in remission of both positive and negative symptoms, while this was only the case for 12.8% of those compliant on medication. Discussion This study is a naturalistic cohort study and we are unable to draw any conclusion regarding the causality between symptoms remission and use of antipsychotic medication. The study shows that a substantial proportion of patients, for several years, can discontinue their medical treatment without being re-hospitalized and with lower symptoms burden then patients who continue their medical treatment. Some patients discontinue their treatment but resume it later. These patients have approximately the same functional level and psychotypological scores as those who are compliant with their medical treatment and are treated with equivalent doses of antipsychotic at the time of the follow-up.

Severe Depression Following Recovery From Thrombotic Thrombocytopenic Purpura (TTP)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 366-366 ◽  
Author(s):  
Cassandra C. Deford ◽  
Lauren H. Schwartz ◽  
Jedidiah J. Perdue ◽  
Jessica A. Reese ◽  
Johanna A. Kremer Hovinga ◽  
...  
Keyword(s):  
Major Depression ◽  
Relative Frequency ◽  
Severe Depression ◽  
Major Depressive ◽  
Psychiatric Interview ◽  
Long Term Follow Up ◽  
Adamts13 Deficiency ◽  
Initial Episode

Abstract Abstract 366 Introduction Recovery from an acute episode of TTP is typically assumed to be complete. However patients from the Oklahoma TTP-HUS Registry have often described persistent problems with memory, concentration, and endurance. Our previous studies have documented long-term deficits in quality-of-life and cognitive functioning. We have also observed an unexpectedly high frequency of severe depression. Therefore we documented the relative frequency of severe depression during long-term follow-up and compared the relative frequency of severe depression in our patients to US and Oklahoma population data. Methods We included all Oklahoma TTP-HUS Registry patients whose initial episode was associated with severe ADAMTS13 deficiency (<10%), 1995–2010, and who were alive in 2004 when our psychiatric evaluations began. Patients completed the Beck Depression Inventory-II (BDI-II) 1–5 times from 2004–2011. The BDI-II is a self-report measure consisting of 21 items. Scores are interpreted as suggesting no/minimal, mild, moderate or severe depression. In 2011, patients who had BDI-II scores indicating moderate or severe depression on at least 1 evaluation had a structured psychiatric interview to support the diagnosis of depression. In 2012, all patients were asked to complete an 8-item measure, the Patient Health Questionnaire-8 (PHQ-8). The relative frequency of patients whose PHQ-8 scores indicated major depression were compared to the relative frequency of major depression determined by the PHQ-8 in the Oklahoma and US populations in the most recent Behavioral Risk Factor Surveillance System (BRFSS) data, 2006 and 2008. Results Of 68 patients who had severe ADAMTS13 deficiency at the time of their initial episode of TTP, 52 were alive in 2004; 47 (90%) were evaluated by the BDI-II. Fifteen (32%) of the 47 patients had scores suggesting severe depression on at least 1 evaluation; 12 were alive in 2011 and 10 (83%) of these 12 patients underwent a structured psychiatric interview; 9 met criteria for a major depressive disorder based on this diagnostic interview. Seven (15%) of the 47 patients had scores indicating only moderate depression; 4 (57%) of these 7 patients underwent a structured psychiatric interview; 1 (25%) met criteria for a major depressive disorder. Thirty-seven (88%) of 42 surviving patients in 2012 were evaluated by the PHQ-8 6.3 years (median) after their initial episode; 7 (18.9%, 95% CI, 8.0–35.2) had scores suggesting major depression, which is significantly greater than the prevalence of major depression in the US (3.4%) and Oklahoma (3.5%). The greater relative frequency of major depression was consistent across demographic subgroups. Conclusion The relative frequency of severe depression is increased in patients during long-term follow-up after recovery from TTP. Recognition and appropriate management of this clinically important health problem are critical components of the care of patients who have survived acute episodes of TTP. Disclosures: Kremer Hovinga: Baxter Healthcare: Consultancy, Research Funding. Terrell:Amgen, Inc.: Consultancy; Baxter, Inc.: Consultancy. George:Alexion, Inc.: Consultancy; Amgen, Inc.: Consultancy, PI for clinical trial involving romiplostim, PI for clinical trial involving romiplostim Other, Research Funding; Baxter, Inc.: Consultancy.

A Trial of Biolite Ventilation Tubes in Children: Is Further Use Warranted?

1983 ◽  
Vol 91 (4) ◽  
pp. 437-440 ◽  
Author(s):  
Steven D. Handler ◽  
William P. Potsic ◽  
Roger R. Marsh
Keyword(s):  
Pilot Study ◽  
Middle Ear ◽  
Silicone Tube ◽  
Long Term Follow Up ◽  
Ventilation Tubes ◽  
Carbon Coated ◽  
Contralateral Ear ◽  
Over Time

A prospective controlled pilot study was undertaken in which Biolite (carbon-coated) ventilation tubes were placed in 44 ears and a conventional silicone tube in the contralateral ear. Long-term follow-up of these patients has revealed little difference in the incidence of tube occlusion or early extrusion. In addition, there were several disadvantages noted with the Biolite tubes: incomplete coating of the tube (especially within the lumen), shedding of the Biolite coating over time, “tattooing” of the tympanic membrane, poor otoscopic visibility, and the higher cost of these tubes. Since the Biolite tube has no documented advantages and, actually, several disadvantages, we believe its use in the treatment of middle ear disorders should be discontinued until significant benefits are demonstrated and present deficiencies are corrected.

scholarly journals Infliximab to Treat Chronic Noninfectious Uveitis in Children: Retrospective Case Series with Long-term Follow-up

2007 ◽  
Vol 144 (6) ◽  
pp. 844-849.e1 ◽  
Author(s):  
Stacy P. Ardoin ◽  
Deborah Kredich ◽  
Egla Rabinovich ◽  
Laura E. Schanberg ◽  
Glenn J. Jaffe
Keyword(s):  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Long Term Follow Up

scholarly journals Long-term follow-up of the RESONATE phase 3 trial of ibrutinib vs ofatumumab

Blood ◽  
2019 ◽  
Vol 133 (19) ◽  
pp. 2031-2042 ◽  
Author(s):  
John C. Byrd ◽  
Peter Hillmen ◽  
Susan O’Brien ◽  
Jacqueline C. Barrientos ◽  
Nishitha M. Reddy ◽  
...  
Keyword(s):  
Single Agent ◽  
The United States ◽  
Lymphocytic Leukemia ◽  
Baseline Risk ◽  
Phase 3 ◽  
Long Term Study ◽  
Long Term Follow Up ◽  
Over Time

Abstract Ibrutinib, a once-daily oral inhibitor of Bruton tyrosine kinase, has greatly improved outcomes for patients with chronic lymphocytic leukemia (CLL). The phase 3 RESONATE trial, which compared single-agent ibrutinib to ofatumumab in high-risk, relapsed patients with CLL, provided support for approval of ibrutinib in the United States and Europe. We describe long-term follow-up of patients treated in RESONATE, where continued superiority of progression-free survival (PFS) (hazard ratio [HR], 0.133; 95% confidence interval [CI], 0.099-0.178) was observed. Overall survival benefit continues (HR, 0.591; 95% CI, 0.378-0.926), although with decreased magnitude relative to that seen before crossover to ibrutinib was implemented for patients on ofatumumab (HR, 0.426; 95% CI, 0.220-0.823). Notably, overall response to ibrutinib increased over time, with 91% of patients attaining a response. The PFS benefit with ibrutinib was independent of baseline risk factors, although patients with ≥2 prior therapies had shorter PFS than those with &lt;2 prior therapies, and the presence of TP53 or SF3B1 mutations showed a trend toward shorter PFS vs without these factors. Median duration of ibrutinib was 41 months, with 46% remaining on treatment at a median follow-up of 44 months. Grade ≥3 adverse events generally decreased over time, causing only a small proportion of patients to cease therapy. Ibrutinib was discontinued due to progressive disease in 27% of patients. This long-term study provides support for sustained efficacy and safety of ibrutinib in relapsed/refractory CLL and consideration of study provisions that allow crossover to investigational therapy when benefit has been clearly demonstrated. This trial was registered at www.clinicaltrials.gov as #NCT01578707.

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