scholarly journals What would be the psychiatric diagnosis of D. Maria I, the “mad queen”?

2021 ◽  
Author(s):  
Elie Cheniaux ◽  
Antonio Egidio Nardi ◽  
Marleide da Mota Gomes
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Mental Disorder ◽  
Psychiatric Diagnosis ◽  
Psychotic Symptoms

ABSTRACT Objective D. Maria I, queen of Portugal, was the mother of João VI and grandmother of Pedro IV of Portugal and I of Brazil. She became the first monarch of Brazil, where she became known as “Maria, the madwoman”. We aimed to try to identify the mental disorder she suffered from. Methods We conducted a review of biographies about D. Maria I and scientific articles that discussed her case. Results The sparse information about her mental illness strongly indicates that she had several depressive and manic episodes, which were accompanied by psychotic symptoms. Conclusion Her probable psychiatric diagnosis is that of bipolar disorder.

scholarly journals The incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorders in children and adolescents

2018 ◽  
Vol 49 ◽  
pp. 16-22 ◽  
Author(s):  
Ragnar Nesvåg ◽  
Jørgen G. Bramness ◽  
Marte Handal ◽  
Ingeborg Hartz ◽  
Vidar Hjellvik ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Children And Adolescents ◽  
Pharmacological Treatment ◽  
Depressive Episode ◽  
Psychotic Symptoms ◽  
Severe Mental Disorder ◽  
Co Morbidity ◽  
First Time

AbstractBackgroundAntipsychotic drug use among children and adolescents is increasing, and there is growing concern about off-label use and adverse effects. The present study aims to investigate the incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorder in Norwegian children and adolescents.MethodsWe obtained data on mental disorders from the Norwegian Patient Registry on 0–18 year olds who during 2009–2011 were diagnosed for the first time with schizophrenia-like disorder (International Classification of Diseases, 10th revision codes F20-F29), bipolar disorder (F30-F31), or severe depressive episode with psychotic symptoms (F32.3 or F33.3). Data on filled prescriptions for psychotropic drugs were obtained from the Norwegian Prescription Database.ResultsA total of 884 children and adolescents (25.1 per 100 000 person years) were first time diagnosed with schizophrenia-like disorder (12.6 per 100 000 person years), bipolar disorder (9.2 per 100 000 person years), or severe depressive episode with psychotic symptoms (3.3 per 100 000 person years) during 2009–2011. The most common co-morbid mental disorders were depressive (38.1%) and anxiety disorders (31.2%). Antipsychotic drugs were prescribed to 62.4% of the patients, 72.0% of the schizophrenia-like disorder patients, 51.7% of the bipolar disorder patients, and 55.4% of the patients with psychotic depression. The most commonly prescribed drugs were quetiapine (29.5%), aripiprazole (19.6%), olanzapine (17.3%), and risperidone (16.6%).ConclusionsWhen a severe mental disorder was diagnosed in children and adolescents, the patient was usually also prescribed antipsychotic medication. Clinicians must be aware of the high prevalence of depressive and anxiety disorders among early psychosis patients.

Overdiagnosis and Over-Treatment

2015 ◽  
pp. 41-54
Author(s):  
Joel Paris
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Mental Disorder ◽  
Psychological Symptoms ◽  
Pharmacological Interventions ◽  
Dsm 5 ◽  
Wide Range ◽  
Clinical Populations

Current neurobiological models of mental illness, accompanied by an increased use of drugs to control symptoms, tend to favor overdiagnosis. This trend has been supported by DSM-5. Yet it is often forgotten that diagnostic manuals are not a guide to treatment. The pigeon-holing of patients with a wide range of psychological symptoms into categories (such as bipolar disorder or ADHD) has been used to justify pharmacological interventions that have been empirically tested in clinical populations who have classical forms of mental disorder, as opposed to falling within spectra. The result is that treatments for this wider range of patients may or may not be valid.

scholarly journals Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring

2018 ◽  
Vol 10 (1) ◽  
pp. 100-107 ◽  
Author(s):  
A. Aylott ◽  
A. Zwicker ◽  
L. E. MacKenzie ◽  
J. Cumby ◽  
L. Propper ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Major Depression ◽  
Psychotic Symptoms ◽  
Same Sex ◽  
Mixed Effect ◽  
Increased Risk ◽  
Opposite Sex ◽  
Parent Of Origin ◽  
Origin Effects

AbstractChildren of parents with major mood and psychotic disorders are at increased risk of psychopathology, including psychotic symptoms. It has been suggested that the risk of psychosis may be more often transmitted from parent to opposite-sex offspring (e.g., from father to daughter) than to same-sex offspring (e.g., from father to son). To test whether sex-specific transmission extends to early manifestations of psychosis, we examined sex-specific contributions to psychotic symptoms among offspring of mothers and fathers with depression, bipolar disorder and schizophrenia. We assessed psychotic symptoms in 309 offspring (160 daughters and 149 sons) aged 8–24 years (mean=13.1, s.d.=4.3), of whom 113 had a mother with schizophrenia, bipolar disorder or major depression and 43 had a father with schizophrenia, bipolar disorder or major depression. In semi-structured interviews, 130 (42%) offspring had definite psychotic symptoms established and confirmed by psychiatrists on one or more assessments. We tested the effects of mental illness in parents on same-sex and opposite-sex offspring psychotic symptoms in mixed-effect logistic regression models. Psychotic symptoms were more prevalent among daughters of affected fathers and sons of affected mothers than among offspring of the same sex as their affected parent. Mental illness in the opposite-sex parent increased the odds of psychotic symptoms (odds ratio (OR)=2.65, 95% confidence interval (CI) 1.43–4.91, P=0.002), but mental illness in the same-sex parent did not have a significant effect on psychotic symptoms in offspring (OR=1.13, 95% CI 0.61–2.07, P=0.697). The opposite-sex-specific parent-of-origin effects may suggest X chromosome-linked genetic transmission or inherited chromosomal modifications in the etiology of psychotic symptoms.

scholarly journals Trends in rates of mental illness in homicide perpetrators

2011 ◽  
Vol 198 (6) ◽  
pp. 485-489 ◽  
Author(s):  
Nicola Swinson ◽  
Sandra M. Flynn ◽  
David While ◽  
Alison Roscoe ◽  
Navneet Kapur ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Disorder ◽  
Serious Mental Illness ◽  
Case Series ◽  
Drug Misuse ◽  
Psychotic Symptoms ◽  
Diminished Responsibility

BackgroundThe rise in homicides by those with serious mental illness is of concern, although this increase may not be continuing.AimsTo examine rates of mental illness among homicide perpetrators.MethodA national consecutive case series of homicide perpetrators in England and Wales from 1997 to 2006. Rates of mental disorder were based on data from psychiatric reports, contact with psychiatric services, diminished responsibility verdict and hospital disposal.ResultsOf the 5884 homicides notified to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness between 1997 and 2006, the number of homicide perpetrators with schizophrenia increased at a rate of 4% per year, those with psychotic symptoms at the time of the offence increased by 6% per year. The number of verdicts of diminished responsibility decreased but no change was found in the number of perpetrators receiving a hospital order disposal. The likeliest explanation for the rise in homicide by people with psychosis is the misuse of drugs and/or alcohol, which our data show increased at a similar magnitude to homicides by those with psychotic symptoms. However, we are unable to demonstrate a causal association. Although the Poisson regression provides evidence of an upward trend in homicide by people with serious mental illness between 1997 and 2006, the number of homicides fell in the final 2 years of data collection, so these findings should be treated with caution.ConclusionsThere appears to be a concomitant increase in drug misuse over the period, which may account for this rise in homicide. However, an increase in the number of people in contact with mental health services may suggest that access to mental health services is improving. Previous studies have used court verdicts such as diminished responsibility as a proxy measure of mental disorder. Our data indicate that this does not reflect accurately the prevalence of mental disorder in this population.

Acceptability of Assisted Suicide in Patients With Severe and Persistent Mental Illness

GeroPsych ◽  
2020 ◽  
pp. 1-8
Author(s):  
Sophie Gloeckler ◽  
Manuel Trachsel
Keyword(s):  
Mental Illness ◽  
Pilot Study ◽  
Psychiatric Diagnosis ◽  
Assisted Suicide ◽  
Shared Values ◽  
Psychiatric Nurses ◽  
Attitudes And Beliefs ◽  
Future Studies ◽  
Persistent Mental Illness ◽  
Moral Attitudes

Abstract. In Switzerland, assisted suicide (AS) may be granted on the basis of a psychiatric diagnosis. This pilot study explored the moral attitudes and beliefs of nurses regarding these practices through a quantitative survey of 38 psychiatric nurses. The pilot study, which serves to inform hypothesis development and future studies, showed that participating nurses supported AS and valued the reduction of suffering in patients with severe persistent mental illness. Findings were compared with those from a previously published study presenting the same questions to psychiatrists. The key differences between nurses’ responses and psychiatrists’ may reflect differences in the burden of responsibility, while similarities might capture shared values worth considering when determining treatment efforts. More information is needed to determine whether these initial findings represent nurses’ views more broadly.

Psychotic symptoms in mass shootings v. mass murders not involving firearms: findings from the Columbia mass murder database

2021 ◽  
pp. 1-9
Author(s):  
Gary Brucato ◽  
Paul S. Appelbaum ◽  
Hannah Hesson ◽  
Eileen A. Shea ◽  
Gabriella Dishy ◽  
...  
Keyword(s):  
Mental Illness ◽  
Drug Use ◽  
Legal History ◽  
Alcohol Misuse ◽  
Mass Murder ◽  
Health Concern ◽  
Psychotic Symptoms ◽  
Mass Shootings ◽  
Fully Automatic ◽  
Mass Murders

Abstract Background Mass shootings account for a small fraction of annual worldwide murders, yet disproportionately affect society and influence policy. Evidence suggesting a link between mass shootings and severe mental illness (i.e. involving psychosis) is often misrepresented, generating stigma. Thus, the actual prevalence constitutes a key public health concern. Methods We examined global personal-cause mass murders from 1900 to 2019, amassed by review of 14 785 murders publicly described in English in print or online, and collected information regarding perpetrator, demographics, legal history, drug use and alcohol misuse, and history of symptoms of psychiatric or neurologic illness using standardized methods. We distinguished whether firearms were or were not used, and, if so, the type (non-automatic v. semi- or fully-automatic). Results We identified 1315 mass murders, 65% of which involved firearms. Lifetime psychotic symptoms were noted among 11% of perpetrators, consistent with previous reports, including 18% of mass murderers who did not use firearms and 8% of those who did (χ2 = 28.0, p < 0.01). US-based mass shooters were more likely to have legal histories, use recreational drugs or misuse alcohol, or have histories of non-psychotic psychiatric or neurologic symptoms. US-based mass shooters with symptoms of any psychiatric or neurologic illness more frequently used semi-or fully-automatic firearms. Conclusions These results suggest that policies aimed at preventing mass shootings by focusing on serious mental illness, characterized by psychotic symptoms, may have limited impact. Policies such as those targeting firearm access, recreational drug use and alcohol misuse, legal history, and non-psychotic psychopathology might yield more substantial results.

scholarly journals Spirituality and Employment in Recovery from Severe and Persistent Mental Illness and Psychological Well-Being

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 57
Author(s):  
Jesús Saiz ◽  
María Galilea ◽  
Antonio J. Molina ◽  
María Salazar ◽  
Tiffany J. Barsotti ◽  
...  
Keyword(s):  
Mental Illness ◽  
Work Motivation ◽  
Psychiatric Treatment ◽  
Predictor Variable ◽  
Recovery Process ◽  
Well Being ◽  
Job Skills ◽  
Psychotic Symptoms ◽  
Psychological Well Being ◽  
Persistent Mental Illness

People diagnosed with severe and persistent mental illness (SPMI) face multiple vulnerabilities, including when seeking employment. Among SPMI patients, studies show that a stronger sense of spirituality can help to reduce psychotic symptoms, increase social integration, reduce the risk of suicide attempts and promote adherence to psychiatric treatment. This study examined how the variables spirituality and employment affect the recovery process and psychological well-being of people with SPMI who attend employment recovery services. The sample consisted of 64 women and men diagnosed with an SPMI. The assessment instruments included the Recovery Assessment Scale, Ryff Psychological Well-Being Scale, Work Motivation Questionnaire, Daily Spiritual Experience Scale, and Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being (FACIT-Sp12). Hierarchical regression analyses were performed to compare three different models for each dependent variable (recovery and psychological well-being). The findings showed that job skills predicted psychological well-being and recovery. When spiritual variables were included in the model, job skills dropped out and the dimension meaning/peace of the FACIT-Sp12 emerged as the only significant predictor variable. Integrating spirituality into recovery programs for people with SPMI may be a helpful complement to facilitate the recovery process and improve psychological well-being.

scholarly journals Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years

2017 ◽  
Vol 52 (6) ◽  
pp. 530-541 ◽  
Author(s):  
Melissa J Green ◽  
Stacy Tzoumakis ◽  
Kristin R Laurens ◽  
Kimberlie Dean ◽  
Maina Kariuki ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Early Development ◽  
Latent Class ◽  
New South ◽  
Criminal Offending ◽  
Parental History ◽  
South Wales ◽  
History Of

Objective: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. Methods: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census–defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. Results: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ ( N = 4368; 6.5%); (2) ‘pervasive risk’ ( N = 2668; 4.0%); (3) ‘mild generalised risk’ ( N = 7822; 11.6%); and (4) ‘no risk’ ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. Conclusion: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

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