scholarly journals Post stroke psychiatric syndrome: a clinical study

2020 ◽  
Vol 8 (5) ◽  
pp. 1864
Author(s):  
Amrendra K. Singh ◽  
Gyanendra Raghuvanshi
Keyword(s):  
Rural Areas ◽  
Psychiatric Symptoms ◽  
Clinical Profile ◽  
Psychiatric Evaluation ◽  
Skilled Worker ◽  
Post Stroke ◽  
Pathological Laughter ◽  
Number Of Patients ◽  
Psychiatric Syndrome ◽  
Psychiatric Manifestations

Background: Various psychiatric symptoms are seen after strokes which are usually deserted due to poor familiarity about it, hence better knowledge and understanding of various post stroke psychiatric manifestations may help in early identification and management of it. The aim of present research is to study the demographic and clinical profile of various post stroke psychiatric manifestations.Methods: The study was conducted on ninety patients developing psychiatric symptoms after stroke. Detailed socio-demographic characteristics, clinical profile along with psychiatric assessment were recorded in proforma specially designed for the study.Results: Bulk of this post- stroke psychiatric subjects (45%) was in the age range of 61-80 years of which male and female were 29% and 16% respectively.  Most of patients (90%) were residing at rural areas. 47.8 % patients were belonging to lower middle socio-economic status.  Majority of subjects (42.8%) were unemployed followed by farmer and skilled worker (20% each), and most of the patients were right handed (97.8%). On clinical parameters maximum subjects (52.2) developed post stroke major depression followed by depression mixed with anxiety (16.6%). Rest of patients suffered from organic anxiety disorder (8.8%), vascular dementia (10%), amnestic syndrome (5.5%), post stroke psychosis (3.3%), organic manic disorder (2.2%), pathological laughter and crying (1.1%).Conclusions: Huge number of patients (52.9%) developed psychiatric problems of diverse nature among patients with stroke syndrome. depression was most common post stroke psychiatric manifestation, followed by mixed anxiety with depression.  Generally the post stroke psychiatric manifestations are unrecognized and untreated, which has adverse impact on process of stroke rehabilitation. Thus a detailed psychiatric evaluation is mandatory in all patients of stroke syndrome to rule out psychiatric illness.

A scoping review on paraneoplastic autoimmune limbic encephalitis (PALE) psychiatric manifestations

CNS Spectrums ◽  
2020 ◽  
pp. 1-8
Author(s):  
João Costa Fernandes ◽  
João Gama Marques
Keyword(s):  
General Population ◽  
Scoping Review ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Controlled Trials ◽  
Initial Manifestation ◽  
Randomized Controlled ◽  
Psychiatric Syndrome ◽  
Autoimmune Limbic Encephalitis ◽  
Psychiatric Manifestations

Abstract The term limbic encephalitis has been used with an oncological precedent for over 50 years and, since then, has been applied in relation to multiple antibodies found in its etiological process. Over the last decade, the psychiatric community has brought paraneoplastic autoimmune limbic encephalitis (PALE) to a new light, scattering the once known relationships between said screened antibodies responsible for causing limbic encephalitis. Due to the fact that some individuals with this condition have a psychiatric syndrome as an initial manifestation, the aim of this updated scoping review is to reestablish a causal relationship between the onconeuronal autoantibodies, both intracellular and extracellular, possible underlying malignancies and subsequent neuropsychiatric syndrome. In pair with it, there is the idea of sketching a cleaner thorough picture of what poses as psychiatric symptoms as well as possible therapeutics. Even though the always evolving epistemology of the neurosciences achieved a significant unveiling of what includes PALE in its relevant pathological subgroups, the amount of gray literature still is much superior, appealing to a further research with more randomized controlled trials, with larger populations, so that the results corroborate the small amount of data that already exist and posteriorly be applied in the general population.

scholarly journals Clinical profile of patients with abdominal tuberculosis in rural North India

2019 ◽  
Vol 6 (3) ◽  
pp. 836
Author(s):  
Saurabh Agrahari ◽  
Maneshwar Singh Utaal ◽  
Sharadendu Bali
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Clinical Features ◽  
Rural Areas ◽  
Health Hazard ◽  
Abdominal Tuberculosis ◽  
Clinical Profile ◽  
North India ◽  
Bowel Habit ◽  
Number Of Patients

 Background: Tuberculosis is a very serious health hazard in India. The nonspecific clinical features of abdominal tuberculosis (TB) have made its diagnosis difficult, which can lead to the poor outcome in patients who are not able to receive early treatment especially from rural areas. Aim of our study was to determine the clinical profile including various clinico-pathological manifestations, demographic profile, spectrum of clinical presentation, etiology, pathological and radiological investigations of patients with abdominal TB.Methods: A total of 30 patients with abdominal TB were analysed. All diagnosed patients received anti-tubercular treatment and were followed up at 1 to 3 months of ATT.Results: The disease was common in both sexes. Most common symptoms were abdominal pain (93%), weight loss (83%), anorexia (68%). Most commonly observed signs were ascities (73.3%) abdominal distension and abdominal tenderness (43.3%) and lymphadenopathy (40%). Most of the patient were diagnosed via radiological and histo-pathological studies. Evidence of active pulmonary TB was present in nearly three fourth of patients. CB-NAAT was positive in 73% of the patients. Most common site of involvement was ileocecal region (36.9%). All patients had a good clinical response to ATT.Conclusions: The diagnosis of GI tuberculosis is often delayed. The onset usually is insidious with symptoms present for many months before diagnosis. A considerable number of patients can be diagnosed from common but non-specific clinical features (like fever, weight loss, altered bowel habit, Abdominal pain and distension). Laparoscopic examination is the Gold standard for diagnosis of peritoneal tuberculosis. Although AFB detection is difficult, a representative tissue biopsy and radiological findings are good method of diagnosis of abdominal tuberculosis.

Psychiatric Manifestations of Ehlers-Danlos Syndrome in Adolescents: A Case Report and Literature Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Daisy Vyas Shirk ◽  
Sarah D. Williams
Keyword(s):  
Chronic Pain ◽  
Literature Review ◽  
Literature Search ◽  
Web Search ◽  
Psychiatric Symptoms ◽  
Connective Tissue Disorders ◽  
Ehlers Danlos Syndrome ◽  
Symptoms Of Depression ◽  
Psychiatric Manifestations ◽  
Danlos Syndrome

Background: Ehlers-Danlos Syndromes (EDS) comprise a group of heterogeneous hereditary connective tissue disorders [1, 2]. Psychiatric disorders such as depression, anxiety, panic disorder, agoraphobia, schizophrenia, neurodevelopmental disorders, personality disorder, eating disorders, substance misuse and interpersonal issues have been reported in the literature to be associated with EDS [1-3]. Objectives: The case of a 15-year -old male who was hospitalized after a suicide attempt by gunshot was discovered to have symptoms suggestive of EDS is presented in this paper along with the results of a literature search of psychiatric manifestations of EDS in children and adolescents. Methods: Literature review was conducted on the UpToDate website on March 11, 2020 to review symptoms of EhlersDanlos Syndrome for the purpose of preliminary diagnosis of this patient. Additional literature search was conducted on PubMed on 4/2/20 at 12:10 P.M. and on 4/9/20 at 10:51 P.M. and on the search engine Google on 4/2/20 at 12:25 P.M. On May 11, 2020 at 2 P.M., another web search was conducted with review of 6 different websites pertaining to EhlersDanlos Syndrome. Results: A systematic review of psychiatric manifestations of Ehlers-Danlos Syndromes revealed a strong incidence of psychiatric symptoms. Conclusion: Our patient’s psychiatric symptoms of depression, suicidal ideations, anxiety and social and educational struggles may have been at least partially due to chronic pain- abdominal, headache and musculoskeletal, and social ostracization associated with Ehlers-Danlos Syndrome. Education regarding this illness helped our patient’s recovery as he came to understand why he was so “odd” and the cause of his multisystemic chronic pain.

scholarly journals The Relationship of Psychiatric Symptoms with Performance-Based and Self-Reported Cognitive Function After Ischemic Stroke

2021 ◽  
pp. 1-13
Author(s):  
Elisabeth Kliem ◽  
Elise Gjestad ◽  
Truls Ryum ◽  
Alexander Olsen ◽  
Bente Thommessen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Executive Function ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Psychiatric Symptoms ◽  
Post Stroke ◽  
Cognitive Difficulties ◽  
Memory And Attention ◽  
Relationship Of ◽  
The Relationship

Abstract Objective: Findings on the relationship of psychiatric symptoms with performance-based and self-reported cognitive function post-stroke are inconclusive. We aimed to (1) study the relation of depression and anxiety to performance-based cognitive function and (2) explore a broader spectrum of psychiatric symptoms and their association with performance-based versus self-reported cognitive function. Method: Individuals with supratentorial ischemic stroke performed neuropsychological examination 3 months after stroke. For primary analyses, composite scores for memory and attention/executive function were calculated based on selected neuropsychological tests, and the Hospital Anxiety and Depression Scale (HADS) was used. Psychiatric symptoms and self-reported cognitive function for secondary aims were assessed using the Symptom-Checklist-90 – Revised (SCL-90-R). Results: In a sample of 86 patients [mean (M) age: 64.6 ± 9.2; Mini-Mental State Examination (MMSE), 3–7 days post-stroke: M = 28.4 ± 1.7; National Institutes of Health Stroke Scale (NIHSS) after 3 months: M = 0.7 ± 1.6] depressive symptoms (HADS) were associated with poorer memory performance after controlling for age, sex, and education (p ≤ .01). In a subsample (n = 41; Age: M = 65.7 ± 8.1; MMSE: M = 28.4 ± 1.8; NIHSS: M = 1.0 ± 1.9), symptoms of phobic anxiety (SCL-90-R) were associated with poorer performance-based memory and attention/executive function, and symptoms of anxiety (SCL-90-R) with lower attention/executive function. Higher levels of self-reported cognitive difficulties were associated with higher scores in all psychiatric domains (p ≤ .05). Conclusion: Even in relatively well-functioning stroke patients, depressive symptoms are associated with poorer memory. The results also suggest that various psychiatric symptoms are more related to self-reported rather than to performance-based cognitive function. Screening for self-reported cognitive difficulties may not only help to identify patients with cognitive impairment, but also those who need psychological treatment.

scholarly journals Incidence of Postpartum Depression and Its Association With Antenatal Psychiatric Symptoms: A Longitudinal Study in 25 Villages of Rural South Karnataka

2021 ◽  
pp. 025371762199106
Author(s):  
Meera George ◽  
Avita Rose Johnson ◽  
Sulekha T.
Keyword(s):  
Longitudinal Study ◽  
Postpartum Depression ◽  
Psychiatric Disorders ◽  
Low Socioeconomic Status ◽  
Rural Women ◽  
Rural Areas ◽  
Psychiatric Symptoms ◽  
Depression Scale ◽  
Newborn Care ◽  
Care Program

Background: Postpartum depression (PPD) is the commonest mental health disorder post-childbirth, yet there is a paucity of data in rural areas regarding the actual incidence of PPD, which excludes pre-existing or antenatal depression. To estimate the incidence of PPD among rural women of south Karnataka and identify predictors of PPD, including antenatal psychiatric disorders. Methods: A longitudinal study in 25 villages in south Karnataka among 150 pregnant women in the third trimester of pregnancy using simple random sampling. Baseline data collected and revised Clinical Interview Schedule used to screen antenatal psychiatric disorders. Participants followed-up 6–8 weeks postpartum, end-line data collected, and Edinburg Postnatal Depression Scale administered. Chi-square and Fischer’s exact tests for association between PPD and covariates. Logistic regression to calculate adjusted odds ratios. Results: Prevalence of antenatal psychiatric disorders was 15.3%. The incidence of PPD was 11%. A significantly higher proportion of PPD was found among women with adverse events in the last year, low socioeconomic status, and perceived lack of care/support at home. Predictors of PPD were antenatal psychiatric disorders (AOR = 4.3, 95% CI = 1.22–5.11; P = 0.028), mothers reporting worry about their infant’s health (AOR = 7.7, 95% CI = 1.22–48.32; P = 0.012) and mothers receiving postpartum care by caregivers other than their own mother (AOR = 4.0, 95% CI = 1.13–8.09; P = 0.030). Conclusions: Our study found that one in ten rural women is developing PPD and there is a strong link between PPD and antenatal psychiatric disorders and family factors. This calls for capacity building of general physicians and village-level workers and strengthening of the Home-Based Newborn Care Program, where weekly postpartum home visits by ASHA are an opportunity for screening and counselling mothers.

Neurosarcoidosis Presenting as Schizophreniform Disorder

1992 ◽  
Vol 22 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Mohamed Sabaawi ◽  
Jose Gutierrez-Nunez ◽  
M. Richard Fragala
Keyword(s):  
Cognitive Decline ◽  
Mental Status ◽  
Clinical Presentation ◽  
Psychiatric Symptoms ◽  
Steroid Treatment ◽  
Schizophreniform Disorder ◽  
Schizophrenic Psychosis ◽  
Neurologic Involvement ◽  
Mental Status Examination ◽  
Psychiatric Manifestations

A patient whose clinical presentation met criteria for schizophreniform disorder was ultimately found to have neurosarcoidosis, and the psychiatric symptoms responded to steroid treatment. The ongoing search for organic etiology was prompted by the presence of cognitive decline, perseveration and rare bizarre automatisms. This is virtually the first reported association between schizophreniform disorder and sarcoidosis. We reviewed the literature on neurologic involvement and psychiatric manifestations in sarcoidosis as well as the concurrence between organicity and schizophrenic psychosis. The importance of attending to all elements of the mental status examination in a patient with complex atypical findings is underscored.

Psychopathologic aspects of obesity: Psychodiagnostic evaluations of bariatric surgery applicants

2011 ◽  
Vol 26 (S2) ◽  
pp. 714-714
Author(s):  
S. Chiappini ◽  
E. Righino ◽  
C. Ciciarelli ◽  
M. Pettorruso ◽  
G. Conte
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Psychiatric Symptoms ◽  
Psychiatric Evaluation ◽  
Psychiatric Interview ◽  
Negative Factor ◽  
Surgical Evaluation ◽  
A Current ◽  
Transoral Gastroplasty

IntroductionPsychiatrists play an important role as members of the bariatric surgery team. A preoperative psychiatric evaluation is considered as part of a mandatory workup before approving surgery.AimsThis evaluation focuses on the identification of any pre-existing psychiatric disorders among candidates for TOGa[1], a new experimental technique of bariatric surgery, and their correlations with post surgical weight loss.Method45 obese patients underwent a psychiatric interview and several psycho diagnostic questionnaires (SCL-90; HAM-D; HAM-A; EDI; TAS).A follow-up was set each 3 months.ResultsWe found that 34.1% of surgery candidates had a current diagnosis of depression; the majority showed anxiety symptoms. We also documented dissatisfaction about body shape, desire of slimness, fear of maturity, perfectionism, bulimia and binge eating disorder. Other frequent psychiatric symptoms were somatization, sensitivity, obsession and compulsion. After 3 months from surgery we found that the best weight loss was associated to low score in HAM-A, high score in hanger-hostility item (SCL-90) and low score in sensitiveness item (SCL-90).ConclusionThe diagnosis of a psychiatric pathology during the pre-surgical evaluation can be considered a predictive negative factor for the outcome of the surgery. The predictive positive factors are firstly the nonexistence of psychiatric symptoms, secondly the high score in sensitiveness-insight item (SCL-90) and the high score in the ability to express feelings. [1] (TransOral Gastroplasty)

“organic Personality Disorder” as Part of Early Neuropsychiatric Manifestations in Huntington’s Disease - a Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Maia
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Psychiatric Symptoms ◽  
Age Of Onset ◽  
Neuropsychiatric Symptoms ◽  
Personality Change ◽  
Psychotic Symptoms ◽  
Autosomal Dominant Disorder ◽  
Neuropsychiatric Manifestations ◽  
Psychiatric Manifestations

Huntington's Disease (HD) is an inherited autosomal dominant disorder characterized by motor, cognitive and psychiatric symptomatology, being considered a paradigmatic neuropsychiatric disorder that includes all three components of the "Triadic Syndromes": dyskinesia, dementia and depression.Firstly described in 1872 as an "Hereditary Chorea" by George Huntington only in 1993 was its responsible gene identified. A person who inherits the HD gene will sooner or later develop the disease. the age of onset, early signs and rate of disease progression vary greatly from person to person.Neuropsychiatric symptoms are an integral part of HD and have been considered the earliest markers of the disease, presenting sometimes more than 10 years before a formal diagnosis is done. Patients may experience dysphoria, mood swings, agitation, irritability, hostile outbursts, psychotic symptoms and deep bouts of depression with suicidal ideation. Personality change is reported in 48% of the cases, with the paranoid subtype being described as the most prevalent. the clinical case presented illustrates a case of HD which started with insidious psychiatric symptoms and an important personality change.Despite a wide number of medications being prescribed to help control emotional, movement and behaviour problems, there is still no treatment to stop or reverse the course of the disease. Furthermore, psychiatric manifestations are often amenable to treatment, and relief of these symptoms may provide significant improvement in patient's and caregivers quality of life.A greater awarness of psychiatric manifestations of HD is essential to an earlier diagnosis and an optimized therapeutic approach.

scholarly journals The Changes in The Utilization Rate of Traditional Chinese Medicine During the 2019 Coronavirus Pandemic

2020 ◽  
Author(s):  
Shun-Ku Lin ◽  
Chien-Tung Wu ◽  
Chia-Jen Liu ◽  
Hui-Jer Chou ◽  
Fu-Yang Ko ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Rural Areas ◽  
Utilization Rate ◽  
City Hospital ◽  
Medical Needs ◽  
Mobile Medicine ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Background: Large-scale epidemics have changed people’s medical behavior, and patients tend to delay non-urgent medical needs. However, the impact of the pandemic on the use of complementary and alternative medicine remains unknown. Methods: This retrospective study aimed to analyze the changes in the number of traditional Chinese medicine (TCM) patients and examine the epidemic prevention policy during the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the number of TCM patients in Taipei City Hospital from January 2017 to May 2020. We tallied the numbers of patients in each month and compared them with those in the same months last year. We calculated the percentage difference in the number of patients to reveal the impact of the COVID-19 pandemic on TCM utilization. We used the Mann­–Whitney U test to examine whether there was a significant difference in the number of patients during the COVID-19 pandemic. Results: We included a total of 41 months and 1,935,827 patients in this study. During the COVID-19 pandemic, the number of patients decreased significantly, except in February 2020. The numbers of patients during the COVID-19 pandemic had fallen by more than 15% compared with those in the same months last year. March and April had the greatest number of patient losses, with falls of 32.8% and 40%, respectively. TCM patients declined significantly during the COVID-19 pandemic, and mobile medicine provided to rural areas fell considerably. Among all the TCM specialties, pediatrics and traumatology, as well as infertility treatment, witnessed the most significant decline in the number of patients. However, the number of cancer patients has reportedly increased. Conclusions: The COVID-19 pandemic decreased the utilization rate of TCM, especially for mobile healthcare in rural areas. We suggest that the government pay attention to the medical disparity between urban and rural areas, which are affected by the pandemic, as well as allocate adequate resources in areas deprived of medical care.

scholarly journals Clinical profile and outcome of pediatric surgical patients in a rural tertiary centre

2021 ◽  
Author(s):  
Sunil Pathak ◽  
R. V. Mhapsekar ◽  
Neeraj Gupta ◽  
Karthik Surabhi ◽  
Shruchi Bhargava ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Clinical Profile ◽  
Surgical Patients ◽  
Curative Therapy ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Important Means ◽  
Surgical Conditions ◽  
Time Of Admission ◽  
Surgical Condition

Background: Pediatric surgery is a sub-speciality involving the surgery of foetuses, infants, children and adolescents. Congenital malformations, trauma and childhood cancers are their three major concerns requiring the focus of their attention. Rural pediatric population in India still remains devoid of such facilities. Little is factually known about the burden of surgical disease globally. Surgical treatment is an essential component of basic medical care and an important means of providing preventive and curative therapy. Pediatrician has a significant role in caring for surgical patients. There is a need to know the spectrum of diseases that warrant admission into the pediatric surgical units. Current study was conducted to find out the clinical profile and immediate outcome of the various pediatric surgical conditions. Methods: This prospective observational study was conducted at Vadodara. All the patients 0-18 years, with surgical condition were enrolled in the study. Patients were followed from the time of admission to discharge.  All the clinical data from admission to discharge were recorded and analyzed.Results: Total 127 (3%) patients were enrolled in the study. Males were 93 (73.2%). One to 5 years 45 (35.4%) was the largest age group folowed by infants 23 (18.1%). Largest number of patients were from Gastro Intestinal Condition 52 (40.9%) and congenital causes forms 83 (65.35%) of admissions. Commonest congenital anomaly was inguinal hernia 23 (27.7%). Complications were recorded in 46 (36.22%) patients. The average duration of stay was 7.7 days. The 124 patients were discharged successfully.Conclusions: Surgical conditions are important part of pediatric and neonatal care. Management of congenital surgical condition is important to decrease infant and under five mortality and other comorbidities as well.

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