scholarly journals Short-term outcome in acute and transient psychotic disorder and its correlate to various sociobiological factors

2017 ◽  
Vol 4 (2) ◽  
pp. 350
Author(s):  
Sumit Chandak ◽  
Sunil N. Gowda
Keyword(s):  
Treatment Adherence ◽  
Psychotic Disorder ◽  
Sleep Disturbances ◽  
Significant Proportion ◽  
Term Outcome ◽  
Population Average ◽  
Icd 10 ◽  
History Of ◽  
Study Population ◽  
Made In

Background: There is a higher incidence of acute and transient psychotic disorder, however there are not much data on the course of disease and its association with sociobiological factors. We assessed the outcome in patients who met the ICD 10 DCR criteria for acute and transient psychotic disorder, at a follow up period of 6 months.Methods: We conducted a prospective observational study conducted at out-patient department of the Institute of Psychiatry and Human Behaviour, Bambolim, Goa. Fifty-seven patients were enrolled and were followed up for a period of 6 months from the day of enrollment. The outcome was ‘review of diagnosis and ‘no review of diagnosis at the end of 6 months.Results: The mean age of the study sample was 32.25 years. In three-fourth of the patients, there was no change in the diagnosis. Nearly 65% of the patients were women and 35% of them were men. No review in diagnosis was made in significant proportion of the population. Average duration of education was 7.35 years. Most of them were unskilled laborers and homemakers. A significant number of the study population was migrants. Two-third of the population did not have any family history of psychiatric disorder. The onset was acute in majority of the patients. Suicidal thoughts were present at the time of diagnosis in certain patients. The treatment adherence was lower in those whose diagnoses did not change at the end of 6 months. Sleep disturbances, ideas of persecution, and concentration difficulties were the frequently reported symptoms.No repeat episodes were noted in our study.Conclusions: No review in diagnosis was made in significant proportion of the population. The treatment adherence was lower in those whose diagnoses did not change at the end of 6 months.

Course and outcome of schizophrenia and their prediction

2012 ◽  
pp. 568-578
Author(s):  
Assen Jablensky
Keyword(s):  
Personal Growth ◽  
Significant Proportion ◽  
Complete Recovery ◽  
Psychotic Symptoms ◽  
Term Outcome ◽  
Longitudinal Course ◽  
Duration Of Illness ◽  
History Of ◽  
Episodic Course ◽  
Accuracy Of Prediction

Studies conducted over many decades consistently demonstrate that schizophrenia presents a broad spectrum of possible outcomes and course patterns, ranging from complete or nearly complete recovery after acute episodes of psychosis to continuous, unremitting illness leading to progressive deterioration of cognitive performance and social functioning. Between these extremes, a substantial proportion of patients show an episodic course with relapses of psychotic symptoms and partial remissions during which affective and cognitive impairments become increasingly conspicuous and may progress to gross deficits. Although no less than one-third of all patients with schizophrenia have relatively benign outcomes, in the majority the illness still has a profound, lifelong impact on personal growth and development. The initial symptoms of the disorder are not strongly predictive of the pattern of course but the mode of onset (acute or insidious), the duration of illness prior to diagnosis and treatment, the presence or absence of comorbid substance use, as well as background variables such as premorbid adjustment (especially during adolescence), educational and occupational achievement, marital status, and availability of a supportive social network allow a reasonable accuracy of prediction in the short- to medium-term (2–5 years). One of the most striking aspects of the longitudinal course of schizophrenia is the so-called ‘terminal improvement’. A relatively high proportion of patients tend to improve substantially with ageing. What determines this long-term outcome is far from clear but the stereotype view of schizophrenia as an invariably progressive, deteriorating disorder does not accord well with the evidence. Similarly, a model of schizophrenia as a static neurodevelopmental encephalopathy decompensating post-adolescence under the influence of a variety of stressors fits only part of the spectrum of course patterns. In a significant proportion of cases, the disorder exhibits the unmistakable features of a shift-like process with acute exacerbations and remissions which may progress to severe deterioration or come to a standstill at any stage. Whether a single underlying pathophysiology can explain the variety of clinical outcomes, or several different pathological processes are at work, remains obscure. It has been suggested that the longitudinal course of schizophrenia should be seen as an open-ended, dynamic life process with multiple, interacting biological and psychosocial determinants. Obviously, such issues cannot be resolved by clinical follow-up studies alone, and require a strong involvement of neurobiological research in prospective investigations of representative samples of cases spanning the entire spectrum of course and outcomes. No such studies have been possible until recently, both because of the technical complexity of such an undertaking and because of the tendency to selectively recruit for biological investigations patients from the severe, deteriorating part of the spectrum. Overcoming such limitations will be essential to the uncovering of the mechanisms driving the ‘natural history’ of schizophrenia.

A 2- TO 3-YEAR OUTCOME AFTER BRONCHIOLITIS

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 254-254
Author(s):  
Nancy Ostrom
Keyword(s):  
Family History ◽  
Positive Family History ◽  
Control Group ◽  
Short Term ◽  
Term Outcome ◽  
Significant Difference ◽  
Socioeconomic Diversity ◽  
History Of ◽  
Study Population ◽  
Viral Etiologies

Purpose of the Study. To evaluate risk factors and short term outcome for subsequent wheezing in children with early bronchiolitis or pneumonia. Study Population. One hundred twenty-seven children (0 to 2 years old) hospitalized for wheezing (83) or pneumonia in a 1-year period in two hospitals in Finland. Methods. Patients with a history of hospitalization for wheezing with respiratory infection (including bronchiolitis) versus pneumonia were examined, and their parents were interviewed at 1 month, 1.5 to 2 years, and 2.5 to 3 years. Family history of atopy, environmental factors, breast feeding history, and other atopy (eczema, elevated IgE) were noted using a standardized questionnaire and physician-documented wheezing episodes were quantified. Statistical χ2 tests were analyzed comparing the wheezing group to the control group of patients with pneumonia not associated with wheezing. Findings. There was no significant difference between the groups in bacterial versus viral etiology of their lower respiratory symptoms. Subsequent wheezing after bronchiolitis occurred in 76% of children 1-2 years of age and 58% of children at 2-3 years of age. This compares with 9% and 16% (respectively by age) of the group with "non-wheezing" pneumonia. Atopic diathesis, particularly a positive family history of asthma was the host factor best associated with initial wheezing. Parenthetically, parental smoking was found in 61% of the wheezing group and 45% of the pneumonia group. Reviewer's Comments. This is a sound study, perhaps limited, in its comparability to our clinical populations with wider racial and socioeconomic diversity. Of note is the finding of no differences between the wheezing and nonwheezing groups in bacterial and viral etiologies.

Brief psychotic disorder with delusion content related to the COVID-19 outbreak

Psychiatriki ◽  
2021 ◽  
Author(s):  
Kyriaki Marouda ◽  
Leonidas Mantonakis ◽  
Konstantinos Kollias
Keyword(s):  
Case Report ◽  
Psychotic Disorder ◽  
Psychiatric Symptoms ◽  
Stressful Life Event ◽  
Psychological Impact ◽  
Strong Relationship ◽  
Brief Psychotic Disorder ◽  
Icd 10 ◽  
History Of

The COVID-19 outbreak has affected millions of people globally and it also has a huge psychological impact. The objective of this case report is to outline the possible effect of the COVID-19 pandemic to the content of delusions in patients with psychosis. Α 34-year-old male with no history of mental disorder, involuntarily hospitalized due to agitation and aggression towards others, experienced grandiose delusions, referential delusions and delusions of passivity. The content of all his delusions was related to the COVID-19 pandemic. His symptoms were not proven to be caused by any physical condition or substance use disorder. He was prescribed olanzapine 10mg bd and lorazepam 2,5mg td and demonstrated significant improvement with a complete subsidence of his symptoms within a week. He was discharged after a total of 13 days with an ICD-10 diagnosis of brief psychotic disorder. At his 6 months follow-up, he reported no psychiatric symptoms. Existing literature indicates a strong relationship between life experiences and the content of delusions. This case report highlights how the stressful life event of the COVID-19 outbreak affected the content of our patient’s delusions.

scholarly journals Fibromyalgia from a psychiatric point of view

2021 ◽  
Vol 21 (2) ◽  
pp. 128-133
Author(s):  
Maja Hasterok ◽  
◽  
Magdalena Piegza ◽  
Paweł Dębski ◽  
◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Chronic Widespread Pain ◽  
Point Of View ◽  
Lively Discussion ◽  
Medical Specialties ◽  
Male Ratio ◽  
Therapeutic Concepts ◽  
Icd 10 ◽  
History Of

Fibromyalgia is a disorder bordering on rheumatology and psychiatry, which was included in the ICD-10 (M79.7) classification in the 1990s. It is characterised by a triad of symptoms including chronic widespread pain, sleep disturbances, and mental or physical exhaustion. According to various estimates, fibromyalgia affects from 2 to 4% of the population, particularly individuals between 50 and 60 years of age. There is a lack of consistent data in the available literature on the prevalence of the disorder between sexes. Depending on the criteria used, the female/male ratio is reported to be 13.7:1, 4.8:1 or 2.3:1. Despite nearly three decades of fibromyalgia presence in the ICD classification system, the nature and treatment of the disease have not been sufficiently recognized and arouse a lively discussion among researchers of various medical specialties. The paper attempts to systematise selected issues related to fibromyalgia which seem particularly important from the point of view of psychiatry. The introduction presents the history of the debate on the concept of fibromyalgia, problems relating to the definition and classification of the condition and, finally, symptomatology. The article focuses on the psychiatric aspect of fibromyalgia and reviews reports of the association of fibromyalgia with mental disorders, as well as issues relating to pathophysiological and therapeutic concepts that may be useful to both psychiatrists and other specialists who may encounter the disorder in their practice.

scholarly journals Ametropia in children with headache

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Mohammad Asim Mehboob ◽  
Haider Nisar ◽  
Memoona Khan
Keyword(s):  
Refractive Error ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Initial Symptoms ◽  
History Of ◽  
Study Population ◽  
Persistent Headache ◽  
Open Access Article

Objective: To measure the frequency of uncorrected ametropia in children with 2 to 8 weeks of persistent headache referred to ophthalmic outpatient department for evaluation. Methods: This cross sectional study was conducted at CMH Gujranwala from March 2018 to November 2018.A total of 262 children, aged from 5 to 16 years, with 2 to 8 weeks history of persistent headache underwent detailed ophthalmic assessment for refractive errors, and other ophthalmic evaluation. Children with ametropia, confirmed with cycloplegic refraction and post-mydriatic testing were prescribed with glasses. Patients without any ophthalmic findings were referred back to pediatrics department for further evaluation. Results: Mean age of study population was 8.97 ± 3.16 years. Mean duration of headache was 5.03 ± 1.81 weeks. Ametropia was found in 56 (21.4%) children, while 206 (78.6%) had no refractive error. Out of children with ametropia, 20 (35.7%) had myopia, 24 (42.8%) had astigmatism and 12 (21.5%) had hypermetropia. There was no difference in ametropic children and children without ametropia with respect to gender (p=0.73), age (p=0.54) and duration of headache (p=0.71). Conclusion: A significant proportion of children with ametropia have initial symptoms of headache. Any child with un-explained headache must undergo ophthalmic evaluation to diagnose refractive error, if any. doi: https://doi.org/10.12669/pjms.35.3.268 How to cite this:Mehboob MA, Nisar H, Khan M. Ametropia in children with headache. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.268 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicolas Veziris ◽  
Claire Andréjak ◽  
Stéphane Bouée ◽  
Corinne Emery ◽  
Marko Obradovic ◽  
...  
Keyword(s):  
Marrow Transplant ◽  
Charlson Comorbidity Index Score ◽  
Control Group ◽  
Treatment Regimens ◽  
Main Driver ◽  
Icd 10 ◽  
History Of ◽  
Study Population ◽  
Annual Total ◽  
Lower Respiratory Disease

Abstract Background The objective of the study was to describe the epidemiology, management and cost of non-tuberculous mycobacteria pulmonary disease (NTM-PD) in France. Methods A retrospective analysis was performed using the SNDS (“Système national des données de santé”) database over 2010–2017. Patients with NTM-PD were identified based on the ICD10 codes during hospitalizations and/or specific antibiotics treatment regimens. The study population was matched (age, sex and region) to a control group (1:3) without NTM-PD. Results 5628 patients with NTM-PD (men: 52.9%, mean age = 60.9 years) were identified over the study period and 1433 (25.5%) were treated with antibiotics. The proportion of patients still receiving treatment at 6 and 12 months was 40% and 22%, respectively. The prevalence of NTM-PD was estimated at 5.92 per 100,000 inhabitants and the incidence rate of NTM-PD remained stable over time between 1.025/100,000 in 2010 and 1.096/100,000 in 2017. Patients with NTM-PD had more co-morbidities compared to controls: corticoids (57.3% vs. 33.8%), chronic lower respiratory disease (34.4% vs. 2.7%), other infectious pneumonia (24.4% vs. 1.4%), malnutrition (based on hospitalization with the ICD-10 code reported during a hospital stay as a main or secondary diagnosis) (22.0% vs. 2.0%), history of tuberculosis (14.1% vs. 0.1%), HIV (8.7% vs. 0.2%), lung cancer and lung graft (5.7% vs. 0.4%), cystic fibrosis (3.2% vs. 0.0%), gastro-esophageal reflux disease (2.9% vs. 0.9%) and bone marrow transplant (1.3% vs. 0.0%) (p < 0.0001). The mean Charlson comorbidity index score was 1.6 (vs. 0.2 for controls; p < 0.0001). NTM-PD was independently associated with an increased mortality rate with a hazard ratio of 2.8 (95% CI: 2.53; 3.11). Mortality was lower for patients treated with antibiotics compared to untreated patients (HR = 0.772 (95% CI [0.628; 0.949]). Annual total expenses the year following the infection in a societal perspective were € 24,083 (SD: 29,358) in NTM-PD subjects vs. € 3402 (SD: 8575) in controls (p < 0.0001). Main driver of the total expense for NTM-PD patients was hospital expense (> 50% of the total expense). Conclusion Patients with NTM-PD in France were shown to have many comorbidities, their mortality risk is high and mainly driven by NTM-PD, and their management costly. Only a minority of patients got treated with antibiotics and of those patients treated, many stopped their therapy prematurely. These results underline the high burden associated with NTM-PD and the need for improvement of NTM-PD management in France.

Comparative outcome of first-admission patients with delusional beliefs

1995 ◽  
Vol 10 (6) ◽  
pp. 276-281 ◽  
Author(s):  
P Jørgensen
Keyword(s):  
Affective Disorder ◽  
Psychotic Disorder ◽  
Diagnostic Category ◽  
Delusional Disorder ◽  
Global Functioning ◽  
Term Outcome ◽  
Middle Term ◽  
Icd 10 ◽  
First Admission

SummaryA study sample of 88 patients suffering from delusional beliefs was examined from first admission to follow-up. From the time of index admission, global functioning differs when distributed in accordance with ICD-10 categories. Patients with the discharge diagnoses affective disorder and acute and transient psychotic disorder have similar and optimistic perspective. The most pessimistic perspectives apply to patients with schizophrenia and an intermedium, but a rather pessimistic position also applies to patients with persistent delusional disorder. According to the discharge diagnosis following first admission, the score of global assessment functioning (GAF) at follow-up (8 years) is: schizophrenia 37; affective disorder 73; persistent delusional disorder 47; and acute and transient psychotic disorder 70. Generally, short-term outcome bears close resemblance to that of middle-term observation. During the observation period, 13 patients died. Amongst the surviving 75 patients, diagnosis at follow-up differed from that given at first-admission discharge, in eight cases using ICD-10 and in ten cases using DSM-III-R. Therefore, the use of ICD-10 as well as DSM-III-R enables clinicians to estimate a high stability (89%) diagnostic category with minimal delay.

scholarly journals Use of trained dogs to determine the age structure and conservation status of kiwi Apteryx spp. populations

2009 ◽  
Vol 19 (2) ◽  
pp. 121-129 ◽  
Author(s):  
HUGH A. ROBERTSON ◽  
JAMES R. FRASER
Keyword(s):  
Age Structure ◽  
Conservation Status ◽  
Bird Species ◽  
Forest Patches ◽  
Radio Transmitters ◽  
History Of ◽  
Study Population ◽  
Experimental Management ◽  
Excellent Tool ◽  
Made In

SummarySpecially trained dogs are used to locate many threatened bird species in New Zealand during conservation management and research projects. Systematic searches were made in four forest patches in Northland where many Brown Kiwi Apteryx mantelli had been fitted with bands, wing tags, transponders or radio-transmitters over a 12-year period of experimental management. The percentage of subadult birds found by dogs increased in line with predictions from population models of the changing age structure of the population. The dogs independently found radio-tagged adults and subadults in close proportion to their known abundance. Dogs proved to be an excellent tool to determine the age structure of a kiwi population. With knowledge of the life history of the species involved, this information was used to make an accurate assessment of the conservation status of the study population of Brown Kiwi in Northland. Our results also support the recent downgrading of Little Spotted Kiwi Apteryx owenii from ‘Vulnerable’ to ‘Near Threatened’, which was based partly on healthy age ratios found during dog searches on Kapiti Island, rather than on results from a study of their breeding biology on the island which showed unsustainably low chick recruitment.

Atypical psychosis – historical and current perspective

2016 ◽  
Vol 33 (S1) ◽  
pp. S362-S362
Author(s):  
M.A. Aleixo ◽  
C.A. Moreira ◽  
G. Sobreira ◽  
J. Oliveira ◽  
L. Carvalhão Gil
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Case Identification ◽  
Current Perspective ◽  
Pubmed Database ◽  
Brief Psychotic Disorder ◽  
Icd 10 ◽  
History Of ◽  
Competing Interest ◽  
Definition Of

IntroductionClinical concepts regarding atypical psychosis such as the French bouffeé délirante, the German cycloid psychosis, and the Scandinavian reactive and schizophreniform psychoses are now under the category of F23 ‘Acute and transient psychotic disorders’ (ATPD) of the tenth revision of the International Classification of Mental and Behavioural Disorders (ICD-10).AimsThe authors’ aim is to highlight the clinical and scientific relevance of atypical psychosis from the historical concepts to the current perspective.MethodsA Pubmed database search using as keywords “atypical psychosis”, “acute and transient psychotic disorders”, and “brief psychotic disorder” and retrieved papers were selected according to their relevance.ResultsDifferent psychiatric schools, often of a regional or national character, have provided concepts for transient psychotic states. The acute and transient psychotic disorders of ICD-10 and the brief psychotic disorder of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reflect the diversity of the history of such concepts. The available evidence suggests that case identification and follow-up is difficult in ATPD due to the heterogeneous and infrequent nature of this clinical phenomenon. Furthermore ATPD has a low diagnostic stability and there are few studies focused on brief psychotic disorders.ConclusionsThe present definition of acute and transient psychotic disorders and brief psychotic disorder, while taking into account the history of the concepts involved, leave many questions open to further studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A history of botanical collections in the Luangwa Valley, Zambia

1998 ◽  
Vol 25 (2) ◽  
pp. 283-291
Author(s):  
P.S.M. PHIRI ◽  
D.M. MOORE
Keyword(s):  
Eighteenth Century ◽  
Environmental Impact ◽  
Impact Assessment ◽  
Vascular Plants ◽  
Central Africa ◽  
Peak Activity ◽  
Historical Account ◽  
History Of ◽  
The 1960S ◽  
Made In

Central Africa remained botanically unknown to the outside world up to the end of the eighteenth century. This paper provides a historical account of plant explorations in the Luangwa Valley. The first plant specimens were collected in 1897 and the last serious botanical explorations were made in 1993. During this period there have been 58 plant collectors in the Luangwa Valley with peak activity recorded in the 1960s. In 1989 1,348 species of vascular plants were described in the Luangwa Valley. More botanical collecting is needed with a view to finding new plant taxa, and also to provide a satisfactory basis for applied disciplines such as ecology, phytogeography, conservation and environmental impact assessment.

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