scholarly journals Consultative psychiatry examinations of patients: Review of twelve months retrospective follow up

2009 ◽  
Vol 62 (11-12) ◽  
pp. 569-572
Author(s):  
Olivera Skakic ◽  
Ljiljana Trajanovic
Keyword(s):  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Psychiatric Symptoms ◽  
Medical Documentation ◽  
Psychiatric Evaluation ◽  
Liaison Psychiatry ◽  
Neurology Clinic ◽  
The Given ◽  
Endocrinology Clinic

Introduction. Psychiatric symptoms in hospitalized somatic patients are not rare in practice, and therefore consultative psychiatric examinations are an important part of the treatment of patients in non-psychiatric departments. The term consultative psychiatry refers to psychiatric evaluation, advising and treatment of numerous and various psychiatric disorders in physically ill patients in non-psychiatric departments. The aim of the research was to determine the wards at which psychiatric consultations were the most frequent as well as the prevalence of psychiatric disorders. Material and method. The research included 887 patients hospitalized at the clinics of the Clinical Centre Nis, examined by consultant psychiatrists during the twelve month period. The research instrument was medical documentation (files of psychiatrist-consultants after the completed consultation). Results and conclusion. The greatest number of psychiatric consultations was made at the Endocrinology Clinic, followed by the Neurology Clinic and the Surgery Clinic, and then at the Clinic for Cardiovascular Diseases. Most diagnoses were syndromological-descriptive, which entailed a relatively high percentage of multiple diagnoses. The most frequent diagnostic groups were chronic and acute psycho-organic syndromes, which cause a bad compliance and can lead to difficulties during somatic examination, intervention or pharmacological treatment. Immediately following are mental disorders due to the use of psychoactive substances, situational reactions and suicide attempts. The obtained results have shown that consultative psychiatric examinations were made in urgent conditions (aggressive patients), with few control examinations, which means without the follow up of the given therapy, without the use of psychotherapy and the principles of liaison psychiatry.

A Psychiatric Consultation/Liaison Clinic: Follow-up of Fifty-Four Patients Referred from Neurology

1988 ◽  
Vol 17 (3) ◽  
pp. 213-221 ◽  
Author(s):  
Joseph Schwartz ◽  
Nancy Speed ◽  
Michael Kuskowski
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Psychiatry Clinic ◽  
Outpatient Consultation ◽  
Neurology Clinic ◽  
Consultation Liaison Psychiatry ◽  
The Impact

To assess the impact of psychiatric consultation, the authors reviewed the charts of patients referred from a neurology clinic to an outpatient consultation/liaison psychiatry clinic. The patients were found to have both significant neurologic and psychiatric disorders. Only 46 percent returned to see their neurologists within six months of the referral. This finding highlights a major problem in outpatient consultation.

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)

scholarly journals Real-time fMRI neurofeedback as a new treatment for psychiatric disorders: a systematic review

2021 ◽  
Author(s):  
Pamela Pindi ◽  
Josselin Houenou ◽  
Camille Piguet ◽  
Pauline Favre
Keyword(s):  
Psychiatric Disorders ◽  
Real Time ◽  
Functional Mri ◽  
Psychiatric Symptoms ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Controlled Trials ◽  
Brain Response ◽  
Double Blind

Background: Neurofeedback using real-time functional MRI (RT-fMRI-NF) is an innovative technique that allows to voluntarily modulating a targeted brain response and its associated behavior. Despite promising results in the current literature, its effectiveness on symptoms’ management in psychiatric disorders is not yet clearly demonstrated. This review aims to evaluate the effectiveness of RT-fMRI-NF in the treatment of psychiatric disorders and to provide methodological suggestions for future studies. Methods: Web of Science and PubMed databases were searched using the keywords: neurofeedback AND (fMRI OR “functional magnetic resonance imag*” OR “functional MRI”) AND (“real-time” OR “real time”). Twenty-six clinical trials focusing on psychiatric disorders were included and categorized according to the diagnostic categories. The RT-fMRI-NF efficacy was assessed by reporting changes in clinical endpoints before vs. after NF training and before or after NF training vs. follow-up. Results: Among the 26 studies, 18 were controlled trials, of which five showed significant clinical improvement in the experimental vs. control group after the training. Eight studies found an effect at follow-up on ADHD symptoms, emotion dysregulation, depressive symptoms, hallucinations, psychotic symptoms and specific fear. Limitations: Here, we only focused our review on fMRI-based NF training. Conclusion: The use of RT-fMRI-NF as a treatment for psychiatric symptoms is promising. However, further double blind, randomized-controlled trials are warranted.

Psychiatric Disorders following Road Traffic and Industrial Injuries

1973 ◽  
Vol 7 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Roger Culpan ◽  
Christine Taylor
Keyword(s):  
Psychiatric Disorders ◽  
Road Traffic ◽  
Psychiatric Treatment ◽  
Early Recognition ◽  
Psychiatric Evaluation ◽  
Accidental Injury ◽  
Neurotic Disorder ◽  
Traumatic Neurosis ◽  
Industrial Injuries

The nature and prognosis of psychoneurotic disorders following accidental injury have long been a source of argument. The present authors have endeavoured to follow up and classify 82 subjects referred by solicitors for psychiatric evaluation following injury. The subsequent progress of 71 (87%) of the original consecutive sample was successfully obtained. Approximately one-third of the group were disabled by neurotic symptoms which appeared to result from the emotional stress of the accident itself and were thus classified as suffering from true “traumatic neurosis”. These patients improved with the passage of time. About one-half of the group were thought to be unconsciously motivated by the possibility of financial compensation and these patients failed to improve or became worse up until the time of settlement of their claims. The sample also included 5 (6%) frank malingerers; the subjects with “compensation neurosis” invariably denied concern over the outcome of their lawsuits. Only two of the group received psychiatric treatment following termination of their litigation and only one able-bodied worker was known not to have returned to work by the end of the study. The need for early recognition of the fact that a neurotic disorder is being perpetuated by secondary gain factors is stressed.

Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

2001 ◽  
Vol 31 (7) ◽  
pp. 1181-1191 ◽  
Author(s):  
WEN-HUNG KUO ◽  
J. J. GALLO ◽  
A. Y. TIEN
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorders ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
Community Sample ◽  
Suicide Behaviour

Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non-fatal suicide behaviour) in a community sample, to evaluate antecedent sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.Method. Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.Results. The incidence of suicide attempts was estimated at 148·8 per 100000 person-years and ideation at 419·9 per 100000 person-years. Persons in the youngest age group, in the lowest socio-economic status, and previously married persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6·09, 95% CI 2·58–14·36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.Conclusions. Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.

scholarly journals Association between inflammatory bowel disease and psychiatric morbidity and suicide: A Swedish nationwide population-based cohort study with sibling comparisons

2021 ◽  
Author(s):  
Jonas F  Ludvigsson ◽  
Ola Olén ◽  
Henrik Larsson ◽  
Jonas Halfvarson ◽  
Catarina Almqvist ◽  
...  
Keyword(s):  
General Population ◽  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Psychiatric Morbidity ◽  
Population Based ◽  
First Year ◽  
Adult Onset ◽  
Increased Risk ◽  
Elderly Onset

Abstract Background and Aims Inflammatory bowel disease (IBD) is linked to psychiatric morbidity, but few studies have assessed general population comparators. We aimed to investigate the risk of psychiatric morbidity and suicide in adult-onset IBD patients. Methods Nationwide population-based cohort study in Sweden (1973-2013). We studied the risk of psychiatric disorders and suicide in 69,865 adult-onset IBD patients (ulcerative colitis, UC: n=43,557; Crohn’s disease, CD: n=21,245; and IBD-unclassified: n=5063) compared to 3,472,913 general population references and 66,292 siblings. Results During a median follow-up of 11 years, we found 7,465 (10.7%) first psychiatric disorders in IBD (incidence rate, IR/1000 person-years 8.4) and 306,911 (9.9%) in the general population (IR 6.6), resulting in 1.8 extra psychiatric morbidity per 100 patients followed-up for 10 years and a hazard ratio (HR) of 1.3 (95% confidence interval, 95%CI=1.2-1.3). The highest risk of overall psychiatric morbidity was seen in the first year after IBD diagnosis (HR=1.4, 95%CI=1.2-1.6) and in patients with extraintestinal manifestations (HR=1.6, 95%CI=1.5-1.7). Psychiatric morbidity was more common in all IBD subtypes (HRs 1.3 to 1.5). An increased risk of suicide attempts was observed among all IBD types (HRs=1.2 to 1.4), whereas completed suicide was explicitly associated with CD (HR=1.5) and elderly-onset (diagnosed at the age of >60 years) IBD (HR=1.7). Conclusion Adult-onset IBD was associated with an increased risk of psychiatric disorders and suicide attempts. Psychological follow-up should be provided to patients with IBD, especially those with extraintestinal manifestations and elderly-onset IBD. This follow-up should transpire within the first year after IBD diagnosis.

The Psychiatric Examination of the Neurologic Patient

2008 ◽  
Author(s):  
Constantine G. Lyketsos
Keyword(s):  
Differential Diagnosis ◽  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Chief Complaint ◽  
Psychiatric Evaluation ◽  
Cognitive State ◽  
Psychiatric History ◽  
Neurologic Disease ◽  
History Of ◽  
Cognitive Problems

A well-conducted psychiatric evaluation is central to the care of neurologic patients with psychiatric disorders. The evaluation is aimed at defining the psychiatric condition in the context of the patient’s past psychiatric history and current neurologic disease. The information derived from the evaluation is used to develop a formulation, establish a diagnosis, and form a basis for treatment planning. This chapter discusses the psychiatric evaluation of the neurologic patient in detail. It includes examination techniques and questions as well as practical approaches to conducting an assessment of the patient’s cognitive state. Along the way, common psychiatric symptoms encountered in neurologic patients are defined and differentiated from related symptoms. The chapter concludes by illustrating how to generate a formulation and differential diagnosis. The psychiatric evaluation consists of three parts: the history; the mental status examination (MSE); and the formulation, including the differential diagnosis. The history, which is essential to defining the problem, is taken from the patient and from one or more informants. The importance of taking a history from an informant is underscored in the context of neurologic disease because patients may be forgetful, lack insight, or have language and other cognitive problems that may limit their ability to provide a good history. History-taking begins with defining the psychiatric chief complaint and then obtaining the family and personal history. Starting in this way, rather than with the chief complaint followed by the history of present illness (HPI), makes it easier to see that the psychiatric symptoms may have been caused by, or influenced by, factors other than the neurologic disease—factors that can include psychiatric disorders as such, aspects of patients’ personalities, and responses patients have to the circumstances of their lives. Table 1–1 provides an outline of important elements of the psychiatric history for neurologic patients and can be used as a checklist in clinical practice. Defining the psychiatric chief complaint is the physician’s first task. ‘‘Psychiatric chief complaint’’ in this context refers to the occurrence of cognitive, affective, behavioral, or perceptual phenomena that are brought to the physician’s attention by the patient, a family member or other informant, or by the physician’s own observation.

Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm

2010 ◽  
Vol 22 (5) ◽  
pp. 223-227 ◽  
Author(s):  
Fernando Machado Dias ◽  
Flávia Doyle ◽  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Leonardo Franklin Fontenelle ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Hemifacial Spasm ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Anxiety Scale ◽  
Psychiatric Evaluation ◽  
Obsessive Compulsive ◽  
Psychometric Scales ◽  
Hamilton Anxiety Scale ◽  
Liebowitz Social Anxiety Scale

Dias FM, Doyle F, Kummer A, Cardoso F, Fontenelle LF, Teixeira AL. Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm.Objective:To compare the frequency of psychiatric disorders and the severity of psychiatric symptoms between patients with blepharospasm (BS) and hemifacial spasm (HS).Methods:BS is a type of primary focal dystonia characterised by recurrent and involuntary eye blinking. HS is a condition with different pathophysiology but similar clinical phenotype. Twenty-two patients with BS and 29 patients with HS participated in this study. They underwent a comprehensive psychiatric evaluation that included a structured clinical interview for current psychiatric diagnosis according to Diagnostic Statistical Manual, fourth edition (DSM-IV) (MINI-Plus) and psychometric scales, including the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HRSD), the Hamilton Anxiety Scale (HAS) and the Liebowitz Social Anxiety Scale (LSAS).Results:BS and HS groups did not differ in most demographic and clinical parameters, such as gender, age and length of symptoms. The frequency of psychiatric disorders and the severity of psychiatric symptoms were similar in both groups.Conclusion:BS does not seem to have more psychiatric disorders than HS.

scholarly journals Psychopathology in patients with psoriasis: a cross-sectional clinical study

2019 ◽  
Vol 8 (1) ◽  
pp. 307
Author(s):  
Kumari Padma ◽  
Sagar Subhash Nanaware ◽  
Aruna Yadihal ◽  
P. John Mathai
Keyword(s):  
Psychiatric Disorders ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Psychiatric Morbidity ◽  
Self Esteem ◽  
Liaison Psychiatry ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Consultation Liaison Psychiatry

Background: Psoriasis is associated with a variety of psychological problems including poor self-esteem, sexual dysfunction, anxiety and depressive disorder and suicidal ideation. There are reports that patients with psoriasis may have significant psychiatric morbidity. The objective of the study is to evaluate the frequency of psychiatric disorders, frequency and nature of psychiatric symptoms in patients with psoriasis.Methods: 100 patients with psoriasis were evaluated and included for the study. Comprehensive Psychopathological Rating Scale (CPRS) is used for assessment of psychiatric symptoms and MINI Plus for assessing psychiatric disorders. Chi-square test was used to compare the proportions.Results: Patients with psoriasis had high frequency of psychiatric morbidity and was found to be 42%.Conclusions: Patients with psoriasis have more psychopathology and higher psychiatric morbidity which may further imply justifiable consultation liaison psychiatry in other speciality fields like Dermatology.

One-year changes in psychiatric disorders following bariatric surgery

2017 ◽  
Vol 41 (S1) ◽  
pp. S467-S467
Author(s):  
E. Bianciardi ◽  
D.L. Giorgio ◽  
N. Cinzia ◽  
G. Flavia ◽  
G. Paolo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Eating Disorder ◽  
Depressive Symptoms ◽  
Binge Eating ◽  
Psychiatric Disorders ◽  
Binge Eating Disorder ◽  
Psychiatric Symptoms ◽  
One Year

IntroductionPsychiatric disorders in obese patients range from 20% to 60%, with a lifetime prevalence as high as 70%. Bariatric surgery (BS) is an effective therapy for long-term weight control and ameliorates comorbidities. After BS, psychiatric outcomes are still a matter of controversy. Moreover, while psychosocial pre-surgical evaluation is mandatory, post-operatively psychiatric follow-up programs are lacking. Aim of this prospective study was to examine changes in psychiatric symptoms and weight over 1 year of follow-up among a population of individuals submitted to BS.MethodsOne hundred forty eight participants were enrolled, 98 women and 50 men; mean age was 46 (SD = 10.7), and mean BMI was 46 (SD = 7.7). Clinical interview and self-report instruments were administered before and one year after BS. Depressive symptoms were measured using Beck Depression Inventory (BDI), Binge Eating Disorder was measured using Binge Eating Scale (BES).ResultsOne year after surgery 86% of patients achieved a percentage excess weight loss (%EWL) ≥40%. Rate of psychiatric comorbidities declined from 41% at pre-surgery to 12% at 1 year post-surgery, P = 0.01. BDI mean score declined from 12 to 8, P > 0.000. After BS, binge eating, depressive symptoms, and age were independent and significant predictors of %EWL (F6,523 = 79.599, P < 0.0001, adjR2 = 0.471).ConclusionsWe reported an improvement of psychiatric symptoms through 1 year after BS. Post surgical binge eating disorder and depression were associated with less weight loss after surgery, adding to the literature suggesting that psychiatric disorder after surgery, unlike pre-surgery, are related to suboptimal weight loss.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document