Sleep Disorder due to General Medical Condition

2020 ◽  
Author(s):  
2001 ◽  
Vol 16 (8) ◽  
pp. 497-500 ◽  
Author(s):  
R. Shiloh ◽  
A. Weizman ◽  
P. Dorfman-Etrog ◽  
N. Weizer ◽  
H. Munitz

SummaryA case is presented in which severe urinary retention (UR) occurred during an acute psychotic exacerbation of paranoid schizophrenia. The voiding dysfunction was apparent during continuous treatment with unchanged doses of haloperidol, and it completely resolved with the remission of the psychotic symptoms. A clear temporal correlation was evident between the patient’s mental status, the Brief Psychiatric Rating Scale (BPRS) score and the degree of the UR as assessed by quantitatively measuring the total daily postvoiding urine residues. We could not relate the UR to any apparent general medical condition or to the haloperidol treatment. The presented data suggests that UR in schizophrenic patients might be the end-result of various psychosis-related mechanisms.


Author(s):  
William S. Breitbart

Anxiety is common in palliative care patients and may significantly impact patients’ quality of life. Anxiety can have many etiologies resulting in different anxiety syndromes, ranging from adjustment disorder, anxiety resulting from general medical condition, to medication-induced anxiety disorders. Pre-existing anxiety disorders should also be taken into consideration in palliative care settings. Different screening and assessment tools have been used to improve recognition and assessment of anxiety in the terminally ill. Treatment of anxiety in this patient population includes use of a variety of pharmacological agents to relieve severe anxiety symptoms and use of psychotherapy interventions that have been shown to be safe and effective in the terminally ill. This chapter includes an overview of the prevalence, assessment, and management of anxiety disorders in palliative care settings.


2019 ◽  
Vol 68 (1) ◽  
pp. 41-54
Author(s):  
Paolo Morocutti

La dimensione religiosa dell’uomo contribuisce in modo sostanziale al mantenimento della condizione medica generale, migliorando e preservando la qualità della vita. Quanto fa bene la fede? La preghiera fa ammalare meno e guarire prima? La partecipazione ai servizi religiosi porta realmente un effetto positivo sulla salute? Gli studi esaminati in questo articolo sembrano rispondere affermativamente a queste domande, evidenziando la stretta correlazione tra religiosità/spiritualità, salute e benessere fisico e psicologico. L’impatto antropologico e sociologico di tale realtà conduce ad evidenti riflessioni storiche e filosofiche, ma anche mediche e bioetiche, generando l’esigenza di una profonda trasformazione nella formazione del personale sanitario, dove l’aspetto religioso o spirituale non è ritenuto importante, né rilevante nell’approccio medico per la cura e l’assistenza del paziente. Nonostante ciò, numerosi studi approfondiscono ed attestano l’importanza di questo aspetto sia dei singoli, sia dell’intera popolazione. ---------- Religious dimension of man contributes substantially to maintain general medical condition, improving and preserving quality of life. How good is faith? Does prayer make you sick less and get better sooner? Does participation in religious services actually have a positive effect on health? The studies examined within this article seem to answer positively to these questions, highlighting the close correlation between religiosity / spirituality, health and physical and psychological well-being. The anthropological and sociological impact of this reality leads to evident historical and philosophical as well as medical and bioethical reflections, generating the need for a deep transformation of health personnel training, where the religious or spiritual aspect are not considered as important, nor relevant for medical approach to patient’s care. Nevertheless, several studies address and highlight the importance of this aspect for both individuals and whole population.


2018 ◽  
Vol 45 (3-4) ◽  
pp. 180-189 ◽  
Author(s):  
Anette Bakkane Bendixen ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Cecilie Bhandari Hartberg

Objective: Anxiety symptoms are common in older adults with depression, but whether severe anxiety is associated with poorer outcomes of depression is unknown. The objective of the present study was to examine the association between severity of anxiety and severity of depression and physical illness, suicidality, and physical and cognitive functioning in older adults with depression. Methods: We included 218 older adults with diagnoses of a depressive disorder according to the ICD-10 criteria; their mean age (SD) was 75.6 (7.2), and 67.0% were women. The Geriatric Anxiety Inventory (GAI) was used to measure the severity of anxiety symptoms. The Montgomery-Aasberg Depression Rating Scale (MADRS) was used to assess the severity of depression. We obtained information on the level of functioning with the Physical Self-Maintenance Scale (PSMS) by Lawton and Brody and on cognition with the Mini-Mental State Examination (MMSE) and the Clock-Drawing Test (CDT). Physical health was determined based on information regarding falls and weight loss and an assessment of each patient’s general medical condition. The treating physician evaluated current suicidality in a comprehensive and standardized way. Results: Higher GAI scores were significantly associated with scores on the MADRS (β = 0.233, p = 0.002) and suicidality (β = 0.206, p = 0.006). Levels of physical or cognitive functioning were not associated with the GAI score. Conclusion: The severity of anxiety symptoms was associated with the severity of depression and suicidality in older adults with depressive disorders. The results could indicate a need to focus greater attention on the treatment of anxiety and suicidality in older patients with depression.


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