Prevalence and Outcomes of Major Psychiatric Disorders Preceding Index Surgery for Degenerative Thoracic/Lumbar Spine Disease

The relationship between preexisting major psychiatric disorders and outcomes of spine surgery for degenerative thoracic/lumbar disease remains unclear. A 5% subset of inpatients was randomly selected from the Taiwan National Health Insurance Research Database. A total of 10,109 inpatients aged 18 years or over with degenerative thoracic/lumbar disease and underwent spine surgery met inclusion criteria. Major psychiatric disorders diagnosed by psychiatrists preceding index surgery, including anxiety disorder, depression disorder, bipolar disorder, schizophrenia and dementia, were identified. The prevalence of psychiatric disorders, and their differential risks on in-hospital and post-discharge outcomes were examined. 10.4% had major psychiatric disorders, of which depression (6.6%) and anxiety (4.9%) were most common. Logistic regression revealed increased risks of ventilator use in depression (OR = 1.62, 95% CI = 1.04–2.54, p < 0.05), extended hospitalization length in bipolar (OR = 1.77, 95% CI = 1.08–2.89, p < 0.05), and higher rehabilitation utilization in depression (OR = 1.25, 95% CI = 1.06–1.47, p < 0.01) and bipolar (OR = 1.69, 95% CI = 1.04–2.76, p < 0.05). Those patients with anxiety had a decreased risk of longer hospitalization duration (OR = 0.77, 95% CI = 0.60–0.98, p < 0.05), while those with dementia and schizophrenia had no change in risks. Preoperative recognition of major psychiatric disorders for risk and treatment assessment is suggested as people with preexisting depression or bipolar disorder have worse outcomes after spine surgery.

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Mentally Sick or Not—(Bio)Markers of Psychiatric Disorders Needed

Journal of Clinical Medicine ◽

10.3390/jcm9082375 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2375 ◽

Cited By ~ 4

Author(s):

Napoleon Waszkiewicz

Keyword(s):

Bipolar Disorder ◽

Major Depression ◽

Mental Disorders ◽

Psychiatric Disorders ◽

Developmental Disorders ◽

Mental Illnesses ◽

Major Depression Disorder ◽

Wide Group ◽

Substance Related Disorders ◽

Depression Disorder

Psychiatric disorders, also called mental illnesses or mental disorders, constitute a wide group of disorders including major depression disorder (MDD), bipolar disorder (BD), schizophrenia (SCZ) and other psychoses, anxiety disorders (ANX), substance-related disorders (SRD), dementia, developmental disorders e [...]

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Immune abnormalities across psychiatric disorders: clinical relevance

BJPsych Advances ◽

10.1192/apt.bp.114.012872 ◽

2015 ◽

Vol 21 (3) ◽

pp. 150-156 ◽

Cited By ~ 4

Author(s):

Valeria Mondelli ◽

Paola Dazzan ◽

Carmine M. Pariante

Keyword(s):

Bipolar Disorder ◽

Immune System ◽

Psychiatric Disorders ◽

Treatment Strategies ◽

Brain Functioning ◽

Nervous Systems ◽

Pathophysiological Role ◽

Central Nervous Systems ◽

New Treatment ◽

The Relationship

SummaryIt is well established that the immune system can modulate brain functioning and influence behavioural processes. Awareness of communication between the immune and nervous systems has, over the years, progressively heightened interest in the relationship between psychiatric disorders and immune function. By reviewing findings from studies investigating inflammation in the periphery and in the central nervous systems, we summarise here the evidence linking inflammation to the development of depression, schizophrenia and bipolar disorder. We discuss how a pathophysiological role for inflammation has now been recognised across different psychiatric disorders, at least in a significant subpopulation of patients. Finally, we discuss a possible role for these findings in the development of future diagnostic classifications of psychiatric disorders as well as of new treatment strategies.

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The Effect of Weather on Peritoneal Dialysis (PD) Prescription: Seasonal Variation in PD Dialysate Utilization

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00118 ◽

2010 ◽

Vol 30 (3) ◽

pp. 320-328 ◽

Cited By ~ 2

Author(s):

Tzen-Wen Chen ◽

Szu-Yuan Li ◽

Tzeng-Ji Chen ◽

Yu-Chun Chen ◽

Chiu-Ling Lai ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Seasonal Variation ◽

Diabetic Patients ◽

Research Database ◽

Cyclic Pattern ◽

Mean Temperature ◽

Taiwan National Health Insurance ◽

Design And Methods ◽

The Relationship

♦ BackgroundThere have been no reports on peritoneal dialysis (PD) solution utilization since this treatment was developed in the 1920s. The aim of the present investigation was to investigate if weather affects PD prescription.♦ Study Design and MethodsThis 10-year observational study used the Taiwan National Health Insurance Research Database. Setting and Participants: Claims for different concentrate PD dialysate were analyzed monthly. 2.5% and 4.25% PD solutes were defined as hypertonic solutions. Predictor: Monthly outdoor mean temperature. Outcome and Measurement: The relationship between monthly mean of PD dialysate utilization and monthly outdoor temperature was analyzed by linear regression. Monthly mean PD dialysate utilization amount in 4 quarters was analyzed by ANOVA.♦ ResultsDuring the 10-year study period, a clear seasonal variation in PD dialysate was observed. This seasonal variation was present regardless of age, gender, and the presence of hypertension, diabetes, and dyslipidemia. Monthly mean temperature was positively correlated to 1.5% dialysate utilization amount ( r = 0.559, p < 0.001) and negatively correlated to 2.5% ( r = –0.533, p < 0.001) and 4.25% ( r= –0.410, p < 0.001) dialysate utilization amount. In longitudinal follow-up, hypertonic PD fluid utilization was higher in diabetic patients than in nondiabetic patients from the beginning of treatment. Thereafter, it increased rapidly and reached a plateau within 1 year. Limitations: Analysis of ultrafiltration amount, blood pressure, and body weight was unfeasible due to the nature of the database.♦ ConclusionsThe utilization of differential strengths of PD solutions has a seasonal cyclic pattern, with more hypertonic PD solution utilized in winter and more hypotonic PD solution in summer.

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High 1-year risk of stroke in patients with hepatocellular carcinoma: a nationwide registry-based cohort study

Scientific Reports ◽

10.1038/s41598-021-89867-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jin-Yi Hsu ◽

Peter Pin-Sung Liu ◽

An-Bang Liu ◽

Huei-Kai Huang ◽

Ching-Hui Loh

Keyword(s):

Hepatocellular Carcinoma ◽

Cohort Study ◽

Stroke Risk ◽

Population Based ◽

Research Database ◽

Hazard Ratios ◽

Taiwan National Health Insurance ◽

Baseline Characteristics ◽

Coagulation Dysfunction ◽

The Relationship

AbstractPatients with hepatocellular carcinoma (HCC) might be more vulnerable to develop stroke than other cancer patients because of HCC-associated coagulation dysfunction. However, limited studies have investigated the relationship between HCC and stroke. This nationwide population-based cohort study enrolled all patients with HCC diagnosed between 2011 and 2015 from the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database; an age- and sex-matched cohort without cancer was included. The primary outcome was the 1-year risk for first-ever stroke after the index date. The Fine and Gray competing risk regression model was used to estimate the 1-year stroke risk with adjusted hazard ratios (aHRs). After propensity score matching, each cohort has 18,506 patients with similar baseline characteristics. Compared with the cancer-free cohort, the aHRs in the HCC cohort for overall, ischemic, and hemorrhagic strokes were 1.59 [95% confidence interval (CI), 1.35–1.88], 1.38 [95% CI, 1.15–1.65], and 2.62 [95% CI, 1.79–3.84], respectively. On subgroup analysis, HCC patients without cirrhosis, those with stage 3 or 4 cancer had a higher stroke risk than cancer-free cohort. Therefore, stroke prevention should be considered in patients with HCC, especially in those without cirrhosis and with stage 3 or 4 cancer.

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Infection with Toxoplasma gondii increases the risk of psychiatric disorders in Taiwan: a nationwide population-based cohort study

Parasitology ◽

10.1017/s0031182020001183 ◽

2020 ◽

Vol 147 (13) ◽

pp. 1577-1586

Author(s):

Hsin-An Lin ◽

Wu-Chien Chien ◽

Kuo-Yang Huang ◽

Chi-Hsiang Chung ◽

Lih-Chyang Chen ◽

...

Keyword(s):

Bipolar Disorder ◽

Toxoplasma Gondii ◽

Psychiatric Disorders ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Control Group ◽

Case Group ◽

Research Database ◽

Significant Difference

AbstractThis study aimed to evaluate associations between toxoplasmosis and psychiatric disorders in Taiwan based on the National Health Insurance Research Database, Taiwan (1997–2013). Patients newly diagnosed with toxoplasmosis formed the case group (n = 259), and the control group included propensity-score matched patients without toxoplasmosis (n = 1036). The primary outcome was incidence of psychiatric disorders. Cox proportional hazards regression and stratified analyses were performed to examine risk of developing specific psychiatric disorders between patients with and without toxoplasmosis. Patients with toxoplasmosis had significantly higher incidence of psychiatric disorders than those without toxoplasmosis (P = 0.016). A significant difference was found in numbers of psychiatric disorders between the two groups during 14 years of follow-up (log-rank P < 0.001). Those with toxoplasmosis had significantly higher risk of bipolar disorder [adjusted hazard ratio (aHR = 3.60, 95% confidence interval (CI) = 2.07, 7.26), depression (aHR = 4.94, 95% CI = 2.15, 11.80) and anxiety (aHR = 5.36, 95% CI = 2.98, 25.88), but no significant between-group differences were found for schizophrenia and other psychiatric disorders. In conclusion, the present nationwide population-based analysis revealed that Toxoplasma gondii infection in Taiwan significantly increases the risk for developing bipolar disorder, depression and anxiety, but not for schizophrenia and other psychiatric disorders.

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The Relationship Between Patient Satisfaction With Hospitalization and Outcomes Up to 6 Months Post-Discharge in Cardiac Patients

Journal of Patient Experience ◽

10.1177/2374373520948389 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1685-1692

Author(s):

Paige M Anderson ◽

Rachel Krallman ◽

Daniel Montgomery ◽

Eva Kline-Rogers ◽

Sherry M Bumpus

Keyword(s):

Patient Satisfaction ◽

Hospital Staff ◽

Emergency Department Visits ◽

Cardiac Patients ◽

Discharge Process ◽

Post Discharge ◽

Discharge Outcomes ◽

System Improvement ◽

Care Satisfaction ◽

The Relationship

Little is known about the relationship between patient satisfaction with inpatient care and post-discharge outcomes. This study examined inpatient hospital satisfaction after a cardiac event and outcomes through 6 months post-discharge. We examined 327 cardiac patients from the Bridging the Discharge Gap Effectively database who completed a patient satisfaction survey about their hospital admission and had post-discharge outcomes data. Higher patient satisfaction with the discharge process correlated with fewer readmissions at 90 days post-discharge. Higher patient satisfaction with hospital staff management of personal issues correlated with fewer emergency department visits at 6 months post-discharge. Higher patient satisfaction with overall assessment of care and hospitalization correlated with lower mortality rate at 6 months post-discharge. Being nonwhite correlated with lower nursing care satisfaction. Associations between cardiac patient satisfaction and outcomes exist. In this population, higher patient satisfaction correlated with better outcomes. Patient satisfaction data may be able to inform areas for health system improvement.

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The Relationship between Cannabis Use and Cognition in People with Bipolar Disorder: A Systematic Scoping Review

10.1101/2020.04.24.20078535 ◽

2020 ◽

Author(s):

T. Jordan Walter ◽

Nina Pocuca ◽

Jared W. Young ◽

Mark A. Geyer ◽

Arpi Minassian ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Scoping Review ◽

Web Of Science ◽

Cannabis Use ◽

Inclusion Criteria ◽

Cognitive Domains ◽

Future Studies ◽

Experimental Trials ◽

The Relationship

ABSTRACTBipolar disorder (BD) and cannabis use are highly comorbid and are each associated with cognitive impairment. It is therefore important to understand the relationship between cannabis use and cognition in people with BD, as cannabis use in BD may be associated with greater cognitive impairment. We performed a scoping review to determine how much and what is currently known in this field. We systematically searched PubMed, Embase, CINAHL, Web of Science, and PsycINFO for studies on the relationship between cannabis and cognition in people with BD or relevant animal models. Six observational human studies met inclusion criteria. Two studies found cannabis use in BD was associated with better performance in some cognitive domains, while three studies found no association. One study found cannabis use in BD was associated with worse overall cognition. Overall, most identified studies suggest cannabis use is not associated with significant cognitive impairment in BD; however, the scope of knowledge in this field is limited, and more systematic studies are clearly required. Future studies should focus on longitudinal and experimental trials, as well as well-controlled observational studies with rigorous quantification of the onset, frequency, quantity, duration, and type of cannabis use.

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Developmental profile of psychiatric risk associated with voltage-gated cation channel activity

10.1101/2020.10.19.345801 ◽

2020 ◽

Author(s):

Nicholas E Clifton ◽

Leonardo Collado-Torres ◽

Emily E Burke ◽

Antonio F Pardiñas ◽

Janet C Harwood ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Association Studies ◽

Early Adulthood ◽

Biological Pathways ◽

Cation Channel ◽

Genome Wide Association Studies ◽

Channel Activity ◽

Voltage Gated ◽

The Relationship

AbstractBackgroundRecent breakthroughs in psychiatric genetics have implicated biological pathways onto which genetic risk for psychiatric disorders converges. However, these studies do not reveal the developmental time point(s) at which these pathways are relevant.MethodsWe aimed to determine the relationship between psychiatric risk and developmental gene expression relating to discrete biological pathways. We used post-mortem RNA sequencing data (BrainSeq and BrainSpan) from brain tissue at multiple pre- and post-natal timepoints and summary statistics from recent genome-wide association studies of schizophrenia, bipolar disorder and major depressive disorder. We prioritised gene sets for overall enrichment of association with each disorder, and then tested the relationship between the association of each of their constituent genes with their relative expression at each developmental stage.ResultsWe observed relationships between the expression of genes involved in voltage-gated cation channel activity during Early Midfetal, Adolescence and Early Adulthood timepoints and association with schizophrenia and bipolar disorder, such that genes more strongly associated with these disorders had relatively low expression during Early Midfetal development and higher expression during Adolescence and Early Adulthood. The relationship with schizophrenia was strongest for the subset of genes related to calcium channel activity, whilst for bipolar disorder the relationship was distributed between calcium and potassium channel activity genes.ConclusionsOur results indicate periods during development when biological pathways related to the activity of calcium and potassium channels may be most vulnerable to the effects of genetic variants conferring risk to psychiatric disorders. Furthermore, they indicate key time points and potential targets for disorder-specific therapeutic interventions.

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Rationale and Design of a Prospective, Multicenter, Observational Study Evaluating Iron Deficiency in Patients Hospitalized for Heart Failure (FERIC-RO)

Revista Romana de Medicina de Laborator ◽

10.2478/rrlm-2018-0022 ◽

2018 ◽

Vol 26 (3) ◽

pp. 271-281

Author(s):

Elena Laura Antohi ◽

Gabriel Tatu Chitoiu ◽

Andrew P Ambrosy ◽

Ioan M Coman ◽

Dragos Vinereanu ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Iron Deficiency ◽

Post Discharge ◽

Multicenter Observational Study ◽

Discharge Outcomes ◽

The Relationship ◽

Prospective Multicenter Observational Study

Abstract Introduction: Several landmark studies, which enrolled heart failure (HF) patients who were ambulatory at the time of inclusion, identified iron deficiency (ID) as an important therapeutic target: intravenous iron administration with ferric carboxymaltose (FCM) improves morbidity, exercise capacity, and quality of life in patients with HF and reduced EF (HFrEF). However, there is still limited knowledge about ID prevalence during hospitalization for Worsening Chronic HF (WCHF) and about the relationship between ID during hospitalization and post-discharge outcomes. Although previous studies documented ID as an independent risk factor for poor outcomes in HFrEF, its prognostic significance in HF patients with EF>40% remains unclear. Method and Results: The FERIC-RO study is a prospective, multicenter, observational study with longitudinal follow up, conducted in 9 Romanian hospitals that will include 200 consecutive patients admitted for worsening HF. A comprehensive description of the Iron metabolism biomarkers will be performed on discharge and 1-month follow up. The primary endpoint is defined as the prevalence of ID on discharge and 1-month post-discharge, and the secondary endpoints include: all-cause re-hospitalization and all-cause-mortality at 1 and 3 months follow up, and quality of life on discharge and 1-month. Conclusions: FERIC-RO will provide new evidence about the prevalence and the predictors of ID in patients hospitalized for WCHF regardless of LVEF. Furthermore, the study will explore the relationship between in-hospital ID and post-discharge outcomes. The results of FERIC-RO will thus be highly relevant to the management of patients hospitalized for AHF.

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Epilepsy and psychosis

Psychotic Disorders ◽

10.1093/med/9780190653279.003.0011 ◽

2020 ◽

pp. 85-92

Author(s):

Michael R. Trimble ◽

Kousuke Kanemoto ◽

Dale C. Hesdorffer

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Intractable Epilepsy ◽

Important Place ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Forced Normalization ◽

Patients With Epilepsy ◽

The Relationship

This chapter reviews the important place that epilepsy has had in developing concepts of psychosis in general and for understanding some of the basic biological issues of schizophrenia and bipolar disorder. It starts out by offering a historical introduction noting important observations stemming from the nineteenth century. It reviews the complexity of classification in this area, highlighting in particular problems with Diagnostic and Statistical Manual, 5th edition (DSM-5). Epidemiology is followed by brief discussions of the relationship between seizures and psychosis, commenting on some paradoxes revealing why postictal psychoses are underdiagnosed, and the pitfalls of missing forced normalization, a concept that relates to the worsening of behavior with the cessation of seizures in people with intractable epilepsy. Finally, the chapter provides some guides to management of patients with epilepsy who have comorbid psychiatric disorders.

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