scholarly journals Comparison of Emotional Dysregulation Features in Cyclothymia and Adult ADHD

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 489
Author(s):  
Giulio Emilio Brancati ◽  
Margherita Barbuti ◽  
Elisa Schiavi ◽  
Paola Colombini ◽  
Martina Moriconi ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Adult Adhd ◽  
Suicide Attempts ◽  
Emotional Dysregulation ◽  
Negative Emotionality ◽  
University Hospital ◽  
Clinical Settings ◽  
Cyclothymic Disorder ◽  
Affective Temperament ◽  
Comorbid Adhd

Background and Objectives: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. Materials and Methods: One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) and the 40-item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RI-PoSt-40) were administered. Results: Cyclothymic patients were more frequently female and older with respect to the ADHD groups. Both comorbid and non-comorbid ADHD patients showed significantly lower educational attainment and more frequently had substance use disorders. Panic disorder was common in non-comorbid cyclothymic patients, who showed significantly higher rates of familial panic disorder, major depressive disorder and suicide attempts in comparison with patients only diagnosed with ADHD. Cyclothymic patients without ADHD were also characterized by fewer hyperthymic temperamental traits, higher depressive and anxious dispositions, and a greater negative emotionality. No significant differences among groups were observed for cyclothymic temperament and overall negative emotional dysregulation, but comorbid patients with both conditions scored the highest in these subscales. This group also showed significantly higher affective instability with respect to ADHD patients without cyclothymia and was less frequently diagnosed with bipolar disorder type II than patients from both the other groups. Conclusions: ADHD and cyclothymia often co-occur and show similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality in clinical settings. Subjects with “sunny” cyclothymic features might escape the attention of clinicians unless ADHD is present.

scholarly journals Affective Temperaments, Panic Disorder and Their Bipolar Connections

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 289
Author(s):  
Zsuzsanna Belteczki ◽  
Zoltan Rihmer ◽  
Sandor Rozsa ◽  
Julia Ujvari ◽  
Maurizio Pompili ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Control Group ◽  
Affective Temperaments ◽  
Gender And Age ◽  
Affective Temperament ◽  
Male Patients ◽  
The One

Background and Objectives: The role of affective temperament in the genesis and outcome of major mood disorders is well studied, but there are only a few reports on the relationship between panic disorder (PD) and affective temperaments. Accordingly, we aimed to study the distribution of affective temperaments (depressive (DE); cyclothymic (CT); irritable (IRR); hyperthymic (HT) and anxious (ANX)) among outpatients with PD. Materials and Methods: Affective temperaments of 118 PD outpatients (80 females and 38 males) with or without agoraphobia but without any other psychiatric disorder at the time of inclusion were evaluated using the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and compared with the affective temperament scores of control subjects. All patients were followed up for at least 1.5 years in order to detect the onset of any major affective disorders, substance use disorders and suicide attempts. Results: Among females, the dominant ANX and DE temperaments were four and three times as common as in a large normative Hungarian sample (for both cases p < 0.01). Among male PD patients, only the dominant DE temperament was slightly overrepresented in a non-significant manner. Females with PD obtained significantly higher scores on ANX, DE and CT subscales of the TEMPS-A, whereas males with PD showed significantly higher scores on ANX, DE and HT temperament subscales compared with the members of a large normative Hungarian sample and also with a gender- and age-matched control group. During the follow-up, newly developed unipolar major depression and bipolar spectrum (bipolar I or II and cyclothymic) disorders appeared in 64% and 22% of subjects, respectively. Conclusions: Our preliminary findings suggest that a specific, ANX-DE-CT affective temperament profile is characteristic primarily for female patients, and an ANX-DE-HT affective temperament profile is characteristic for male patients with PD, respectively. These findings are in line with expectations because PD is an anxiety disorder par excellence on the one hand, whereas, on the other hand, it is quite frequently comorbid with mood (including bipolar) disorders.

Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Stephanie De Munck ◽  
Gwendolyn Portzky ◽  
Kees Van Heeringen
Keyword(s):  
Young Adults ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Epidemiological Studies ◽  
Adolescents And Young Adults ◽  
University Hospital ◽  
International Studies ◽  
Suicide Attempters ◽  
Increased Risk ◽  
Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

scholarly journals Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study

2021 ◽  
Vol 9 (4) ◽  
pp. 798
Author(s):  
Giorgia Caruana ◽  
Antony Croxatto ◽  
Eleftheria Kampouri ◽  
Antonios Kritikos ◽  
Onya Opota ◽  
...  
Keyword(s):  
Immunoglobulin A ◽  
University Hospital ◽  
Lower Sensitivity ◽  
Clinical Settings ◽  
Rt Pcr ◽  
Emergency Ward ◽  
Viral Loads ◽  
Asymptomatic Patients ◽  
Asymptomatic Subjects ◽  
Antigen Testing

Following the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patients and save resources. Among 532 patients, overall sensitivities were 48.3% for Exdia and 41.2% for Standard Q®, PanbioTM and BD Veritor™. All RATs exhibited specificity above 99%. Sensitivity increased to 74.6%, 66.2%, 66.2% and 64.8% for Exdia, Standard Q®, PanbioTM and BD Veritor™, respectively, for viral loads above 105 copies/mL, to 100%, 97.8%, 96.6% and 95.6% for viral loads above 106 copies/mL and 100% for viral loads above 107 copies/mL. Sensitivity was significantly higher for patients with symptoms onset within four days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with the evolution of symptoms longer than four days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Among COVID-19 asymptomatic patients, sensitivity was 33%. All Immunoglobulin-A-positive patients resulted negative for RAT. The RAT might represent a useful resource in selected clinical settings as a complementary tool in RT-PCR for rapid patient triaging, but the lower sensitivity, especially in late presenters and COVID-19 asymptomatic subjects, must be taken into account.

Could it be Adult ADHD?

2017 ◽  
Author(s):  
Jan Willer
Keyword(s):  
Mental Health ◽  
Behavioral Treatment ◽  
Adult Adhd ◽  
Adaptive Functioning ◽  
Mental Health Problems ◽  
Emotional Dysregulation ◽  
Full Description ◽  
Health Practitioner ◽  
Cognitive Behavioral Treatment ◽  
Adhd Treatment

One out of every 10 adult psychotherapy clients—or more—probably has attention deficit/hyperactivity disorder (ADHD). When psychotherapists miss the ADHD, treatment is frustrating and less effective. This book is for the general mental health professional who wishes to learn how to recognize, assess, and treat adult ADHD. Adults with ADHD are very different, developmentally and symptomatically, from children. ADHD affects adults of all races, gender identities, and backgrounds, and obvious hyperactivity is rarely part of the adult clinical picture. This book provides a full description of adult ADHD symptoms, based on the most current research, including executive functioning problems, emotional dysregulation, atypical reward sensitivity, and problems with time perception. Complete guidance to recognizing adult ADHD is provided, including behavior displayed during psychotherapy, developmental issues, educational challenges, and adaptive functioning problems. Depression, anxiety, self-image issues, and substance abuse are addressed, since these mental health problems are commonly associated with adult ADHD. Guidance is provided to help the mental health practitioner provide psychoeducation about cognitive differences in ADHD, which is essential for client self-acceptance and adaptive functioning. Common psychotherapy problems with ADHD clients are addressed, including chronic lateness to sessions, missed appointments, motivation problems, difficulties with homework, and tangentiality. The principles of cognitive-behavioral treatment of ADHD are provided, along with case examples to illustrate the implementation of these techniques. An overview of medications for ADHD is provided, including their benefits, contraindications, and side effects. Nontraditional treatments are reviewed for their effectiveness.

scholarly journals Response to Lenvatinib Is Associated with Optimal RelativeDose Intensity in Hepatocellular Carcinoma: Experience in Clinical Settings

Cancers ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1769 ◽  
Author(s):  
Sasaki ◽  
Fukushima ◽  
Haraguchi ◽  
Miuma ◽  
Miyaaki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Dose Intensity ◽  
Hepatic Function ◽  
University Hospital ◽  
Clinical Settings ◽  
Operating Characteristics ◽  
Or Groups ◽  
Significant Difference

Background: Lenvatinib is currently available as the first-line treatment for advanced unresectable hepatocellular carcinoma. We evaluated the relationship between its relative dose intensity (RDI) and response in clinical settings. Methods: From March 2018 to May 2019, 93 patients were administered lenvatinib at the Nagasaki University Hospital and its related facilities. Among these, 81 patients (66 men, 15 women, median age 72.0) who received lenvatinib were analyzed retrospectively. Results: Fourteen patients were Child–Pugh grade B, and 15 had received other systemic therapy. According to Response Evaluation Criteria in Solid Tumors (RECIST), the objective response (OR) rate was 17.3%. The overall survival (OS) was significantly better in the OR group (p = 0.011). There was a significant difference in RDI between the OR and non-OR groups (p < 0.05). The area under the receiver operating characteristics curve for OR prediction by the 4, 8, 12, and 16-week RDI were 0.666, 0.747, 0.731, and 0.704, respectively. In the 8-week RDI 67.0% group, OS was significantly better than in the 8-week RDI< 67.0% group (p = 0.003). Conclusions: Because a sufficient RDI is required to achieve an OR, it is strongly recommended that lenvatinib should be administered to patients with good hepatic function and status.

Caring for “Socially Undesirable” Patients

1996 ◽  
Vol 5 (4) ◽  
pp. 500-510 ◽  
Author(s):  
Nancy S. Jecker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Renal Insufficiency ◽  
Suicide Attempts ◽  
University Hospital ◽  
Healthcare Team ◽  
Local Hospital ◽  
The University ◽  
Osmolar Gap

Mr. Bernard was a homeless man, aged 58. His medical history revealed alcohol abuse, seizure disorder, and two suicide attempts. Brought to the emergency room at a local hospital after being found “semi-comatose,” his respiratory distress led to his being intubated and placed on a ventilator. The healthcare team suspected the patient ingested antifreeze. Transferred from that hospital to the intensive care unit (ICU) of the university hospital, his diagnosis was “high osmolar gap with high-anion gap metabolic acidosis, most likely secondary to ethylene glycol ingestion and renal insufficiency.”

Screening for Attention-Deficit/Hyperactivity Disorder in Adult Inpatients with Psychiatric Disorders

2011 ◽  
Vol 108 (3) ◽  
pp. 815-824 ◽  
Author(s):  
Geetha Kumar ◽  
Justin Faden ◽  
Robert A. Steer
Keyword(s):  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Rating Scales ◽  
Male Adult ◽  
Hyperactivity Disorder ◽  
Dsm Iv ◽  
Assessment Measures ◽  
Comorbid Adhd ◽  
Symptom Criteria

The purpose was to assess the effectiveness of the adult ADHD Module from the MINI International Neuropsychiatrie Interview (MINI) and the Conners' Adult ADHD Rating Scales: Screening Version DSM-IV ADHD Symptoms Total Scale (CAARS-S:SV) in screening for attention-deficit/hyperactivity (ADHD) disorder in patients hospitalized for other psychiatric disorders. Assessment measures were administered to 55 (50%) female and 55 (50%) male adult (> 18 yr. old) inpatients. Only six (5%) of the 110 inpatients had been diagnosed with comorbid ADHD according to medical charts. In contrast, 55 (50%) patients met criteria for ADHD according to the MINI, and 39 (36%) patients met criteria on the CAARS-S:SV. The higher rates of prevalence for the MINI and the CAARS-S:SV were attributable to symptom criteria for ADHD being similar to those shared with comorbid disorders.

Separation anxiety disorder from the perspective of DSM-5: clinical investigation among subjects with panic disorder and associations with mood disorders spectrum

CNS Spectrums ◽  
2015 ◽  
Vol 21 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Camilla Gesi ◽  
Marianna Abelli ◽  
Alessandra Cardini ◽  
Lisa Lari ◽  
Luca Di Paolo ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Mood Disorders ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Clinical Interview ◽  
Self Report ◽  
Clinical Settings ◽  
Compulsive Disorder ◽  
Axis I

Objective/IntroductionHigh levels of comorbidity between separation anxiety disorder (SEPAD) and panic disorder (PD) have been found in clinical settings. In addition, there is some evidence for a relationship involving bipolar disorder (BD) and combined PD and SEPAD. We aim to investigate the prevalence and correlates of SEPAD among patients with PD and whether the presence of SEPAD is associated with frank diagnoses of mood disorders or with mood spectrum symptoms.MethodsAdult outpatients (235) with PD were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Panic Disorder Severity Scale (PDSS), the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), and the Mood Spectrum Self-Report Instrument (MOODS-SR, lifetime version).ResultsOf ther 235 subjects, 125 (53.2%) were categorized as having SEPAD and 110 (46.8%) as not. Groups did not differ regarding onset of PD, lifetime prevalence of obsessive compulsive disorder (OCD), social phobia, simple phobia, BD I and II, or major depressive disorder (MDD). SEPAD subjects were more likely to be female and younger; they showed higher rates of childhood SEPAD, higher PDSS scores, and higher MOODS-SR total and manic component scores than subjects without SEPAD.DiscussionSEPAD is highly prevalent among PD subjects. Patients with both PD and SEPAD show higher lifetime mood spectrum symptoms than patients with PD alone. Specifically, SEPAD is correlated with the manic/hypomanic spectrum component.ConclusionOur data confirm the high prevalence of SEPAD in clinical settings. Moreover, our findings corroborate a relationship between mood disorders and SEPAD, highlighting a relationship between lifetime mood spectrum symptoms and SEPAD.

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