Interactions between brain, psyche and thyroid

2008 ◽  
Vol 47 (06) ◽  
pp. 225-234 ◽  
Author(s):  
W. Huff ◽  
M. Dietlein ◽  
C. Kobe ◽  
H. Schicha ◽  
M. Schmidt

SummaryInteractions between brain, psyche and thyroid are known from historical descriptions of thyroidectomy (Kocher) and hyperthyroidism. However, their importance is often underscored in clinical routine. Thyroid hormone deficiency during pregnancy may result in irreversible mental retardation and requires levothyroxine substitution. TSH screening after delivery must identify newborns with congenital hypothyroidism: An early levothyroxine substitution and long term therapy control are required.Hypothyroidism and depression have many symptoms in common. Cognitive deficits and depressive states are often found in overt hypothyroidism, psychotic derangements are rare. Levothyroxine improves hypothyroid symptoms and mental performance, mood and motivation. Psychic symptoms of hyperthyroidism include agitation, irritability, mood disturbances, hyperactivity, anxiousness and even panic attacks. Manic and delusional states are rare. In geriatric patients hyperthyroidism may be oligosymptomatic. In psychiatric patients more frequent but unspecific disturbances of thyroid laboratory values being reversible without specific therapy have to be distinguished from rather rare but causative organic thyroid diseases with therapeutic consequences. Some psychiatric drugs influence thyroid laboratory results. Hypothyroidism in depressive patients is a negative prognostic parameter and requires therapy. Psychiatric symptoms associated with hypothyroidism are usually reversible under levothyroxine within 4–8 weeks. The standard for hypothyroidism is mono-levothyroxine therapy.

Author(s):  
Sandip Barvaliya ◽  
Jigar R. Panchal ◽  
Mira K. Desai ◽  
Minakshi Parikh

Background: To analyse adverse drug reactions (ADRs) reported in patients prescribed psychiatric medications at tertiary care hospital.Methods: ADRs reported in psychiatric patients between January 2011 to June 2017 were analyzed for demographic details, causal drugs, system organ classification, causality assessment (WHO-UMC criteria and Naranjo’s scale), preventability (Modified Schumock and Thorton’s criteria) and severity (Hartwing scale).Results: A total 4368 ADRs were reported during study period, out of which 658 (15.06%) were in psychiatric patients. The mean age of patients was 38±13.34 years and men (57.3%) were most commonly affected than women (42.7%). The most common causal drug groups were antidepressants (29.48%) followed by antipsychotics (23.12%) which include drug fluoxetine (33.9%) and olanzapine (34.3%) respectively. The most common system involved were central nervous system (32.8%) followed by gastrointestinal system (22.8%). Most of ADRs (42.7%) were observed after one month of therapy and showed possible (77%) causal relation with drug therapy. Majority of ADRs (77.4%) were not preventable and mild in nature (83.3%).Conclusions: ADRs are commonly seen in psychiatric patients. Hence, their monitoring and assessment in these patients who require multidrug and long-term therapy may help improve patient management.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
K. Joutsenniemi ◽  
O. Lindfors ◽  
M. Laaksonen ◽  
P. Haaramo ◽  
P. Knekt

Background:Demographic factors have been shown to predict the outcome of short-term psychotherapy in the treatment of depressive and anxiety disorders. So far, however, information on the prediction for long- term therapy is missing. to be able to choose an optimal psychotherapy length for the patient, it is essential to know, which demographic factors predict different outcome in short- and long-term therapy.Aim:To compare the prediction of demographic factors on changes in psychiatric symptoms in short- and long-term psychotherapy.Methods:In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term therapy (short-term psychodynamic psychotherapy or solution-focused therapy combined) or long-term psychodynamic psychotherapy. the demographic factors (i.e. age, gender, education, income, and living arrangement) were assessed at baseline by a questionnaire. Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and 7 times during a 3-year follow-up.Results:Demographic factors were found to predict symptom development during follow-up irrespective of baseline symptom level. Female gender, being aged 25 or more, living with a spouse/partner, high education, and medium level personal income predicted benefiting sufficiently from short-term therapy, whereas being aged under 25, medium education, and living with other(s) than a partner or child(ren) predicted the need of long-term therapy.Conclusions:Demographic factors may be a useful tool in the selection of patients for short- and long term therapy.


1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.


2007 ◽  
Vol 40 (05) ◽  
Author(s):  
M Kungel ◽  
A Engelhardt ◽  
T Spevakné-Göröcs ◽  
M Ebrecht ◽  
C Werner ◽  
...  

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