Comorbidity Issues and Treatment in Chronic Mental Illness

2017 ◽  
pp. 77-100
Author(s):  
Deepika Srivastav ◽  
Tej Bahadur Singh
Keyword(s):  
Clinical Picture ◽  
Correct Diagnosis ◽  
Multidisciplinary Treatment ◽  
Major Effect ◽  
Obsessive Compulsive ◽  
Treatment Need ◽  
Compulsive Disorder ◽  
Primary Disorder ◽  
Panic Symptoms ◽  
Anxiety Depression

Comorbidity refers to presence of one or more additional disorders along with a primary disorder. It affects the prognosis and course of treatment. It is often difficult for clinician to make correct diagnosis in presence of various disorders. The clinical picture of various disorders interferes with treatment process and the outcome. There are some disorders in psychiatry, known as chronic illness. These are schizophrenia, bipolar disorder and obsessive-compulsive disorder. All these three disorder have a major effect on individual's life. Anxiety, depression, substance abuse and panic symptoms are common in schizophrenia; hence the clinical picture changes frequently. While the literature suggests that presence of two or three disorders make treatment worse, hence multidisciplinary treatment need to be used.

scholarly journals A Systematic Review on TeleMental Health in Youth Mental Health: Focus on Anxiety, Depression and Obsessive-Compulsive Disorder

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 793
Author(s):  
Laura Orsolini ◽  
Simone Pompili ◽  
Virginio Salvi ◽  
Umberto Volpe
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Obsessive Compulsive Disorder ◽  
Selection Process ◽  
Telemental Health ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Youth Anxiety ◽  
Anxiety Depression

Background and Objectives: The Internet is widely used and disseminated amongst youngsters and many web-based applications may serve to improve mental health care access, particularly in remote and distant sites or in settings where there is a shortage of mental health practitioners. However, in recent years, specific digital psychiatry interventions have been developed and implemented for special populations such as children and adolescents. Materials and Methods: Hereby, we describe the current state-of-the-art in the field of TMH application for young mental health, focusing on recent studies concerning anxiety, obsessive-compulsive disorder and affective disorders. Results: After screening and selection process, a total of 56 studies focusing on TMH applied to youth depression (n = 29), to only youth anxiety (n = 12) or mixed youth anxiety/depression (n = 7) and youth OCD (n = 8) were selected and retrieved. Conclusions: Telemental Health (TMH; i.e., the use of telecommunications and information technology to provide access to mental health assessment, diagnosis, intervention, consultation, supervision across distance) may offer an effective and efficacious tool to overcome many of the barriers encountering in the delivery of young mental health care.

scholarly journals Likely Exacerbation of Psychological Disorders from Covid-19 Response

2021 ◽  
Vol 12 ◽  
pp. 215013272110167
Author(s):  
Tara Rava Zolnikov ◽  
Tanya Clark ◽  
Tessa Zolnikov
Keyword(s):  
Psychological Disorders ◽  
Emotional Reactions ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
The Face ◽  
Adults And Children ◽  
Post Traumatic ◽  
Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

scholarly journals Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

2021 ◽  
pp. 105413732110239
Author(s):  
G. Brewer ◽  
L. Centifanti ◽  
J. Castro Caicedo ◽  
G. Huxley ◽  
C. Peddie ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Mental Distress ◽  
Psychological Impact ◽  
Discussion Forum ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Care Workers ◽  
Positive Experiences ◽  
Anxiety Depression ◽  
The Impact

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

Obsessive—Compulsive Disorder as a 5-HT Subsystem-Related Behavioural Disorder

1989 ◽  
Vol 155 (S8) ◽  
pp. 15-24 ◽  
Author(s):  
D. L. Murphy ◽  
J. Zohar ◽  
C. Benkelfat ◽  
M. T. Pato ◽  
T. A. Pigott ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Serotonin Uptake ◽  
Selective Serotonin ◽  
Therapeutic Effects ◽  
Obsessive Compulsive ◽  
Neurotransmitter System ◽  
Compulsive Disorder ◽  
Uptake Inhibitors ◽  
Anxiety Depression ◽  
Abnormal Brain

Involvement of the brain serotonin (5-HT) neurotransmitter system in obsessive-compulsive disorder (OCD) was originally suggested on the basis of therapeutic effects found with the semi-selective serotonin uptake inhibitor, clomipramine. More recent studies directly comparing clomipramine with non-selective or norepinephrine-selective uptake inhibitors, such as desipramine or nortriptyline, as well as studies with new, more selective serotonin uptake inhibitors, including fluvoxamine and fluoxetine, have supported that hypothesis. Clomipramine's antiobsessional effect has been augmented with the serotonin precursor, L-tryptophan, or with lithium, which has prominent serotonergic effects. Patients whose OCD symptoms improved on clomipramine worsened when the drug was discontinued (regardless of duration of therapy) and improved when clomipramine was reinstituted. OCD symptoms also worsened when metergoline, a 5-HT antagonist, was given to patients who had improved with clomipramine. Metergoline given alone had no effect. Administration of m-chlorophenylpiperazine (m-CPP), a 5-HT receptor agonist, to untreated OCD patients increased their anxiety, depression, and dysphoria, and exacerbated their OC symptoms. After 4 months of clomipramine therapy, m-CPP failed to produce the same behavioural effects, suggesting an alteration of a 5-HT subsystem (possibly downregulation of some 5-HT receptors). The data reviewed suggest an important role for an abnormal brain 5-HT subsystem in patients with OCD.

scholarly journals The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

2019 ◽  
Vol 44 (1) ◽  
pp. 120-135 ◽  
Author(s):  
Tamara Leeuwerik ◽  
Kate Cavanagh ◽  
Clara Strauss
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Distress Tolerance ◽  
Treatment Seeking ◽  
Trait Mindfulness ◽  
Obsessive Beliefs ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Compassion ◽  
Clinically Significant ◽  
Anxiety Depression

Abstract Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.

The Bowerbird Symptom': A Case of Severe Hoarding of Possessions

1997 ◽  
Vol 31 (4) ◽  
pp. 597-600 ◽  
Author(s):  
Paul B. Fitzgerald
Keyword(s):  
Early Childhood ◽  
Obsessive Compulsive Disorder ◽  
Clinical Picture ◽  
Poor Prognosis ◽  
Severe Case ◽  
Obsessive Compulsive ◽  
Psychiatric Distress ◽  
Compulsive Disorder

Objective: To describe a severe case of hoarding of possessions in a patient with obsessive-compulsive disorder. Clinical picture: A 22-year-old male presented with a history from early childhood of persistent collecting of valueless objects and the inability to give up possessions. He had significant insight but ambivalent feelings about changing his behaviour, despite the degree of disruption it produced in his environment. Treatment and outcome: Attempts to engage the patient in treatment were unsuccessful because of the patient's ambivalence towards change. Conclusions: The symptom of hoarding behaviour may be a severe and disruptive expression of psychiatric distress, and in obsessive-compulsive disorder it is likely to indicate a poor prognosis due to the difficulties of engaging the patient in treatment.

scholarly journals Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets

2020 ◽  
Vol 10 (5) ◽  
pp. 301 ◽  
Author(s):  
Domenico Servello ◽  
Tommaso Francesco Galbiati ◽  
Roberta Balestrino ◽  
Guglielmo Iess ◽  
Edvin Zekaj ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Clinical Response ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Clinical Picture ◽  
Effective Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Over Time ◽  
Deep Brain

Gilles de la Tourette syndrome (GTS) is a complex neurodevelopmental disorder characterized by tics and, frequently, psychiatric and behavioral comorbidities. Above all, obsessive compulsive disorder/behavior (OCD/OCB) influences the clinical picture and has a severe impact on quality of life, eventually more than the tics themselves. Deep brain stimulation (DBS) is an effective therapy in selected, refractory cases. Clinical response to DBS may vary according to the clinical picture, comorbidities, and to the anatomical target. This retrospective study compares the results obtained from DBS in the ventralis oralis/centromedian-parascicular nucleus of the thalamus (Voi-Cm/Pf) (41 patients) and antero-medial Globus Pallidus internus (am-GPi) (14 patients), evaluating clinical response over time by means of Yale Global Tic Severity Scale (YGTSS) and Yale–Brown Obsessive-Compulsive Scale (YBOCS) scores over a period of 48 months. A significant and stable improvement in the YGTSS and YBOCS has been obtained in both groups (p < 0.001). There was a significant difference in YBOCS improvement over time between the am-GPi group and the Voi-Cm/Pf group, indicating a better and faster control of OCD/OCB symptoms in the former group. The ratio of hardware removal was 23% and limited to 13 patients in the Voi-Cm/Pf group. These results confirm that DBS is an effective therapy in treating GTS and suggest that the am-GPi might be superior to Voi-Cm/Pf in alleviating comorbid OCD/OCB.

Body Dysmorphic Disorder

1996 ◽  
Vol 169 (2) ◽  
pp. 196-201 ◽  
Author(s):  
David Veale ◽  
Ann Boocock ◽  
Kevin Gournay ◽  
Windy Dryden ◽  
Fozia Shah ◽  
...  
Keyword(s):  
Body Dysmorphic Disorder ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Compulsive Disorder ◽  
Primary Disorder ◽  
The Usa ◽  
Axis I ◽  
High Degree

BackgroundBody dysmorphic disorder (BDD) consists of a preoccupation with an ‘imagined’ defect in appearance which causes significant distress or impairment in functioning. There has been little previous research into BDD. This study replicates a survey from the USA in a UK population and evaluates specific measures of BDD.MethodCross-sectional interview survey of 50 patients who satisfied DSM–IV criteria for BDD as their primary disorder.ResultsThe average age at onset was late adolescence and a large proportion of patients were either single or divorced. Three-quarters of the sample were female. There was a high degree of comorbidity with the most common additional Axis I diagnosis being either a mood disorder (26%), social phobia (16%) or obsessive–compulsive disorder (6%). Twenty-four per cent had made a suicide attempt in the past. Personality disorders were present in 72% of patients, the most common being paranoid, avoidant and obsessive–compulsive.ConclusionsBDD patients had a high associated comorbidity and previous suicide attempts. BDD is a chronic handicapping disorder and patients are not being adequately identified or treated by health professionals.

The Neuroscience of the Tourette Syndrome Spectrum

CNS Spectrums ◽  
1999 ◽  
Vol 4 (3) ◽  
pp. 13-13
Author(s):  
Eric Hollander
Keyword(s):  
Tourette Syndrome ◽  
Role Model ◽  
Correct Diagnosis ◽  
Associate Professor ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Research Findings ◽  
Person Account ◽  
The Relationship ◽  
Scientific Director

This is the second installment of a double issue on Tourette syndrome (TS) for CNS Spectrums. This issue highlights recent research findings in the field and provides a state-of-the art update on the relationship between TS and obsessive-compulsive disorder (OCD), as well as on the genetics, functional imaging and neurocircuitry, and neuropathology of TS.I would again like to express my appreciation to the guest editor of this superb issue—Neal Swerdlow, MD, PhD, associate professor of psychiatry at University of California, San Diego, and scientific director of the Tourette Syndrome Association (TSA)—as well as Sue Levi-Pearl of the TSA.The issue begins with a first-person account of TS by Major League baseball player Jim Eisenreich. His .300 lifetime batting average in professional baseball is a reflection of the superior focus he achieves in sports. In his work as a spokesman on behalf of TS, he serves as a role model, and his work will certainly help to raise awareness about TS so that others may avoid his experience of a 17-year gap between onset of symptoms and correct diagnosis.

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