Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy

The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.

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A Pessimistic Attitude Towards the Future and Low Psychosocial Functioning Predict Psychiatric Diagnosis Among Treatment-Seeking Adolescents

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2001.00875.x ◽

2001 ◽

Vol 35 (2) ◽

pp. 160-165 ◽

Cited By ~ 2

Author(s):

Eila Laukkanen ◽

Veijo Korhonen ◽

Sirkka Peiponen ◽

Marjatta Nuutinen ◽

Heimo Viinamäki

Keyword(s):

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Psychosocial Functioning ◽

Psychiatric Diagnosis ◽

Diagnostic Interview ◽

Factors Associated ◽

Self Image ◽

Service Staff ◽

The Future ◽

Pessimistic Attitude

Objective: The objective was to study factors associated with psychiatric diagnosis among adolescents (n = 164) seeking psychiatric care for mental symptoms. Method: Psychiatric diagnosis was confirmed by a structured diagnostic interview. Psychosocial functioning was assessed with the Global Assessment of Functioning Scale, and the Beck Depression Inventory and Offer Self-Image Questionnaire were also used. Background data were gathered. Results: A majority (76%) of the adolescents met DSM-III-R criteria for psychiatric diagnosis. The self-image was more negative and the Beck score was higher among these adolescents than the others. All who had attempted suicide had a psychiatric disorder. Those diagnosed as having a psychiatric disorder consumed alcohol in order to get drunk more often than others. Continual conflicts with parents and smoking were not associated with the existence of a psychiatric disorder. In logistic regression analysis, low psychosocial functioning (OR = 3.9) and an uncertain or pessimistic attitude towards the future (OR = 9.1) proved to be independent risk factors for psychiatric disorders. Conclusions: Health service staff should be aware of factors associated with psychiatric disorders in adolescents so that they can identify those at high risk.

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Natural history of nonfunctioning adrenal incidentalomas: A 10-year longitudinal observational study

Endocrine Abstracts ◽

10.1530/endoabs.73.aep37 ◽

2021 ◽

Author(s):

Mojca Jensterle ◽

Kocjan Tomaž ◽

Matej Rakusa ◽

Andrej Janez ◽

Peter Popovic ◽

...

Keyword(s):

Natural History ◽

Observational Study ◽

Adrenal Incidentalomas ◽

Longitudinal Observational Study ◽

History Of

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Depression in Chronic Hepatitis C Treated with Interferon: Prevalence and Management

European Psychiatry ◽

10.1016/s0924-9338(09)71200-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 1

Author(s):

A. Scalori ◽

L. Gandossini ◽

G. Santamaria ◽

V. Bellia ◽

T. Bordoni ◽

...

Keyword(s):

Side Effects ◽

Psychiatric Disorder ◽

Minnesota Multiphasic Personality Inventory ◽

Antidepressant Drugs ◽

Chronic Viral Hepatitis ◽

Psychiatric Evaluation ◽

Patients At Risk ◽

History Of ◽

Ifn Therapy ◽

Psychiatric Side Effects

Neuropsychiatric disturbances, from depression to psychosis and attempted or successful suicides are reported during interferon (IFN) therapy for chronic viral hepatitis. IFN schedule and history of psychiatric illness are not enough to predict who will develop symptoms.Aims:To assess the prevalence of depression during IFN therapy; to test whether a computerized version of the Minnesota Multiphasic Personality Inventory (MMPI) is a sensitive and reliable test for the early identification of patients at risk of depression before IFN therapy is started; and whether and how the depression can be cured. Patients. 185 patients treated with IFN.Methods:Before therapy, all patients underwent an MMPI and a clinical examination for identification of depressive symptoms.Results:Thirty-one patients developed a psychiatric disorder, 11 of them requiring treatment. Among the 18 patients with MMPI positive tests, 16 developed a psychiatric disorder (sensitivity of 0.58). Among the 154 who did not develop psychiatric side effects, 152 had a negative MMPI (specificity: 0.99). Severe psychiatric disorders (8 patients) were successfully treated with antidepressant drugs.Conclusions:Psychiatric side effects are easy to see during IFN therapy. An accurate psychiatric evaluation should be considered on all patients before treatment. However, as this specific examination cannot always be performed because of the lack of psychiatrists in liver units, it is necessary to identify tests, that are easy to carry out, reproducible, self-administered and inexpensive in order to screen all patients. If depression develops, it should be treated aggressively, and selective serotonin re-uptake inhibitors are the anti-depressant of choice.

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Gender and Sexuality

Sociocultural Issues in Psychiatry ◽

10.1093/med/9780190849986.003.0010 ◽

2019 ◽

pp. 165-184

Author(s):

Andrew Cruz ◽

Julianne Torrence ◽

Christopher M. Palmer

Keyword(s):

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Sexual Behaviors ◽

Gender And Sexuality ◽

Sexual History ◽

Psychiatric Evaluation ◽

And Behaviors

The psychiatric encounter provides an opportunity to discuss sexuality and sexual behaviors with patients. Often patients are reluctant to discuss sexual matters with clinicians, as shame can often be associated with sexual behaviors and fantasies. Clinicians, therefore, need to be aware of both common and uncommon fantasies and behaviors and be willing to initiate conversations with patients in a safe and respectful manner. Sexual behaviors can be associated with some psychiatric disorders and can sometimes be a psychiatric disorder unto themselves. Therefore, a sexual history and assessment is often a required portion of a complete psychiatric evaluation. However, there is tremendous variability in what is considered normal and abnormal, posing challenges for clinicians. This chapter sets out to provide a framework for approaching some of these challenging situations.

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The Psychiatric Examination of the Neurologic Patient

Psychiatric Aspects of Neurologic Diseases ◽

10.1093/oso/9780195309430.003.0007 ◽

2008 ◽

Author(s):

Constantine G. Lyketsos

Keyword(s):

Differential Diagnosis ◽

Psychiatric Disorders ◽

Psychiatric Symptoms ◽

Chief Complaint ◽

Psychiatric Evaluation ◽

Cognitive State ◽

Psychiatric History ◽

Neurologic Disease ◽

History Of ◽

Cognitive Problems

A well-conducted psychiatric evaluation is central to the care of neurologic patients with psychiatric disorders. The evaluation is aimed at defining the psychiatric condition in the context of the patient’s past psychiatric history and current neurologic disease. The information derived from the evaluation is used to develop a formulation, establish a diagnosis, and form a basis for treatment planning. This chapter discusses the psychiatric evaluation of the neurologic patient in detail. It includes examination techniques and questions as well as practical approaches to conducting an assessment of the patient’s cognitive state. Along the way, common psychiatric symptoms encountered in neurologic patients are defined and differentiated from related symptoms. The chapter concludes by illustrating how to generate a formulation and differential diagnosis. The psychiatric evaluation consists of three parts: the history; the mental status examination (MSE); and the formulation, including the differential diagnosis. The history, which is essential to defining the problem, is taken from the patient and from one or more informants. The importance of taking a history from an informant is underscored in the context of neurologic disease because patients may be forgetful, lack insight, or have language and other cognitive problems that may limit their ability to provide a good history. History-taking begins with defining the psychiatric chief complaint and then obtaining the family and personal history. Starting in this way, rather than with the chief complaint followed by the history of present illness (HPI), makes it easier to see that the psychiatric symptoms may have been caused by, or influenced by, factors other than the neurologic disease—factors that can include psychiatric disorders as such, aspects of patients’ personalities, and responses patients have to the circumstances of their lives. Table 1–1 provides an outline of important elements of the psychiatric history for neurologic patients and can be used as a checklist in clinical practice. Defining the psychiatric chief complaint is the physician’s first task. ‘‘Psychiatric chief complaint’’ in this context refers to the occurrence of cognitive, affective, behavioral, or perceptual phenomena that are brought to the physician’s attention by the patient, a family member or other informant, or by the physician’s own observation.

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Nightmares in Patients with Major Depressive Disorder, Bipolar Disorder, and Psychotic Disorders: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm9123990 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3990

Author(s):

Marine Ambar Akkaoui ◽

Michel Lejoyeux ◽

Marie-Pia d’Ortho ◽

Pierre A. Geoffroy

Keyword(s):

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Mood Disorders ◽

Psychotic Disorders ◽

Stress Disorders ◽

Cochrane Library ◽

Post Traumatic Stress ◽

Therapeutic Implications ◽

History Of ◽

Nightmare Treatment

Chronic nightmares are very common in psychiatric disorders, affecting up to 70% of patients with personality or post-traumatic stress disorders. In other psychiatric disorders, the relationships with nightmares are poorly known. This review aimed to clarify the relationship between nightmares and both mood and psychotic disorders. We performed a systematic literature search using the PubMed, Cochrane Library and PsycINFO databases until December 2019, to identify studies of patients suffering from either a mood disorder or a psychotic disorder associated with nightmares. From the 1145 articles screened, 24 were retained, including 9 studies with patients with mood disorders, 11 studies with patients with psychotic disorders and 4 studies with either psychotic or mood disorders. Nightmares were more frequent in individuals with mood or psychotic disorders than in healthy controls (more than two-fold). Patients with frequent nightmares had higher suicidality scores and had more frequently a history of suicide attempt. The distress associated with nightmares, rather than the frequency of nightmares, was associated with the severity of the psychiatric disorder. Further studies assessing whether nightmare treatment not only improves patient–sleep perception but also improves underlying psychiatric diseases are needed. In conclusion, nightmares are overrepresented in mood and psychotic disorders, with the frequency associated with suicidal behaviors and the distress associated with the psychiatric disorder severity. These findings emphasize major clinical and therapeutic implications.

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Association between Psychiatric Disorders and Glomerular Disease

Glomerular Diseases ◽

10.1159/000516359 ◽

2021 ◽

pp. 1-11

Author(s):

Hailey E. Desmond ◽

Clare Lindner ◽

Jonathan P. Troost ◽

Zack Held ◽

Andrea Callaway ◽

...

Keyword(s):

Kidney Disease ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Psychiatric Diagnosis ◽

Vital Signs ◽

Disease Diagnosis ◽

Glomerular Disease ◽

Research Network ◽

Time Varying

Introduction: Patients with chronic health conditions, particularly chronic kidney disease, are at heightened risk for psychiatric disorders; yet, there are limited data on those with primary glomerular disease. Methods: This study included patients with glomerular disease enrolled in the kidney research network multisite patient registry. Registry data include encounter, diagnoses, medication, laboratory, and vital signs data extracted from participants’ electronic health records. ICD-9/10 diagnosis codes were used to identify a subset of psychiatric disorders focused on anxiety, mood, and behavioral disorders. Time-varying Cox proportional hazard models were used to analyze time from the onset of kidney disease to diagnosis of psychiatric disorder. Adjusted models retained significant covariates from the full list of potential confounders, including age, sex, race, ethnicity, time-varying treatment, the estimated glomerular filtration rate, and proteinuria (urine protein-to-creatinine ratio [UPCR]). Analogous models examined diagnosis of psychiatric disorder as a predictor of time to end-stage kidney disease (ESKD). Results: Data were available for 950 participants, with a median of 58 months of follow-up. 110 (12%) participants were diagnosed with psychiatric disorder during the follow-up. The estimated rate of psychiatric diagnosis after kidney disease was 14.7 cases per 1,000 person-years and was highest among those of adolescent age at the time of kidney disease diagnosis. Adjusted analyses found adolescent age (vs. adult, hazard ratio [HR] = 3.11, 95% confidence interval [CI] 1.87–5.17) and Asian race (vs. white, HR = 0.34, 95% CI 0.16–0.71) were associated with psychiatric diagnosis. A higher UPCR per 1 log unit (HR 1.13, 95% CI 1.01–1.27) and a higher total number of oral medications were associated with psychiatric disorder (p < 0.001). Psychiatric diagnosis was also associated with progression to ESKD (HR = 2.45, 95% CI 1.53–3.92) in adjusted models. Discussion/Conclusion: Psychiatric disorders were documented in approximately one-eighth of patients with glomerular disease and correlated with clinical disease characteristics such as age, race, proteinuria, and oral medication burden. These findings suggest mental health screening is warranted in patients of all ages with glomerular disease.

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Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from 4 centres in Italy

International Journal of Psychiatry in Clinical Practice ◽

10.1080/13651501.2021.1980588 ◽

2021 ◽

pp. 1-5

Author(s):

Massimiliano Beghi ◽

Silvia Ferrari ◽

Riccardo Brandolini ◽

Ilaria Casolaro ◽

Matteo Balestrieri ◽

...

Keyword(s):

Observational Study ◽

Emergency Room ◽

Psychiatric Evaluation

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Psychiatric comorbidities in dermatitis artefacta: A systematic review and meta-analysis

10.25259/csdm_44_2021 ◽

2021 ◽

Vol 1 ◽

pp. 49

Author(s):

Ravi Philip Rajkumar

Keyword(s):

Systematic Review ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Somatoform Disorders ◽

Stressful Life Event ◽

Meta Analysis ◽

Significant Proportion ◽

Skin Lesions ◽

Psychiatric Evaluation ◽

Dermatitis Artefacta

Dermatitis artefacta, also known as factitious or factitial dermatitis, is a rare and difficult-to-treat condition characterized by self-inflicted skin lesions. Despite the well-documented psychological disturbances that characterize this condition, little is known about the relative frequency of specific psychiatric disorders in this patient group. The current systematic review was undertaken to address this gap in our knowledge and was conducted in accordance with PRISMA guidelines. The PubMed and Scopus databases were searched using the terms “dermatitis artefacta,” “factitious dermatitis,” and “factitial dermatitis” in combination with “psychiatry,” “psychiatric diagnosis,” “psychiatric disorder,” “mental illness,” “depression,” and “anxiety.” After screening a total of 215 citations, a total of 11 papers were included in the final review. All the included studies were of low to very low quality as per the GRADE guidelines, and there was substantial heterogeneity among them (I2 = 50.4). It was observed that 46.2% of patients (95% CI: 35.4–57.4%) with dermatitis artefacta had a comorbid psychiatric disorder, with the most common diagnoses being depression, somatoform disorders, anxiety disorders, substance use disorder, and intellectual disability. About 20.1% of patients refused a psychiatric evaluation, while 40.9% reported a significant stressful life event. These results suggest that a significant proportion of patients with dermatitis artefacta suffer from psychiatric disorders, which may be related to their self-infliction of lesions either biologically or psychologically. Treatment of these disorders may lead to a partial or complete improvement in their dermatological condition. A sensitive, non-confrontational approach is essential when evaluating these patients to minimize the chances of refusal and improve patient compliance.

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CLINICAL PROFILE AND PSYCHIATRIC MORBIDITY IN PATIENTS WITH DELIBERATE SELF-HARM

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.861 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Yogesh Motwani ◽

Shobha Nair ◽

Aditi Chaudhari ◽

Kaustubh Mazumdar

Keyword(s):

Psychiatric Disorder ◽

Personality Disorders ◽

Psychiatric Disorders ◽

Demographic Data ◽

Psychiatric Morbidity ◽

Deliberate Self Harm ◽

Icd 10 ◽

History Of ◽

Case Files ◽

Self Harm

Background: It requires detailed research to understand the psychopathology behind DSH attempts. Apart from social factors, psychiatric disorders and individual coping mechanisms can contribute to DSH. This study will be helpful in knowing the prevalence of psychiatric morbidity in these patients. Aims and Objectives: To study the Psychiatric morbidity in patients with DSH. Materials and Methods: This is a retrospective, descriptive study including 42 patients who had history of DSH and were referred to psychiatry department of BARC Hospital, Mumbai. Patients who were below 45 years of age at the time of DSH and above 18 years at the time of study were included. Their socio-demographic data were collected, psychiatric diagnosis were noted from the case files, personality disorders were evaluated using ICD-10 IPDE. Data were analysed using descriptive and analytic statistical methods. Results: 42.86% of the population was diagnosed as having psychiatric disorder. Most common disorder was depression. 7.14% of the patients were diagnosed as having borderline personality disorder. Conclusions: Depression was the most common psychiatric disorder found in our study. Key words: Deliberate self-harm, psychiatric disorders, personality disorders.

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