Client Presenting with First-Onset Depression

2014 ◽  
pp. 33-48
Author(s):  
Ian Ross
Keyword(s):  
First Onset

Early Psychosis: Diagnosis and Treatment

2020 ◽  
Vol 09 ◽  
Author(s):  
Nataly S. Beck ◽  
Melanie L. Lean ◽  
Kate V. Hardy ◽  
Jacob S. Ballon
Keyword(s):  
United States ◽  
Early Identification ◽  
Mental Health Problems ◽  
The United States ◽  
Early Psychosis ◽  
Screening Tools ◽  
Diagnosis And Treatment ◽  
First Episode ◽  
Psychotic Episode ◽  
First Onset

Background: The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment in higher education. College and graduate students often experience new academic and social demands that may leave them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode. Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services, along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the treatment gap. Method: A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university. Results: Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects. Conclusion: Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.

scholarly journals Clinical characteristics and sociodemographic features of psychotic major depression

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  
Keyword(s):  
Family History ◽  
Major Depression ◽  
Clinical Characteristics ◽  
Missing Values ◽  
Psychotic Disorders ◽  
Mental Health Center ◽  
Psychiatric Diseases ◽  
First Onset ◽  
History Of ◽  
Psychotic Major Depression

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.

scholarly journals Predictors of First-Onset Substance Use Disorders During the Prospective Course of Bipolar Spectrum Disorders in Adolescents

2013 ◽  
Vol 52 (10) ◽  
pp. 1026-1037 ◽  
Author(s):  
Benjamin I. Goldstein ◽  
Michael Strober ◽  
David Axelson ◽  
Tina R. Goldstein ◽  
Mary Kay Gill ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
First Onset ◽  
Spectrum Disorders

Time-course of treatment-emergent adverse events in a long-term safety study of lisdexamfetamine dimesylate in children and adolescents with ADHD

2016 ◽  
Vol 33 (S1) ◽  
pp. S132-S132
Author(s):  
I. Hernández Otero ◽  
T. Banaschewski ◽  
P. Nagy ◽  
C.A. Soutullo ◽  
A. Zuddas ◽  
...  
Keyword(s):  
Adverse Events ◽  
Children And Adolescents ◽  
Time Course ◽  
Open Label ◽  
Lisdexamfetamine Dimesylate ◽  
Safety Population ◽  
First Onset ◽  
Stimulant Medications ◽  
Competing Interest

IntroductionThe long-term safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with attention deficit/hyperactivity disorder (ADHD) was evaluated in a European 2-year, open-label study (SPD489-404).ObjectiveTo evaluate the time-course of treatment-emergent adverse events (TEAEs) in SPD489-404.MethodsParticipants aged 6–17 years received open-label LDX (30, 50 or 70 mg/day) for 104 weeks (4 weeks dose-optimization; 100 weeks dose-maintenance).ResultsAll enrolled participants (n = 314) were included in the safety population and 191 (60.8%) completed the study. TEAEs occurred in 282 (89.8%) participants; most were mild or moderate. TEAEs considered by the investigators as related to LDX were reported by 232 (73.9%) participants with the following reported for ≥ 10% of participants: decreased appetite (49.4%), weight decreased (18.2%), insomnia (13.1%). TEAEs leading to discontinuation and serious TEAEs occurred in 39 (12.4%) and 28 (8.9%) participants, respectively. The median (range) time to first onset and duration, respectively, of TEAEs identified by the sponsor as being of special interest were: insomnia (insomnia, initial insomnia, middle insomnia, terminal insomnia), 17.0 (1–729) and 42.8 (1–739) days; weight decreased, 29.0 (1–677) and 225.0 (26–724) days; decreased appetite, 13.5 (1–653) and 169.0 (1–749) days; headache, 22.0 (1–718) and 2.0 (1–729) days. Reports of insomnia, weight decreased, decreased appetite and headache were highest in the first 4–12 weeks.ConclusionsTEAEs associated with long-term LDX treatment were characteristic of stimulant medications, with the greatest incidence observed during the first 4–12 weeks.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Assessment of needs for care among patients with schizophrenic disorders 15 and 17 years after first onset of psychosis

1997 ◽  
Vol 6 (S1) ◽  
pp. 21-28 ◽  
Author(s):  
Durk Wiersma ◽  
Fokko J. Nienhuis ◽  
Cees J. Slooff ◽  
Robert Giel ◽  
Aant De Jong
Keyword(s):  
Mental Disorders ◽  
Empirical Studies ◽  
Signs And Symptoms ◽  
Expected Improvement ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Wide Range ◽  
Social Disablement ◽  
First Onset

Severe and long term mental disorders, like schizophrenia, show in general a wide range of psychiatric signs and symptoms, psychological and physiological impairments and social disablement (Shepherd, 1994; Wing, 1982) reflecting a variety of mental health needs. Many studies provide only a cross-sectional view of the clinical and social problems of the patient population, for example at intake or admission to a mental hospital. Longitudinal studies following patients after discharge for some period of months or years show in general the expected improvement of functioning (e.g. Nienhuis et al., 1994), but as far as only chronic patients are concerned such a positive change is much less noted. The concept of chronicity of mental disorders would presume that after some time needs are fairly predictable and stable and do not change much over time. Our investigation on the long-term course of schizophrenia (Wiersma et al., 1996; 1997) enables us to study over a period of two years, from 15 to 17 years since first onset of psychosis, the stability or variability of needs in schizophrenic disorder. We are not aware of empirical studies on changes in needs among patients with long-term disorders.

Anorexia Nervosa in an Elderly Woman

2001 ◽  
Vol 35 (2) ◽  
pp. 246-248 ◽  
Author(s):  
Rosalie Hill ◽  
Christopher Haslett ◽  
Shailesh Kumar
Keyword(s):  
Anorexia Nervosa ◽  
Depressive Symptoms ◽  
Electroconvulsive Therapy ◽  
Clinical Picture ◽  
Elderly Woman ◽  
Eating Behaviour ◽  
The Elderly ◽  
Aggressive Treatment ◽  
Comorbid Depression ◽  
First Onset

Objective: To demonstrate a case of anorexia nervosa in the elderly and to highlight the need for broadening of current diagnostic criteria. Clinical picture: First onset of anorexia nervosa in a 72-year-old woman following bereavement of her husband. Treatment: Nine treatments of electroconvulsive therapy. Outcome: Treatment resulted in remission of the depressive symptoms and improvement of eating behaviour. Conclusions: Anorexia nervosa does occur in the elderly and can be difficult to detect. Where comorbid depression exists it requires aggressive treatment.

scholarly journals Do adverse life events at first onset of auditory verbal hallucinations influence subsequent voice characteristics? Results from an epidemiological study

2018 ◽  
Vol 261 ◽  
pp. 232-236 ◽  
Author(s):  
Josef J. Bless ◽  
Frank Larøi ◽  
Julien Laloyaux ◽  
Kristiina Kompus ◽  
Bodil Kråkvik ◽  
...  
Keyword(s):  
Epidemiological Study ◽  
Life Events ◽  
Adverse Life Events ◽  
Auditory Verbal Hallucinations ◽  
First Onset

Abstract W MP53: The Prevalence and Characteristics of Attention Disorders in The Patients with First-onset Mild Hemorrhagic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Haruki Tokida ◽  
Masakazu Nishigaki ◽  
Masaru Kuriyama
Keyword(s):  
Selective Attention ◽  
Acute Phase ◽  
Hemorrhagic Stroke ◽  
False Negative ◽  
Previous History ◽  
Attention Deficits ◽  
Stroke Patients ◽  
Attention Disorders ◽  
First Onset ◽  
Mild Stroke

Objectives: Recent study revealed that over 50 % of stroke patients had some form of attention deficits. However, few reports focused on acute phase and mild stroke patients. This study aimed to investigate the prevalence of attention disorders and the change of their symptoms during the hospitalization in the patients with first-onset mild hemorrhagic stroke. Methods: Study subjects were 231 consecutive patients diagnosed as hemorrhage stroke and treated at our hospital from 2011 to 2012. Patients with severe hemorrhage (i.e., amount of bleeding >5cc), with previous history of cerebrovascular diseases or dementia, with decreased level of consciousness or with impaired activity of daily living were not eligible to this study. Neuropsychological assessments were conducted by speech therapists at 1 and 2 week after stroke onset using Clinical Assessment for Attention (CAT) and examined how they changed. CAT was a test battery developed by the Japan Society for Higher Brain Dysfunction to evaluate deficit of attention disorders. Results: Among the study subjects, 46 patients met the selection criteria and 16 patients (34.8%, 6 men, mean age was 66) were identified as having attention disorders. Bleeding lesions were left putamen (n=3), right putamen (n=9) and right thalamus (n=4). Significant improvements were observed in two types of focused attention and auditory selective attention measures: percentage of correct answers of Visual Cancellation Task (VCT, p=0.027) and Auditory Detection Task (ADT, p = 0.01). Additionally, working hours in VCT was significantly shortened, and the false-negative rate was also significantly decreased (p= 0.028). In ADT, the false-positive rate was significantly decreased (p= 0.012). No significant changes were observed in other type of tasks. Discussion: More than one-third of patients showed attention deficits even though they had mild stroke. Only focused and selective attentions were improved in acute phase of mild stroke. These results suggested that improvement in focused and selective attention precede improvement in other attentional functions.

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