Causes Of Psychiatric Illness Research Articles

Post-traumatic Stress Disorder in School-age Children: A Nationwide Prospective Birth Cohort Study

Traumatic childhood events are some of the few identifiable and to some extent preventable causes of psychiatric illness. Children exposed to severely stressful events may react with post-traumatic stress disorder (PTSD) and this may impact their level of function in daily life, their future development and mental health. The traumatic stress model suggests that traumatic stress in the family, community violence, and other traumas are regarded as additive environmental factors that can outweigh protective compensatory factors and thus interact with individual vulnerabilities. This study is based on prospective panel data including the whole population of children born in Denmark from 1984 to 1994, who are followed from age 7 to age 18 (N = 679,000) in the window between 2001 and 2012. Risk factors for first-time diagnose with PTSD are analyzed by the discrete time log-odd model. We found a lifetime prevalence of 2.3% PTSD in school-age children (n = 15,636). In accordance with the model, indicators of traumatic stress in the family, family disintegration, community violence, and individual vulnerabilities predicted later diagnose with PTSD. Individual neurodevelopmental disorder – especially autism (adjusted Odds Ratio (OR 7.1) and ADHD (OR 10.7) – were predicative of PTSD. The results cooperated the traumatic stress model. Some results were inconsistent with the traumatic stress model e.g., parental substance abuse were associated with less than expected PTSD in school-age children when adjusted for other risk factors. This indicates that PTSD may be underestimated in these groups. PTSD diagnoses in administrative records underestimate the prevalence, systematically. Efforts to increase PTSD screening may allow for better management.

Does application of complexity theory simplify concepts of psychiatry: Analogies and insights.

Scientific curiosity has not been able to explain the cause of psychiatric illness based on primarily biological or social paradigm. Available literatures were explored to understand causality of psychiatric illness from perspective of physics. Theory of complexity and other relevant theories were extrapolated to address these questions. Mental illness appeared to be a complex interplay of reductionism and emergentism, genetic and epigenetics, stress and the vulnerability or the core and the periphery. Mental illness displayed complex interaction between biological trait and environmental state.

Examining the clinical utility of neuroimaging on an inpatient psychiatric unit

IntroductionRecent developments in neuroimaging have revolutionized medicine and aided in our understanding of how biological abnormalities may contribute to clinical presentation. While such advances have begun to enhance our knowledge about the timing of abnormalities, it remains unclear at this time how neuroimaging impacts the clinical course of the patient. In addition, much debate exists regarding the clinical necessity of neuroimaging for psychiatric conditions, and there are contradictory reports and guidelines for the application of conventional brain imaging (MRI and CT) in the evaluation of patients with mental illness.ObjectiveWe aim to review the clinical utility of neuroimaging in an acute psychiatric setting, and hypothesize that there will be no significant differences between the outcome of neuroimaging and clinical course for patients.MethodWe conducted a retrospective chart review of adult patients who were diagnosed and treated for psychiatric conditions on an inpatient psychiatric service over a period of 36 months July 1, 2013–June 30, 2016.ConclusionsWhile imaging advances have added to our understanding of biological abnormalities and can aid in ruling out organic causes of psychiatric illness, at this time it is not guiding clinical management for patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Mental disorders in adults with congenital heart disease: Unmet needs and impact on quality of life

ObjectiveIn adult congenital heart disease (ACHD), mental health status and quality of life become important issues due to improved life expectancy. Current literature provides conflicting data regarding mental health status in ACHD. Furthermore, none of the studies so far compared prevalence rates with a matched control group. MethodsThe prevalence of mental disorders was assessed in 150 ACHD using a structured interview, and compared to 12-months estimates of the general German population. Quality of life (QoL) was measured with World Health Organization Quality of Life instrument. Furthermore, we related the diagnostic results of widely used screening instruments for depression (Beck Depression Inventory-2; BDI-2; Hospital Anxiety and Depression Scale; HADS) with clinical diagnoses, to receive optimal sensitivity and specificity values. ResultsThe prevalence of psychiatric disorders was significantly higher in ACHD than in the general population (48.0%; CI: 44.7–60.0 vs. 35.7%; CI: 33.5–37.9). Mood (30.7%; CI: 24.0–38.0 vs. 10.7%;CI:9.4–12.0) and anxiety disorders (28.0%; CI:22.0–36.7 vs. 16.8%; CI: 15.0–18.6) were the leading causes of psychiatric illness. Sixteen of 150 ACHD patients (10.7%) received specific treatment for psychiatric disorders before entering the study. Overall quality of life was independently and negatively associated with a diagnosis of major depression (p<0.001), alcohol dependency (p=0.004), nicotine dependency (p=0.036), and NYHA class (p=0.007). Accuracy of the HADS-D and BDI-2 as screening instruments was moderate (AUC 0.60–0.81), depending on the cut-off score used. ConclusionsPsychiatric disorders, particularly mood and anxiety disorders are significantly more frequent in ACHD compared to the general population. However, these disorders are rarely diagnosed resulting in under treatment and loss of quality of life. Quality of life is independently associated with the existence of mood, anxiety and substance use disorders. When self-rating instruments (BDI-2, HADS) are used as screening instruments in ACHD care, lower cut-off values are recommended.

Traumatic Childhood Events and Autism Spectrum Disorder.

Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae; however, this topic has been understudied. This review considers the rationale for examining traumatic events and related symptomology in individuals with ASD and summarizes the limited research on this topic. A conceptual framework for understanding the interplay of ASD, trauma and traumatic sequelae is proposed and recommendations for future research presented.

The dappled nature of causes of psychiatric illness: replacing the organic-functional/hardware-software dichotomy with empirically based pluralism.

Our tendency to see the world of psychiatric illness in dichotomous and opposing terms has three major sources: the philosophy of Descartes, the state of neuropathology in late nineteenth century Europe (when disorders were divided into those with and without demonstrable pathology and labeled, respectively, organic and functional), and the influential concept of computer functionalism wherein the computer is viewed as a model for the human mind-brain system (brain=hardware, mind=software). These mutually re-enforcing dichotomies, which have had a pernicious influence on our field, make a clear prediction about how 'difference-makers' (aka causal risk factors) for psychiatric disorders should be distributed in nature. In particular, are psychiatric disorders like our laptops, which when they dysfunction, can be cleanly divided into those with software versus hardware problems? I propose 11 categories of difference-makers for psychiatric illness from molecular genetics through culture and review their distribution in schizophrenia, major depression and alcohol dependence. In no case do these distributions resemble that predicted by the organic-functional/hardware-software dichotomy. Instead, the causes of psychiatric illness are dappled, distributed widely across multiple categories. We should abandon Cartesian and computer-functionalism-based dichotomies as scientifically inadequate and an impediment to our ability to integrate the diverse information about psychiatric illness our research has produced. Empirically based pluralism provides a rigorous but dappled view of the etiology of psychiatric illness. Critically, it is based not on how we wish the world to be but how the difference-makers for psychiatric illness are in fact distributed.

Genes and Environment and the World of Psychiatry

Genes and Environment and the World of Psychiatry

Psychiatric genetic counselling for parents of individuals affected with psychotic disorders: a pilot study

There has been increasing interest in the concept of applying genetic counselling to psychiatric disorders, but despite its relevance to psychiatric illness, and interest from the target group, there have been no empiric investigations of psychiatric genetic counselling. In a population of unaffected parents of individuals with first episode as well as more chronic psychotic disorders, we aimed to investigate whether psychiatric genetic counselling: is perceived to be useful, could increase understanding of the causes of psychiatric illness and decrease concern about other relatives becoming affected. Subjects (n=13) participated in a genetic counselling session. The session was a clinical intervention similar to what would be carried out as part of a referral for any disease with a hereditary component, but specific for psychosis. Questionnaires were used to assess (pre-counselling): motivations for attending, concern about other relatives developing psychiatric illness, and (post-counselling) whether the intervention: (i) improved understanding of mental illness; (ii) modified concern about other relatives becoming affected; and (iii) was perceived to be useful. Desire for knowledge motivated participation. Immediately after the session, and 1 month later >92% and 100% of participants, respectively, felt that the session was useful. Genetic counselling reduced concern about other relatives becoming affected as risks were lower than participants had expected. All participants felt that their understanding of the causes of psychiatric illness had improved through genetic counselling. Psychiatric genetic counselling may benefit parents of individuals with psychiatric illnesses. Avenues for future research are highlighted.

Károly Schaffer and his school: The birth of biological psychiatry in Hungary, 1890–1940

In the first third of the twentieth century, neuropathology seemed to offer the key to unlock the causes of psychiatric illness. Among the top centers devoted to the microscopic anatomy of the brain was that of Károly Schaffer in Budapest. Schaffer, a pioneer in the histopathology of Tay–Sachs–Schaffer disease, was also a charismatic teacher, bringing forth a school of investigators in psychopathology. Among them was László Meduna, who originated convulsive therapy. Despite the importance of the Schaffer school, it is almost unknown outside of Hungary, largely the result of the introduction of neurophysiological, neurochemical and molecular genetic methods that distracted attention away from histopathological contributions in psychiatry after the Second World War. The microscopic study of the brain and its diseases seemed increasingly less important. The present biographical account of Károly Schaffer and his school seeks to bring this important story in the early history of biological psychiatry to a wider audience and explain why it has since been forgotten.

The neuropsychiatry of adult-onset adrenoleukodystrophy.

Adrenoleukodystrophy is an inherited X-linked peroxisomal disorder that preferentially affects the adrenal cortex, testes, and brain and may occur at almost any age. Psychiatric symptomatology is present in many of the adult-onset cases reported in the literature and may be one of the earliest manifestations of the disease. The majority of patients with psychiatric disturbances have signs and symptoms typical of mania. Psychosis and cognitive impairment may also be prominent. Metabolic diseases such as adrenoleukodystrophy are probably underrecognized as a cause of psychiatric illness. Increased awareness of these disorders will lead to accurate diagnosis, appropriate treatment selection, and genetic counseling.

Biological psychiatry in perspective.

Biological psychiatry is a technical term that denotes physiological and biochemical approaches to psychiatric aetiology and, despite the usual wider meaning of the word biological, excludes psychosocial approaches. 'Biological' causes of severe psychiatric disorder have been suspected from the earliest times, and in some periods an excessive focus upon them has led to neglect of psychological and social approaches to treatment, to the detriment of patients. It is important that current research into biological psychiatry should be carried forward in conjunction with the important advances that have been made in psychological and social research. The causes of psychiatric illness are complex and it is unlikely that any single approach, biological or psychosocial, will be sufficient on its own. The great potential of biological psychiatry will be realized only if it is viewed within these wider historical and scientific perspectives.

Dr. Spitzer and Associates Reply

Back to table of contents Previous article Next article ArticleNo AccessDr. Spitzer and Associates ReplyROBERT L. SPITZER, MICHAEL B. FIRST, JANET B.W. WILLIAMS, KENNETH KENDLER, HAROLD ALAN PINCUS, and GARY TUCKERROBERT L. SPITZERSearch for more papers by this author, MICHAEL B. FIRSTSearch for more papers by this author, JANET B.W. WILLIAMSSearch for more papers by this author, KENNETH KENDLERSearch for more papers by this author, HAROLD ALAN PINCUSSearch for more papers by this author, and GARY TUCKERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.149.11.1619AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Dr. Spitzer and Associates Reply." American Journal of Psychiatry, 149(11), pp. 1619–1620 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByThe dappled nature of causes of psychiatric illness: replacing the organic–functional/hardware–software dichotomy with empirically based pluralism10 January 2012 | Molecular Psychiatry, Vol. 17, No. 4Two “Mind”-“Body” Models for a Holistic PsychiatryEthical Human Psychology and Psychiatry, Vol. 8, No. 1Diagnostic classification of organic psychiatric disorders after aneurysmal subarachnoid hemorrhage: a comparison between ICD-10, DSM-IV and the Lindqvist & Malmgren classification system31 July 2003 | Acta Psychiatrica Scandinavica, Vol. 108, No. 3Psychiatry, Vol. 60, No. 1, Vol. 73Journal of Nutritional Medicine, Vol. 4, No. 2Acta Psychiatrica Scandinavica, Vol. 88, No. S373International Journal of Geriatric Psychiatry, Vol. 7, No. 8 Volume 149Issue 11 November 1992Pages 1619-1620 Metrics PDF download History Published online 1 April 2006 Published in print 1 November 1992

Crack/cocaine abusers in the general hospital: assessment and initiation of care.

Cocaine, either smoked (as "crack") or taken intranasally, is now a common cause of psychiatric illness. This study was designed to assess the impact of cocaine abuse on a general psychiatric service and an obstetrics service in an urban general hospital and to evaluate a program for engaging affected patients in addiction treatment. The charts of 300 general psychiatric patients (not admitted for addiction treatment) and 60 cocaine-abusing prenatal or postpartum patients were reviewed. A treatment referral program based on professionally directed peer leadership was established for patients with cocaine abuse. Results of evaluation and referral of 100 other cocaine-abusing psychiatric patients and the 60 prenatal or postpartum patients were then determined. Fully 64% (N = 191) of the 300 psychiatric patients were diagnosed as substance abusers; 38% (N = 113) of them abused cocaine. Almost one-third of these cocaine abusers had no axis I diagnosis other than substance abuse/dependence, and the majority were homeless. Urine samples were positive for cocaine in a majority of the obstetric patients studied. A majority of the psychiatric patients who were referred through the peer-led program enrolled in outpatient cocaine treatment--three times as many as in the chart review group. Most of the obstetric patients suitable for referral enrolled for treatment as well. Cocaine abuse may be responsible for a large portion of psychiatric admissions in urban public general hospitals. Cocaine abusers in psychiatric and obstetrics services are apparently responsive to a peer-oriented mode of referral into treatment.

Pregnancy and birth complications as causes of psychiatric illness in adult life: A study utilizing the perinatal mortality survey (1958)

Pre-gestational diabetes (PGDM) is a significant cause of neonatal morbidity and mortality. Delayed villous maturation (DVM) is a placental diagnosis with increased risk of perinatal mortality.This study aimed to prospectively look at the incidence of DVM in a PGDM population compared to non-diabetic controls. Additionally, we analysed antenatal ultrasound and clinical markers for DVM in the diabetic population.This is a prospective study.Placentae of women with non-diabetic and PGDM pregnancies underwent detailed blinded histo-pathological examination.Clinical data, including birth weight, peri-natal outcome, and, in PGDM group, glycaemic control and ultrasound findings, were obtained.77 non-diabetic women and 74 PGDM women consented to the study. The incidence of DVM in the PGDM group was higher than in the non-diabetic group (21/74 (28.4%) vs. 11/77 (14.3%) p = 0.02; RR 1.98). In the PGDM group clinical and ultrasound markers were compared between the DVM group (n = 21) and the non‐DVM group (n = 53). There was no difference in perinatal outcome nor glycaemic control between these two groups.DVM, a placental finding with an increased risk of perinatal mortality, is increased in PGDM population compared to non-diabetic controls. No association was found with maternal glycaemic control. The presence of placental DVM was not associated with antenatal ultrasound parameters nor clinical perinatal outcome.

Parent-child separation. Is it really a cause of psychiatric illness in adult life?

THE available methods of investigating parental deprivation in all its forms are crude and unsatisfactory. The evidence that deprivation is an important etiological factor in various forms of psychiatric illness once appeared overwhelming, 1-3 but nowadays this is no longer uncritically acceptable. 4,5 It has become obvious that deprivation is an extremely complex phenomenon and, while it may play some part in the causation of certain psychiatric disorders, the nature of the relationship between deprivation and illness is much less clear-cut than was once thought. Re-evaluation of our available data is necessary so that we may devise more meaningful methods to investigate the effects of parental dperivation. This article reviews briefly some of the more reliable reports on deprivation due to physical separation of parent and child (for example, by parental absence or death, or by the child's having to be in hospital). It also attempts to evaluate the alleged