Diagnosis Of Affective Disorder Research Articles

Suicide risk after discharge from in-patient psychiatric care: A 15-year retrospective cohort study of individual patient data

BackgroundSuicide rates are known to be increased in patients after discharge from in-patient psychiatric treatment. However, evidence on risk factors for suicide within this patient group are contradictory. Thus, this study aims to investigate suicide after discharge from a sizeable psychiatric care facility to determine associated risk factors. MethodsData on individual patient level from a 15-year single-centre cohort were linked to data from the national death registry and cumulative incidence rates were calculated applying competing risk models. Independent variables included the patients' sex, age at admission, diagnosis, and length of admission. For each of these factors, subdistribution hazards ratios were calculated using a Fine-Gray model. ResultsIn our sample of 18,425 discharges, when using patients with the diagnosis of substance-use-disorders as a comparator, a significant increase in hazard of post-discharge suicide for male sex (SHR = 1.67;p = 0.037) as well as the discharge diagnoses of affective disorders (SHR = 3.56;p = 0.017) and neurotic stress and somatoform disorders (SHR = 3.73;p = 0.024) were found. Interestingly, the hazard of suicide significantly decreased in more recent discharges (SHR = 0.93;p = 0.006). No statistically significant association of the length of admission with the suicide risk was found (SHR = 0.98;p = 0.834).Limitations.Suicides may have been mis-identified as natural death in the national death register. ConclusionMale sex and distinct diagnoses were associated with an increased risk for suicide after discharge from a psychiatric care institution. The markedly increased suicide risk within this patient collective highlights the need for the development of tools to assess suicidal behaviour in this group of patients reliably.

Video consultation and treatment in the community smoking cessation therapy success rates in patients with mental illness: a randomized controlled trial

Purpose Smoking is the single factor with the highest impact on reducing life expectancy of patients with mental illness. Patients experience difficulty in participating in smoking cessation programs but are concerned about the impact of tobacco on their health and finances. Smoking cessation advice via videoconferencing might be an alternative to an ordinary in-person consultation. Material and Method Randomized controlled trial with follow-up at 6 months. We included patients with diagnoses of schizophrenia and affective disorder from psychiatric outpatient clinics. Intervention 1 involved daily video consultations; intervention 2 was treatment as usual. Results Seventy patients were included. For both/all groups/interventions, rates of smoking cessation were 45% and predictors for a 50% reduction in smoking were antipsychotic medication load [odds ratio (OR) 0.54; p = 0.045] and number of nicotine patches (OR 1.02; p = 0.06). Predictors for a reduction in the number of cigarettes to < 10 were antipsychotic medication load (OR 0.52; p = 0.04), number of nicotine patches (OR 1.01; p = 0.02) and number of cigarettes at baseline [OR 0.95 (p = 0.09); adjusted OR 0.94 (p = 0.02)]. Patients prevented weight gain during the cessation period. Conclusion The smoking cessation rate was high. One of the reasons for the high cessation rate was that the intervention was carried out by highly experienced and professionally qualified staff. In addition, we used free nicotine patches to increase the patients’ motivation to quit smoking. It is very important that we introduce these results into our clinical work with the patients.

Neuropsychological assessment of the morphofunctional organization of humour perception processes

A review of studies analysing the process of humour perception under normal conditions and its disturbances in brain damage is presented. The perception of humour is considered to be a multicomponent mental activity that occurs through a series of cognitive and affective processes characterized by a specific brain organization. The results of studies on the perception of humour in healthy people and in patients with brain damage are largely inconsistent: neuroimaging studies confirm the important role of structures of both hemispheres of the brain, while clinical data indicate a significant contribution of structures of the right hemisphere to the perception of humour. Studies on humour perception in healthy individuals and clinical studies have found no differences between the neuronal correlates of verbal and non-verbal humour perception. A neuropsychological approach to the study of the structure of the process of humour perception may be important for diagnosis of affective and cognitive disorders in patients with brain damage, as difficulties in the perception of humour may reflect disturbances of the most subtle aspects of the functioning and interaction of cognitive and emotional-personal processes.

The role of hematological coefficients of systemic inflammation in the diagnosis and risk assessment of affective disorders

The review article highlights the problem of using hematological coefficients of systemic inflammation in clinical practice, as well as the results of studies aimed at its use in the diagnosis and evaluation of therapeutic response in the treatment of mood disorders. The contribution of each individual link of the immune system to the pathogenesis of an inflammatory reaction is known, but currently of most interest are neutrophil-lymphocytic (NLR), monocyte-lymphocytic (MLR) and platelet-lymphocytic (PLR) ratios, as well as indices of systemic immune-inflammation (SII, platelet count x number of neutrophils / lymphocytes) and system inflammation response (SIRI, number of neutrophils x number of monocytes / lymphocytes). All coefficients are available for calculation based on a routine complete blood count. The analysis of the literature demonstrates the significance of these ratios, but emphasizes the need for further research. A more detailed study of these ratios will allow achieving their prognostic value and a more objective assessment of their validity and specificity for the diagnosis, prediction of risks and variants of the affective disorders course.

The development of type 2 diabetes management in people with severe mental illness in the Capital Region of Denmark from 2001 to 2015.

Type 2 diabetes (T2D) treatment has changed markedly within the last decades. We aimed to explore whether people with severe mental illness (SMI) have followed the same changes in T2D treatment as those without SMI, as multiple studies suggest that people with SMI receive suboptimal care for somatic disorders. In this registry-based annual cohort study, we explored the T2D treatment from 2001 to 2015 provided in general practices of the Greater Copenhagen area. We stratified the T2D cohorts by their pre-existing SMI status. T2D was defined based on elevated glycated hemoglobin (≥48 mmol/mol) or glucose (≥11 mmol/L) using data from the Copenhagen Primary Care Laboratory Database. Individuals with schizophrenia spectrum disorders (ICD-10 F20-29) or affective disorders (bipolar disorder or unipolar depression, ICD-10 F30-33) were identified based on hospital-acquired diagnoses made within 5 years before January 1 each year for people with prevalent T2D or 5 years before meeting our T2D definition for incident patients. For comparison, we defined a non-SMI group, including people who did not have a hospital-acquired diagnosis of schizophrenia spectrum disorders, affective disorders, or personality disorders. For each calendar year, we assembled cohorts of people with T2D with or without SMI. We used Poisson regression to calculate the rates per 100 person-years of having at least one biochemical test (glycated hemoglobin, low-density lipoprotein cholesterol, estimated glomerular filtration rate, and urine albumin-creatinine ratio), having poor control of these biochemical results, taking glucose-lowering or cardiovascular medications, or experiencing a clinical outcome, including all-cause mortality and cardiovascular mortality. Three outcomes (cardiovascular events, cardiovascular mortality, and all-cause mortality) were additionally examined and adjusted for age and sex in a post hoc analysis. From 2001 to 2015, 66,914 individuals were identified as having T2D. In 2015, 1.5% of the study population had schizophrenia spectrum disorder and 1.4% had an affective disorder. The number of people who used biochemical tests or had poor biochemical risk factor control was essentially unrelated to SMI status. One exception was that fewer LDL cholesterol tests were done on people with affective disorders and schizophrenia spectrum disorders at the beginning of the study period compared to people in the non-SMI group. This difference gradually diminished and was almost nonexistent by 2011. There was also a slightly slower rise in UACR test rates in the SMI groups compared to other people with T2D during the period. Throughout the study period, all groups changed their use of medications in similar ways: more metformin, less sulfonylurea, more lipid-lowering drugs, and more ACEi/ARBs. However, people with schizophrenia disorder consistently used fewer cardiovascular medications. Cardiovascular events were more common in the affective disorder group compared to the non-SMI group from 2009 to 2015 (rate ratio 2015 : 1.36 [95% CI 1.18-1.57]). After adjustment for age and sex, all-cause mortality was significantly higher among people with a schizophrenia spectrum disorder each year from 2003 to 2015 compared to the non-SMI group (rate ratio 2015 : 1.99 [95% CI 1.26-3.12]). Persons with schizophrenia or affective disorders demonstrated the same treatment changes for T2D as those without SMI in general practice. The lower use of most types of cardiovascular medications among people with schizophrenia disorders indicates potential undertreatment of hypertension and dyslipidemia and remains throughout the study period. Cardiovascular events were most common among people with affective disorders, but this was not reflected in a higher proportion using cardiovascular preventive medications. This knowledge should be considered in the management of this vulnerable patient group.

Mild Traumatic Brain Injuries and Risk for Affective and Behavioral Disorders.

Recent studies document an association between mild traumatic brain injuries (mTBIs) in children and postinjury psychiatric disorders. However. these studies were subject to limitations in the design, lack of long-term follow-up, and poorly defined psychiatric outcomes. This study determines the incidence and relative risk of postinjury new affective and behavior disorders 4 years after mTBIs. A cohort study of mTBI cases and matched comparisons within an integrated health care system. The mTBI group included patients ≤17 years of age, diagnosed with mTBI from 2000 to 2014 (N = 18 917). Comparisons included 2 unexposed patients (N = 37 834) per each mTBI-exposed patient, randomly selected and matched for age, sex, race/ethnicity, and date of medical visit (reference date to mTBI injury). Outcomes included a diagnosis of affective or behavioral disorders in the 4 years after mTBI or the reference date. Adjusted risks for affective disorders were significantly higher across the first 3 years after injury for the mTBI group, especially during the second year, with a 34% increase in risk. Adjusted risks for behavioral disorders were significant at years 2 and 4, with up to a 37% increase in risk. The age group with the highest risk for postinjury affective and behavioral disorders was 10- to 13-year-old patients. Sustaining an mTBI significantly increased the risks of having a new affective or behavioral disorder up to 4 years after injury. Initial and ongoing screening for affective and behavior disorders following an mTBI can identify persistent conditions that may pose barriers to recovery.

Kathleen's journey: improving mental health outcomes for women with bipolar affective disorder

For most women, pregnancy and the postpartum period are times of great joy and expectation. However, for women with a diagnosis of bipolar affective disorder, there is an exceptionally high risk of deterioration in their mental health. There is the real possibility of developing postpartum psychosis, possibly requiring acute psychiatric admission and being separated from their baby. This can have devastating consequences for a woman, her baby, the family and society. Multiple services/disciplines across primary, secondary and tertiary care settings need to work together to enhance outcomes for these women. In Ireland, a relatively new collaborative way of working is emerging, as specialist perinatal mental health teams are developed. This case review aims to illustrate the complexities of and potential in collaborative team working to support a woman with a pre-existing a mental health disorder, and her family, during pregnancy. This was done through a specialist perinatal mental health teams collaboration co-ordinated by a clinical nurse specialist.

Epidemiological profile of involuntary admission in the Psychiatry Service of the University Hospital of Gran Canaria Doctor Negrín

IntroductionInvoluntary admissions due to mental disorders occur with relative regularity in hospital admission units in our country. This work will study the socio-demographic and clinical characteristics found in relation to these type of patients, in order to have more information, both clinical and legal, with which to work and perform a better function, administration of resources, and development of necessary skills in these situations. Material and methodsRetrospective descriptive observational study, in which different variables will be analyzed, previously selected, present in the population of psychiatric patients involuntarily admitted to the Doctor Negrín Hospital in a period of 2 years, 2019 and 2020, thus determining, the degree of prevalence of each of them. ResultsAmong the variables most associated with involuntary admission are, being a man, in the fourth decade of life, single, without children, or employment, with a diagnosis of major psychotic or affective disorder who has most likely abandoned treatment. DiscussionIt would be advisable to carry out a special follow-up of patients who meet the profile described above in order to minimize involuntary occurrence. It is necessary to develop educational, follow-up, and adherence programs within the reach of the population of psychiatric patients in order to minimize the need for involuntary admissions in our environment.

Comorbidity of anxiety/affective, conduct/antisocial, attention deficit, and alcohol use disorders with suicidal behaviors in an American Indian community sample of adults and adolescents

AimsTo study the associations of anxiety/affective disorders, conduct/antisocial disorders (ASPD/CD), attention deficit disorders (ADHD), and alcohol use disorders (AUD) with suicidal behaviors in an American Indian (AI) community sample of adolescents and adults. MethodsParticipants were AI (360 adolescents, 925 adults) recruited from reservations who were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). ResultsAmong AI adults (mean age = 33 years), 17% percent reported lifetime experiences of suicidal thoughts (ideation and/or plans) and 14% reported suicidal acts (including either a suicide attempt history or verified death by suicide; n = 19 deaths). Among AI adolescents (mean age = 15 years), 20% experienced suicidal thoughts and 9% experienced suicidal acts (including 3 deaths). In logistic regression analyses, suicidal thoughts were significantly associated with lifetime diagnoses of affective disorder, CD and ADHD in adolescents, and with anxiety disorder, affective disorder, and ASPD/CD in adults. Suicidal acts were associated with affective disorder, ADHD, and alcohol drinking in adolescents and with anxiety disorder, ASPD/CD and AUD in adults. The number of comorbid disorders greatly increased the risk of both suicidal thoughts and acts among both adolescents and adults. ConclusionsIn addition to affective disorders, both ADHD and CD in adolescents, and ASPD in adults, demonstrated an association with suicidal thoughts. Alcohol use by adolescents and AUD among adults also were associated with suicidal attempts in this AI sample. These findings suggest need for additional research and potential integration of alcohol in screening and intervention programs focused on the prevention of suicide among AI.

The Course Patterns and Diagnostic Shifts of Patients With Schizoaffective Disorder: A Retrospective Cohort Study.

Since its introduction, schizoaffective disorder (SAD) has been one of the most controversial diagnoses in psychiatry, both clinically and nosologically. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), SAD diagnostic criteria were changed, and instead of a cross-sectional diagnosis, a longitudinal approach covering the life course of the illness was adopted. In this study, the meaning of this conceptual shift in the diagnosis of SAD in clinical practice is investigated throughout the course of the illness for patients with SAD. Sixty-two inpatients diagnosed with SAD according to DSM-5 diagnostic criteria are included in this study. The course of the illness from its onset to the present is investigated retrospectively. The disease duration is 18.3 ± 9.1 years. The most common diagnoses in the first hospitalization are bipolar disorder (manic episodes) and psychotic disorder, not otherwise specified. Furthermore, the time that elapsed between the first psychiatric application of the patients and the diagnosis of SAD is 9.5 ± 7.3 years. Further, when the course of the illness is grouped according to the predominance of affective and psychotic disorders, recurrent affective disorders are observed most frequently (29.3%), followed by mixed-episode disorders and a shift from affective disorders to psychotic disorders (22.4%). It is found that SAD has a heterogeneous course, and affective disorder diagnoses are more dominant during the course of the illness. The clinical relevance of the longitudinal emphasis on the total duration of the illness in the DSM-5 is also demonstrated. The affective and psychotic dichotomy, based on Kraepelin, has failed to elucidate the course of the disease in clinical practice. Therefore, clinicians should meticulously evaluate the entire course of the illness for SAD and avoid conclusive judgments over a single episode.

Catatonia in the Structure of Affective and Schizoaffective Disorders of the Postpartum Period

Background: аt the present stage of psychiatry, within the framework of the dimensional paradigm, catatonia is considered as a transnosological entity that manifests within the clinical space of various affective and schizoaffective disorders. In the 21st century studies, devoted to the analysis of motor disorders that appear in the clinical space of postpartum affective and schizoaffective disorders, become increasingly relevant (J.Y. Lai, T.L. Huang, 2004; A. Nahar and et al., 2017; C. Kamau, 2017; L. Csihi and et al., 2022). However, research on this issue is very limited. The objective: the analysis of catatonic phenomenon, manifesting in the postpartum period, based on the observations of three clinical cases.Patients and methods: 3 clinical cases of patients, undergoing treatment in the clinical department of the FSBSI “Mental Health Research Centre” with established diagnoses of bipolar affective disorder (ICD-10: F31.1; 1 case) and schizoaffective disorder (ICD-10: F25.2; 2 cases) with a predominance of motor disorders in the clinical picture of the disease. The main method was clinical with the use of psychological examination and data from instrumental (EEG) diagnostics.Results: movement disorders registered in the structure of apathoanesthetic depressions within the exacerbation of bipolar affective disorder are represented by the phenomena of hypokinetic catatonia and act as an amplifier of affective disorders. Catatonic symptoms within the clinical space of schizoaffective disorders, are limited by manifestations of parakinetic catatonia, do not have a direct correlation with the structure and severity of affective disorders, and indicate an increase in the progredient endogenous process.Conclusion: the analysis of clinical observations testifies in favor of the heterogeneity of affective-catatonic states not only in terms of the structure of motor phenomena, but also in terms of the psychopathological profile of affective disorders.

Perfil epidemiológico de los ingresos involuntarios en el Servicio de Psiquiatría del Hospital Universitario de Gran Canaria Doctor Negrín

IntroductionInvoluntary admissions due to mental disorders occur with relative regularity in hospital admission units in our country. This work will study the socio-demographic and clinical characteristics found in relation to this type of patients, in order to have more information, both clinical and legal, with which to work and perform a better function, administration of resources and development of necessary skills in these situations. Material and methodsRetrospective descriptive observational study, in which different variables will be analyzed, previously selected, present in the population of psychiatric patients involuntarily admitted to the Doctor Negrín Hospital in a period of 2 years, 2019 and 2020, thus determining, the degree of prevalence of each of them. ResultsAmong the variables most associated with involuntary admission are, being a man, in the fourth decade of life, single, without children, or employment, with a diagnosis of major psychotic or affective disorder who has most likely abandoned treatment. DiscussionIt would be advisable to carry out a special follow-up of patients who meet the profile described above in order to minimize involuntary occurrence. It is necessary to develop educational, follow-up and adherence programs within the reach of the population of psychiatric patients in order to minimize the need for involuntary admissions in our environment.

Absconding among admitted patients with bipolar affective disorder diagnosis in Uganda

BackgroundHospitalization is often necessary for individuals with Bipolar affective Disorder (BAD) during severe manic or depressive episodes, as well as for stabilizing treatment regimens. However, a significant proportion of patients admitted for treatment of BAD abscond or leave the hospital without permission during their stay. In addition, patients managed for BAD may have unique characteristics that might force them into absconding. For example, the high prevalence of co-morbid substance use disorder – craving to use substances, suicidal behaviors – attempts to die by suicide, and cluster B personality disorders – characterized by impulsive acts. It is, therefore, essential to understand the factors contributing to absconding among patients with BAD, to facilitate designing strategies for preventing and managing this behavior.MethodThis study was based on a retrospective chart review of the inpatients diagnosed with BAD at a tertiary psychiatry facility in Uganda from January 2018 to December 2021.ResultsApproximately 7.8% of those with BAD absconded from the hospital. The likelihood of absconding among those with BAD increased with the use of cannabis [adjusted odds ratio (aOR) = 4.00, 95% confidence interval (CI) = 1.22–13.09, p-value = 0.022] and having mood lability [aOR = 2.15, 95% CI = 1.10–4.21, p-value = 0.025]. However, receiving psychotherapy during the admission (aOR = 0.44, 95 CI = 0.26–0.74, p-value = 0.002) and treatment with haloperidol (aOR = 0.39, 95% CI = 0.18–0.83, p-value = 0.014) reduced the likelihood of absconding.ConclusionAbsconding among patients with BAD is common in Uganda. Those with symptoms of affective lability and those with comorbid cannabis use tend to abscond more, while those who receive haloperidol and psychotherapy are less likely to abscond.

The psychosocial impact of microtia and ear reconstruction: A national data-linkage study.

Children with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the associated surgical intervention, is associated with psychosocial implications including impaired educational attainment and a diagnosis of an affective disorder. A retrospective case-control study was conducted using data linkage to identify patients in Wales with a diagnosis of microtia. Matched controls were sought on the basis of age, gender and socioeconomic deprivation status to yield a total sample size of 709. incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Educational attainment at 11 years of age, plus a diagnosis of depression or anxiety were used as markers of adverse psychosocial outcomes and the relative risk was attained using logistic regression analyses. There were no significant associations between a diagnosis of microtia and an increased risk of adverse educational attainment or a risk of an affective disorder diagnosis. Male gender and higher deprivation scores were significantly associated with poorer educational attainment, irrespective of a diagnosis of microtia. Surgical intervention of any nature was also not associated with any increased risk of adverse educational or psychosocial outcomes in microtia patients. Microtia patients in Wales do not appear to be at greater risk of developing affective disorders or impaired academic performance as a result of their diagnosis or associated surgical intervention. Whilst reassuring, the need for appropriate support mechanisms to maintain positive psychosocial wellbeing and academic achievement in this patient cohort is reinforced.

Клинические проявления COVID-19 у сотрудников медицинских организаций в ранний и поздний восстановительный периоды и вопросы их реабилитации

BACKGROUND: Medical workers are one of the groups at high risk of contracting a new coronavirus infection (COVID-19), which requires in-depth study of this professional group. AIM: To determine the main directions for the rehabilitation of medical workers with past COVID–19 based on the study of residual clinical manifestations in the early and late recovery periods. MATERIALS AND METHODS: The study was conducted based on the materials of an online survey of employees of medical organizations in three consecutive stages. At the first and second stages, residual clinical manifestations data of the coronavirus infection in the early (up to 6 months) and late recovery periods (6-15 months) were analyzed. At the third stage of the study, the characteristics of affective disorders of COVID-19 convalescents in comparison with employees intact for COVID-19, were given. RESULT: During the first 6 months after the disease, asthenovegetative manifestations persisted in the form of general weakness and increased fatigue, unproductive cough, shortness of breath, anosmia, disorders of a number of cognitive functions. In the late recovery period (from 6 to 15 months), the majority of respondents noted increased fatigue, impaired memory and concentration. Some of the study participants had a change in the structure of their hair and its loss (alopecia). Some of the employees were first diagnosed with arterial hypertension in the long-term after the disease. It was found that the frequency and severity of affective disorders and asthenic manifestations in COVID-19 convalescents were significantly higher than in the group of employees intact for the disease, which is a direct indication for inclusion of the diagnosis of affective disorders and the provision of specialized psychological assistance in the rehabilitation programs of COVID-19 patients. CONCLUSIONS: During the study, data were obtained on the negative consequences of a coronavirus infection for the health of medical workers, which should be used in the development of rehabilitation programs for employees in the early and late recovery periods.

Organic affective disorder due to meningioma, case report

IntroductionBrain tumors can be associated with psychiatric symptoms in up to 50% of cases. The most frequent primary is meningioma and the clinic will depend on its location. Since surgical treatment does not always guarantee complete resolution of the condition, concomitant psychopharmacological treatment is usually recommended.ObjectivesTo review about organic mania and its differential diagnosis.MethodsWe carry out a literature review about organic affective disorder accompanied by a clinical description of one patient with organic mania.ResultsA 50-year-old woman admitted due to psychotic symptoms. She had a diagnosis of frontal and parietal meningioma treated with surgical treatment 10 years ago. In this context she had a diagnosis of Organic Affective Disorder and 3 previous psychiatric admissions due to affective or psychotic symptoms. Current episode consisted in dysphoria, magalomanic ideation, delusional ideation of harm and mystical-religious content, high speech pressure and insomnia with little awareness of the disease. Cranial magnetic resonance showed postoperative right frontal changes and stability in parietal meningioma, with no significant differences compared to the previous study. Diagnosis of Organic Affective Disorder is maintained and reintroduced treatment with aripiprazole withdrawaled by the patient weeks before. Because of adverse effects and persistence of the symptoms described, it was changed to olanzapine with good response and tolerability. The behavior was progressively adapted with improvement of the dysphoria and without psychotic symptoms at discharge.ConclusionsAffective symptons due to organic disorders such as brain tumors can be treated surgically and with psychopharmacological treatment.Disclosure of InterestNone Declared

Neuroleptic Malignant Syndrome Concurrent with COVID-19 Infection: A Case Report.

Neuroleptic malignant syndrome (NMS), which most often occurs after the use of antipsychotics, is a rare but life-threatening condition. In this article, a 56-year-old male patient with a diagnosis of bipolar affective disorder (BPD) who developed NMS after a COVID-19 infection will be presented. The patient had been brought to the emergency room with high fever, fatigue, and slowness of movements that had been going on for two days. The examination revealed tachycardia, tachypnea, lethargy and rigidity. Upon further investigation the COVID-19 test came out positive and the serum levels of creatine kinase were considerably high. He was admitted to the psychiatric ward with diagnoses of COVID-19 infection and NMS. COVID-19 infection might have been a risk factor for NMS in this patient. Especially in patients who are taking antipsychotic drugs, if COVID-19 is present, the risk of NMS should be taken into consideration. Keyword: COVID-19, Neuroleptic Malignant Syndrome, Risperidone, Antipsikotik, Enfeksiyon.

Psychosocial Functioning and Quality of Life in Remitted Males with Dual Diagnosis of Bipolar Affective Disorder and Alcohol Dependence Syndrome: A Cross-Sectional Study from South India

Abstract Background: Studies on psychosocial functioning and quality of life (QOL) of Bipolar Affective disorder (BPAD) patients with comorbid alcohol dependence syndrome (ADS), during BPAD remission and sobriety from alcohol, are sparse. Objectives: To assess the psychosocial functioning, QOL and associated factors in remitted males with dual diagnosis of BPAD and ADS. Methods: 132 males aged 18–60 years on psychiatry outpatient department follow-up from a tertiary care center, having BPAD– Currently in remission (F31.7) and co-morbid ADS (F10.2) according to the International classification of mental and behavioral disorders, Diagnostic Criteria for Research (ICD-10 DCR) were enrolled. Semi-structured proforma, Kuppuswamy’s Socioeconomic status Scale, Functioning Assessment Short Test (FAST), and WHO QOL– BREF scales were administered. Statistical analysis was performed using R software (EZR). Results: 68.94% had moderate impairment in psychosocial functioning (FAST score 21–40). The median WHO QOL-BREF total score was 72 (interquartile range 68, 77) – lowest scores were for social relationships and psychological domain. Age (P = 0.014), residential area (P = 0.031), age of onset of ADS (P = 0.038), duration of ADS (P = 0.003), and total duration of BPAD (P = 0.05) showed significant association with FAST scores. Binge-drinking pattern was significantly associated with WHO QOL-BREF total scores. The total FAST scores showed a weak negative correlation with WHO QOL-BREF total scores (rs = −0.15, P = 0.01). Conclusion: Psychosocial functioning and QOL of dual diagnosis patients with BPAD and ADS were significantly impaired, even while in remission from both the disorders, which makes the elucidation of the associated factors a pressing priority.

Sexual disorders in the men treated in a psychiatric ward.

An attempt to assess the impact of dual diagnosis - mental illness and addiction on the occurrence of sexual dysfunctions, and evaluation of problems with sexual functioning in men treated in a psychiatric ward. 140 psychiatrically hospitalized men (mean age 40.4 ± 12.7 years) with the diagnosis of schizophrenia, affective disorders, anxiety disorders, addiction and double diagnosis (schizophrenia and addiction) took part in the study. The Sexological Questionnaire, developed by Professor Andrzej Kokoszka, and the International Index of Erectile Function IIEF-5 were used in the study. The occurrence of sexual dysfunctions in the study group was reported in 83.6% of patients. The most common was reduction in sexual needs (53.6%) and orgasm delay (40%). Depending on the research tool used, erectile dysfunction appeared in 38.6% of respondents (according to Kokoszka's Questionnaire) and 61.4% of patients (IIEF-5). Severe erectile dysfunction was more common in the group of patients without a partner (12.4% vs. 0; p = 0.000) compared to people in relationships and in the group with anxiety disorders (p = 0.028) compared to groups with other mental disorders. In the group of people with dual diagnosis (DD), sexual dysfunctions were observed more frequently in comparison to patients with schizophrenia (p = 0.034). Treatment lasting over 5 years was more often associated with sexual dysfunctions (p = 0.007). In the DD group, lack of orgasm and excessive sexual needs were more frequent in comparison to people with one diagnosis (p = 0.0145; p = 0.035). Sexual dysfunctions are more common in patients with DD in comparison to patients diagnosed with schizophrenia. Lack of a partner and the duration of psychiatric treatment over 5 years is associated with more frequent occurrence of sexual dysfunctions.

Decision tree distinguish affective disorder diagnosis from psychotic disorder diagnosis with clinical and lab factors

BackgroundAffective symptoms usually occur at the same time of psychotic symptoms. An effective predictive method would help the differential diagnosis at an early stage of the mental disorder. The purpose of the study was to establish a predictive model by using laboratory indexes and clinical factors to improve the diagnostic accuracy. MethodsSubjects were patients diagnosed with psychiatric disorders with affective and/or psychotic symptoms. Two patient samples were collected in the study (n = 309) With three classification methods (logistic regression, decision tree, and discriminant analysis), we established the models and verified the models. ResultsSeven predictors were found to be significant to distinguish the affective disorder diagnosis from the psychotic disorder diagnosis in all three methods, the 7 factors were Activities of daily living, direct bilirubin, apolipoproteinA1, lactic dehydrogenase, creatinine, monocyte count and interleukin-8. The decision tree outperformed the other 2 methods in area under the receiver operating characteristic curve, and also had the highest percentage of correctly classification. ConclusionWe established a predictive model that included activities of daily living, biochemical, and immune indicators. In addition, the model established by the decision tree method had the highest predictive power, which provided a reliable basis for future clinical work. Our work would help make diagnosis more accurate at an early stage of the disorder.