Organic Disorders Research Articles

The Efficacy of the Herbal Formula of Bunium persicum and Coriandrum sativum on Clinical Symptoms of Patients with Functional Dyspepsia: A Double-Blind Randomized Controlled Trial

Introduction: Functional dyspepsia (FD) is one of the most prevalent chronic disorders affecting up to 30% of the world population with considerable impairment of quality of life. This study evaluated the efficacy of the herbal preparation of Bunium persicum (Boiss.) B.Fedtsch. and Coriandrum sativum L. on symptom severity, symptom frequency, and quality of life of patients with FD. Methods: This double-blind randomized controlled clinical trial, with parallel groups allocation ratio of 1:1, was conducted in a referral clinic of Afzalipour Hospital affiliated with Kerman University of Medical Sciences in Kerman, southeastern Iran. A total of 90 patients with FD (diagnosed based on the Rome IV criteria) were included in this study. The patients with complications during the intervention, pregnancy or lactation, a history of allergy to herbal drugs, use of other medication that affect the symptoms of FD during the study, and severe organic or psychiatric disorders were excluded. The participants received one capsule containing 500 mg of herbal preparation or placebo twice a day for 4 weeks and were subsequently followed up for 4 more weeks. Clinical outcomes were assessed via the Dyspepsia Severity Questionnaire, the Rome IV Diagnostic Questionnaire, and Nepean Dyspepsia Index Questionnaire. Results: A total 40 participants in each group completed the follow-up period, and their data were analyzed statistically. All clinical outcomes showed significant improvements by herbal preparation compared to the placebo without serious side effects (p < 0.05). Conclusions: This herbal preparation can significantly improve the quality of life, and symptoms of FD compared to placebo.

Comparative analysis of the clinical and social characteristics of persons with organic mental disorders suffering from mental retardation who have repeatedly committed socially dangerous acts

BACKGROUND: The study of various characteristics of mentally ill persons suffering from mental disorders that influence the possibility of committing a repeated socially dangerous act. This has been one of the most urgent tasks of forensic psychiatry in recent years. The identification of such factors will significantly improve the secondary prevention of crime among the mentally ill. AIM: The purpose of the study — a comparative analysis of clinical and social characteristics in patients with mental retardation and organic psychological disorders (hereinafter referred to as DIS) who have repeatedly committed socially dangerous acts (hereafter referred to as DIS) and the identification of factors specific to patients with mental retardation that contribute to the commission of repeated DIS. Design: comparative study. MATERIALS AND METHODS: The comparative study included 65 patients diagnosed with mild and moderate mental retardation (who made up the main group A) and 45 patients with organic mental disorders (who made up the comparative group B) had repeatedly committed socially dangerous acts (OOD), who had been recognised as insane and who had undergone two or more periods of court-ordered compulsory medical treatment (hereafter referred to as MMMT) of various types. The study was carried out both in the form of a personal questionnaire and through a retrospective study of the patients' medical records. Correlation and comparative analysis were the main research methods used in the thesis. RESULTS: A number of clinical and social characteristics such as: hereditary burden of exogenous diseases (r +0.58, pi 0.05); single lifestyle (r +0.33, pi 0.05); urban place of residence (r +0.21, pi 0.05) increase the risk of repeated OOD, and are specific predictors for patients with mental retardation. A number of characteristics had a negative impact on the possibility of repeated OOD and negative correlations: the absence of any hereditary burden (r –0.44, pi 0.05), the presence of severe endogenous heredity (r –0.35, pi 0.05), living in rural areas (r –0.21, pi 0.05), concomitant alcohol dependence (r –0.29, pi 0.05). CONCLUSION: The data obtained will form the basis for the development of practical recommendations for secondary forensic psychiatric prevention, specifically for this nosological group, as well as methods for predicting and preventing recurrent DIS.

Sacral nerve stimulation leads to long-term improvement in fecal incontinence and quality of life for children with functional and organic defecation disorders.

Our objective was to evaluate long-term outcomes of sacral nerve stimulation (SNS) for children with functional and organic defecation disorders. We performed a prospective study of children <21 years of age who started SNS treatment between 2012 and 2018. We recorded demographics, medical history, and diagnostic testing. We obtained measures of symptom severity and quality of life at baseline and follow up at 1, 6, 12, 24, 36, 48, and ≥60 months. Successful response was defined as bowel movements >2 times/week and fecal incontinence (FI) <1 time/week. Families were contacted to administer the Glasgow Children's Benefit Inventory and to evaluate patient satisfaction. We included 65 patients (59% female, median age at SNS 14 years, range 9-21) with median follow-up of 32 months. Thirty patients had functional constipation (FC), 15 had non-retentive FI (NRFI), and 16 had an anorectal malformation (ARM). The percentage with FI <1 time/week improved from 30% at baseline to 64% at 1 year (p < 0.001) and 77% at most recent follow-up (p < 0.001). Patients with FC, NRFI, and ARM had sustained improvement in FI (p = 0.02, p < 0.001, p = 0.02). Patients also reported fewer hard stools (p = 0.001). Bowel movement frequency did not improve after SNS. At most recent follow-up, 77% of patients with a functional disorder and 50% with an organic disorder had responded (p = 0.03). Nearly all families reported benefit. SNS led to sustained improvement in FI regardless of underlying etiology, but children with functional disorders were more likely to respond than those with organic disorders.

Bio-behavioral scientific evidence alters judges' sentencing decision-making: A quantitative analysis

The present study surveyed judges to examine how they consider and apply scientific information during sentencing determinations. Judges in criminal courts are increasingly asked to assess and make decisions based on evidence surrounding psychiatric disorders, with unclear results on sentencing outcomes. We qualitatively interviewed 34 judges who have presided over criminal cases in 16 different states and also administered vignette surveys during the interviews. We asked them to make sentencing decisions for hypothetical defendants in cases presenting evidence of either no psychiatric disorder, an organic brain disorder, or past trauma, as well as to rate the importance of different goals of sentencing for each case. Results indicated that the case presenting no evidence of a mental health condition received significantly more severe sentences as compared to either psychiatric condition. Judges' ratings of sentencing goals showed that the importance of retribution was a significant mediator of this relationship. Trauma was not deemed to be as mitigating as an organic brain disorder. These results provide unique insights into how judges assess cases and consider sentencing outcomes when presented with scientific information to explicate defendants' behavior. We propose ways forward that may help better integrate scientific understandings of behavior into criminal justice decision-making.

Нейропсихологическая оценка и верификация когнитивных нарушений в практике судебно-психиатрической экспертизы

&lt;p style="text-align: justify;"&gt;In modern clinical psychiatry, there is a tendency to introduce the principle of quasi-dimensional assessment, which can be facilitated by the use of specialized diagnostic methods such as neuropsychological examination. The purpose of the study is to clarify the possibilities of neuropsychological examination during forensic psychiatric examination for persons held criminally responsible. As part of the forensic psychiatric examination of persons brought to criminal responsibility on the basis of the Serbsky State Scientific Center for Social and Forensic Psychiatry Ministry of Health of the Russian Federation, 113 men (age 42&amp;plusmn;13) were examined with established groups of diagnoses, including organic, personality disorders, as well as schizophrenic spectrum disorders, disorders associated with the use of psychoactive substances. Of these, 50 people were declared &amp;ldquo;insane&amp;rdquo; and 63 were &amp;ldquo;sane&amp;rdquo;. A neuropsychological examination was performed using qualitative syndrome and quantitative analysis. In individuals with organic mental disorders (OMD), there were more pronounced disorders of neurocognitive functioning compared to those surveyed with other mental disorders. In addition, persons with OMD who were recognized as &amp;ldquo;insane&amp;rdquo;, compared with persons recognized as &amp;ldquo;sane&amp;rdquo;, had more pronounced disorders in such parameters as: programming, regulation and control, neurodynamic characteristics, auditory&amp;mdash;speech memory, with primary interest - frontal (p=0.004), temporal (p=0.004), and subcortical structures (p=0.005). The results of a neuropsychological examination can be used to verify an expert decision at the level of both medical and psychological criteria, primarily in the examination of persons suffering from an organic mental disorder.&lt;/p&gt;

Involuntary psychiatric hospitalisation – differences and similarities between patients detained under the mental health act and according to the legal guardianship legislation

BackgroundInvoluntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL.MethodsWe conducted a retrospective health records analysis of all involuntarily hospitalised cases in the four psychiatric hospitals of the city of Cologne, Germany, in 2011. Of the 1,773 cases, 87.3% were detained under the MHA of the federal state of North Rhine-Westphalia and 6.4% were hospitalised according to the federal LGL. Another 6.3% of the cases were originally admitted under the MHA, but the legal basis of detention was converted to LGL during the inpatient psychiatric stay (MHA→LGL cases). We compared sociodemographic, clinical, systemic and environmental socioeconomic (ESED) variables of the three groups by means of descriptive statistics. We also trained and tested a machine learning-based algorithm to predict class membership of the involuntary modes of psychiatric inpatient care.ResultsCases with an admission under the premises of LGL lived less often on their own, and they were more often retired compared to MHA cases. They more often had received previous outpatient or inpatient treatment than MHA cases, they were more often diagnosed with a psychotic disorder and they lived in neighbourhoods that were on average more socially advantaged. MHA→LGL cases were on average older and more often retired than MHA cases. More often, they had a main diagnosis of an organic mental disorder compared to both MHA and LGL cases. Also, they less often received previous psychiatric inpatient treatment compared to LGL cases. The reason for detention (self-harm or harm to others) did not differ between the three groups. The proportion of LGL and MHA cases differed between the four hospitals. Effect sizes were mostly small and the balanced accuracy of the Random Forest was low.ConclusionWe found some plausible differences in patient characteristics depending on the legal foundation of the involuntary psychiatric hospitalisation. The differences relate to clinical, sociodemographic and socioeconomical issues. However, the low effect sizes and the limited accuracy of the machine learning models indicate that the investigated variables do not sufficiently explain the respective choice of the legal framework. In addition, we found some indication for possibly different interpretation and handling of the premises of the law in practice. Our findings pose the need for further research in this field.

Enhancing the accuracy of register-based metrics: Comparing methods for handling overlapping psychiatric register entries in Finnish healthcare registers.

Healthcare registers are invaluable resources for research. Partly overlapping register entries and preliminary diagnoses may introduce bias. We compare various methods to address this issue and provide fully reproducible open-source R scripts. We used all Finnish healthcare registers 1969-2020, including inpatient, outpatient and primary care. Four distinct models were formulated based on previous reports to identify actual admissions, discharges, and discharge diagnoses. We calculated the annual number of treatment events and patients, and the median length of hospital stay (LOS). We compared these metrics to non-processed data. Additionally, we analyzed the lifetime number of individuals with registered mental disorders. Overall, 2,130,468 individuals had a registered medical contact related to mental disorders. After processing, the annual number of inpatient episodes decreased by 5.85%-10.87% and LOS increased by up to 3days (27.27%) in years 2011-2020. The number of individuals with lifetime diagnoses reduced by more than 1 percent point (pp) in two categories: schizophrenia spectrum (3.69-3.81pp) and organic mental disorders (1.2-1.27pp). The methods employed in pre-processing register data significantly impact the number of inpatient episodes and LOS. Regarding lifetime incidence of mental disorders, schizophrenia spectrum disorders require a particular focus on data pre-processing.

Clinical effectiveness and cost-effectiveness of Structured Psychological Support for people with probable personality disorder in mental health services in England: study protocol for a randomised controlled trial

IntroductionEvidence-based psychological treatments for people with personality disorder usually involve attending group-based sessions over many months. Low-intensity psychological interventions of less than 6 months duration have been developed, but their...

Disease spectrum, prevalence, genetic characteristics of inborn errors of metabolism in 21,840 hospitalized infants in Chongqing, China, 2017-2022.

Inborn errors of metabolism (IEMs) are uncommon. Although some studies have explored the distribution and characteristics of IEMs in newborns, the impact of these disorders on hospitalized newborns remains unclear. In this study, we gathered data from 21,840 newborn patients admitted for various medical conditions at the Children's Hospital of Chongqing Medical University from January 2017 and December 2022. Liquid chromatography-tandem mass spectrometry (LC-MS/MS), gas chromatography-mass spectrometry (GC-MS/MS), and genetic analysis were used to elucidate the disease spectrum, incidence rate, and genetic characteristics of IEMs in hospitalized newborns. The results revealed that the incidence of IEMs in hospitalized newborns was 1/377 (58/21,840), with a higher incidence in full-term infants (1/428) than in premature infants (1/3,120). Among the diagnosed genetic metabolic diseases, organic acid metabolism disorders (1/662), amino acid metabolism disorders (1/950), and fatty acid oxidation disorders (1/10,920) were the most prevalent. Methylmalonic acidemia (MMA), especially the isolated form, emerged as the most common IEM, while neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and ornithine transcarbamylase deficiency (OTCD) were prevalent in premature infants. Of the 58 confirmed cases of IEMs, 72 variants were identified, of which 31.94% (23/72) had not been reported previously. This study contributes to understanding the incidence and clinical features of IEMs in hospitalized newborns, offering more efficient strategies for screening and diagnosing these disorders.

Функциональные маски неврологических нарушений: дифференциальный диагноз органического и психогенного расстройства

Differentiation of organic and psychogenic disorders is one of the most difficult tasks of neurology and psychiatry, both because of the difficulties in determining the genesis of the condition itself, and because of their frequent comorbidity. A certain commonality of the pathogenetic nature of both disorders allows, when choosing therapeutic tactics, to rely on drugs that affect the central link in the pathophysiology of these processes – an imbalance of mediator systems. The purpose of this study was to study the efficacy and safety of Pantogam Active in patients in the complex therapy of neurological and psychiatric diseases in outpatient settings. The analysis included 120 people divided into 2 groups: group 1 took the main therapy and Pantogam Active on the recommendation of the attending physician at a daily dosage of 600–1200 mg (the average daily dosage is 900 mg), group 2 – only the main therapy. Patients were randomly assigned to groups. The duration of the study was 3 months. The effectiveness and safety were evaluated during a control examination by a specialist and based on the results of evaluation scales. The results of the study demonstrate a positive effect on both subjective feelings (well-being of patients receiving complex therapy) and changes in an objective assessment. The addition of the main therapeutic regimen with Pantogam Active is recommended for patients in order to correct concomitant symptoms that reduce the quality of life and adherence to treatment: asthenic syndrome, anxiety and depressive disorders, cognitive impairment.

Qual a importância das tenascinas na fisiopatologia de diversas doenças?

Tenascins are a group of proteins that make up the extracellular matrix of different tissues. They are involved with signaling and structural functions in different organs, which justifies the development of studies on their relationship with diseases in different systems. Our objective was to shed light, through an in-depth review, of the way in which tenascins are involved in triggering various organic disorders. Each type of Tenascin is related to specific disorders. Tenascin X is involved in triggering collagen diseases, while types C and W stand out in situations of trauma, inflammation and tumors. Tenascin R is involved exclusively in the central nervous system and in neuronal migration and differentiation processes. Understanding the real role of these proteins is a valuable resource for understanding the pathophysiology of various diseases, in addition to providing research into new diagnostic methods and prospecting therapeutic targets for drug development.

Closing the gap: an urgent need for newborn screening of organic acid disorders in developing countries

Organic acid disorders are rare inherited metabolic disorders of key metabolic pathways. For the identification of specific organic acids, investigation of urinary metabolites and genetic testing are required through newborn screening programmes. Delayed diagnosis leads to complications, such as cardiac attacks, respiratory problems, neuro-developmental disorders, intellectual disability, and even premature death. The burden of such inherited disorders is quite high in developing countries of South Asia due to high rate of consanguinity in the region. Unfortunately, such disorders are left untreated due to the lack of screening facilities in such countries. The current narrative review was planned to highlight the urgent need for closing this gap and implementing effective newborn screening programmes for organic acid disorders in developing countries. ---Continue

DOLPHIN ASSISTED THERAPY: WELFARE OF BOTH PATIENTS WITH DEPRESSION AND PARTICIPATING DOLPHINS

The main aim of this research was to measure the effect of dolphin assisted therapy on both patients and participating dolphins. The research measured welfare of patients with depression and situational welfare of dolphins which participated in the dolphin assisted therapy programme. Patients with organic depression took part in two-week dolphin assisted therapy sessions. When measuring situational welfare of dolphins, the study sample consisted of nine individual dolphins (Tursiops truncatus ponticus, Lat.): three males and six females ranging from five to twenty years. The main research results revealed that psychosocial characteristics of patients with organic depression disorder as well as patients’ self-evaluation changed statistically significantly, the symptoms of depression decreased. The research revealed that patients were much more physically active during the period of participation in the dolphin assisted therapy process than before. The analysis of dolphin behaviour brought to the light that most of the therapy time dolphins behaved positively. There were noticed no therapy sessions where the dolphin behaviour would be evaluated as more negative than positive or just negative.

A Minority of Childhood Disorders of Gut-Brain Interaction Persist Into Adulthood: A Risk-Factor Analysis.

Disorders of gut-brain interaction (DGBIs) may originate in childhood. There are currently limited data on persistence of DGBI into adulthood and risk factors for persistence. Furthermore, there are no data on this question from general practice, where the majority of DGBIs are diagnosed and managed. This study documents the proportion of childhood-diagnosed DGBIs that persisted into adulthood and what factors were associated with persistence. General practice records were obtained for more than 60,000 patients whose medical record spanned both childhood and adulthood years. Patients with diagnosed organic gastrointestinal disorder were excluded. Medical records were also interrogated for potential risk factors. Eleven percent of patients with irritable bowel syndrome (IBS) and 20% of patients with functional dyspepsia (FD) diagnosed in childhood had repeat diagnoses of the same condition in adulthood. Female sex (odds ratio [OR] 2.02) was associated with persistence for IBS, while a childhood diagnosis of gastritis (OR 0.46) was risk-protective. Childhood non-steroidal anti-inflammatory drug use (OR 1.31, 95% confidence interval [CI] 1.09-1.56) was a risk factor for persistence in IBS. For FD, a childhood diagnosis of asthma (OR 1.30, 95% CI 1.00-1.70) was a risk factor, as was anxiety for both IBS (OR 1.24, 95% CI 1.00-1.54) and FD (OR 1.48 95% CI 1.11-1.97) with a similar finding for depression for IBS (OR 1.34, 95% CI 1.11-1.62) and FD (OR 1.88 95% CI 1.47-2.42). Childhood DGBIs persist into adulthood in 10%-20% of patients, suggesting that management monitoring should continue into adulthood. Those diagnosed with anxiety or mood disorders in childhood should receive particular attention, and prescription of non-steroidal anti-inflammatory drugs in children should be made judiciously.

Socio-Demographic and Clinical Profile of Patients Attending Geriatric Clinic Over Five Years: A Retrospective, Hospital Based Study

Background: Population ageing is an inescapable and irreversible phenomenon, increasing the burden on the health care system. Mental illnesses in the geriatric population are unique and identification of the same amidst the co-morbidities is a challenging task. Objectives: To assess the difference in the clinical and sociodemographic profile of patients attending Geriatric Clinic in a tertiary care centre over five years. Materials and Methods: A retrospective chart review of patients, who attended the Geriatric Clinic of a tertiary care centre in 2012 and 2016 was conducted. The psychiatric diagnoses were made according to the ICD-10 diagnostic guidelines. Sociodemographic variables and clinical variables including social support were assessed. Data were analysed by Statistical Package for Social Science (SPSS) 16 version and Microsoft Excel Version 2007. Results: The total number of patients attending Geriatric clinics were 31 and 147 in 2012 and 2016 respectively. The mean age of patients attending the geriatric clinic was 74.32±7.89 in 2012 and 71.88±6.76 in 2012. The difference between the study group was statistically significant with regard to religion, marital status, socio-economic status and location of residence.64.52% of the study population had average social support in 2012 and a statistically significant decline was noticed in 2016.The most common psychiatric diagnoses were organic mental disorders (93.55%) in 2012 and mood disorders (40.82%) in 2016. Cardiovascular diseases were most common medical co-morbidity seen among the geriatric patients in both the years. Conclusions: Psychiatric illness in geriatric population is often associated with medical co-morbidities. With the increase in longevity, awareness and identification of symptoms can decrease significant morbidity and improve the quality of life. Keywords: Ageing, psychiatric disorders, medical comorbidity

Alexithymia in primary ciliary dyskinesia.

Recent evidence suggests that alexithymic deficits in emotional processing may also affect physical health, and alexithymia may also be associated with organic disorders. The emotional well-being of patients with primary ciliary dyskinesia (PCD) is often negatively affected by uncertainty about the prognosis, lack of ongoing medical care, and lack of symptom control. This study aims to evaluate the frequency of alexithymia and its possible impact on the management of childhood PCD. Subjects were recruited from patients with PCD and healthy volunteers aged 8-18 years. The questionnaire included sociodemographic characteristics and self-report scales. Data were compared between patient and control groups. In the >14 years of age group, the total Toronto Alexithymia Scale (TAS-20) score was significantly higher in the patients (56.60 ± 13.01) compared to the control group (46.47 ± 7.50) (p = .007). There were 6 (30) patients with a TAS-20 score ≥61. There was a significant correlation between TAS-20 and Pediatric Quality of Life (PedsQL) score (child), but no correlation between TAS-20 and Kovacs Children Depression Inventory (CDI) and PedsQL score (parents). The TAS-20 score was significantly higher in patients with bronchiectasis (p = .035), nasal polyps (p = .045), and siblings with PCD (p = .001). Furthermore, the TAS-20 score had a significant negative correlation with pulmonary function tests. Although this study is based on limited data from a single center and cannot be generalized to all PCD patient communities, our results show that PCD patients are more likely to have alexithymia compared to healthy controls and highlight the need to evaluate for alexithymia in patients with PCD. It is important for pediatric pulmonologists to have a thorough knowledge of the alexithymic features associated with PCD and to refer patients to pediatric psychiatry when necessary, especially in patients who are noncompliant with treatment protocols.

A case of NMDAR Encephalitis with muscular pain as the main presentation

BackgroundPersistent somatoform pain disorder (PSPD) is often the initial diagnosis in patients seeking treatment in psychiatric departments, making it challenging to consider organic nervous system diseases. However, autoimmune encephalitis can present with atypical initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture, with antibody support, plays a crucial role in diagnosing autoimmune encephalitis.Case presentationThis report describes a 40-year-old male adult patient who was initially diagnosed with persistent somatoform pain disorder in 2022. The patient reported a reduction in pain while resting on his back. There were no fever or relevant medical history. Despite 8 months of symptomatic treatment, the symptoms did not improve. Moreover, the patient developed confusion, gibberish speech, non-cooperation during questioning, and increased frequency and amplitude of upper limb convulsions. Lumbar puncture revealed elevated protein levels and protein-cell dissociation. The autoimmune encephalitis antibody NMDAR (+) was detected, leading to a diagnosis of autoimmune encephalitis (NMDAR).ConclusionAutoimmune encephalitis (NMDAR), starting with persistent somatoform pain (PSPD), often presents with atypical symptoms and can be easily misdiagnosed. Therefore, it is important to consider the possibility of organic nervous system disease in time, and to test serum or cerebrospinal fluid antibodies to rule out organic nervous system disease after symptomatic treatment of mental disorders is ineffective. This approach facilitates the early diagnosis of autoimmune encephalitis and other underlying organic neurological disorders.

Suicide within five years of hospital-treated self-harm: A data linkage cohort study

BackgroundHospital-treated self-harm is a strong predictor of suicide and hospital contacts may include missed opportunities for suicide prevention. We conducted a data linkage study to identify factors associated with suicide in people treated in hospital for self-harm in Victoria, Australia. MethodWe undertook a cohort study following 14,307 people treated in hospital for an episode of self-harm (i.e., either admitted or non-admitted ED presentations) over the period 2011 and 2012 and used data from the Victorian Suicide Register to identify suicides within 5 years. We estimated unadjusted hazard ratios (HRs) for suicide using survival analysis for each exposure variable and then computed adjusted HRs using a multivariate model that included all exposure variables. ResultsAmong females, the risk of suicide was higher in those aged 50–74 years (HR 1.78; Cl: 1.02, 3.10), residing in areas of least disadvantage (HR 2.58; Cl: 1.21, 5.50), who used hanging as a method of self-harm (HR 5.17; Cl: 1.86, 14.35) and with organic disorders (HR 6.71; Cl: 2.61, 17.23) or disorders of adult personality and behaviour (HR 2.10; Cl: 1.03, 4.27). In males, the risk of suicide was higher in those who used motor vehicle exhaust gas (MVEG) as a method of self-harm (HR 3.48; Cl: 1.73, 7.01), and with disorders due to psychoactive substance abuse (HR 1.75; Cl: 1.14, 2.67). ConclusionAlthough all patients should be routinely assessed for risk and needs following hospital-treated self-harm including appropriate follow-up care, people who use MVEG or hanging as methods of self-harm are obvious candidates for close follow-up.

Incidence of post-COVID psychiatric disorders according to the periods of SARS-CoV-2 variant dominance: The LIFE study

This retrospective cohort study examined the incidence of post-COVID psychiatric disorders in older adults according to hospitalization status and SARS-CoV-2 variant period in Japan. Claims data, COVID-19 case-related information, and vaccination records were obtained from three Japanese municipalities. We identified individuals aged ≥65 years who had COVID-19 or other respiratory tract infection (RTI) between March 2021 and December 2022. Participants were categorized into non-hospitalized and hospitalized patients, and the study period was divided into the Alpha (March to May 2021), Delta (June to December 2021), Omicron BA.1/BA.2 (January to June 2022), and Omicron BA.5 (July to December 2022) periods. Modified Poisson regression analyses were performed to estimate the incidence rate ratios (IRRs) for the occurrence of psychiatric disorders (organic mental disorders, psychotic disorders, mood disorders, anxiety disorders, and insomnia) three months after COVID-19 (reference: other RTI). For overall psychiatric disorders, we analyzed 19,489 non-hospitalized patients (COVID-19: 6,728, Other RTI: 12,761) and 2925 hospitalized patients (COVID-19: 1,036, Other RTI: 1889). When compared with other RTI cases, COVID-19 cases had significantly lower IRRs for overall psychiatric disorders in both non-hospitalized (IRR: 0.59, P < 0.001) and hospitalized cases (IRR: 0. 83, P = 0.045) during the Omicron BA.1/BA.2 period, but only in non-hospitalized cases (IRR: 0.45, P < 0.001) during the Omicron BA.5 period. The incidences of the individual post-COVID psychiatric disorders varied according to disorder type, hospitalization status, and SARS-CoV-2 variant period. These findings provide a foundation for further research to explore these variations and improve the provision of psychiatric care in future epidemics.

Impact of the COVID-19 pandemic on the manifestation and course of mental illness in elderly

IntroductionCOVID-19 is a multisystem disease affecting not only the respiratory, gastroenterstitial and vascular systems, but also the central nervous system, which leads to a wide range of neurological and mental complications. 3 years of experience in combating the pandemic has shown that elderly people burdened with chronic somatic diseases are the most vulnerable risk group for the development of severe course and complications of COVID-19.ObjectivesTo study the impact of COVID-19 on the onset and course of mental illness in elderly inpatientsMethodsWe examined 67 inpatients aged 50 to 95 years with various mental pathologies, who underwent COVID-19 from February 2020 to December 2021. 46 people had previous history of mentall disease (PHMD), in 21 cases the disease developed for the first time. Statistical analysis was performed.ResultsIn the manifest group of patients, depressive episodes predominated (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability, organic depression, mild cognitive impairment and delirium. In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions, panic and generalized anxiety disorder. In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia was diagnosed. The PHMD group includes affective disorders - 45.7%; organic disorders, including dementia 26.1%; schizophrenic spectrum disorders -19.6% and neurotic somatoform disorders - 8.7%. In the acute and subacute periods of COVID-19, acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in PHMD patients with organic (50%) and schizophrenic spectrum disorders (33.3%) with a predominance of delirium. In the long-term period of COVID-19, PHMD patients more often than non-PHMD (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenia-like (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p&lt;0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p&lt;0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916).ConclusionsThe age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The PHMD patients, especially with disorders of organic and schizophrenic spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, and patients with affective and neurotic disorders, CI was reversible or had the character of a mild cognitive disorder.Disclosure of InterestNone Declared