Prior Psychiatric Treatment Research Articles

Anxiety and posttraumatic stress in post-acute sequelae of COVID-19: prevalence, characteristics, comorbidity, and clinical correlates.

Anxiety and post-traumatic stress symptoms have been reported in association with acute and post-acute sequelae of COVID-19 (PASC). This study aimed to document the cross-sectional prevalence, characteristics and clinical correlates of anxiety and post-traumatic stress in a study of neuropsychiatric sequelae of COVID-19. 75 participants recruited from a post-COVID-19 recovery program and the community were assessed for sociodemographic, medical, psychiatric, and neurocognitive symptoms and performance. The generalized anxiety questionnaire-7 (GAD-7) and post-traumatic stress disorder questionnaire for DSM5 (PCL5) were utilized to measure anxiety and PTSD symptoms. Established cutoff scoring for the GAD-7 and algorithm-based scoring of the PCL5 were utilized to determine clinically significant anxiety symptoms and PTSD, respectively. The cohort was 71% female, 36% ethnic minority, with the main age of 43.5 years, 80% employment, 40% with the prior psychiatric treatment history and 2/3 seeking post-COVID care for PASC. Clinically significant anxiety symptoms were found in 31% and PTSD was found in 29% of the cohort. Nervousness and excessive worry were the most prominent anxiety symptoms, while changes in mood/cognition and avoidance were most frequent in PTSD. There was a high degree of comorbidity between clinically significant anxiety symptoms, PTSD, depression and fatigue. In logistic regression, acute COVID illness severity, prior psychiatric history, and memory complaints (but not objective neuropsychological performance) predicted clinically significant anxiety symptoms and/or PTSD. Clinically significant anxiety and PTSD are found in approximately 1 of 3 individuals after COVID-19 infection. They are highly comorbid with each other as well as with depression and fatigue. All patients seeking care for PASC should be screened for these neuropsychiatric complications. Symptoms of worry, nervousness, subjective changes in mood, and cognition as well as behavioral avoidance are particularly important targets of clinical intervention.

Suicidal Offenders and Non-Offenders with Schizophrenia Spectrum Disorders: A Retrospective Evaluation of Distinguishing Factors Using Machine Learning.

Patients with schizophrenia spectrum disorders (SSD) have an elevated risk of suicidality. The same has been found for people within the penitentiary system, suggesting a cumulative effect for offender patients suffering from SSD. While there appear to be overlapping characteristics, there is little research on factors distinguishing between offenders and non-offenders with SSD regarding suicidality. Our study therefore aimed at evaluating distinguishing such factors through the application of supervised machine learning (ML) algorithms on a dataset of 232 offenders and 167 non-offender patients with SSD and history of suicidality. With an AUC of 0.81, Naïve Bayes outperformed all other ML algorithms. The following factors emerged as most powerful in their interplay in distinguishing between offender and non-offender patients with a history of suicidality: Prior outpatient psychiatric treatment, regular intake of antipsychotic medication, global cognitive deficit, a prescription of antidepressants during the referenced hospitalisation and higher levels of anxiety and a lack of spontaneity and flow of conversation measured by an adapted positive and negative syndrome scale (PANSS). Interestingly, neither aggression nor overall psychopathology emerged as distinguishers between the two groups. The present findings contribute to a better understanding of suicidality in offender and non-offender patients with SSD and their differing characteristics.

Psychiatric Treatment and Repeat Suicide Attempts Among Adults With Substance Use, by HIV Status, United States, 2014-2020.

The association among psychiatric treatment history, HIV, and suicide reattempts among people starting treatment for substance use is not well understood. The objective of this study was to describe, by HIV status, the risk and protective factors associated with suicide reattempts among adults seeking treatment for substance use. The study included 340 390 US adult residents aged ≥18 years in the Addiction Severity Index-Multimedia Version network from January 1, 2014, through December 31, 2020. We used adjusted logistic regression models to estimate strength of association between prior psychiatric treatment, HIV status, and sociodemographic factors and suicide reattempts within 30 days of treatment evaluation. Adults who had been prescribed psychiatric medication were less likely to have a recent suicide reattempt (adjusted odds ratio [aOR] = 0.8; 95% CI, 0.7-0.8) than adults with no prescription history. Adjusted models found similar protective effects between psychiatric treatment and suicide reattempts among adults reporting abuse, mental illness, injection drug use, and limited activity because of a medical condition. Conversely, the following were associated with recent suicide reattempts: being male (aOR = 1.4; 95% CI, 1.3-1.5), having a high school education/GED (General Educational Development) or less (aOR = 1.2; 95% CI, 1.1-1.2), being single (aOR = 1.2; 95% CI, 1.1-1.3), experiencing a pain problem (aOR = 1.2; 95% CI, 1.2-1.3), and not being referred to substance use treatment by court (aOR = 3.4; 95% CI, 3.2-3.7). A history of prescribed psychiatric medication is significantly associated with a reduced risk for suicide reattempts among adults seeking substance use treatment. Clinicians should consider incorporating mental health and suicide assessments into substance use treatment plans.

Time-series analysis of trends in the incidence rates of successful and attempted suicides in Thailand in 2013–2019 and their predictors

BackgroundSuicide rates are of increasing concern worldwide. There are approximately 4000–5000 deaths by suicide each year in Thailand. This study examined trends in annual incidence rates and predictors of successful and attempted suicides in Thailand (2013–2019).MethodsSecondary data analysis was conducted on data from two national-level databases: The National Health Security Office and the National Death Certification Registry System. Time-related trends and predictors of successful and attempted suicides were calculated using joinpoint regression and multivariable logistic regression analyses, respectively.ResultsOf all successful suicide cases from 2013 to 2019, about 80% involved men, with an average age of 45.37 (± 16.43) years. Predictors of successful suicide included male sex, older age, using highly lethal methods, and no prior psychiatric treatment. Among individuals admitted to hospitals following a suicide attempt from 2013– to 2019, the average age at first admission was 38.83 ± 22.47 years, with women more heavily represented than men. Only 2.3% of these patients received psychiatric treatment in the hospital. Predictors of attempted suicide included female sex; adolescent or adult; and mental, alcohol, or substance-related disorder(s). Age-standardized annual rates per 100,000 people showed that, through 2019, suicide incidence increased slightly, and attempts decreased.ConclusionsThere was a significantly increasing trend in successful suicide during the 7 years; the increase was more notable among men. The study highlights sex-related gaps in public health owing to an identified higher incidence of suicide among men, and a higher incidence of suicide attempts in women adolescents, emphasizing the need to consider sex-sensitive issues in individual as well as societal contexts.

Exploring substance use as rule-violating behaviour during inpatient treatment of offender patients with schizophrenia.

BackgroundRule‐violating behaviour in the form of substance misuse has been studied primarily within the context of prison settings, but not in forensic psychiatric settings.AimsOur aim was to explore factors that are associated with substance misuse during hospitalisation in patients among those patients in a Swiss forensic psychiatric inpatient unit who were suffering from a disorder along the schizophrenia spectrum.MethodsFrom a database of demographic, clinical and offending data on all residents at any time between 1982 and 2016 in the forensic psychiatric hospital in Zurich, 364 cases fulfilled diagnostic criteria for schizophrenia or a schizophrenia‐like illness and formed our sample. Any confirmed use of alcohol or illicit substances during admission (yes/no) was the dependent variable. Its relationship to all 507 other variables was explored by machine learning. To counteract overfitting, data were divided into training and validation set. The best model from the training set was tested on the validation set.ResultsSubstance use as a secure hospital inpatient was unusual (15, 14%). Prior substance use disorder accounted for so much of the variance (AUC 0.92) that it was noted but excluded from further models. In the resulting model of best fit, variables related to rule breaking, younger age overall and at onset of schizophrenia and nature of offending behaviour, substance misuse as a minor and having records of complications in prior psychiatric treatment were associated with substance misuse during hospitalisation, as was length of inpatient treatment. In the initial model the AUC was 0.92. Even after removal of substance use disorder from the final model, performance indicators were meaningful with a balanced accuracy of 67.95, an AUC of 0.735, a sensitivity of 81.48% and a specificity of 57.58%.ConclusionsSubstance misuse in secure forensic psychiatric hospitals is unusual but worthy of clinical and research consideration because of its association with other rule violations and longer hospitalisation. More knowledge is needed about effective interventions and rehabilitation for this group.

Increased risk of psychosis to ivermectin treatment

IntroductionAdolescence: a state of mental fragility, where psychiatric disorders may debut, where have been reported several cases of toxidermy, encephalopathy and neuropsychiatric disorder related to ivermectin treatment (excluding organicity, substance abuse or medication) (1). It has effect on the dopaminergic system with an alteration on glycoprotein P leading to high levels of ivermectin causing neurotoxicity (2). In this poster, we discuss the case of a 14 y/o´s psychosis to ivermectinObjectivesPresentation of a clinical reportMethods14 years old woman. Background: father with schizophrenia. Comorbility: None. Initially, presented to ER with 2 week of treatment to ivermectin 6mg for pediculosis; presenting first psychotic episode. She presented first clinical outbreak of psychosis characterized by mystical-religious, erotomaniac, harm and reference delusions, auditory and visual hallucinations adding isolation, abulia, apathy, dialogued soliloquies, and spontaneous crying. No prior psychiatric treatment.ResultsIn hospitalization: elevated indirect and direct bilirubins and hiponatremia; neuroimaging studies are reported normal. Haloperidol 7.5 mg/day is indicated and parkinsonism is presented. Treatment is changed to olanzapine 15mg/day with notorious improvement. Diagnostic impression: Acute polymorphic psychotic disorder with symptoms of schizophreniaConclusionsPossible causes were analyzed, finding a relationship with ivermectin treatment. This case makes evident the importance of conducting in-depht evaluations and finding risks factors for psychosis.DisclosureNo significant relationships.

Psychiatric management of Patients in intensive care units.

Psychiatric management of Patients in intensive care units.

Impact of the COVID-19 Pandemic on Mental Well-Being. A Nationwide Online Survey Covering Three Pandemic Waves in Poland.

The COVID-19 pandemic has a significant impact on human life. This study aims to assess the prevalence of depressive and anxiety symptoms, and the assessment of the quality of life in different stages of the COVID-19 pandemic based on an online nationwide survey. The study was based on a voluntary, anonymous, and authors' own questionnaire. The first section assesses sociodemographic status. Then, standardized psychometric tools were used such as the Beck Depression Inventory (BDI), the Generalized Anxiety Disorder Assessment (GAD-7), and the Manchester Short Assessment of Quality of Life (MANSA). The study was conducted in three stages corresponding to the waves of the COVID-19 pandemic in Poland. The survey involved 5,790 respondents; 2,457, 1,626, and 1,707 for the first, second, and third pandemic wave, respectively. It was found that anxiety and depressive symptoms increased as the pandemic progressed. There was no significant effect on the subjective quality-of-life assessment. Moreover, there was a gradual decrease in anxiety about being infected with COVID-19 as well as reduced adherence to the Minister of Health's recommendations. As the COVID-19 pandemic progressed, depressive and anxiety symptoms increased among Poles. Women, singles, and people with prior psychiatric treatment are more likely to develop the aforementioned symptoms.

Screening for Psychiatric Comorbidities and Psychotherapeutic Assessment in Inpatient Epilepsy Care: Preliminary Results of an Implementation Study.

Background: Anxiety and depression remain underdiagnosed in routine clinical practice in up to two thirds of epilepsy patients despite significant impact on medical and psychosocial outcome. Barriers to adequate mental health care for epilepsy and/or psychogenic non-epileptic seizures (PNES) include a lack of integrated mental health specialists and standardized procedures. This naturalistic study outlines the procedures and outcome of a recently established psychotherapeutic service.Methods: Routine screening included the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E, cut-off value > 13) and Generalized Anxiety Disorder scale (GAD-7, cut-off value > 5). Positively (above cut-off in at least one questionnaire) screened patients were seen for a standardized interview for mental health disorders and the development of a personalized treatment plan. PNES patients were seen irrespective of their screening score. Resources were provided to support self-help and access to psychotherapy. Patients were contacted 1 month after discharge to evaluate adherence to therapeutic recommendations.Results: 120 patients were screened. Overall, 56 of 77 positively screened patients (77%) were found to have a psychiatric diagnosis through standardized interview. More epilepsy patients with an anxiety disorder had previously been undiagnosed compared to those with a depressive episode (63% vs. 30%); 24 epilepsy patients (62%) with a psychiatric comorbidity and 10 PNES patients (59%) were not receiving any mental health care. At follow-up, 16/17 (94%) epilepsy patients and 7/7 PNES patients without prior psychiatric treatment were adhering to therapeutic recommendations.Conclusion: Integrating mental health specialists and establishing standardized screening and follow-up procedures improve adherence to mental health care recommendations in epilepsy and PNES patients.

Mental Health in COVID-2019 Survivors from a General Hospital in Peru: Sociodemographic, Clinical, and Inflammatory Variable Associations.

The current coronavirus disease-2019 (COVID-19) pandemic constitutes a significant public health problem worldwide, as well as mental health problems. This study aimed to evaluate the mental health of COVID-19 survivors, considering their sociodemographic, clinical, and immune variables. A cross-sectional and correlational study was conducted on 318 COVID-19 survivors from one hospital in Peru. Through telephone interviews, evaluation of the presence of depressive symptoms using the Patient Health Questionnaire-9, anxiety symptoms through the Generalized Anxiety Disorder-7, somatic symptoms through Patient Health Questionnaire-15, and posttraumatic stress disorder (PTSD) symptoms through Impact of Event Scale-Revised was carried out. Poisson regression analyses were performed with their adjusted variances to calculate the prevalence ratio (PR) with their 95% confidence interval. All regression models were adjusted (PRa) for follow-up time. A significant proportion of patients have depressive (30.9%), anxious (31.1%), somatic (35.2%), and PTSD (29.5%) symptoms. The variables associated with a higher frequency of clinically relevant mental symptoms were female sex, self-perception of greater COVID-19 severity, presence of persistent COVID-19 symptoms, loss of a family member due to COVID-19, and prior psychiatric diagnosis or treatment. In addition, the neutrophil-to-lymphocyte ratio was significantly higher in patients with clinically relevant symptoms of depression. COVID-19 survivors showed a high prevalence of negative mental symptoms. Our findings help to identify patients who are vulnerable and require psychiatric care.

Psychiatric Morbidity among Incarcerated Individuals in an Underserved Region of Nigeria: Revisiting the Unmet Mental Health Needs in Correction Services.

While epidemiological description of psychiatric morbidity can promote evidenceinformed mental health services, there is a paucity of such evidence among incarcerated individuals in prisons with underserved healthcare. We evaluated 250 incarcerated individuals detained in an underserved prison in north-western Nigeria with the Mini International Neuropsychiatric Inventory (MINI). Predominantly, study participants were men (97.6%) and the mean age was 35.4 (SD=13.5) years. The majority of the incarcerated individuals (81.2%) were awaiting trial, the most common crime was armed robbery (38.8%), and 16.4% of participants were recidivists. The prevalence of psychiatric morbidity was 47.4%, with major depression being the most common diagnosis (23.2%). The majority (92.8%) had no prior contact with psychiatric treatment. Being single, employed, and lacking prior psychiatric treatment were independently associated with psychiatric morbidity (R2=0.27). These findings underscore the need for better investment in correctional mental health services. Multi-pronged efforts with multisectoral collaboration between the government and other stakeholders to develop scalable interventions are advocated.

Psychotherapy Patients of Psychiatry Residents: A Descriptive Study.

Psychiatry residents learn psychodynamic psychotherapy for generalizable skills and as a transdiagnostic, long-term treatment indicated for patients with chronic mood, anxiety, or personality disorders. It is unknown how these indications align with actual patients of trainees. The aim of this descriptive study was to define characteristics of outpatients receiving psychodynamic psychotherapy from psychiatry residents. Case reports (N=204) from 184 psychiatry residents were analyzed for patients' diagnoses and past treatments. Eighty-six percent of patients had prior psychiatric medication or treatment, 31% had three or more past courses of psychotherapy, and48% had two or more diagnoses, including depression (62%), anxiety (46%), and personality disorders or traits (27%). Patients receiving psychodynamic psychotherapy from psychiatry residents had multiple psychiatric illnesses and a history of prior treatments that had not achieved or sustained recovery, suggesting complex and chronic illness. Consistent with community-based findings, these patient characteristics correspond with psychodynamic psychotherapy treatment indications.

Pathway to Care of Psychiatric Services in Gandaki Medical College Teaching Hospital in Western Nepal

Aims and Objectives: The sequence of contacts with individuals and organizations prompted by the distressed person's efforts, and those of his or her significant others, to seek help is known as the pathways to care. The study of the pathways to care provides the relevant information regarding the individual's health seeking and illness behaviour. A wide range of professionals including psychiatrists, psychologists, other doctors, faith-healers and religious healers cater to the needs of mentally ill patients. This study was carried out to identify the pathway to care of patients up to psychiatric care with no prior psychiatric treatment at GMCTH.
 Methodology: It is a cross-sectional, descriptive study conducted in GMCTH, Pokhara from Jan 2015 to Dec 2016. After ethical consideration, all new patients and those newly referred to the psychiatric services and agreed to participate were interviewed until the target 100 participants were recruited. ICD-10 was used for diagnosis. Data were computed and analyzed by using Microsoft excel and SPSS. Parametric & non parametric statistical technique was applied wherever appropriate.
 Results: Total of 100 patients (56 females, 44 males) was included in the study. Mean age of the entire study cohort was 37.17 years (SD 15.45). The mean no. of months to seek first help from a psychiatrist was 53.03 months (SD: 81.70).
 Conclusion: All the patients here eventually made treatment contact with psychiatrists. However, delay was pervasive. Delay in treatment has negative effect in the treatment outcome. The knowledge and recognition of psychological disorders by the traditional healers as well as other treatment providers in the community are crucial for early treatment of psychiatric patients.

Predictors of short- and long-term recurrence of suicidal behavior in borderline personality disorder.

To evaluate the incidence of suicidal outcomes and risk factors for short- and long-term recurrence of suicidal behavior (SB) among high-risk borderline personality disorder (BPD) patients during a 24-month prospective follow-up period. A multicenter prospective cohort study was designed to compare data obtained from 136 patients admitted to the emergency department for current suicidal ideation (SI) or a recent suicide attempt (SA). Subjects were clinically evaluated and monitored for a new SA or suicide. The incidence of a new SA was 25.63 events/100 persons-year, and one patient died by suicide. Child sexual abuse (CSA) was the only significant predictor throughout the complete follow-up period. The absence of prior psychiatric treatment predicts the recurrence of SB in the first 6months of follow-up. Patient age, poor psychosocial functioning before hospitalization, age at first SA, and having multiple suicide attempts increased risk of SB recurrence at the long-term period (24th months). In addition, there was an interaction between CSA and poor psychosocial functioning that increased risk of SB. The risk of recurrence was higher during the first 6months. Risk factors at 6 and 24months vary. These findings are important for implementing suicide strategies.

Suicide and all-cause mortality in a high-risk cohort: A latent class approach

ObjectiveTo use latent class analysis to group patients consulted to an emergency psychiatry consultation service and assess occurrence of suicide attempts and all-cause mortality across groups. MethodLatent class analysis was used to classify individuals assessed by psychiatry in the emergency department of the two teaching hospitals in Winnipeg, Canada. A second latent class analysis was done on individuals presenting with a suicide attempt. Indicators variables included a variety of clinically assessed factors, such as presentation suicidality and occurrence of anxiety/depression/psychosis, and prior medical treatment. Two post-treatment indicators were used; suicide attempt hospitalizations and all-cause mortality within 12 months of assessment. ResultsLatent class analysis identified 8 classes for all presentations (n = 5292) and 3 classes for the attempter subgroup (n = 730). Although there is considerable overlap in indicators among the classes certain indicators differentiated between the groups: suicide attempt presentation, prior psychiatric treatment, psychotropic medication polypharmacy, childhood abuse, and addictions. Although the presence of deaths and future attempts varied between the identified groups, there were no groups with a >10% proportion of individuals with either of these outcomes. ConclusionsPotential exists for latent class-based assessments, but additional samples with better indicators are needed.

The long-term financial consequences of breast cancer: a Danish registry-based cohort study

BackgroundA breast cancer diagnosis affects an individual’s affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that participated in the work force. We also examined the roles of sociodemographic factors and prior psychiatric medical treatment.MethodsThis registry-based cohort study was based on information retrieved from linked Danish nationwide registries. We compared the incomes of 13,101 women (aged 30–59 years) diagnosed with breast cancer (exposed) to those of 60,819 women without breast cancer (unexposed). Changes in income were examined during a 10-year follow-up; for each follow-up year, we calculated the mean annual income and the relative change compared to the income earned one year prior to diagnosis. Expected changes in Danish female income, according to calendar year and age, were estimated based on information from Statistics Denmark. For exposed and unexposed groups, the observed income changes were dichotomized to those above and those below the expected change in income in the Danish female population. We examined the impact of breast cancer on income each year of follow-up with logistic regression models. Analyses were stratified according to educational level, marital status, and prior psychiatric medical treatment.ResultsBreast cancer had a temporary negative effect on income. The effect was largest during the first three years after diagnosis; thereafter, the gap narrowed between exposed and unexposed cohorts. The odds ratio for an increase in income in the cancer cohort compared to the cancer-free cohort was 0.81 (95% CI 0.77–0.84) after three years. After seven years, no significant difference was observed between cohorts. Stratified analyses demonstrated that the negative effect of breast cancer on income lasted longest among women with high educational levels. Being single or having received psychiatric medical treatment increased the chance to experience an increase in income among women with breast cancer.ConclusionA breast cancer diagnosis led to negative effects on income, which ameliorated over the following seven years. Sociodemographic factors and prior psychiatric medical treatment might influence long-term consequences of breast cancer on income.

The Long-term financial consequences of breast cancer: a Danish registry-based cohort study

Background A breast cancer diagnosis affects an individual’s affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that participated in the work force. We also examined the roles of sociodemographic factors and prior psychiatric medical treatment.

The impact of prior psychiatric medical treatment on return to work after a diagnosis of breast cancer: A registry based study.

Purpose: Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2-4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy. Methods: 16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. 'Return to work' was defined as being self-supporting one year after diagnosis of breast cancer. Results: 16% of our cohort had used psychiatric medical treatment 2-4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87-0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity. Conclusions: Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer. Implications for cancer survivors: Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.

Relation of Medical History to the Pediatric Out-of-Hospital Cardiac Arrest Managed by Emergency Medical Services.

The aim of this study was to examine the medical history of the pediatric out-of-hospital cardiac arrest (OHCA) patients to determine preexisting conditions that may relate to a later OHCA. The study was a retrospective population-based cohort study in Helsinki (population 595,000) served by a single emergency medical service (EMS) system. All OHCA patients aged between 0 and 17 met by the local EMS from 2002 to 2011 were included. Medical records of the Helsinki University Hospital and its clinics were examined to find preexisting medical or surgical conditions. Forty-three patients experienced an EMS-treated OHCA. The annual incidence of an EMS-treated OHCA was 4.4 per 100,000 population younger than the age of 18 years. The mean age of patients was 7.9 years, largest age groups being younger than 1 year (30.2%) and 17 years (23.2%). The leading cause of OHCA was trauma (30.2%) followed by sudden infant death syndrome (18.6%) and cardiac reasons (14.0%). Nine patients (20.9%) survived to hospital, and 5 (11.6%) were discharged alive. Of the 43 patients, 28 (65.1%) had prior medical records in Helsinki University Hospital considering suspected or diagnosed chronic or otherwise significant conditions. The most common conditions were perinatal adaptation abnormalities (20.9%), psychiatric treatment (16.3%), and epilepsy (13.9%). Five patients had previous cardiac conditions. Trauma as a cause of OHCA was frequently represented among patients with prior psychiatric diagnosis or treatment. Among 17-year-old OHCA patients, 5 of 10 had psychiatric records. Majority of the patients had prior medical records. Psychiatric disorders were strongly presented.

Lithium and It’s Association with Physical Disorders: Focus on theKidney

The aim of this cross-sectional study was to identify if there was a specific difference between patients with functional dystonia (DysF) and those with adult-onset, isolated idiopathic (“primary”) dystonia (DysP) in terms of psychiatric disorders, psychological stressor, dissociation correlates, and personality traits.Thirty-nine clinically definite DysF and 30 DysP patients matched by age, gender and dystonia distribution underwent psychiatric interview based on DSM-5 criteria and additional testings for global cognitive and psychiatric functions (Mini-Mental State Examination, Hamilton Depression and Hamilton Anxiety Rating Scale, Apathy Scale, Somatoform Dissociation Questionnaire-20, Dissociative Experiences Scale II, and the five-dimensional Revised Neuroticism-Extroversion-Openness Personality Inventory).Almost half of our DysF patients had prior psychiatric treatment, which was significantly more frequent when compared to DysP. Patients with DysF in comparison to DysP also had considerably more frequent preceding stress, higher apathy, dissociative and somatoform scores, as well as significantly higher rate of la belle indifférence sign. This sign, stress before dystonia and prior psychiatric disorder independently predicted having DysF. Some of psychiatric disorders (i.e. substance-related disorders, schizophrenia, adjustment disorder, borderline personality disorder, post-traumatic stress disorder, psychotic depression, delusional disorder) were exclusively present among DysF patients. DysF compared to DysP patients had lower scores for both extroversion and openness to experiences.Our data found different pattern of psychiatric comorbidity and personality traits between DysF and DysP patients, including a higher prevalence of psychological stressor and dissociative correlates, indicating at least a partial role of psychological mechanisms in the pathogenesis of DysF.