Psychiatric Department Research Articles

Prevalence of Brugada ECG pattern in psychiatric patients: a longitudinal prospective cohort of 550 patients

Abstract Background Brugada syndrome (BrS) is an inherited disorder with autosomal dominant transmission, which occurs predominantly in males in the third to fourth decade of life with resting syncope, nocturnal agonic breathing, major ventricular arrhythmias and sudden death. Arrhythmic complications can occur spontaneously or following exposure to triggers such as fever, or certain categories of medications, including psychiatric drugs. Aim of the study To evaluate the prevalence of Brugada ECG pattern in psychiatric patients. Methods from January 2023 to Decembre 2023, 550 consecutive patients who were admitted to the psychiatric department of our university hospital were enrolled. For each patient, electrocardiographic and anamnestic data including psychiatric diagnosis, current drug therapy and family history were collected. Results Twenty-one out of five-hundred and fifty patients (3.8%) presented with a Brugada ECG pattern. Mean age was 42±6 years and seventeen out of twenty-one patients (81%) were male. Two patients exhibited a Spontaneous type 1 Brugada ECG pattern meanwhile nineteen patients had a Brugada type 2 or 3 ECG pattern. When compared to the general population, those with Brugada ECG had longer P wave duration (110±7 vs 103±13 msec p<0.01) and longer QRS duration (97±14 vs 89±12 msec p=0.04). Evaluating psychiatric disorders, patients with Brugada ECG had high prevalence of mood disorders (10 out of 21, 47%). Other disorders were schizophrenia (3 out of 21, 14%), cognitive retardation (5 out of 21, 23%), and attention disorder (1 out of 21, 5%). Moreover 4 patients were drug addicted. Only 5 out of 21 (24%) patients had a family history of psychiatric and neurological disorders. Conclusions Brugada ECG pattern has a prevalence of 3.8% in a large cohort of psychiatric patients. Mood disorders was the most common diagnosis in this cohort. Large prospective registries are needed to evaluate the clinical feature and potential clinical implication of this findings.

Study of prescribing pattern of drugs in the management of migraine with psychiatric comorbidities at integral institute of medical science and research

Background: Migraine headaches, a prevalent and serious brain condition, often coincide with mental health issues. This study aims to explore drug prescribing patterns for migraine patients with psychiatric comorbidities. Methods: Over six months, a prospective observational study was conducted at the psychiatric department of IIMS&R Hospital. 100 prescriptions were analyzed based on specific criteria. Results: Total 14 different drugs were prescribed. NSAIDs were most common (87%), followed by multivitamins (50%), benzodiazepines (30%), and tricyclic antidepressants (23%).Naxdom (NSAIDs) was frequently used (87%). Patients aged 31-45 years had higher prevalence. Comorbidities associated are depression (18%), anxiety disorder (10%), insomnia (5%). Conclusions: The study highlights various orally administered drugs, including anti-migraine meds, antidepressants, anticonvulsants, and more. Patients within the 31-45years age group were significantly affected. Migraine correlated with depression, anxiety, and insomnia. The most common medication was naxdom 250mg taken orally.

Online Mental Health Assessment in a psychiatry emergency department in adults using touchscreen mobile devices: A randomised controlled trial.

To determine whether completion of an online mental health self-assessment by patients who are waiting in the emergency department can save clinician time taken to complete clinical assessment and documentation. Patients presenting to a psychiatric emergency department for a period of 6 months were allocated by week of presentation to either the intervention arm (online mental health self-assessment, followed by a clinical interview) or the control arm (usual assessment) arm on a random basis. Time at the beginning and end of the interview was recorded and used to derive interview time. Similarly, time at the beginning and end of the clinical documentation was recorded and used to derive the time to complete clinical documentation. Of 168 patients who presented during the study period, 69 (38.55%) agreed to participate, 33 completed the usual assessment and 30 completed the online mental health self-assessment followed by a clinical interview. Patients receiving usual care had a statistically significant, t(61) = 2.15, p = 0.035, longer interview duration (M = 48.7 minutes, SD = 19.8) compared with those in the online mental health self-assessment arm (M = 38.9 minutes, SD = 15.9). There was no statistically significant difference between groups for documentation time, t(61) = -0.64, p = 0.52. Online mental health self-assessment was associated with a statistically significant reduction in interview time by approximately 10 minutes without increasing documentation time. While online mental health self-assessment is not appropriate for all patients in the emergency department setting, it is likely to yield greater benefits in less acute settings.

Smartphone Screen Time Characteristics in People With Suicidal Thoughts: Retrospective Observational Data Analysis Study.

Smartphone-based monitoring in natural settings provides opportunities to monitor mental health behaviors, including suicidal thoughts and behaviors. To date, most suicidal thoughts and behaviors research using smartphones has primarily relied on collecting so-called "active" data, requiring participants to engage by completing surveys. Data collected passively from smartphone sensors and logs may offer an objectively measured representation of an individual's behavior, including smartphone screen time. This study aims to present methods for identifying screen-on bouts and deriving screen time characteristics from passively collected smartphone state logs and to estimate daily smartphone screen time in people with suicidal thinking, providing a more reliable alternative to traditional self-report. Participants (N=126; median age 22, IQR 16-33 years) installed the Beiwe app (Harvard University) on their smartphones, which passively collected phone state logs for up to 6 months after discharge from an inpatient psychiatric unit (adolescents) or emergency department visit (adults). We derived daily screen time measures from these logs, including screen-on time, screen-on bout duration, screen-off bout duration, and screen-on bout count. We estimated the mean of these measures across age subgroups (adults and adolescents), phone operating systems (Android and iOS), and monitoring stages after the discharge (first 4 weeks vs subsequent weeks). We evaluated the sensitivity of daily screen time measures to changes in the parameters of the screen-on bout identification method. Additionally, we estimated the impact of a daylight time change on minute-level screen time using function-on-scalar generalized linear mixed-effects regression. The median monitoring period was 169 (IQR 42-169) days. For adolescents and adults, mean daily screen-on time was 254.6 (95% CI 231.4-277.7) and 271.0 (95% CI 252.2-289.8) minutes, mean daily screen-on bout duration was 4.233 (95% CI 3.565-4.902) and 4.998 (95% CI 4.455-5.541) minutes, mean daily screen-off bout duration was 25.90 (95% CI 20.09-31.71) and 26.90 (95% CI 22.18-31.66) minutes, and mean daily screen-on bout count (natural logarithm transformed) was 4.192 (95% CI 4.041-4.343) and 4.090 (95% CI 3.968-4.213), respectively; there were no significant differences between smartphone operating systems (all P values were >.05). The daily measures were not significantly different for the first 4 weeks compared to the fifth week onward (all P values were >.05), except average screen-on bout in adults (P value = .018). Our sensitivity analysis indicated that in the screen-on bout identification method, the cap on an individual screen-on bout duration has a substantial effect on the resulting daily screen time measures. We observed time windows with a statistically significant effect of daylight time change on screen-on time (based on 95% joint confidence intervals bands), plausibly attributable to sleep time adjustments related to clock changes. Passively collected phone logs offer an alternative to self-report measures for studying smartphone screen time characteristics in people with suicidal thinking. Our work demonstrates the feasibility of this approach, opening doors for further research on the associations between daily screen time, mental health, and other factors.

Training Needs for School Staff Supporting Students Returning to School After a Psychiatric Hospitalization

AbstractSupporting students returning to school after a mental health crisis often involves more training than many school staff members receive. With the increase in youth mental health diagnoses, there has also been an increase in the number of youth requiring psychiatric emergency department visits and hospitalizations. As such, this study employed a basic qualitative design to gather the perspectives of school staff who support students’ mental health about their experiences and training needs related to supporting youth returning to school after psychiatric hospitalization. Semi-structured interviews were conducted with 10 school mental health professionals or administrators. Thematic analysis was used to analyze the data. Three themes were identified: (1) most participants received minimal formal training in graduate school on hospital-to-school transition, (2) most participants learned about hospital-to-school transition on the job, and (3) participants made recommendations and identified specific training needs. Implications for training are discussed including a need for variety (e.g., some practitioners need basic training while others need more advanced training) and different format preferences (in-person may be preferred but online asynchronous is more convenient).

Comparative Study of Effectiveness of Haloperidol Versus Olanzapine among Patients with Schizophrenia

Aim: To compare the efficacy of oral Typical Antipsychotic drug [Haloperidol] Group A versus oral Atypical Antipsychotic drug [Olanzapine] Group B in patients who met the criteria for schizophrenia. This study includes observe and compare the positive symptoms and negative symptoms in Group A and Group B by using PSYRATS scale and negative symptom assessment tool. Study Design: Prospective comparative observational study. Place and Duration of Study: The study was carried from April 2023 – September 2023 at Psychiatric Outpatient Department in the Government Medical College and Hospital, Nagapattinam. Methodology: The study sample comprised 60 patients [N=60], The 30 subjects were in Group A and 30 subjects were in Group B who met the SCID – DSM V criteria and also include criteria 1. Age between 22 – 65 years. 2. Subject should have Minimum mental state examination [MMSE] score between 25 – 30. Paired and Unpaired t test was performed to observe statistical significance. Results: Out of 60 patients Olanzapine was associated with a mean baseline to endpoint improvement of ( -22.77) versus a Mean change of ( -14.39) in Haloperidol. Olanzapine [Group B] had higher mean difference than Haloperidol [Group A]. Conclusion: By using PSYRATS scale and Negative symptom assessment tool, Olanzapine treated group were numerically better than the Haloperidol treated group in both Negative and Positive Symptoms.

Assessment of Children and Adolescents’ Admissions to Pediatric Psychiatric Emergency Department

Objective Emergencies in child and adolescent psychiatry are prevalent, and pediatric psychiatric emergency departments play a crucial role in acute intervention during mental health-related crises. This retrospective cross-sectional study aimed to analyze the characteristics of children and adolescents who were admitted to a pediatric psychiatric emergency department. Method The data were collected from the records of 8803 patients (females 56.6%, Mage = 15.07 ± 2.6) admitted to our pediatric psychiatry emergency department between 2014 and 2021. Diagnoses were made using the International Statistical Classification of Diseases, 10th Revision. We used descriptive statistics to determine patient characteristics and conducted a regression analysis to compare the changes in the admissions numbers by the year. Results It was found that depressive disorder was the highest psychiatric diagnosis, with a percentage of 21.4%. Depressive disorder, autism spectrum disorder, and obsessive-compulsive disorder have shown an increase over the years. In 2020, with the onset of the COVID-19 pandemic, psychiatric admissions reached their lowest level. The percentage of hospitalizations was 21.1% for the total of all years. No significant change was found in the total number of admissions, sex, and age. Conclusions The number of admissions for female adolescents who were diagnosed with depressive disorder to our pediatric psychiatry emergency department is shown to be high. The fact that these patients seek help more frequently should be taken into consideration during the planning of mental health services for outpatient and inpatient clinics as well as pediatric psychiatry emergency services.

Impact of Comorbid Personality Disorder on the Risk of Involuntary Hospitalization in Patients Referred for Urgent Forensic Assessment: A Cross-Sectional Study.

In Belgium, involuntary psychiatric hospitalization is authorized in the presence of certain criteria governed by the law relating to the protection of the mentally ill. The number of involuntary hospitalizations has been increasing continuously in recent years. Since personality disorders are frequent comorbidities in involuntarily hospitalized patients, the aim of this study was to investigate the potential role played by comorbid personality disorders in the decisions about involuntary hospitalization made during urgent forensic assessment. A total of 565 individuals were retrospectively recruited from the database of urgent forensic assessment carried out in the Psychiatric Emergency Department. Logistic regression analyses were performed to investigate the risk of involuntary hospitalization associated with comorbid personality disorders in patients referred for urgent forensic assessment. 66.7% of urgent forensic assessments resulted in involuntary hospitalization. In addition, comorbid personality disorders (especially borderline personality disorder) were associated with a lower risk of involuntary hospitalization in patients referred for urgent forensic assessment. In this study, we demonstrated that urgent forensic assessments frequently result in involuntary hospitalizations. Furthermore, this study highlighted that comorbid personality disorders (especially borderline personality disorder) appeared to have a major impact on the decision not to involuntarily hospitalize patients referred for urgent forensic assessment. These elements therefore justify the establishment of adequate clinical reflection to avoid the stigmatization related to these frequent comorbidities in patients at risk of involuntary hospitalization.

Virtual Versus In-Person Follow-up After a Psychiatric Emergency Visit: A Population-Based Cohort Study: Suivi virtuel opposé à en personne après une visite à l’urgence psychiatrique : une étude de cohorte dans la population

Objective With increased utilization of virtual care in mental health, examining its appropriateness in various clinical scenarios is warranted. This study aimed to compare the risk of adverse psychiatric outcomes following virtual versus in-person mental health follow-up care after a psychiatric emergency department (ED) visit. Methods Using population-based health administrative data in Ontario (2021), we identified 28,232 adults discharged from a psychiatric ED visit who had a follow-up mental health visit within 14 days postdischarge. We compared those whose first follow-up visit was virtual (telephone or video) versus in-person on their risk for experiencing either a repeat psychiatric ED visit, psychiatric hospitalization, intentional self-injury, or suicide in the 15–90 days post-ED visit. Cox proportional hazard models generated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs), adjusted for age, income quintile, psychiatric hospitalization, and intentional self-injury in the 2 years prior to ED visit. We stratified by sex and diagnosis at index ED visits based on the International Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA) coding. Results About 65% ( n = 18,354) of first follow-up visits were virtual, while 35% ( n = 9,878) were in-person. About 13.9% and 14.6% of the virtual and in-person groups, respectively, experienced the composite outcome, corresponding to incidence rates of 60.9 versus 74.2 per 1000 person-years (aHR 0.95, 95% CI 0.89 to 1.01). Results were similar for individual elements of the composite outcome, when stratifying by sex and index psychiatric diagnosis, when varying exposure (7 days) and outcome periods (60 and 30 days), and comparing “only” virtual versus “any” in-person follow-up during the 14-day follow-up. Conclusions and Relevance These results support virtual care as a modality to increase access to follow-up after an acute care psychiatric encounter across a wide range of diagnoses. Prospective trials to discern whether this is due to the comparable efficacy of virtual and in-person care, or due solely to appropriate patient selection may be warranted.

Patterns and characteristics of visits to psychiatric emergency departments: a three-year data study in China.

The composition and characteristics of emergency patients in the Affiliated Brain Hospital, Guangzhou Medical University during 2020-2022 were retrospectively analyzed to provide data support for the optimization of the process of psychiatric emergency and the elastic allocation of emergency medical staff. This study collected data from patients who sought medical attention at the emergency department of the Affiliated Brain Hospital, Guangzhou Medical University between January 1, 2020, and December 31, 2022. The fundamental information of these patients was statistically analyzed using descriptive analytic methods. In addition, a comprehensive statistical analysis was performed on the data of patient visits, which included precise triage time points, months, and seasons, in order to evaluate the temporal distribution of patient visits. The patient population had an average age of 36.4 years and was slightly more female (54.08%). The mean age of the male and female patients was 36.4 ± 18.91 and 36.4 ± 16.80 years, respectively. There was no statistically significant age difference between the male and female patients (p > 0.05). The top five diseases were mental disorder (6,483 cases), bipolar disorder (3,017 cases), depressive episode (2522 cases), schizophrenia (1778 cases) and anxiety state (1097 cases), accounting for 35.63%, 16.58%, 13.86%, 9.77% and 6.03% of the total, respectively. Additionally, a notable record of psychiatric drug intoxication was noted. Significant comorbidity with physical disorders, such as hypertension (9.36%), hypokalemia (3.41%), diabetes (2.83%), and cerebral infarction (2.79%), was also seen. The results of seasonal and monthly analysis indicated that emergency attendance patterns fluctuated, peaking in the spring and fall. The patterns of daily visits also revealed two peak times. The first peak occurs from 8:00 to 10:00, and the second peak occurs from 14:00 to 16:00. This study emphasizes the increasing occurrence of mental problems in psychiatric crises, particularly among younger populations, underscoring the necessity for comprehensive care methods. Specialized treatment methods and collaborative networks are required to address the substantial prevalence of psychiatric medication poisoning. Efficient allocation of resources and heightened security protocols are vital in emergency departments, particularly during periods of high demand and in handling instances of patient hostility.

Individual placement and support in mental health services: evaluation of routine clinical data using aretrospective chart review

People with severe mental illnesses are often excluded from working life and would like support to (re)enter the general labor market as part of the psychiatric treatment. Individual placement and support (IPS) is an effective method of finding and retaining work in the general labor market. The aim of the study was to determine the integration rates of IPS into the general labor market in acute and postacute psychiatric settings, identifying patient, setting and program characteristics associated with (re)entering work. A retrospective chart review (RCR) of routine clinical data between 2016 and 2021 was carried out. The IPS program adherence was rated using the IPS fidelity scale. A total of 375 patients participated in the IPS with at least 4 appointments. The (re)integration rate into the general labor market was 51.7%. A shorter time period to the last working day, diagnosis of F1, F2, F3 (vs. F4), change of treatment setting and IPS in the psychiatric institute outpatient department (PIA), IPS fidelity and the number of IPS coaching sessions were positively correlated with (re)integration into work. The implementation of IPS in clinical mental healthcare is possible and leads to high integration rates in the open labor market. An early start of IPS during the clinical treatment can promote social inclusion.

Drug utilization pattern of antidepressant used in depression disorder in psychiatric department in Northern India: a prospective observational study

Drug utilization pattern of antidepressant used in depression disorder in psychiatric department in Northern India: a prospective observational study

The Use of Nursing Theory and Model in Mental Health and Psychiatric Nursing Doctoral Theses: Turkiye Sample

Aim: The aim of this study is to identify nursing models used in doctoral theses in psychiatric and mental health nursing. Material and Methods: In this descriptive-type retrospective document analysis study, theses in mental health and psychiatric nursing departments of health sciences institutes were reviewed at the National Thesis Center of the Council of Higher Education on from September to October 2023. The study was completed with 14 doctoral theses. Word and Excel programs were used to record and analyze data. Results: The Roy Adaptation Model and then the Neuman Systems Model were mostly used in doctoral theses. It was determined that four theses were randomized controlled, and six theses were done within the scope of community mental health nursing when the sample group was examined. Conclusions: The Roy Adaptation Model has positive effects on issues such as emotional expression, self-esteem, and treatment areas. As a sample group, there was a tendency towards preventive mental health services. Experimental designs with control groups were used in doctoral theses, and four theses were determined to be randomized controlled.

Suicide by different methods in Toronto: A quantitative study examining of 23-years of coronial records

The objective of the study is to understand the characteristics of people who died by different suicide methods in Toronto, Canada. Suicide cases were identified by the Office of the Chief Coroner of Ontario (1998–2020). Demographic and clinical variables were retrieved. All suicide deaths were classified into different groups based on suicide method. Bivariate analyses and multinomial logistic regressions were performed to compare their demographic and clinical characteristics. Hanging (N = 1721), jumping from height (N = 1280), and poisoning (N = 955) were the most common suicide methods in Toronto. Those who died by hanging were more likely to be married or in common law relationships, live with others, experience employment/financial/academic-related stressors and die at home. People who died by jumping from height had a higher likelihood of having a psychiatric and/or emergency department visit in the past week and having schizophrenia or related disorders/symptoms. People who died by poisoning had higher odds of being female and leaving suicide notes. They were also more likely to have previous suicide attempts, experience depression and/or bipolar disorder and have physical conditions. Specific suicide prevention strategies should be designed and implemented to account both for commonalities and differences among people who die by different suicide methods.

Experience of using Beers criteria in clinical practice (according to Russian literature)

Objective: analysis of domestic scientific literature to identify ways of applying the Beers criteria, frequency of prescriptions and the structure of potentially inappropriate medications (PIMs) in elderly patients.Material and methods. The search for publications was carried out in Google Scholar abstract database, as wel as in eLibrary and CyberLeninka information-bearing networks for the period from 2013 to 2023. In total, 34 articles were found, among which 18 sources used Beers criteria as a tool for identifying PIMs.Results. In inpatient therapeutic departments, the maximum frequency of PIMs prescriptions according to the Beers criteria was 66.6% of cases, in surgical departments – 70%, in psychiatric departments – 90.4%, and in outpatient treatment settings – 28%. Non-steroidal anti-inflammatory drugs at different diseases were the most prescribed group of PIMs in both inpatients and outpatients. Surgical hospitals took the leading position in prescribing these drugs; specifically, more than 2/3 of elderly patients (75%) received them. According to two studies describing clinical cases of drug-induced falls in patients, the Beers criteria were effective in identifying drugs that can provoke this condition. One of papers presented application of Beers criteria to assess the economic affordability of replacing PIMs with safer new generation drugs.Conclusion. An analysis of domestic literature data has shown various ways of applying the Beers criteria, the frequency of prescriptions, and the most common PIMs. This information will help healthcare workers to be more wary of such drugs and think over applying the Beers criteria in routine practice of geriatric patients, which will further prevent or reduce the number of adverse drug reactions.

Predictive Ability of the Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) in Medical-Surgical Units.

Workplace violence persists in health care with nurses reporting physical and verbal abuse from aggressive patients causing emotional stress and lost workdays. The Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) was developed to measure risk for aggression in patients with behavioral health conditions in psychiatric and emergency department settings. The DASA-IV has not been validated with adult patients admitted to medical-surgical units. To determine whether DASA-IV scores are predictive of aggressive events in adults hospitalized on medical-surgical units. This multisite study used a case-control design. DASA-IV scores and acts of aggression were extracted from the medical record retrospectively to validate the appraisal's predictability. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to correlate DASA-IV scores with aggressive events. DASA-IV assessments (N=156 999; mean [SD] 10.1 [10.7]/patient; range 1-220) were collected from 13 611 patients. Patients were primarily White (86.1%) and female (51.7%). Aggression (n = 509 patients; 3.7%) was significantly associated with older age, male sex, smoking, illicit drug use, and high DASA-IV scores. AUC of the ROC analysis for the DASA-IV showed a 97% probability (95% confidence interval [CI] 0.964-0.977) that an aggressive patient would have a higher score on the DASA-IV than a nonaggressive patient. Binary logistic regression predicted that for every point increase in the DASA-IV, there was a 3.51 (95% CI 3.38-3.63) times increased risk for aggression (B = 1.255, SE = 0.18, Wald = 4766.6, P < .001). This study is the first to validate use of the DASA-IV in medical-surgical populations, demonstrating predictive ability for aggressive incidents. The DASA-IV can be used successfully in medical-surgical populations for early identification of potential aggression.

Patient and quality characteristics in the treatment with disulfiram (Antabus) in the German "Network for Alcohol Aversive Pharmacotherapy"

More than adecade ago disulfiram lost its approval for use in Germany. Nonetheless, aconsiderable number of psychiatric hospital outpatient departments as well as practicing physicians continue to prescribe it. These professionals have formed the "Network for Alcohol Aversive Pharmacotherapy" (NAP) to maintain a high quality of this treatment approach. To describe the current use of disulfiram with respect to patient numbers and characteristics, side effects, and use of concomitant multimodal treatment forms. Since 2019 the NAP has conducted an annual retrospective survey among its members regarding the aforementioned parameters. From 2019 to 2023 atotal of 1579 treatment cases were described by 33centers, 152 patients reported atotal of 241 drinking events, 26of them resulting in hospitalization but none causing complications or permanent harm. The most frequent side effects, in descending order, were unpleasant body odor (2.5%), fatigue, male sexual dysfunction, mildly elevated liver enzymes, allergic skin reactions and polyneuropathy (0.8%). More than one quarter of the patients suffered from comorbid depression, and approximately 5% from ADHD, borderline or other personality disorders, trauma-related disorders and anxiety disorders, respectively. Of the patients 33% were treated with antidepressants and 12% with sedating antipsychotics. Various forms of concomitant group therapy were offered to 66% of the patients. Treatment with disulfiram is legally possible, generally well-tolerated and safe. It is offered in most treatment centers as part of acomprehensive treatment plan that includes multimodal treatment of comorbid psychiatric disorders.

Case report and literature review of AIDS-related progressive multifocal leukoencephalopathy diagnosed in a psychiatric department

A progresszív multifokális leukoencephalopathiát a John Cunningham-vírus reaktiválódása okozza, amely szinte kizárólag immunhiányos betegeknél fordul elő. A betegség tüneteit elsősorban a demyelinisatiós gócok lokalizációja határozza meg; a betegség a kezdeti szakaszban tünetszegény lehet, és a neurológiai tünetek csak később jelennek meg. Diagnosztikájában elsősorban a képalkotó vizsgálatok és a vírus-DNS liquorból történő kimutatása játszik fontos szerepet. Specifikus terápiája nem ismert, a cél az immunrendszer működésének helyreállítása. Kazuisztikánkban egy pszichiátriai osztályon észlelt páciens kórtörténetét ismertetjük, akinek esetében AIDS-hez köthető jobb féltekei progresszív multifokális leukoencephalopathia képe igazolódott. Korai differenciáldiagnosztikai nehézséget jelentettek a páciensnél észlelhető patológiás személyiségjegyek, illetve az élethelyzeti nehézségek és a párkapcsolati veszteség talaján kialakult krízisállapot. Esetünkkel szeretnénk felhívni a figyelmet az immunhiányos betegeknél jelentkező pszichiátriai tünetek fontosságára. Orv Hetil. 2024; 165(33): 1295–1302.

Correlation between the features of cognitive activity and clinical manifestations of schizophrenia in patients who have committed socially dangerous acts

The commission of socially dangerous acts always sparks a public outcry, and special attention and close interest are noted when the perpetrator suffers from a mental disorder. As far as the mental disorders diagnosed in this group of individuals are concerned, schizophrenia ranks among the first, and the research of its complex clinical picture is a promising direction for studying the features of delinquent behavior. The relevance of the study lies in the investigation of the nature of cognitive activity and its relationship with the clinical manifestations of schizophrenia. The purpose of the work was to analyze cognitive activity in schizophrenia patients who committed socially dangerous acts and identify their relationship with clinical manifestations of schizophrenia. The study was performed on 22 examinees of the department of inpatient forensic psychiatric examination for persons in custody who committed socially dangerous acts against the health and life of an individual, and 26 patients who were being treated in a general psychiatric department. According to the criteria of ICD-10, all subjects were diagnosed with paranoid schizophrenia at the stage of inpatient remission. In all participants of the experiment, the clinical picture of schizophrenia using the Positive and Negative Syndrome Scale (PANSS) was assessed, and the analysis of cognitive activity by means of the method of discrimination of properties of concepts was carried out. It has been established that the clinical manifestations of schizophrenia are characterized by diversity, persistence, and independence from committed aggressive delicts, and the cognitive activity of such patients is characterized by pronounced subjectivity and moderate realism, which makes their behavior peculiar, rigid to external influence, and extremely persistent in relation to their own goals.

Ambient temperature and psychiatric emergency department visits among unhoused, uninsured, and publicly insured persons

Ambient temperature and psychiatric emergency department visits among unhoused, uninsured, and publicly insured persons