Psychiatric Disturbances In Patients Research Articles

Correction to "The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study" [Osong Public Health Res Perspect 2023;14(5):368-78

Correction to "The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study" [Osong Public Health Res Perspect 2023;14(5):368-78

The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study.

The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30-59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer). This cross-sectional study utilized data from the 2018 Indonesian National Health Survey (Riskesdas). The study population comprised respondents aged between 30 and 59 years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents. Data were analyzed using logistic regression. Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex, education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481-9.928; p<0.001). The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.

Psychiatric Disturbances in Patients and Relatives Due to Intensive Care Admission

The issue of psychiatric disorders arising from the admission of inpatient patients and their relatives has persisted for a significant period of time. This phenomenon may occur as a result of psychological trauma experienced by either the patient or their family. The majority of the family members experience fear and anxiety around the potential loss of their loved ones. Recent research has indicated that a significant proportion, ranging from 51% to 69%, of individuals within familial relationships exhibit this particular occurrence. Outpatient cardiac arrest (OCA) is recognized as a highly influential occurrence in precipitating this psychological phenomenon. The management of critically ill patients in the intensive care unit (ICU) presents a complex and demanding task. The individual's status undergoes quick and unpredictable fluctuations. The presence of ambiguity gives rise to the development of delirium, which is characterized as a state of acute brain malfunction and is observed in 50–80% of patients in the intensive care unit (ICU). The phenomenon is also correlated with prolonged hospitalizations and increased mortality rates. This review was aimed to described psychiatric disturbances in patients and relatives due to ICU admission.

Disrupted Eye Gaze Perception as a Biobehavioral Marker of Social Dysfunction: An RDoC Investigation.

Social dysfunction is an intractable problem in a wide spectrum of psychiatric illnesses, undermining patients' capacities for employment, independent living, and maintaining meaningful relationships. Identifying common markers of social impairment across disorders and understanding their mechanisms are prerequisites to developing targeted neurobiological treatments that can be applied productively across diagnoses and illness stages to improve functional outcome. This project focuses on eye gaze perception, the ability to accurately and efficiently discriminate others' gaze direction, as a potential biomarker of social functioning that cuts across psychiatric diagnoses. This premise builds on both the monkey and human literatures showing gaze perception as a basic building block supporting higher-level social communication and social development, and reports of abnormal gaze perception in multiple psychiatric conditions accompanied by prominent social dysfunction (e.g., psychosis-spectrum disorders, autism-spectrum disorders, social phobia). A large sample (n = 225) of adolescent and young adult (age 14-30) psychiatric patients (regardless of diagnosis) with various degrees of impaired social functioning, and demographically-matched healthy controls (n = 75) will be recruited for this study. Participant's psychiatric phenotypes, cognition, social cognition, and community functioning will be dimensionally characterized. Eye gaze perception will be assessed using a psychophysical task, and two metrics (precision, self-referential bias) that respectively tap into gaze perception disturbances at the visual perceptual and interpretation levels, independent of general deficits, will be derived using hierarchical Bayesian modeling. A subset of the participants (150 psychiatric patients, 75 controls) will additionally undergo multimodal fMRI to determine the functional and structural brain network features of altered gaze perception. The specific aims of this project are three-fold: (1) Determine the generality of gaze perception disturbances in psychiatric patients with prominent social dysfunction; (2) Map behavioral indices of gaze perception disturbances to dimensions of psychiatric phenotypes and core functional domains; and (3) Identify the neural correlates of altered gaze perception in psychiatric patients with social dysfunction. Successfully completing these specific aims will identify the specific basic deficits, clinical profile, and underlying neural circuits associated with social dysfunction that can be used to guide targeted, personalized treatments, thus advancing NIMH's Strategic Objective 1 (describe neural circuits associated with mental illnesses and map the connectomes for mental illnesses) and Objective 3 (develop new treatments based on discoveries in neuroscience and behavioral science).

Psychiatric disturbances in patients undergoing open-heart surgery

BackgroundEmotional and behavioral problems have been noted in a considerable number of patients after open-heart surgery. However, great discrepancy exists in the literature regarding the frequency and the course of psychiatric symptoms, cognitive performance, and quality of life among those patients. This prospective study was designed to assess the pre- and postoperative psychiatric profile, as well as the quality of life of patients undergoing open-heart surgery.MethodsOne hundred patients who were prepared for cardiac surgery and met our selection criteria were recruited in this study. Each patient was subjected to the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination with selective subtests of Wechsler Adult intelligence scale, and the Short Form 36 questionnaire to assess psychiatric symptoms, cognitive performance, and quality of life respectively. Assessment was done for each of the evaluated items before surgery as well as at 1 week and 6 months postoperatively.ResultsThe anxiety and depressive symptoms were significantly lower at 6 months postoperatively than preoperatively. The cognitive performance declined after 1 week, then improved significantly at the 6-month follow-up. The quality of life scale was significantly lower preoperatively than after surgery.ConclusionsAnxiety and depressive symptoms, which occurred in substantial percentage of patients undergoing open-heart surgery, were gradually improved with time. Cognitive functions showed early deterioration with significant improvement at 6 months. Psychiatric problems had an adverse impact on patients’ quality of life which raised the importance of psychiatric consultation before and after cardiac surgeries to shorten recovery time.

Description of the prevalence of psychiatric disturbances in patients with refractory epilepsy

IntroductionPsychiatric morbidity in epilepsy is high, with prevalence rates of up to 50%, being higher in treatment-refractory cases. This co-morbidity worsen the quality of life. Psychiatric comorbidities are hampered by atypical presentations or disorders, which do not appear in the DSM-IV or ICD.ObjectivesTo describe the psychiatric morbidity in a group of patients with refractory-epilepsy.AimsTo provide evidence of the high morbidity and show the prevalence of the different psychiatric disorders.MethodsWe cross-sectional assessed psychiatric disturbances in resistant-epileptic patients using SCID for DSM-IV and clinical interview for epileptic specific psychiatric conditions. We grouped psychiatric disturbances into six clusters:– affective disorders;– anxiety disorders;– psychotic disorders;– eating disorders;– conduct disorder;– substance use disorder.We also considered epilepsy specific conditions as Interictal Psychotic Disorder (IPI) and Interictal Dysphoric Disorder (IDD) characterized by 3/8 symptoms: depressive mood, anergia, pain, insomnia, fear, anxiety, irritability, and euphoric mood.ResultsThe sample consist on 153 patients, with a mean age of 37. In total, 42.5% were males. One or more axis I diagnoses was seen in 38% of the patients. The most common condition was IDD (27.1%), followed by affective disorders (22%), anxiety disorders (15.3%), psychotic disorders (4%) and drug use (2%). There were no patients with eating or conduct disorders or IPI.ConclusionsPsychiatric morbidity is frequent in resistant-epilepsy. Despite 38% of patients suffered from at least one axis I diagnoses, IDD was the most prevalent condition and not included in SCID interview.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders.

The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders.

Drugs pharmacokinetics interactions with cardiac and renal disease patients in consultation-liaison psychiatry

The prevalence of psychiatric disturbances in patients with cardiovascular disease is elevated. For example the prevalence of major depression can reach 15–20% and of anxiety disturbances 5–20%.When we treat psychiatric symptoms in cardiovascular disease we must have in mind four particular effects of psychiatric drugs: (1) disturbances of atrial-ventricular conduction; (2) QTc interval prolongation that can lead to torsade de pointes and ventricular fibrillation; (3) hypertension; (4) changes in platelet aggregation.On the other hand, there is a great prevalence of psychiatric disease in patients with renal disease. For example, about 5–25% of the patients with advanced renal disease have major depression.Renal disease patients can evidence changes in several pharmacokinetic parameters such as: (1) biodisponibility; (2) distribution; (3) metabolism; (4) excretion. Therefore, when we treat these patients we have to keep in mind the effect of psychiatric drugs over the renal functioning, but also the effect of the deficient renal function in the pharmacokinetics of the drugs.I this presentation we intend to reveal what are the main concerns when we prescribe psychiatric drugs in patients with cardiovascular and renal disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Classical homocystinuria and psychiatric disturbances – A case report

IntroductionClassical homocystinuria (cystathionine beta synthase deficiency) is a rare autosomal recessive disease of methionine metabolism that causes accumulation of homocysteine in the blood and cysteine deficiency. It is characterized by intellectual disability, ectopia lentis, skeleton abnormalities resembling Marfan syndrome and thromboembolic episodes. The majority of patients have psychiatric disturbances as depression, behavioral disorders, personality disorders, obsessive-compulsive disorder and, less commonly, bipolar disorder and psychosis.Objectives and aimsTo briefly review psychiatric disturbances in patients with homocystinuria and present a case report.MethodsLiterature research and analysis of patient's clinical data.ResultsA 22-year-old male was diagnosed with classical homocystinuria at age 4 due to intellectual disability and renal alterations. With aging, other problems emerged: epilepsy; postural tremor; dysesthesia; ectopia lentis; orofacial myofunctional disorder; asthma; and patellar instability. He went to a special education program. At age sixteen, he initiated Child Psychiatry consultations due to anxiety and behavioral changes, as difficulty in controlling impulses, establishing relationships and in the perception of the self. Nowadays, the patient is followed in psychiatric consultations, where he has demonstrated high difficulty to empathize. He is being treated with vitamin supplements; betaine; levetiracetam; clobazam; and propranolol, combined with a special diet.ConclusionsIt is not practical to screen every psychiatric patient for Homocystinuria, but this disease should be considered when there is a family history, early and/or acute onset, intellectual disability, atypical symptoms, unusual response to treatment, progressive cognitive change and other organic disturbances present in this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The association between sleep disturbances and suicidal behaviors in patients with psychiatric diagnoses: a systematic review and meta-analysis

BackgroundIdentifying patients with increased risk of suicidal behaviors is a constant challenge and concern for clinicians caring for patients with psychiatric conditions. We conducted a systematic review to assess the association between suicidal behaviors and sleep disturbances in psychiatric patients.MethodsA systematic literature search of Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycInfo, Ovid Cochrane Database of Systematic Reviews, Ovid Cochrane Central Register of Controlled Trials, and Scopus was conducted using earliest inclusive dates to 28 June 2013. Eligible studies were comparative observational studies that reported sleep disturbances in psychiatric patients and the outcome of interest (any type of suicidal behaviors). Pairs of reviewers extracted descriptive data, study quality, and outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were pooled across studies using the random-effects model. Newcastle-Ottawa scale was used to critically appraise study quality.ResultsNineteen studies met the inclusion criteria. Compared to those without sleep disturbances, patients with psychiatric diagnoses and co-morbid sleep disturbances were significantly more likely to report suicidal behaviors (OR = 1.99, 95% CI 1.72, 2.30, P <0.001). The association was also demonstrated across several psychiatric conditions including depression (OR = 3.05, 95% CI 2.07, 4.48, P <0.001), post-traumatic stress disorder (PTSD) (OR = 2.56, 95% CI 1.91, 3.43, P <0.001), panic disorder (OR = 3.22, 95% CI 1.09, 9.45, P = 0.03), and schizophrenia (OR = 12.66, 95% CI 1.40, 114.44, P = 0.02). In subgroup analysis based on the type of sleep disorder, we also found suicidal behavior to be significantly associated with the presence of insomnia, parasomnias, and sleep-related breathing disorders, but not hypersomnias.ConclusionsThis systematic review and meta-analysis suggests that in patients with psychiatric diagnoses, sleep disturbances are associated with the increased risk of suicidal behaviors.

Psychiatric comorbidities in dystonia: Emerging concepts

Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms, suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified, and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia. This article, solicited for a special Movement Disorders issue on novel research findings and emerging concepts in dystonia, addresses the following issues: (1) To what extent are psychiatric disturbances related to the pathophysiology of dystonia? (2) What is the impact of psychiatric disturbances on outcome measures of current assessment tools for dystonia? (3) How do psychiatric comorbidities influence the treatment of dystonia? Answers to these questions will lead to an increased appreciation of psychiatric disorders in dystonia, a better understanding of brain physiology, more nuanced research questions pertaining to this population, better clinical scales that can be used to further patient management and research, and improved patient outcomes. © 2013 Movement Disorder Society.

Improving Detection of Psychiatric Disturbances in Parkinson's Disease: The Role of Informants

Under-recognition of psychiatric disturbances in patients with Parkinson's disease (PD) contributes to greater overall morbidity. Little is known about the value of collateral psychiatric history, obtained using standardized assessments with informants, for increasing recognition of PD-related psychiatric illness. To examine the extent to which informants provide critical information that enabled psychiatrists to establish psychiatric diagnoses in patients with PD. Individuals with PD (n = 223) and an informant were interviewed separately regarding the PD patient's psychiatric history and current status. A six-psychiatrist panel rated the extent to which informant data was required to establish the final consensus best-estimate current psychiatric diagnoses. Informants rated as "Crucial" or "Significantly Informative" comprised a "Critical Informant" (CI) subgroup; remaining informants were classified as the "Non-Critical Informant" (NCI) subgroup. Of the informants, 71 (31.4%) were "critical" for determining a psychiatric diagnosis. Without a CI, 81.3% of those with impulse control disorders and 43.8% of those with anxiety disorders would not have been diagnosed. Male PD patients and those with less severe motor deficits were also more likely to require a CI. Informants aid in the identification of psychiatric diagnoses, especially impulse control and anxiety disorders. This has implications for clinical practice and conduction of clinical trials.

Need for Sleep Clinics in Psychiatric Practice

Sleep medicine is a rapidly developing specialty. Detection and treatment of sleep disorders is on the rise with changing lifestyles and more awareness. Sleep disturbances are increasingly commonly encountered in psychiatric practice compared with the general population. Sleep disturbances can be secondary to the psychiatric illness or might manifest as a side effect of psychotropic medications. However, they are frequently neglected or may be misdiagnosed as a primary psychiatric disorder and treated wrongly. Psychological disturbances such as depression can also occur due to primary sleep disorders. Comorbidity of sleep disorder and psychiatric disorder can affect treatment, course of both the disorders and ultimately affect the quality of life of the patients. Specialized sleep clinics are now a part of many specialties,such as pulmonary medicine. These clinics require specific standards with respect to staff and infrastructure; in addition, they necessitate effective liaison between multiple specialties. Development of sleep clinics in psychiatry would help in better detection, assessment, and treatment of sleep disturbances in psychiatric patients as well as those with primary sleep disturbances with secondary psychological distress. Sleep clinics would also help in understanding the complex relation between sleep and psychiatric disorders through research and would help in developing more effective management techniques.

Childhood Mood Disorder in Spinocerebellar Ataxia Type 2: A Case Report

Childhood Mood Disorder in Spinocerebellar Ataxia Type 2: A Case Report

Psychological assessment in patients with phobic postural vertigo

Phobic postural vertigo (PPV) is a frequent diagnosis which can be challenging to treat. To investigate the presence of psychiatric disturbances in patients with PPV; to assess the psychological status of patients using adaptive diagnosis; to verify possible correlations between severity of psychiatric disturbance and adaptive efficacy. A total of nineteen subjects were assessed and two instruments applied: the Primary Care Evaluation of Mental Disorders Questionnaire (PRIME-MD) and the Adaptive Operationalized Diagnostic Scale (AODS), and results from both tests were compared. Fourteen patients presented with mood disorder and thirteen with anxiety. All patients presented compromised adaptive efficacy. Correlation was found between overall outcome on the PRIME and the AODS (tau= -0.42, p=0.027), Separate analysis revealed correlation between results of the AODS and anxiety disorders (tau= -0.45, p=0.018) but not with mood disorders (tau= -0.36, p=0.054). Adaptive compromise was observed in individuals with PPV which was shown to be associated to psychiatric disorders.

I.P5 Psychiatric disturbances in patients with Parkinson's Disease

I.P5 Psychiatric disturbances in patients with Parkinson's Disease

Cognitive Modulation of the Endocrine Stress Response to a Pharmacological Challenge in Normal and Panic Disorder Subjects

The hypothalamic-pituitary-adrenal (HPA) axis may mediate the deleterious effects of stress on health. It is sensitive to cognitive and emotional aspects of organism-environment interactions, such as familiarity, control, and social support. Scientific study of how such factors moderate human HPA axis activity has been limited. Their relevance to HPA axis disturbances in psychiatric patients is largely unexplored. To determine whether cognitive manipulation can alter HPA axis activity in laboratory studies and whether patients with panic disorder are differentially sensitive to the manipulated factors. Pharmacological activation paradigm (cholecystokinin-B agonist pentagastrin) by which we examined symptom and endocrine effects on subjects randomly assigned to a standard introduction or a cognitive intervention. Clinical research center. Recruited from university clinic and newspaper advertisements. Fourteen patients with panic disorder and 14 controls, individually matched for age and sex. Intervention Half of each group received a 9-minute cognitive intervention designed to reduce novelty, increase cognitive coping, and provide a sense of control. Corticotropin (ACTH) and cortisol levels. The cognitive intervention significantly reduced cortisol (P = .02) and ACTH (P = .01) levels, despite pentagastrin's robust stimulation of both hormones (P<.001). The intervention effect was evident in patients and controls, who did not differ in basal HPA axis activity or response to pentagastrin. They did differ in panic symptom responses, which were unaffected by the intervention, and in ACTH effects of the intervention. Patients' exaggerated anxiety responses to pentagastrin were normalized by the intervention. Cognitive/emotional manipulation can substantially modulate HPA axis responses to pharmacological activation in humans, and HPA disturbances in panic disorder may be secondary to manipulable cognitive/emotional sensitivities. Further study of such factors as novelty, control, and coping may help clarify the origins of HPA axis disturbance in psychiatric disorders and the mediators linking psychosocial stress to disease.

The Assessment and Management of Antipsychotic-Associated Metabolic Disturbances from a Psychiatric Perspective

To review the available data on the management of antipsychotic-associated metabolic disturbances from a psychiatric perspective. A literature search was initially conducted using the key words followed by a search of relevant articles, including conference abstracts. The investigation and management of metabolic disturbances in psychiatric patients poses particular problems. Given that this population is at high risk, early identification and prevention are particularly important. Strategies for the management of metabolic disturbances in psychiatric patients are primarily based on treatments used in the general population, but their effectiveness in psychiatric populations is anecdotal. In view of the high levels of untreated medical comorbidity in psychiatric patients and the potential exacerbation through antipsychotic use in this high-risk population, specific outcome research in this population is needed. Further, referral for specialist management is recommended.

Affective and Anxiety Disorders in Patients with Cancer

Cancer, at all sites and stages (from early diagnosis to terminal phase), has psychological effects in a significant number of patients. Diagnosis of depression and anxiety in this patient population can be difficult and must involve awareness of the symptoms and signs resulting from the cancer itself and antineoplastic therapies, and the differential diagnosis of ‘function’ and ‘organic’ mental disorders. When prescribing psychotropic medications to patients with cancer, particular attention should be paid to drug interactions (e.g. the potential influence of psychoactive drugs on the metabolism of chemotherapeutic agents). Despite provocative reports, it has to be acknowledged that to date, there is no evidence to substantiate the claim of a negative impact of antidepressants on cancer initiation or prognosis. Although studies assessing the comparative effectiveness of psychopharmacological agents are difficult to perform in patients with cancer, the efficacy and tolerability of several antidepressants and anxiolytics have been shown and a mixed approach, combining drug treatments and various forms of psychotherapy, is now widely encouraged. However, a lot of research remains to be conducted in order to better understand the specific relationships between cancer and psychopathology, to identify risk factors and develop preventative strategies and to define a general model of treatment for psychiatric disturbances in patients with cancer.

The relationship between information processing and language production.

We explored the relationships between information processing and language in order to further the understanding of language disturbances in psychiatric patients. To assess the impact of reduced processing capacity on language, 50 undergraduates completed an interview concurrent with a category monitoring task and a control interview without a concurrent task. Syntactic complexity, verbosity, and pause patterns were all disrupted by a reduction in processing capacity. In addition, individual differences in syntactic complexity and information processing were significantly associated, even after accounting for verbal intelligence. We discuss the relevance of the results for understanding language disturbances in psychopathology and hypothesize that a reduction in processing capacity may underlie the decreased syntactic complexity, decreased verbal output, and increased pause length found in schizophrenia.