Psychic Side Research Articles

Psychiatric Manifestations Secondary to the use of a Dopaminergic Agonist Antiparkinsonian: A Case Report

Psychiatric disorders in Parkinson's disease can be classified into two opposing categories: hypodopaminergic if related to dopaminergic denervation and hyperdopaminergic if related to dopaminergic treatment. In this context the aim of this clinical case study is to present the psychiatric manifestations due to the use of a dopaminergic agonist anti parkinsonian (piribedil). We report the clinical case of a 55-year-old patient, hypertensive on Amlodipine, suffering from a parkinsonian disorder for 4 years; presenting to the psychiatric consultation at Ibn Nafis Hospital for a behavioural disorder following the introduction of Piribedil (antiparkinsonian dopaminergic agonist). Most of the psychic side effects of antiparkinsonian drugs are linked to their central dopaminergic properties. These effects are secondary to excessive stimulation of mesocorticolimbic dopamine receptors and/or serotonin hyperactivity.

Smart care facilities space for employees

Introduction Smart care in offices and industrials approach has the best way for the results of staying healthy in the transmission chain and this issue is not only a moral necessity but also it can be a successful plan where personal care centers start keeping the patients, employees, and experts of healthcare ward healthy by digital industries. In this project, the environment along with the individual`s body scan and accessing his /her biomarkers, the environment mechanism will be approached to the welfare level to disappear the disease, then change the air by antiseptic materials for air conditioning desirably.ObjectivesDesigning the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.MethodsContent analysis of environmental components of space and categorizing of sensors. Determining the basic model for programming Designing the architectural environment in accordance with the standards set in the previous section, preparation of the model with thermal, biological, biochemical,.sensors.ResultsDesigning the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.ConclusionsBy a positive design in architectural changes in care units in the field of public spaces, offices and industrial parts, we can easily control individual behaviors in the face of pandemic diseases and decline their psychic side effects.Conflict of interestOur work experience requires investment to run on a real scale

Hakikat Reward and Punishment Dalam Pendidkan Islam

The study wants to provide an insight into the importance of reward and punishment in relation to education. It is realized that the learning method by using reward and punishment can encourage students to have motivation to learn. As for the results in this study Reward and punishment are techniques to touch someone's psychic side so that they understand if they make a mistake, as a result the child will continue to be optimistic if what he did is right and stop after making a mistake.

An open-label randomised comparison of aripiprazole, olanzapine and risperidone for the acute treatment of first-episode schizophrenia: Eight-week outcomes

This study aimed to investigate the efficacy and tolerability of aripiprazole, olanzapine and risperidone in first-episode schizophrenia (FES). The eight-week, open, randomised study was conducted in six Chinese medical centres. Altogether, 498 FES subjects were randomised to aripiprazole (n = 165), olanzapine (n = 168) or risperidone (n = 165). Efficacy was measured with the Positive and Negative Syndrome Scale (PANSS), tolerability with the Udvalg for Kliniske Undersogelser Side Effect Rating Scale (UKU) and functioning with the Personal and Social Performance Scale (PSP). All three antipsychotics significantly improved the baseline to end-point PANSS total and each of the sub-scale scores (p < 0.001). Risperidone was superior to olanzapine and aripiprazole regarding PANSS total end-point scores (p < 0.05). Cumulative response (PANSS total score reduction ⩾30%) was similar between risperidone, olanzapine and aripiprazole (74.8%, 73.5% and 70.1%; p = 0.707), but risperidone was superior to aripiprazole regarding PANSS total score reduction ⩾50% (37.8% vs. 26.6%; p < 0.05). Olanzapine was associated with the largest weight gain at week 4 and 8 (p < 0.01), weight gain ⩾7% (olanzapine = 49.0% vs. risperidone = 32.5% vs. aripiprazole = 17.0%; p < 0.01), more psychic side effects at week 8 (p < 0.01 each) and more 'other' side effects at week 4 (p < 0.001) and week 8 (p < 0.05) but fewer neurological side effects at week 4 (p < 0.05) and week 8 (p < 0.01). PSP improved more with risperidone than with aripiprazole at week 4 and 8 (p < 0.05). For FES, risperidone might be a better choice than aripiprazole due to improved efficacy and functional improvement, without inferior tolerability. Aripiprazole is a better choice to avoid relevant short-term weight gain. Olanzapine could be chosen to avoid neurological adverse effects.

Switching to Clozapine Using Immediate Versus Gradual Antipsychotic Discontinuation: A Pilot, Double-Blind, Randomized Controlled Trial.

To examine effects of different antipsychotic discontinuation strategies on clinical outcomes in patients with schizophrenia undergoing a switch to clozapine. This pilot, 8-week, double-blind, randomized controlled trial was conducted from May 1999 to July 2004. Outpatients with a diagnosis of schizophrenia or schizoaffective disorder based on the Structured Clinical Interview for DSM-IV and eligible for a switch to clozapine were included. Participants were randomly assigned to the immediate discontinuation (prior antipsychotics were discontinued at baseline) or gradual discontinuation (prior antipsychotics were reduced by 25% each week) group. For each group, clozapine was gradually increased to 300 mg/d at day 12, with this dose maintained for 3 weeks and thereafter adjusted as needed. Clinical outcome measures included the Brief Psychiatric Rating Scale (BPRS), UKU Side Effect Rating Scale, and extrapyramidal symptoms scales. Thirty-three patients were enrolled; 15 and 18 patients were assigned to the immediate and gradual discontinuation groups, respectively. While significant improvements were observed in BPRS total scores after the switch to clozapine in both groups (P values < .001), no significant differences were found on any clinical outcome measures between the groups; however, additional analyses revealed a significant interaction between group and time for the UKU Psychic Side Effects subscale scores (P = .038). This preliminary study demonstrated no statistically significant differences in efficacy or tolerability between immediate and gradual antipsychotic discontinuation strategies when switching to clozapine in patients with schizophrenia; however, due to the small sample size, larger-scale trials are needed to confirm these results. ClinicalTrials.gov identifier: NCT02640300.

Reliability and Validity of the Short Version of Udvalg for Kliniske Undersogelser in Antipsychotic Treatment.

The aim of this study was to develop a reliable and valid short version of the Udvalg for Kliniske Undersogelser (UKU) to efficiently evaluate the side effects of antipsychotics in patients with schizophrenia. This multi-site study included 10 hospitals, which included 331 inpatients and outpatients diagnosed with schizophrenia. UKU, Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP) and dosage of paliperidone were collected. The predictive validity of the UKU-short version, as well as that of the CGI-S, PSP and paliperidone dosages, was analyzed using structural equation modeling (SEM), latent growth models (LGM), and confirmatory factor analysis to test its content and construct validity. The UKU-short included nine-items of sedation, reduced sleep, rigidity, tremor, akathisia, headache, reduced salivation, constipation and orthostatic dizziness, and has good construct and content validity over time. Confirmatory factor analysis showed good construct validity, with the psychic, neurological and autonomic side effect dimensions having correlations between 0.60 and 0.71. The predictive validity of the short-version UKU for psychiatric symptoms (CGI-S), quality of life (PSP) and dosage showed that the effects of drug dosage were negligible, and only neurological side effects were associated with psychiatric symptoms and quality of life. The UKU-short showed good content, construct and predictive validity. It is a more time-efficient instrument than the original UKU. This study only included patients treated with paliperidone, larger scale studies is needed to validate the UKU-short in detection of side effects in routine clinical practice to prevent non-adherence in patients with schizophrenia.

Apport du psychodrame psychanalytique dans le traitement d’une adolescente état-limite suivie en hôpital de jour

Psychodrama is a form of technical care particularly useful among adolescents who display identity and narcissistic disorder symptoms. After an explanation of the references to theatre and the notion of representing the psychic side of the brain, the role that fantasies and body pulses play in the brain's development, the authors highlight the importance of symbols, as theorized by Winnicott through his concept of illusion. The treatment consists of uncovering traces of hidden experiences that have remained out of reach from a person's psyche. The aim is to seek out a pattern of potential game, through the use of psychodrama, which had not yet emerged or developed, thus revealing the symbolism. The clinical example of a teenager bereft of structure sheds light upon this dynamic as well as the risks of the treatment.

Attitudes toward antipsychotic medications as a useful feature in exploring medication non-adherence in schizophrenia

ObjectiveTo investigate the interest in the attitudes toward antipsychotic medication in exploring medication non-adherence. MethodsSchizophrenic patients (N=120) completed the Beliefs about Medicines Questionnaire and measures of medication adherence, and clinical outcomes. Comparison between four attitudinal groups and logistic regressions were performed. ResultsHigh level of adherence varied significantly between attitudinal groups (Accepting, 70%; Indifferent, 63%; Ambivalent, 50%; Sceptical, 14%; p<0.001). Poor insight and psychic side effects were the most significant predictors of negative beliefs. ConclusionThe attitudinal groups approach could facilitate the identification of patients with non-adherence and determine individual targets of interventions to improve negative beliefs.

Side effects associated with psychotropic medications in patients with bipolar disorder: evidence from two independent samples

Available evidence concerning the side effects experienced by bipolar disorder (BD) patients under naturalistic conditions has been poorly investigated. The aim of this study was therefore to investigate side effects related to major psychotropic drugs in two independent samples of BD patients naturalistically treated with mood stabilizers, antidepressants, antipsychotics and/or anxiolytics. Overall, 3654 patients from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) sample and 282 patients from the Clinical Outcome and Psycho-Education for Bipolar Disorder (COPE-BD) sample were included. The primary outcome measure was the influence of each class of psychotropic drugs under investigation on the emergence of any side effect, as measured with the monitoring form in the STEP-BD study and the Udvalg for Kliniske Undersøgelser Side Effect Rating Scale in the COPE-BD study. Secondary outcome measures included the effects of such drugs on psychic, neurologic, autonomic and other side effects. Mood stabilizers and antipsychotics were associated with high rates of side effects in both samples. Furthermore, antipsychotics were specifically associated with psychic side effects, whereas mood stabilizers were specifically associated with neurologic side effects. Our results largely confirm in a naturalistic setting results previously observed in randomized controlled trials focusing on BD patients.

The impact of antipsychotic side effects on attitudes towards medication in people with schizophrenia and related disorders

This research aimed to: (i) investigate the prevalence and perceived severity of antipsychotic side effects in people with schizophrenia and related disorders living in communities in Singapore; (ii) examine the relationship between antipsychotic variables (type, dose, route, prescription duration) and side effects; and (iii) examine the relationship between side effects and attitudes towards medication. Antipsychotics are the mainstay treatment in schizophrenia and other psychotic disorders. However, antipsychotics are associated with a wide range of side effects, which potentially have adverse effects on patients' functioning. A lack of studies comparing the frequency of side effects and their associated levels of distress across multiple antipsychotics and different medication variables has been noted. Additionally, it is essential to assess patients' attitudes towards antipsychotics in relation to their experience of side effects. A cross-sectional, non-experimental research design was used. A convenience sample of 96 adults with schizophrenia and related disorders on antipsychotic treatment and attending the hospital's outpatient clinic was recruited. Variables collected included antipsychotic type, dose, route, prescription duration and side effects, attitudes towards medication and demographic and clinical variables. They were analysed with descriptive statistics and correlational analyses. Many participants experienced psychic (80·2%), extrapyramidal (69·8%) and miscellaneous side effects (61·5%). Side effects positively correlated with dose (p = 0·016) and negatively correlated with prescription duration (p = 0·014). Negative attitudes towards medication were positively correlated with side effects in general (p = 0·023), along with hormonal (p = 0·013) and psychic side effects (p = 0·008). Findings revealed that majority of the participants experienced and were distressed over psychic, extrapyramidal and weight gain, which may be related to high doses and treatment duration. Additionally, patients experiencing psychic and hormonal side effects are at risk of developing negative attitudes towards medication. Findings guide the development of appropriate nursing interventions that aim to alleviate side effects, reduce negative attitudes towards medication and prevent compliance problems.

The Relationship Between Akathisia and Subjective Tolerability in Patients With Schizophrenia

ABSTRACTAkathisia remains a significant issue even in the era of atypical antipsychotics. The purpose of the present study was to examine the association of akathisia with various domains of subjective tolerability in order to contribute to the renewed interest in akathisia and the subjective experience of antipsychotic treatment. Fifty schizophrenic outpatients receiving stable doses of risperidone were evaluated for akathisia, schizophrenic symptoms, and subjective tolerability. Subjective tolerability was comprehensively assessed using the Liverpool University Neuroleptic Side Effect Rating Scale. Analysis of covariance revealed that the akathisia group had a significantly higher total score as well as higher subscale scores of extrapyramidal side effect, psychic side effect, and autonomic side effect on the Liverpool University Neuroleptic Side Effect Rating Scale. Further analysis using binary logistic regression analysis revealed that these variables were significantly associated with akathisia. The results of our study suggest that akathisia is significantly associated with a wide range of subjective tolerability profiles, implying the necessity to effectively manage akathisia even its mild forms considering its strong association with subjective tolerability in general.

Self-reported Side Effects in children and Adolescents Taking Risperidone

We aimed to describe medication side effects in a cross-section of young people taking low-dose risperidone, using a self-report measure. The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) was completed by 66 patients aged between 6 and 18 years who had been taking low-dose risperidone (alone or in conjunction with other medications) for up to 13 years. Young persons, overall, seemed to tolerate risperidone well, but longer exposure to the medication was associated with higher side effect levels, particularly for the psychic (pertaining to mind and emotion) and extrapyramidal subscales. The most common complaints related to psychic side effects, such as tiredness, difficulty concentrating, difficulty remembering things and increased dreaming. Clinicians need to monitor the side effects of young patients taking low doses of risperidone, and other psychotropics, and maintain vigilance in those who have been taking medication for extended periods.

ZUSAMMENFASSENDER ERFAHRUNGSBERICHT ÜBER DIE KLINISCHE ANWENDUNG UND WIRKSAMKEIT VON Ro 5-4023 (CLONAZEPAM) AUF VERSCHIEDENE FORMEN EPILEPTISCHER ANFÄLLE

Ro 5-4023 was administered orally and intravenously. Oral long-term therapy of at least one month (average 10 months) was given to 100 patients, mainly children aged up to 14 years (90 per cent of cases) with cerebral damage since early infancy. Most were suffering from severe epilepsy of early childhood, which had proved resistant to former treatment. The principal form was myoclonic-astatic seizures (67 per cent) often combined with tonic seizures or grand mal. The initial effect of the long-term treatment was satisfactory, especially in non-major seizures (positive initial effect in 62 per cent), although in general freedom from seizures was not obtained, but only an improvement in their frequency. The incidence of recurrences in the further course was high, however, and after 6–12 months of treatment the positive effect of clonazepam was below 30 per cent, i. e. within the range of chance in the spontaneous course of epilepsy. After the patient had relapsed and oral long-term therapy had been withdrawn it was in many cases still possible to exploit the immediate effect of small oral doses taken “as needed”, i. e. only on days in which there was a particular clustering of petit mal fits or a tendency towards petit mal status. Apart from untoward psychic side effects and, very rarely, activation of tonic seizures, no serious side effects were seen. The immediate effect of intravenous administration on various forms of status epilepticus (without grand mal status) was good, and a positive effect was obtained in 75 per cent of cases. The positive clinical effect of a single intravenous dose lasted for more than 24 hours in 60 per cent of cases. On the whole clonazepam has shown itself to be a “broad-spectrum” anti-epileptic agent with a wide range of indications, which in spite of the often purely palliative effect and high rate of recurrence is particularly suitable for the treatment of severe, combined epilepsies and their status forms.

Psychische Nebenwirkungen unter Therapie mit Interferon-α - Eine Fallstudie

Psychological side effects of the therapy with interferon-alpha (IFN-alpha) have frequently been reported. The symptomatology varies, although there seems to be a predominance of depressive complaints. Mediating somatopsychological vs. psychosomatic pathways remain unknown so far. We describe the case of a 26-year old female inpatient suffering from hepatitis C infection. During medical treatment with interferon-alpha, a transfer to a psychosomatic unit became necessary due to increasing agitation, somatization and a lacking response to psychopharmacological medication. After the discontinuation of IFN-alpha-treatment, the patient's gradual emotional stabilization could be attained. In psychotherapy, inner conflicts as well as fears about possible side effects of the medication were worked through. After discharge, parallel to an ambulatory psychotherapy, the IFN-alpha medication was readministered and completed successfully. As long as aetiology and mechanisms of psychic side effects of IFN-alpha-treatment remain unclear, ward-based integrative psychosomatic psychotherapy can be supportive and enlightening with regard to psychosocial factors of influence on the IFN-alpha-induced side effects.

Patient outcomes in schizophrenia I: correlates with sociodemographic variables, psychopathology, and side effects

Objective. – The present cross-sectional study examined the relationships of psychopathology, side effects, and sociodemographic factors with treatment outcomes in terms of patients' quality of life (QOL), functioning, and needs for care. Method. – Sixty outpatients with chronic schizophrenia who had been treated with either clozapine or olanzapine for at least 6 months were investigated. Results. – Most psychopathological symptoms as well as psychic side effects, weight gain, and female sex were associated with lower QOL, while cognitive symptoms correlated with better QOL. Female sex, cognitive symptoms, and parkinsonism negatively influenced occupational functioning, and negative symptoms determined a lesser likelihood of living independently. Age, education, depression/anxiety, negative symptoms, and psychic side effects were predictors of patients' needs for care. Conclusion. – Our results highlight the complex nature of patient outcomes in schizophrenia. They reemphasize the need of targeting effectiveness, i.e. both symptomatic improvement as well as drug safety, in such patients.

Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence

Objective. – (1) determine which antipsychotic side effects (SE) schizophrenic patients consider the most distressing during treatment with typical antipsychotics, (2) measure the impact of actual and past SE on patients' attitude toward antipsychotics and (3) assess the influence of both on adherence. Methods. – The 213 schizophrenics, treated with conventional antipsychotics, were recruited in two psychiatric hospitals in Hamburg. Subjects were assessed about type and severity of present and past side effects and their attitude and adherence to antipsychotic treatment. Results. – The 82 (39%) patients presented present SE while 131 (61%) did not. Sexual dysfunctions ( P < 0.001), extrapyramidal ( P < 0.05) and psychic side effects ( P < 0.05) were rated as significantly subjectively more distressing than sedation or vegetative side effects. Patients presenting with present SE compared with patients without present SE had a significantly more negative general attitude toward antipsychotics ( P < 0.05), were more doubtful about their efficacy ( P < 0.01) and were less likely to encourage a relative to take such a medication in case of need ( P < 0.001). A regression analysis indicated that nonadherence was mainly influenced by negative general and efficacy attitudes toward antipsychotics and the experience of past or present antipsychotic side effects. Conclusions. – All antipsychotic side effects, present or past, can have a durable negative impact on patient's attitude toward antipsychotic treatment and adherence. Non-adherence is mainly determined, among other factors, by these negative attitudes, which are partly influenced by the experience of past or present antipsychotic-induced side effects.

Adaptability and compliance of the obese patient to restrictive gastric surgery in the short term.

Low compliance, as well as recurrent vomiting, are often pointed out as the main causes of both postoperative technical complications and poor weight loss. 50 patients were examined. All underwent preoperative psychological assessment through an intensive clinical interview. Between October 1999 and January 2000, all the patients underwent vertical banded gastroplasty (VBG). Excess Weight Loss (EWL) was followed, and the number of vomiting episodes was recorded at 1, 3 and 6 months after surgery. 3 different groups of patients could be distinguished: 1) those with no vomiting and good weight loss; 2) those with sporadic vomiting and fairly good weight loss; and 3) those with frequent vomiting and poorer weight loss. However, this last group of patients was not homogeneous and should be divided into 2 subgroups: 1) patients who lose weight, while vomiting; 2) patients who do not lose weight, while vomiting. The experience of vomiting is a crucial cross-roads. The influence of psychosocial factors was noticed in all patients. The absence of psychosocial stressors, together with realistic expectations and a strong motivation to change, should be considered as reliable and replicable predictors of success. However, even those patients with accentuated psychological difficulties were able to succeed in coping with them, and achieved a good weight outcome, with good effects on the psychic side. Therefore, the evidence of psychological disorders cannot be taken as an absolute criterion of selection/exclusion of candidates for the operation. Accurate presurgical education and postoperative psychological support are likely to increase the patient's compliance and the percentage of successful cases.

Self-reported personality disorders in patients with schizophrenia and the relationship to symptoms, side effects and social functioning

In a national, naturalistic, point prevalence, multicenter study, patients with schizophrenic syndromes were studied with regard to self-reported personality disorders, symptoms, side effects, and social functioning. Ninety-one of 116 patients with a schizophrenic syndrome responded to the DSM-IV and the ICD-10 Personality Questionnaire (DIP-Q). In total, 43 of the patients (47%) fulfilled the criteria for one or more personality disorders. The most common personality disorders found were in cluster C and in cluster A? 44% and 34%, respectively. Comorbidity between and within clusters was high. Personality-disordered patients displayed significantly more negative, anxious:depressive, and cognitive symptoms than patients without personality disorders. Sex, age, duration of illness, and extrapyramidal side effects on the basis of the Extrapyramidal Side effect Rating Scale (ESRS) did not differ between the groups. However, psychic side effects, measured with the UKU (Utvalg for Kliniske Undersøkelser) Side Effect Rating Scale were significantly more common in the group of patients with self-reported personality disorders. Social functioning rated by a modified version of the Strauss ? Carpenter rating scale and the Global Assessment of Functioning scale (GAF) did not differ between the groups.

Ketamine anaesthesia for electrocochleography in children. Are psychic side effects more common than believed?

Ketamine anaesthesia for electrocochleography in children. Are psychic side effects more common than believed?

Ketamine and military anaesthesia. The effect of heavy papaveretum premedication and Althesin induction on the incidence of emergence phenomena.

An anaesthetic technique suitable for military field anaesthesia was sought which would attenuate the psychic side effects of ketamine. Heavy premedication with 30 mg of papaveretum and induction of anaesthesia with Althesin were evaluated. A combination of the two lowered the incidence of side effects, but they still occurred frequently enough to pose problems. Ketamine sequelae are considered incompatible with the battlefield environment.