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Epileptic Disorders : International... Feb 2022Unverricht-Lundborg disease (ULD), also called progressive myoclonic epilepsy type 1, is usually characterized by the presence of ataxia associated with myoclonus and...
Unverricht-Lundborg disease (ULD), also called progressive myoclonic epilepsy type 1, is usually characterized by the presence of ataxia associated with myoclonus and epileptic seizures without progressive cognitive deficit, presenting during late childhood and early adolescence. Currently, there is a growing body of evidence for atypical presentations of the disease with a milder phenotype or without the full symptomatology. We describe a case report of a late-onset phenotype with progressive myoclonus-ataxia syndrome accompanied by initial recurrent falls, resulting in specific phobia and agoraphobia starting at the age of 50 years old. The examination revealed multifocal myoclonus with cerebellar ataxia and electroencephalogram showed generalized polyspikes and spike-wave discharges. Electromyogram revealed positive myoclonus of 60-ms duration in the face and the presence of C reflex. A genetic study confirmed the diagnosis of ULD in the patient and other additional family members, presenting a wide range of intra-familial variability. We discuss the challenging differential diagnosis for such a misleading presentation and its possible underlying pathophysiological mechanisms. Our case report may contribute to broadening the age and clinical boundaries for this disease and emphasizes the intra-familial age and symptom variability. Based on a suggestive family history, the diagnosis of ULD should be considered in this context, even in older patients.
Topics: Ataxia; Electroencephalography; Humans; Medical History Taking; Middle Aged; Myoclonus; Unverricht-Lundborg Syndrome
PubMed: 34787084
DOI: 10.1684/epd.2021.1372 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2020Anxiety and related disorders are the most common type of mental disorders in both the general population and the neurological clinic. A current typology of anxiety...
Anxiety and related disorders are the most common type of mental disorders in both the general population and the neurological clinic. A current typology of anxiety disorders includes panic disorder, agoraphobia, simple (specific) phobias, social anxiety disorder, and generalized anxiety disorder. Anxiety disorders often accompany diseases of the nervous system, worsen their course and impede treatment, and the degree of anxiety usually corresponds to the severity of neurological symptoms. Anxiety may precede brain diseases, but the answer to the question of whether it contributes to these diseases or predicts them or can be an early manifestation of these diseases requires further studies. Modern approaches to the treatment of anxiety involve the use of benzodiazepines, antidepressants, some mood stabilizers, antipsychotics, as well as psychological interventions.
Topics: Anxiety; Anxiety Disorders; Humans
PubMed: 32621484
DOI: 10.17116/jnevro2020120051165 -
The Journal of the Egyptian Public... Dec 2022People with mental health problems are at particular risk both for infection with COVID-19 and for more severe course of illness. Understanding COVID-19 vaccine... (Review)
Review
BACKGROUND
People with mental health problems are at particular risk both for infection with COVID-19 and for more severe course of illness. Understanding COVID-19 vaccine hesitancy is crucial in promoting vaccine acceptance among people with mental health diagnoses. This review aims to identify the prevalence and discuss factors associated with COVID-19 vaccine hesitancy among the mentally ill population.
MAIN BODY
We conducted a detailed literature search and included 15 articles for discussion in this review. Several studies showed varying trends of vaccine hesitancy rates among different countries. Major factors involved in vaccine hesitancy in general include mistrust, misinformation, believing in conspiracy theories, and negative attitudes towards vaccines. It was surprising that none of the studies were focused on vaccine acceptance rates and factors associated with vaccine hesitancy among the mentally ill population. However, studies do show that COVID-19 is associated with worse healthcare outcomes for psychiatric patients, and vaccine hesitancy correlated with a lower likelihood of receiving mental health treatment and vaccinations. Psychiatrists need to address issues among patients who are particularly vulnerable to the fear of vaccines which include anxiety, panic attacks, certain phobias including trypanophobia and agoraphobia, obsessive-compulsive disorder, and certain types of traumas. Psychiatrists need to communicate effectively, show respect, empathy, and deliver accurate and honest information about the vaccines. Motivational interviewing, getting people with mental health illness to organize vaccine campaigns, and involving families with mental health problems may promote vaccine acceptance among this group.
CONCLUSION
Existing literature on the rates of vaccine hesitancy among people with mental health illness is limited. The mental health illness may increase the risk of hesitancy especially in patients having certain emotional disorders such as anxiety and phobia. More studies addressing vaccine hesitancy rates and factors associated with the mentally ill population need to be done in the future.
PubMed: 35079435
DOI: 10.1186/s42506-022-00102-8 -
Depression and Anxiety Mar 2021Prompt Mental Health Care (PMHC, Norwegian adaption of Improving Access to Psychological Therapies) has shown effects on symptoms of anxiety and depression compared to... (Randomized Controlled Trial)
Randomized Controlled Trial
Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6- and 12-month follow-up: Secondary analysis from a randomized controlled trial.
BACKGROUND
Prompt Mental Health Care (PMHC, Norwegian adaption of Improving Access to Psychological Therapies) has shown effects on symptoms of anxiety and depression compared to treatment as usual (TAU). In this secondary analysis, we examine the effectiveness of PMHC among clients presenting with symptoms of social anxiety disorder (SAD) and/or agoraphobia on core symptoms at 6- and 12-month follow-up.
METHODS
Randomized controlled trial in two PMHC sites (70:30 ratio PMHC:TAU). Of participants, 61.3% (n = 472) scored at caseness for SAD and 47.7% (n = 367) for agoraphobia (40% both). Effects on SAD avoidance and physiological discomfort (SPIN-9), SAD cognitions (ATQ-SA), agoraphobic avoidance (MIA-8), and agoraphobic cognitions (ATQ-AP) were examined in piecewise growth models.
RESULTS
The PMHC group showed substantially greater symptom reduction than the TAU group for all outcomes: At 6-month follow-up, the between-group effect sizes were d -0.60 (95% CI: -0.94 to -0.26) for SPIN-9, -0.45 (95% CI: -0.70 to -0.20) for ATQ-SA, -0.50 (95% CI: -0.87 to -0.13) for MIA-8, and -0.61 (95% CI: -0.92 to -0.31) for ATQ-AP. All effects were sustained at similar level at a 12-month follow-up.
CONCLUSION
PMHC effectively alleviated SAD and agoraphobia symptoms, and individuals struggling with such symptoms constituted a large proportion of clients. Although results should be interpreted with caution due to risk of attrition bias, they lend further support for a scale-up of PMHC and similar initiatives. Individuals struggling with SAD and/or agoraphobia stood out as relatively high burdened, whereas only one of five had sought help the last 12 months, underscoring the need for the PMHC service.
Topics: Agoraphobia; Anxiety; Anxiety Disorders; Humans; Mental Health; Norway; Treatment Outcome
PubMed: 33393688
DOI: 10.1002/da.23132 -
Frontiers in Psychology 2023A number of case studies describing hypnotherapy in the treatment of anxiety disorder patients have already been published. Only a few randomized controlled trials...
UNLABELLED
A number of case studies describing hypnotherapy in the treatment of anxiety disorder patients have already been published. Only a few randomized controlled trials (RCTs) investigated the efficacy of hypnotherapy but focused mainly on symptoms rather than specific mental disorders. The goal of this study was to investigate whether hypnotherapy (HT) was superior to a waitlist control group (WL) in the reduction of agoraphobia-related symptoms. Further goals were to report the feasibility of hypnotherapy as well as attrition and completion rates and detect (epi-)genetic variables, which might play a role in treatment outcome. This pilot study was based on a monocentric two-armed randomized controlled rater-blind clinical trial that was conducted between 2018 and 2020 with a waitlist control group. A total of 36 patients diagnosed with agoraphobia were randomized to either HT or WL. Patients in HT received individual outpatient treatment with hypnotherapy with 8 to 12 sessions for a period of 3 months. Patients in WL received HT after 3 months. Agoraphobia-related symptoms were assessed at baseline, after the treatment, and 3 months later in both groups with a clinician rating. The primary hypothesis concerning the difference between groups in the individual percentage symptom reduction could be confirmed in the intention-to-treat, not the per-protocol sample. Additionally, we applied repeated-measures analyses of variance and found a higher symptom decrease in HT compared with WL patients in three of the five imputed datasets. The dropout rate was low, and satisfaction with the treatment was high. HT patients experienced a strong symptom reduction after receiving hypnotherapy. WL patients improved slightly during the waiting period. The ValMet genotype had an effect on the agoraphobia-related symptoms as well as on DNA methylation levels. This is the first study to indicate that hypnotherapy performed better than a waitlist control group regarding the reduction in anxiety symptoms in an RCT. Future studies should confirm the efficacy of hypnotherapy and compare the treatment with a standard treatment for anxiety disorders in a larger trial. Future studies should also investigate whether hypnotic susceptibility is associated with ValMet genotype and could predict treatment success for HT.
CLINICAL TRIAL REGISTRATION
https://classic.clinicaltrials.gov/ct2/show/NCT03684577, identifier: NCT03684577.
PubMed: 37637902
DOI: 10.3389/fpsyg.2023.1213792 -
Neuro Endocrinology Letters Dec 2020In the new millennium, a growing focus on human rights and preserving individual autonomy urges the promotion of needs of the psychiatric patients. The topic of human... (Review)
Review
OBJECTIVES
In the new millennium, a growing focus on human rights and preserving individual autonomy urges the promotion of needs of the psychiatric patients. The topic of human needs takes its place also in patients with panic disorder. This review intended to explore current facts concerning the needs of the patients and present a broader understanding of patients' needs, due to the complexity of problems of patients with panic disorder. The text also focuses on psychosocial well-being and the quality of life of patients with panic disorder.
METHODS
The PubMed was used to search for articles published between January 2000 and February 2020 using the following keywords: "panic disorder" or "agoraphobia" and "unmet needs" in combination with "pharmacotherapy" or "psychotherapy" or "cognitive behavioural therapy" or "family" or "quality of life." A total of 264 articles were selected by primary keyword picking in different combinations. Altogether 182 articles were reviewed.
RESULTS
We identified the most important unmet needs of patients with panic disorder connected to symptoms, treatment and help-seeking, stigma and self-stigma, family and quality of life. To help the patients to improve the unmet needs connected with: (1) symptoms is to increase the awareness of treatment steps for patients and their families, good cooperation with therapists, and management of persistent symptoms, alleviation or elimination of anxiety symptoms, avoidance and safety behaviour. (2) treatment is the quick approach, effective one, not too difficult, without side effects and harmless, not requiring hospitalization and not disturbing the daily routine, increasing treatment compliance, improving patient self-confidence and an active social network, affordable health and social services and more suitable information for families; (3) stigma is to change of public opinion about people with mental health problems and to create effective antistigma programs; (4) family is to include the support for a functional and independent life, helping to manage everyday tasks and stop excessive protection, while reducing the stigmatization of the whole family. (5) the quality of life is to help to integrate into the community and improve the factors that affect the quality of life; like esteem, self-acceptance, social acceptance etc. CONCLUSIONS: This review aimed to explore the unmet needs in patients with panic disorder or agoraphobia. In selected articles we identified 5 basic unmet needs and described the basic strategies to cope with them. It is essential for every clinician to understand those needs as it can substantially help to alleviate patients' symptoms and improve their quality of life. The importance of this understanding further highlights that unmet needs described for panic disorder overlap with unmet needs of other psychiatric disorder and thus have broader utility.
Topics: Agoraphobia; Cognitive Behavioral Therapy; Humans; Panic Disorder; Psychotherapy; Quality of Life
PubMed: 33754599
DOI: No ID Found -
Frontiers in Neurology 2020Tinnitus is the perception of sound without an external stimulus. A large part of the adult population experiences this symptom but never seeks professional help, where...
Tinnitus is the perception of sound without an external stimulus. A large part of the adult population experiences this symptom but never seeks professional help, where others have devastating complaints in daily life. This suggests that the impact of tinnitus varies among patients and may be influenced by coping strategies and multiple psychological factors. Cross- sectional study of patients visiting the tertiary tinnitus referral center of the University Medical Center Utrecht, the Netherlands. Three hundred and twenty-one consecutive chronic tinnitus patients were evaluated by the tinnitus care group Utrecht from 6-2007 till 11-2012 of which 308 patients were included. Patients completed two tinnitus distress questionnaires (THI, TQ), a coping questionnaire (CISS) as well as a psychopathological questionnaire (SCL-90-R). Emotional-orientated coping and distraction-orientated coping strategies were significantly correlated with the experienced tinnitus burden. Also a significant negative correlation with task orientated coping was found. The effect size was small. Tinnitus distress also had a significant positive correlation with anxiety, agoraphobia, depression, insufficiency of handling, distrust & personal sensitivity, hostility and sleeping problems. Patients with higher tinnitus handicap scores demonstrated the use different coping strategies than the patients with lower distress scores. This insight in coping strategies in a group of patients with high tinnitus burden is useful for counseling patients. As tinnitus coping strategy might be related to the extent and success of habituation, this outcome could be of interest to optimize tinnitus treatments in the near future.
PubMed: 33329312
DOI: 10.3389/fneur.2020.570989 -
Cureus Aug 2023YouTube, known as an online video platform, is one of the most popular and dynamic video platforms in the world. it provides access to videos with a variety of content,...
BACKGROUND
YouTube, known as an online video platform, is one of the most popular and dynamic video platforms in the world. it provides access to videos with a variety of content, both in health and many other areas. The fact that it is accessible to everyone and free of charge makes it frequently preferred by individuals. The effectiveness of social media platforms on the thoughts and behaviors of individuals has caused YouTube and other similar platforms to be the subject of health research in recent years. Agoraphobia is an anxiety disorder characterized by an intense fear of feeling trapped somewhere. Agoraphobia is a common type of anxiety disorder in society, and cognitive behavioral and psychopharmacological agents are used in its treatment. Our aim in this research is to examine YouTube videos on agoraphobia in terms of reliability and quality.
METHODS
The first 50 videos related to agoraphobia were included in the analysis, and the duration (minutes), video content, institutions/individuals who uploaded the video, the time elapsed since uploading, total views, and likes were recorded. In addition, all videos were evaluated on two different scales: Quality Criteria for Consumer Health Information (DISCERN) and the Global Quality Scale (GQS). The obtained data were analyzed statistically.
RESULTS
The mean video duration was 11.4±9.38 minutes, the mean views count was 113299.5±333091, and the mean like count was 8512.76±31429.37. Videos were evaluated in terms of content; 50% included general information, 28% agoraphobia experience, and 22% information about overcoming agoraphobia. The GQS and DISCERN scores were significantly higher in professional videos than in non-professionals (<0.005).
CONCLUSION
As a result of the evaluation of YouTube videos about agoraphobia in terms of quality and content, it has been determined that it is necessary to increase the rate of videos prepared by mental health professionals. Psychiatrists and other healthcare professionals working in the field of anxiety should be encouraged to provide videos with scientific and reliable content.
PubMed: 37577273
DOI: 10.7759/cureus.43318 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2020Anxiety disorders are the most common type of mental disorders and include such core forms as generalized anxiety disorder, panic disorder, agoraphobia, specific...
Anxiety disorders are the most common type of mental disorders and include such core forms as generalized anxiety disorder, panic disorder, agoraphobia, specific phobias, and social anxiety disorder. Anxiety disorders contribute significantly to the global burden of disease, and the diagnosis and treatment of these disorders is of great social and economic importance. Current approaches to the treatment of anxiety disorders involve the use of cognitive behavioral therapy, antidepressants, benzodiazepines, antipsychotics, few anticonvulsants, and some other medications.
Topics: Agoraphobia; Anxiety Disorders; Humans; Panic Disorder; Phobic Disorders; Selective Serotonin Reuptake Inhibitors
PubMed: 32790986
DOI: 10.17116/jnevro2020120071121 -
PloS One 2022Anxiety disorders, including panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), agoraphobia, and specific phobia, are among the most... (Review)
Review
Anxiety disorders, including panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), agoraphobia, and specific phobia, are among the most common psychiatric disorders. Although the traditional pharmacologic treatments for anxiety included barbiturates and then benzodiazepines, the introduction of tricyclic antidepressants, followed by the selective serotonin reuptake inhibitors (SSRIs), marked a tidal shift in the treatment of anxiety. Although not approved for treatment of anxiety disorders (with the exception of trifluoperazine) there is ongoing off-label, unapproved use of both first-generation "typical" antipsychotics (FGAs) and second-generation or "atypical" antipsychotics (SGAs) for anxiety. Although there have been systematic reviews and meta-analyses on the use of antipsychotics in anxiety disorders, most of these reviews focused on SGAs, primarily the use of quetiapine in GAD. Given that there is little known about the potential benefits and short-and long-term risks of using antipsychotics in anxiety, there is a need for an umbrella review of systematic reviews and meta-analyses of the use of both FGAs and SGAs in anxiety disorders. The specific aims of this study are as follows: (1) Evaluate the evidence of efficacy of FGAs and SGAs in anxiety disorders as an adjunctive treatment to SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs) and other non-antipsychotic medications; (2) Compare monotherapy with antipsychotics to first-line treatments for anxiety disorders in terms of effectiveness, risks, and side effects; and (3) Evaluate the short- and long-term risks and side effects of prescribing antipsychotics in anxiety disorders. The review is registered on PROSPERO (CRD42021237436). Since data extraction has not begun, there is not preliminary data to share.
Topics: Antipsychotic Agents; Anxiety Disorders; Benzodiazepines; Humans; Quetiapine Fumarate; Selective Serotonin Reuptake Inhibitors; Systematic Reviews as Topic
PubMed: 35709149
DOI: 10.1371/journal.pone.0269772