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L'Encephale Dec 2009Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. It is also... (Review)
Review
INTRODUCTION
Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. It is also generally thought that schizophrenia predisposes subjects to homicidal behaviour.
OBJECTIVE
The aim of the present paper was to estimate the rate of mental disorder in people convicted of homicide and to examine the relationship between definitions. We investigated the links between homicide and major mental disorders.
METHODS
This paper reviews studies on the epidemiology of homicide committed by mentally disordered people, taken from recent international academic literature. The studies included were identified as part of a wider systematic review of the epidemiology of offending combined with mental disorder. The main databases searched were Medline. A comprehensive search was made for studies published since 1990.
RESULTS
There is an association of homicide with mental disorder, most particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. However, it is not clear why some patients behave violently and others do not. Studies of people convicted of homicide have used different definitions of mental disorder. According to the definition of Hodgins, only 15% of murderers have a major mental disorder (schizophrenia, paranoia, melancholia). Mental disorder increases the risk of homicidal violence by two-fold in men and six-fold in women. Schizophrenia increases the risk of violence by six to 10-fold in men and eight to 10-fold in women. Schizophrenia without alcoholism increased the odds ratio more than seven-fold; schizophrenia with coexisting alcoholism more than 17-fold in men. We wish to emphasize that all patients with schizophrenia should not be considered to be violent, although there are minor subgroups of schizophrenic patients in whom the risk of violence may be remarkably high. According to studies, we estimated that this increase in risk could be associated with a paranoid form of schizophrenia and coexisting substance abuse. The prevalence of schizophrenia in the homicide offenders is around 6%. Despite this, the prevalence of personality disorder or of alcohol abuse/dependence is higher: 10% to 38% respectively. The disorders with the most substantially higher odds ratios were alcohol abuse/dependence and antisocial personality disorder. Antisocial personality disorder increases the risk over 10-fold in men and over 50-fold in women. Affective disorders, anxiety disorders, dysthymia and mental retardation do not elevate the risk. Hence, according to the DMS-IV, 30 to 70% of murderers have a mental disorder of grade I or a personality disorder of grade II. However, many studies have suffered from methodological weaknesses notably since obtaining comprehensive study groups of homicide offenders has been difficult.
CONCLUSIONS
There is an association of homicide with mental disorder, particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Homicidal behaviour in a country with a relatively low crime rate appears to be statistically associated with some specific mental disorders, classified according to the DSM-IV-TR classifications.
Topics: Alcoholism; Antisocial Personality Disorder; Comorbidity; Cross-Sectional Studies; Dangerous Behavior; Female; Homicide; Humans; Incidence; Male; Odds Ratio; Risk Factors; Schizophrenia; Schizophrenic Psychology; Substance-Related Disorders; Violence
PubMed: 20004282
DOI: 10.1016/j.encep.2008.10.009 -
Critical Care (London, England) Feb 2006Traditional teaching suggests that corticosteroids should be avoided during acute infectious episodes for fear of compromising the immune response. However, the outcome... (Review)
Review
Traditional teaching suggests that corticosteroids should be avoided during acute infectious episodes for fear of compromising the immune response. However, the outcome benefit shown through steroid administration in early septic shock implies this paranoia may be misplaced. We therefore performed a systematic review of the literature to identify the current strength of evidence for the use of corticosteroids in specified infections, and to make appropriate graded recommendations.
Topics: Adrenal Cortex Hormones; Communicable Diseases; Humans; Practice Guidelines as Topic; Randomized Controlled Trials as Topic
PubMed: 16356204
DOI: 10.1186/cc3904 -
International Review of Psychiatry... 2019There is an increase in interest in the relationships between loneliness and psychosis. The notion of psychosis continuum implies that psychotic experiences extend from... (Meta-Analysis)
Meta-Analysis
There is an increase in interest in the relationships between loneliness and psychosis. The notion of psychosis continuum implies that psychotic experiences extend from clinical populations with psychotic disorders to non-clinical populations. This meta-analytic review aimed to examine the respective associations of loneliness with positive and negative psychotic experiences along the psychosis continuum. A systematic database search was conducted and a total of 30 studies were included in the first meta-analysis and 15 studies were included in the second meta-analysis. There was a medium association between loneliness and positive psychotic experiences ( = 0.302, < 0.001). In particular, the association between loneliness and paranoia was robust ( = 0.448, < 0.001). The second meta-analysis revealed a medium association between loneliness and negative psychotic experiences ( = 0.347, < 0.001). The associations between loneliness and both positive and negative psychotic experiences were found to be smaller among clinical than non-clinical samples. The above findings provided evidence for the associations between loneliness and the two core dimensions of psychotic experiences along the phenomenological continuum. Future research should examine the dynamics of these relationships in both clinical and non-clinical samples, preferably using a single-symptom approach.
Topics: Humans; Loneliness; Psychotic Disorders; Social Isolation
PubMed: 31331209
DOI: 10.1080/09540261.2019.1636005 -
Neuropsychology Review Sep 2018Delusions in Parkinson's disease (PD) are thought to be associated with disease progression and cognitive impairment. However, this symptom description is not consistent...
Delusions in Parkinson's disease (PD) are thought to be associated with disease progression and cognitive impairment. However, this symptom description is not consistent in the literature and there is a suggestion that different subgroups of psychotic patients occur in PD, which we aimed to clarify. Case reports were identified through a systematic search of databases (PUBMED, EMBASE, PsychInfo). Cases with isolated delusions were compared to those with both delusions and hallucinations. We identified 184 cases of delusions in PD. Delusions were primarily paranoid in nature (83%) and isolated in 50%. Those with isolated delusions had an earlier onset of PD (46 years vs 55 years), higher rates of impulse control disorders (40.2 vs 10.3%), dopamine dysregulation (29.9 vs 11.3%) and lower rates of cognitive impairment (8.0 vs 26.8%). There is unexpected heterogeneity amongst cases of delusional psychosis, that cannot adequately be explained by existing models of PD psychosis.
Topics: Delusions; Humans; Parkinson Disease
PubMed: 30073446
DOI: 10.1007/s11065-018-9379-3 -
Journal of Translational Medicine Oct 2020Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and...
BACKGROUND
Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and psychosis. In humans, Δ-tetrahydrocannabinol (THC) has been associated with an anxiogenic response, while anxiolytic activity has been attributed mainly to cannabidiol (CBD). In animal studies, the effects of THC are highly dose-dependent, and biphasic effects of cannabinoids on anxiety-related responses have been extensively documented. A more precise assessment is required of both the anxiolytic and anxiogenic potentials of phytocannabinoids, with an aim towards the development of the 'holy grail' in cannabis research, a medicinally-active formulation which may assist in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects.
OBJECTIVES
To systematically review studies assessing cannabinoid interventions (e.g. THC or CBD or whole cannabis interventions) both in animals and humans, as well as recent epidemiological studies reporting on anxiolytic or anxiogenic effects from cannabis consumption.
METHOD
The articles selected for this review were identified up to January 2020 through searches in the electronic databases OVID MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO.
RESULTS
Acute doses of CBD were found to reduce anxiety both in animals and humans, without having an anxiogenic effect at higher doses. Epidemiological studies tend to support an anxiolytic effect from the consumption of either CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses).
CONCLUSION
Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders. However, further research is needed to explore other cannabinoids and phytochemical constituents present in cannabis (e.g. terpenes) as anxiolytic interventions. Future clinical trials involving patients with anxiety disorders are warranted due to the small number of available human studies.
Topics: Animals; Anti-Anxiety Agents; Anxiety; Anxiety Disorders; Cannabidiol; Cannabis; Humans
PubMed: 33008420
DOI: 10.1186/s12967-020-02518-2 -
Annals of Clinical Psychiatry :... Aug 2018This systematic review identified published studies that evaluated the use of ondansetron in individuals with psychosis associated with dementia.
BACKGROUND
This systematic review identified published studies that evaluated the use of ondansetron in individuals with psychosis associated with dementia.
METHODS
A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO, and Cochrane Collaboration databases for randomized controlled trials (RCTs), cohort studies, and case reports that evaluated the use of ondansetron for individuals with psychosis associated with dementia. Bibliographic databases of published articles were also searched for additional studies.
RESULTS
A total of 4 studies were identified, all of which were open-label trials of ondansetron for psychosis associated with Parkinson's disease. All trials showed improvements in visual hallucinations and paranoid ideations in most patients, as well as a modest improvement in functioning, but no evidence of cognitive improvement.
CONCLUSIONS
Ondansetron appears to have benefit in improving positive symptoms of psychosis in individuals with Parkinson's disease, but RCTs are needed before routine use is recommended. There is a paucity of evidence for the use of ondansetron for psychosis associated with other forms of dementia.
Topics: Antipsychotic Agents; Cognition Disorders; Dementia; Humans; Ondansetron; Parkinson Disease; Psychotic Disorders
PubMed: 30028894
DOI: No ID Found -
JMIR Mental Health Jan 2024This study examined and reflected on the frequency of people with psychotic symptoms and features as the target population in design studies for mental health care...
This study examined and reflected on the frequency of people with psychotic symptoms and features as the target population in design studies for mental health care innovation.
Topics: Humans; Mental Health; Psychotic Disorders; Research Design
PubMed: 38194249
DOI: 10.2196/54202 -
Plastic and Reconstructive Surgery Aug 2020Recent clinical experience with migraine surgery has demonstrated both the safety and the efficacy of operative decompression of the peripheral nerves in the face, head,...
BACKGROUND
Recent clinical experience with migraine surgery has demonstrated both the safety and the efficacy of operative decompression of the peripheral nerves in the face, head, and neck for the alleviation of migraine symptoms. Because of the perceived novelty of these procedures, and the paranoia surrounding a theoretical loss of clinical territory, neurologists have condemned the field of migraine surgery. The Patient Safety Subcommittee of the American Society of Plastic Surgeons ventured to investigate the published safety track record of migraine surgery in the existing body of literature.
METHODS
A comprehensive review of the relevant published literature was performed. The relevant databases and literature libraries were reviewed from the date of their inception through early 2018. These articles were reviewed and their findings analyzed.
RESULTS
Thirty-nine published articles were found that demonstrated a substantial, extensively replicated body of data that demonstrate a significant reduction in migraine headache symptoms and frequency (even complete elimination of headache pain) following trigger-site surgery.
CONCLUSIONS
Migraine surgery is a valid method of treatment for migraine sufferers when performed by experienced plastic surgeons following a methodical protocol. These operations are associated with a high level of safety. The safety and efficacy of migraine surgery should be recognized by plastic surgeons, insurance companies, and the neurology societies.
Topics: Decompression, Surgical; Humans; Migraine Disorders; Neurosurgical Procedures; Pain Measurement; Peripheral Nerves; Treatment Outcome
PubMed: 32740592
DOI: 10.1097/PRS.0000000000007020 -
Human Psychopharmacology May 2017Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients.... (Review)
Review
OBJECTIVE
Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients. Consequently, it is of the greatest interest to examine which effects NPS can exert in patients with previous severe mental illness (SMI), such as psychotic patients. The aim of this work was a comprehensive review about NPS use in patients with SMI.
METHODS
We searched Medline or PubMed for relevant English-language citations and reviews describing relationships between NPS use and mental disorders, as well as for the main groups of substances and associated psychiatric manifestations. All studies reporting single case or case series of patients were selected.
RESULTS
The NPS use in patients with SMI is probably underestimated. The one existing systematic review considers only 14 studies, 12 of which are case reports. Most clinical results report acute symptom exacerbation of preexisting psychosis. Paranoid, mood, and aggression symptoms occur more frequently.
CONCLUSIONS
NPS use could modify clinical features of SMI, but these conclusions cannot be generalizable. More evidence is needed to establish the causal and effective connection between NPS use and course of illness, type of psychiatric symptoms, and outcome of treatment in terms of adherence or response.
Topics: Humans; Illicit Drugs; Mental Disorders; Mentally Ill Persons; Psychotropic Drugs; Severity of Illness Index
PubMed: 28657186
DOI: 10.1002/hup.2591 -
Nursing Forum Jul 2022Identifying a nursing diagnosis to support women victims of violence is challenging for nurses. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Identifying a nursing diagnosis to support women victims of violence is challenging for nurses.
OBJECTIVE
To identify clinical indicators related to the nursing diagnosis Post-trauma syndrome in women victims of violence.
METHODS
A systematic review to estimate diagnostic accuracy indices was conducted. The review was registered on the Prospective International Registry of Systematic Reviews approved with the register CDR42020222474.
RESULTS
Twelve clinical indicators were investigated: depression symptoms, anxiety symptoms, alcohol abuse, stress overload, illicit drug use, body image disorder, paranoid ideation, hostility, somatic symptoms, insomnia, binge eating, and obesity. The six articles included in the quantitative synthesis provided four clinical indicators feasible for statistical analysis: depressive symptoms, anxiety symptoms, somatic symptoms, and stress overload.
CONCLUSION
The study addresses the need for refinements in the nursing diagnoses related to violence against women. The identification of the nursing diagnosis Post-trauma syndrome in nursing practice enables the development of standardized and effective care plans for women victimized by violence.
Topics: Anxiety; Female; Humans; Nursing Diagnosis; Prospective Studies; Stress Disorders, Post-Traumatic; Substance-Related Disorders; Violence
PubMed: 35194787
DOI: 10.1111/nuf.12710