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Journal of Clinical Medicine Jul 2023Although the influence of the weather on the well-being and mental health of psychiatric patients has been widely seen, the relationships between various seasonal...
Although the influence of the weather on the well-being and mental health of psychiatric patients has been widely seen, the relationships between various seasonal weather factors and depressive, manic, anxiety, and psychotic states have not been systematized in the literature. The current article describes the seasonal changes in weather-related immune responses and their impact on the development of episodes of depression, mania, psychosis, and anxiety, highlighting the T-helper 1 (Th1) and Th2 immune balance as their potential trigger. In autumn-winter depression, the hyperactivation of the Th1 system, possibly by microbial/airborne pathogens, may lead to the inflammatory inhibition of prefrontal activity and the subcortical centers responsible for mood, drive, and motivation. Depressive mood periods are present in most people suffering from schizophrenia. In the spring and summertime, when the compensating anti-Th1 property of the Th2 immune system is activated, it decreases the Th1 response. In individuals immunogenetically susceptible to psychosis and mania, the inhibition of Th1 by the Th2 system may be excessive and lead to Th2-related frontal and subcortical hyperactivation and subsequent psychosis. In people suffering from bipolar disorder, hyperintense changes in white matter may be responsible for the partial activation of subcortical areas, preventing full paranoid psychosis. Thus, psychosis may be mood-congruent in affective disorders.
PubMed: 37510730
DOI: 10.3390/jcm12144615 -
Cureus Jun 2023Lithium is primarily known to cause neurological and gastrointestinal side effects, however, cardiac effects have been rarely reported. We present a unique case of...
Lithium is primarily known to cause neurological and gastrointestinal side effects, however, cardiac effects have been rarely reported. We present a unique case of lithium cardiotoxicity causing bradyarrhythmia and cardiomyopathy. A 68-year-old man with a history of paranoid schizophrenia and bipolar disorder presented with altered mental status. On examination, the patient was lethargic, afebrile, with dry oral mucosa, and a regular pulse of 42 bpm. Labs revealed acute kidney injury and elevated lithium levels. Electrocardiogram (ECG) revealed a junctional escape rhythm with a right bundle morphology. Lithium toxicity was strongly suspected in the setting of raised serum lithium levels, decreased oral intake and acute kidney injury. The patient was found to have lithium-induced junctional bradycardia. Transvenous pacing was not indicated as the patient responded to fluids and atropine and had no severe hemodynamic compromise. As his serum lithium levels decreased, the bradycardia gradually improved. His echocardiogram revealed moderate left ventricular systolic dysfunction. Workup of cardiomyopathies was negative: no obstructive coronary artery disease; viral panel, and autoimmune markers were unremarkable. Thus, his cardiomyopathy was attributed to lithium toxicity. Lithium cardiotoxicity may manifest as arrhythmias and/or cardiomyopathy. Clinicians should have a high index of suspicion for lithium cardiotoxicity due to the narrow therapeutic range of lithium.
PubMed: 37503482
DOI: 10.7759/cureus.40949 -
Indian Journal of Psychological Medicine Jul 2023
PubMed: 37483577
DOI: 10.1177/02537176221142874 -
Schizophrenia Research Aug 2023
Topics: Humans; Schizophrenia; Paranoid Disorders
PubMed: 37480719
DOI: 10.1016/j.schres.2023.07.016 -
Healthcare (Basel, Switzerland) Jun 2023One of the strangest kinds of misperceptions of the body is "Body Integrity Dysphoria" (BID), formerly named as "Body Identity Integrity Disorder" (BIID). The affected... (Review)
Review
INTRODUCTION
One of the strangest kinds of misperceptions of the body is "Body Integrity Dysphoria" (BID), formerly named as "Body Identity Integrity Disorder" (BIID). The affected people have the feeling that a limb is not part of their body. They can feel it, they can use it, they can move it, but they cannot get along with the fact that it is a part of their own body. Most feel the need for an amputation of a leg, others of both legs, some want a palsy and use a wheelchair. Still discussed is whether other disablements such as blindness, dumbness, deafness or a desire to have an incontinency can be included in this diagnosis. This review discusses parallels and differences to transgender/trans identity, body dysmorphic disorder, alien limb syndrome, hemineglect, and self-induced amputations in schizophrenic patients. The cause for the need to be disabled is still unknown; the review gives an overview about psychological and neurological theories of explanation and what kind of therapy may help.
METHODS
This is a narrative review of about 20 years of research about Body Integrity Dysphoria by the author.
RESULTS
Overall, no psychopathological deviations were found, none of the affected persons examined by us were actually delusional or schizophrenic, which underlines that there is a neurological malfunction in the brain that has existed since birth. However, psychological mechanisms intensify the symptoms. There are clear parallels to other forms of interference between the external body and mental body representation. Different types of therapies have been able to provide help to better deal with BID, but there has been little to bring about a real cure. In contrast, BID-affected persons who achieved amputation (or other desired forms of disability) were satisfied and able to return to work.
CONCLUSIONS
BID remains an enigmatic disorder. We have learned a lot over the past 20 years that the mental and physical bodies do not have to match.
PubMed: 37444736
DOI: 10.3390/healthcare11131901 -
SAGE Open Medical Case Reports 2023Nicolau syndrome is a rare condition characterized by severe pain at the site of injection, leading to ulceration and necrosis of the local tissues. Its presentation is...
Nicolau syndrome is a rare condition characterized by severe pain at the site of injection, leading to ulceration and necrosis of the local tissues. Its presentation is usually acute. Nicolau syndrome is commonly seen in patients after intramuscular, intra-articular, or subcutaneous injections of non-steroidal anti-inflammatory drugs, antiepileptics, antipsychotics, antibiotics, antihistamines, and corticosteroids. Immediate diagnosis and management of this syndrome are of great importance. We herein report a rare presentation of Nicolau syndrome in a 36-year-old married male who suffered from paranoid schizophrenia for the past 3 years. The patient presented with dull pain, mild swelling, and necrotic ulceration over the injection site after receiving intramuscular fluphenazine. The patient underwent wound debridement and was given prophylactic antibiotics. Despite a wide range of therapeutic options for the management of Nicolau syndrome described in the literature, there exist limited guidelines for its management.
PubMed: 37440972
DOI: 10.1177/2050313X231180747 -
Frontiers in Psychiatry 2023Psychopathic traits have been associated with impaired emotion recognition in criminal, clinical and community samples. A recent study however, suggested that cognitive...
BACKGROUND
Psychopathic traits have been associated with impaired emotion recognition in criminal, clinical and community samples. A recent study however, suggested that cognitive impairment reduced the relationship between psychopathy and emotion recognition. We therefore investigated if reasoning ability and psychomotor speed were impacting emotion recognition in individuals with psychotic spectrum disorders (PSD) with and without a history of aggression, as well as in healthy individuals, more than self-rated psychopathy ratings on the Triarchic Psychopathy Measure (TriPM).
METHODS
Eighty individuals with PSD (schizophrenia, schizoaffective disorder, delusional disorder, other psychoses, psychotic bipolar disorder) and documented history of aggression (PSD+Agg) were compared with 54 individuals with PSD without prior aggression (PSD-Agg) and with 86 healthy individuals on the Emotion Recognition Assessment in Multiple Modalities (ERAM test). Individuals were psychiatrically stable and in remission from possible substance use disorders. Scaled scores on matrix reasoning, averages of dominant hand psychomotor speed and self-rated TriPM scores were obtained.
RESULTS
Associations existed between low reasoning ability, low psychomotor speed, patient status and prior aggression with total accuracy on the ERAM test. PSD groups performed worse than the healthy group. Whole group correlations between total and subscale scores of TriPM to ERAM were found, but no associations with TriPM scores within each group or in general linear models when accounting for reasoning ability, psychomotor speed, understanding of emotion words and prior aggression.
CONCLUSION
Self-rated psychopathy was not independently linked to emotion recognition in PSD groups when considering prior aggression, patient status, reasoning ability, psychomotor speed and emotion word understanding.
PubMed: 37426085
DOI: 10.3389/fpsyt.2023.1111896 -
Annals of Agricultural and... Jun 2023The aim of the study was to evaluate the peripheral level of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) during rehabilitation...
INTRODUCTION AND OBJECTIVE
The aim of the study was to evaluate the peripheral level of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) during rehabilitation therapy, combined with neurofeedback in schizophrenic patients, and to investigate whether these biomarkers are related to psychopathological symptoms, changes in auditory evoked potentials (AEPs), and quantitative EEG (QEEGs) mapping.
MATERIAL AND METHODS
The study involved two groups of patients diagnosed with paranoid schizophrenia in partial remission who participated in a 3-month structured rehabilitation programme combined with neurofeedback (REH group) and a standard support group (CON group). The following parameters were assessed: BDNF and MMP-9 serum levels, AEPs, QEEGs, and psychopathological symptoms (PANSS).
RESULTS
A clinical improvement within the 3-month rehabilitation therapy course was correlated with the increase in BDNF and MMP-9 serum level. Despite the increase in BDNF and MMP-9 during the 3-month rehabilitation therapy, it was not possible to demonstrate any strong and significant correlation between the 2 examined neuropeptides. During the 3-month rehabilitation therapy, the theta waveform share reduction in QEEG, P50 latency reduction and amplitude increase correlated with PANSS Total and MMP-9 results.
CONCLUSIONS
All clinical (PANSS Positive, Negative, General, Total) and biochemical results (BDNF, MMP-9) of the REH group changed significantly over the 3-month period. Positive symptoms improved only in the CON group.
Topics: Humans; Brain-Derived Neurotrophic Factor; Matrix Metalloproteinase 9; Patients; Pilot Projects; Schizophrenia
PubMed: 37387382
DOI: 10.26444/aaem/163327 -
The Psychological Record Apr 2023Stimulus equivalence is a behavioral phenomenon that has been related to complex human behavior (e.g., remembering, cognitive functioning, and symbolic behavior). As a...
Stimulus equivalence is a behavioral phenomenon that has been related to complex human behavior (e.g., remembering, cognitive functioning, and symbolic behavior). As a rule, people diagnosed with severe mental disorders (e.g., schizophrenia, bipolar disorder) that exhibit delusional and hallucinatory behavior, and disorganized speech have shown cognitive impairment (e.g., processing speed, reasoning/problem solving). Not enough research has analyzed the stimulus equivalence performance in this population. This study aims to investigate the stimulus equivalence performance in adults diagnosed with severe mental disorders. In particular, this study analyzes the many-to-one (MTO) and one-to-many (OTM) training structures effects, and the simultaneous (SIM) and the simple-to-complex (STC) training and testing protocol effects on equivalence class formation in this population. To achieve it, we analyzed the behavior of 18 participants diagnosed with severe mental disorders in three different conditions (Condition 1 OTM/SIM; 2 MTO/SIM; and 3 MTO/STC). Behavior consistent with stimulus equivalence was found in 11 out of 13 participants who had finished the study (5 participants decided to leave before completing the tasks). STC yielded better results than the SIM protocol. No differences were found between MTO and OTM training structures. Implications and suggestions for further research have been discussed.
PubMed: 37363039
DOI: 10.1007/s40732-023-00540-6