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Journal of Affective Disorders Apr 2024The high prevalence of stress-related disorders and depression underscores the urgent need to unravel their impact on individual well-being. This study aim to...
Differences in psychiatric comorbidity patterns in patients diagnosed with chronic stress-induced exhaustion disorder and depression - A cohort study in the total population of Region Stockholm.
The high prevalence of stress-related disorders and depression underscores the urgent need to unravel their impact on individual well-being. This study aim to investigate common psychiatric and stress-related diagnoses, along with postviral fatigue, in individuals with prior stress-induced exhaustion disorder (SED) and prior depression compared to those without prior SED or depression, and to study whether the psychiatric comorbidity patterns differ. The study includes individuals in Region Stockholm who, in 2011, did not have a diagnosis of SED or depression. ICD-10 diagnosis of SED, depression, or both, recorded in 2012-2013, were compared to individuals without prior SED or depression in a cohort (n = 1,362,886), aged 18 to 65. Odds ratios (OR) with 99 % confidence intervals, adjusted for age and neighborhood socioeconomic status, were calculated for psychiatric disorders and post-viral fatigue in 2014-2022. Patients with prior SED showed associations primarily with stress related diagnoses, including acute stress reaction, reaction to severe stress, as well as post-COVID-19 and post-viral fatigue syndrome. These ORs were all larger for SED than depression. Depression was primarily associated with post-traumatic stress disorder (PTSD), alcohol related and substance use disorders, schizophrenia, schizotypal disorders, delusional disorders, manic episode, bipolar affective disorder, persistent mood disorder, neurotic disorder, borderline personality disorder, autistic disorder, Asperger's syndrome, attention -deficit hyperactivity disorder, attention-deficit disorders ADHD/ADD), and suicide attempt. These ORs were all higher for depression, although autistic disorders, ADHD/ADD and PTSD were also highly associated with prior SED (OR > 3.5). The divergent psychiatric comorbidity patterns suggest different underlying mechanisms and clinical prognosis.
Topics: Humans; Stress Disorders, Post-Traumatic; Cohort Studies; Depression; Comorbidity; Attention Deficit Disorder with Hyperactivity; Fatigue Syndrome, Chronic; Fatigue
PubMed: 38331048
DOI: 10.1016/j.jad.2024.01.273 -
Early Intervention in Psychiatry Feb 2024Psychotic-like experiences (PLEs) are experiences in the general population that, in their extreme form, are attributed to clinical psychosis. They are correlated with...
AIM
Psychotic-like experiences (PLEs) are experiences in the general population that, in their extreme form, are attributed to clinical psychosis. They are correlated with general psychopathology and increased risk of developing psychosis. Previous research show a multitude of measuring tools which most often lack psychometric validation. This study aimed to examine both categorical and metacognitive measures of PLEs.
METHODS
Confirmatory Factor Analysis (CFA) was used in seven online studies with n's ranging from 259 to 6772 to explore factor structures of Prodromal Questionnaire 16 item (PQ-16), Revised Green et al. Paranoid Thoughts Scale (R-GPTS), Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ), Beliefs about Paranoia Scale (BAPS) and Interpretation of Voices Inventory (IVI). Additionally, we explored measurement invariance between diagnosed with psychiatric disorders and undiagnosed individuals in PQ-16, R-GPTS and BAPS.
RESULTS
We confirmed the factor structures of all questionnaires except IVI. We confirmed configural, threshold and metric measurement invariance in R-GPTS and BAPS and partially PQ-16.
CONCLUSIONS
The current results demonstrate structural validity and measurement invariance of several categorical and metacognitive measures of PLEs.
PubMed: 38318936
DOI: 10.1111/eip.13504 -
Skin Appendage Disorders Feb 2024Lipedematous scalp (LS) is a rare disorder characterized by thickening of the adipose subcutaneous scalp layer without associated hair loss. To date, there have been...
INTRODUCTION
Lipedematous scalp (LS) is a rare disorder characterized by thickening of the adipose subcutaneous scalp layer without associated hair loss. To date, there have been fewer than 100 reported cases of LS. LS occurring in siblings has not been previously reported.
CASE PRESENTATION
We present a 58-year-old and 63-year-old pair of black Caribbean female siblings with LS. Scalp thickness on ultrasound of the vertex in each case was 12 mm and 11 mm from skin to periosteum, respectively (normal range: 5-6 mm). Histopathological analysis in the younger sibling demonstrated prominent fat, high in the dermis around hair follicles, with follicular distortion and focal perifollicular fibrosis. Co-morbidities in the younger sibling were obesity (body mass index [BMI] 39.0), paranoid schizophrenia, and bipolar disorder; the older sibling was overweight (BMI 26.0) with co-morbidities of hypercholesterolemia, type 2 diabetes mellitus, hypomania, and migraines; both siblings were taking psychiatric medication.
CONCLUSION
We present an unusual case of LS in a pair of female siblings, adding to the limited existing evidence that there may be a genetic role in the pathogenesis of LS. Furthermore, both siblings in this case had psychiatric co-morbidities and were taking psychiatric medication, which have not been previously identified as associations of LS.
PubMed: 38318429
DOI: 10.1159/000534698 -
Orvosi Hetilap Feb 2024
Topics: Humans; Mental Disorders; Cognitive Dysfunction
PubMed: 38310518
DOI: 10.1556/650.2024.32971 -
Schizophrenia Bulletin Mar 2024
Topics: Humans; Delusions; Paranoid Disorders; Schizophrenia, Paranoid
PubMed: 38309718
DOI: 10.1093/schbul/sbae012 -
Cureus Dec 2023Acute colonic pseudo-obstruction or Ogilvie's syndrome is a disorder causing massive colonic dilation with no evidence of mechanical obstruction. The actual incidence of...
Acute colonic pseudo-obstruction or Ogilvie's syndrome is a disorder causing massive colonic dilation with no evidence of mechanical obstruction. The actual incidence of acute colonic pseudo-obstruction is unclear; However, electrolyte imbalance, psychiatric disorders, the use of medications such as anticholinergics or antipsychotics, and recent abdominal surgery are the most common predisposing factors associated with this syndrome. Ogilvie's syndrome is most likely caused due to impairment of the gut's motor system and an imbalance of the autonomic nervous system including a reduction in the activity of stimulatory neurotransmitters. The predisposition to psychotic disorders could be, in some instances, due to neurodevelopmental abnormalities of the brain and the gut's autonomic nervous system. The symptoms of Ogilvie's syndrome are similar to mechanical obstruction of the colon but no physical cause of obstruction is usually present. Ogilvie's syndrome can be managed conservatively; however, if left untreated, Ogilvie's syndrome can lead to bowel perforation, which is associated with a high mortality risk. Antipsychotics have been considered the cornerstone treatment for psychiatric disorders including schizophrenia. Even though they are highly effective in treating psychiatric illnesses, their usage carries multiple risks. Overall, constipation is a common side effect of antipsychotic medications with some classes posing more risk than others. Constipation can be severe and may lead to serious complications such as paralytic ileus, bowel ischemia, and death. We present here a case of delusional disorder managed with risperidone and complicated by intestinal pseudo-obstruction. This case reiterates the need to consider all complications of antipsychotic medications, even rare ones, and include them in the discussion with patients and their caregivers before commencement.
PubMed: 38292959
DOI: 10.7759/cureus.51389 -
Intensive & Critical Care Nursing Jun 2024To explore the differences in post-intensive care unit memory and posttraumatic stress disorder symptoms between patients with and without delirium, and assess the... (Observational Study)
Observational Study
Investigating the correlation of delirium after cardiac surgery with memories and posttraumatic stress disorder consequences of intensive care unit: A prospective cohort study.
OBJECTIVES
To explore the differences in post-intensive care unit memory and posttraumatic stress disorder symptoms between patients with and without delirium, and assess the correlations between the two.
DESIGN
Prospective cohort observation study.
SETTING
A cardiac intensive care unit of a tertiary hospital in China. We enrolled 318 consecutive patients after cardiac surgery between December 2017 and March 2019.
MAIN OUTCOME MEASURES
Delirium was assessed using the Confusion Assessment Method for the ICU from intensive care unit admission to discharge. Intensive care unit memory was assessed using the ICU-Memory Tool through face-to-face interviews one week after discharge. Posttraumatic stress disorder was measured telephonically using the Impact of Events Scale-revised questionnaire at three months post-discharge.
RESULTS
Eighty patients each in the delirium and non-delirium groups were enrolled for follow-up interviews. Patients with delirium had vaguer memories of pre-intensive care unit admission and of their stay, and recollected more memories of feelings (vs. without delirium). Posttraumatic stress disorder was diagnosed in 14 patients with and in seven without delirium, with non-significant differences between groups. Delirium did not influence post-intensive care unit factual, feeling, and delusional memories, nor posttraumatic stress disorder and hyperarousal, intrusion, and avoidance. The memories of feelings were positively correlated with the last three (r = 0.285, r = 0.390 and r = 0.373, respectively).
CONCLUSION
Patients with delirium had vague intensive care unit memories. Memories of feelings were positively correlated with symptoms of hyperarousal, intrusion, and avoidance. Delirium did not influence factual, feeling, or delusional memories nor posttraumatic stress disorder incidence and symptoms.
IMPLICATIONS FOR CLINICAL PRACTICE
Interventions are needed to reduce the impact of vague memory in patients with post-intensive care unit delirium. Memories of feelings should be focused on because of their correlation with hyperarousal, intrusion, and avoidance. Delirium prevention and early recognition measures are suggested.
Topics: Humans; Aftercare; Cardiac Surgical Procedures; Critical Care; Delirium; Intensive Care Units; Patient Discharge; Prospective Studies; Stress Disorders, Post-Traumatic
PubMed: 38290221
DOI: 10.1016/j.iccn.2024.103632 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: The objective of the research was to study the indicators of oxidative modification of proteins (OMP) and the activity of matrix metalloproteinase-9 (MMP-9) in...
PECULIARITIES OF DYNAMICS OF INDICATORS OF PROTEINS OXIDATIVE MODIFICATION AND MATRIX METALLOPROTEINASE-9 ACTIVITY IN PATIENTS WITH PARANOID SCHIZOPHRENIA DEPENDING ON THE DISEASE DURATION.
OBJECTIVE
The aim: The objective of the research was to study the indicators of oxidative modification of proteins (OMP) and the activity of matrix metalloproteinase-9 (MMP-9) in patients with paranoid schizophrenia depending on the disease duration.
PATIENTS AND METHODS
Materials and methods: 320 patients were included in the examination. 20 patients were with "Primary psychotic episode" (Comparison Group) and 300 patients were diagnosed with "Paranoid schizophrenia" (Experimental Group): 60 of them have suffered from this disease for a duration from 3 to 5 years (Subgroup I ); 60 patients have suffered for a period from 6 to 10 years (Subgroup II); 60 individuals - from 11 to 15 years (Subgroup III); 60 patients have suffered for a duration from 16 to 20 years (Subgroup IV); 60 patients - from 21 years and longer (Subgroup V).
RESULTS
Results: The presented data showed that the levels of OMP indicators in Subgroup I constituted 0.826±0.046 conventional units at a wavelength of 356 nm; 0.864±0.051 conventional units at a wavelength of 370 nm; 0.444±0.019 conventional units at a wavelength of 430 nm; 0.176±0.007 conventional units at a wavelength of 530 nm, which is 1.99; 1.6; 1.13 and 1.43 times higher than in the Comparison Group. The content of OMP products was higher by 2.24; 1.74; 1.17, and 1.43 times in Subgroup II, respectively, by 2.4; 1.80; 1.36 and 1.46 times in Subgroup III, respectively; by 2.5; 1.9; 1.4; 1.6 times in Subgroup IV, respectively; by 2.5; 2.02; 1.54; 1.7 times in Subgroup V, respectively. The conducted correlation analysis indicated a direct correlation between OMP indicators and the disease duration. The concentration of MMP-9 in the patients of the Comparison Group was equal to 892.84±87.80 pg/ml, which was 11.2% less compared to the Experimental Subgroup I, where this indicator was 992.84±67.50 pg/ml. MMP-9 constituted 1092.53±47.20 pg/ml on average in the patients of Subgroup II, which was 22.36% higher than in the Comparison Group. This indicator was 1702.84±37.60 pg/ml in Subgroup III, which was 90.7% higher than in the Comparison Group. It constituted 1492.84±47.29 pg/ml in Subgroup IV, which was 67.2% higher than in the Comparison Group; and 2037.21±57.80 pg/ ml in Subgroup V, which was more than two times higher than in the Comparison Group (p<0.05). The conducted correlation analysis showed a direct relation between MMP-9 expression and the increase in OMP indicators. This relation was more significant between MMP-9 and OMP products of a neutral nature. The correlation strength between MMP-9 and OMP products of a basic nature was somewhat less significant.
CONCLUSION
Conclusions: According to the results of the conducted analysis, the examined patients had the signs of decompensation of reactive-adaptive biomolecular mechanisms which activated radical reactions with the subsequent accumulation of oxidation products.
Topics: Humans; Matrix Metalloproteinase 9; Oxidative Stress; Schizophrenia, Paranoid
PubMed: 38290026
DOI: 10.36740/WLek202312111 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To determine the main trajectories of the association between eating disorders (ED) and depressive symptoms and their impact on the quality of the prognosis of the...
OBJECTIVE
To determine the main trajectories of the association between eating disorders (ED) and depressive symptoms and their impact on the quality of the prognosis of the disease as a whole.
MATERIAL AND METHODS
A total sample included 59 female patients, aged 15 to 25 years (average age 16.2+0.9), who were under outpatient and inpatient observation in the department for the study of endogenous mental disorders and affective states in the clinic at the Mental Health Research Center.
RESULTS
The authors identified variants of the main trajectories of the association between ED and depression, taking into account the role and place of ED and interdependence with depressive symptoms. The following variants have been established: with a stable (44.0%, 26), labile type of dynamics (25.0%, 19) and dynamics according to the type of selective dissociation (22.4%, 14).
CONCLUSION
The study allows us to assume the development of fundamentally different trajectories of the conjugation of eating behavior and depression, showing prognostic capacity and different tropism for therapeutic interventions.
Topics: Humans; Female; Adolescent; Feeding and Eating Disorders; Ambulatory Care Facilities; Dissociative Disorders; Emotions; Hospitals, Psychiatric
PubMed: 38261292
DOI: 10.17116/jnevro2024124011109 -
Frontiers in Psychiatry 2023New subgroups of psychiatric disorders are often claimed. In contrast, classification systems have repeatedly had to abandon established subgroups such as paranoid vs....
New subgroups of psychiatric disorders are often claimed. In contrast, classification systems have repeatedly had to abandon established subgroups such as paranoid vs. disorganised and catatonic schizophrenia due to lack of empirical evidence. Four criteria are proposed that should be met to claim valid subgroups: 1. distinct distribution of the defining characteristic between groups; 2. significant differences in variables other than those defining the subgroups cross-sectionally and longitudinally; 3. long-term stability; 4. significant differences between groups in aetiology, pathophysiology, and evidence-based therapy. In contrast to examples from somatic medicine, such as type 1 and type 2 diabetes, few psychiatric disorders meet these requirements.
PubMed: 38260787
DOI: 10.3389/fpsyt.2023.1292917