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International Journal of Environmental... Mar 2019In this paper, we aimed to examine the patterns of sleep disturbance in adjustment disorder (AD) and depressive episode (DE), to examine the variables associated with...
In this paper, we aimed to examine the patterns of sleep disturbance in adjustment disorder (AD) and depressive episode (DE), to examine the variables associated with sleep disturbance in AD and DE and associated impairment in functioning. This is a multi-centre case-control study of 370 patients: 185 patients with AD and 185 patients with a diagnosis of DE, recruited from the liaison psychiatry services of three Dublin hospitals. We examined the participants' sleep pathology using the sleep disturbance items on the Schedule for Clinical Assessment in Neuropsychiatry, and the Inventory of Depressive Symptoms-Clinician-rated-30. Patients with a diagnosis of AD were less likely to report disturbed sleep than those with a diagnosis of DE ( = 0.002). On multivariate analysis, sleep disturbance was significantly associated with greater severity of certain depressive symptoms: decreased appetite ( < 0.001) and psychomotor agitation ( = 0.009). Decreased appetite, younger age and single marital status were significantly associated with sleep disturbance in male patients, and decreased appetite and psychomotor agitation were significantly associated with sleep disturbance in female participants. This is the largest study to date which has examined sleep disturbance in adjustment disorder. Disturbance of sleep is a significant symptom in AD and may represent a potential target for treatment. With further research, patterns of sleep disturbance may be useful in differentiating AD from DE.
Topics: Adjustment Disorders; Adult; Appetite; Case-Control Studies; Depression; Female; Humans; Middle Aged; Psychomotor Agitation; Sleep Wake Disorders; Young Adult
PubMed: 30917591
DOI: 10.3390/ijerph16061083 -
Tijdschrift Voor Psychiatrie 2014The 12 anxiety disorders which were defined in the DSM-IV, have been increased to 27 disorders in the DSM-5. These 27 disorders have been subdivided into three chapters:... (Review)
Review
BACKGROUND
The 12 anxiety disorders which were defined in the DSM-IV, have been increased to 27 disorders in the DSM-5. These 27 disorders have been subdivided into three chapters: 1. anxiety disorders, 2. obsessive-compulsive and related disorders (OCRD) and 3. trauma and stressor-related disorders.
AIM
To describe the most important differences between the DSM-IV and DSM-5 classifications of the above-mentioned disorders.
METHOD
Survey of the relevant literature.
RESULTS
Within the chapter on anxiety disorders in DSM-5 the classifications of 'panic disorder' and 'agoraphobia' have been separated. In addition, DSM-5 allows the specification 'with panic attacks' to be applied to all psychiatric disorders. New additions to the group ocrd are: 'trichotillomania' and 'body dysmorphic disorder'. Also newly added to the group are the new classifications 'excoriation disorder' and 'hoarding disorder'. The DSM-IV group of adjustment disorders has been merged with the group of stress disorders. In accordance with the system adopted elsewhere in DSM-5, the disorders which are 'usually first diagnosed in infancy, childhood and adolescence' and which resemble the disorders defined in the three chapters have been added to these chapters. Two extra categories are defined in each of the three chapters.
CONCLUSION
The three chapters in DSM-5 are little more than a re-arrangement of the disorders defined in DSM-IV. The revision has not led to any clarification of or insight into the relationship between and the etiology of these disorders.
Topics: Anxiety Disorders; Diagnostic and Statistical Manual of Mental Disorders; Humans; Obsessive-Compulsive Disorder; Severity of Illness Index; Stress Disorders, Traumatic
PubMed: 24643827
DOI: No ID Found -
Dialogues in Clinical Neuroscience Jun 2012Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known... (Review)
Review
Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG, Attachment theory and cognitive stress theory are reviewed as they pertain to bereavement, as is the biopsychosocial model of CG. Reduced immune cell function has been replicated in a variety of bereaved populations. The regional brain activation to grief cues frequently includes the dorsal anterior cingulate cortex and insula, and also the posterior cingulate cortex. Using theory to point to future research directions, we may eventually learn which biomarkers are helpful in predicting CG, and its treatment.
Topics: Adjustment Disorders; Biomarkers; Brain; Grief; Humans; Neuroimaging
PubMed: 22754286
DOI: 10.31887/DCNS.2012.14.2/mfoconnor -
Work (Reading, Mass.) 2023Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW)... (Clinical Trial)
Clinical Trial
BACKGROUND
Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW) intervention was attempted, targeting patients with mood and adjustment disorders.
OBJECTIVE
This study aimed to investigate the outcome of an interdisciplinary RTW intervention including occupational therapy implemented within the Japanese healthcare framework.
METHODS
An interdisciplinary RTW intervention including occupational therapy was conducted five times a week for approximately three months, targeting individuals with mood and adjustment disorders who took a leave of absence. Their mental symptoms, cognitive functioning, job performance, temperament, social adaptation, psychosocial state, and readiness to RTW before and after the intervention were evaluated. Full-time RTW ratios at 3, 6, 12, 18, and 24 months from baseline were followed up and compared with those of prior studies.
RESULTS
A total of 30 individuals completed the intervention. After the intervention, participants' psychological symptoms, cognitive function, vocational aptitude, temperament, social adaptation, psychosocial state, and readiness to RTW improved (p≤0.001-0.0279). The ratios of RTW at 3, 6, 12, 18, and 24 months from the baseline were 6.7%, 46.7%, 73.3%, 77.8%, and 82.6%, respectively, reflecting a higher pattern than prior reports.
CONCLUSIONS
The interdisciplinary RTW intervention including occupational therapy has the potential to improve not only depressive symptoms but also cognitive functioning, job performance, social adaptation, and readiness to RTW. They can also raise RTW ratios.
Topics: Humans; Return to Work; Adjustment Disorders; Occupational Therapy; Employment; Affect; Sick Leave
PubMed: 36278381
DOI: 10.3233/WOR-211144 -
Epilepsy Research Jan 2023The currently available evidence is unclear in regard to psychiatric outcomes of temporal lobe epilepsy (TLE) in patients with comorbid psychiatric disorders (PD). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The currently available evidence is unclear in regard to psychiatric outcomes of temporal lobe epilepsy (TLE) in patients with comorbid psychiatric disorders (PD).
AIM
To identify and synthesize psychiatric outcomes in patients with TLE and comorbid psychiatric illnesses before and after TLE surgery.
METHODS
Studies were included if participants were adults and/or children with temporal epilepsy and comorbid psychiatric illness. Surgical interventions included focal resection (e.g., lobectomy, selective amygdalohippocampectomy) or stereotactic laser ablation. Included studies reported on pre- and post- surgery data of comorbid psychiatric illness (e.g., mood and anxiety disorders, depression, psychosis, adjustment disorders, non-epileptic seizures, and personality disorders).
RESULTS
Ten studies were included in the review. The proportion of patients achieving PD resolution or improvements after surgery varied widely between studies, ranging from 15 % to 57 % at the reported follow-up time. Three studies reported on PD symptom worsening after surgery, with considerable variations of patient proportions across studies. Meta-analysis suggests that 43 % of patients demonstrated improvement and 33 % of patients showed a worsening in psychiatric scores across all studies. Preliminary data from three studies suggest that seizure control may be associated with favourable psychiatric outcomes.
CONCLUSION
A considerable proportion of reported TLE patients with comorbid psychiatric illnesses have improvement in their psychiatric symptoms after temporal lobe epilepsy surgery. There is scarcity of detailed outcome reporting including symptom scores, and to date, predictive factors for favourable vs unfavourable outcomes in this patient population are not clear. Further research on the topic is warranted.
Topics: Adult; Child; Humans; Epilepsy, Temporal Lobe; Treatment Outcome; Mental Disorders; Seizures; Temporal Lobe
PubMed: 36473277
DOI: 10.1016/j.eplepsyres.2022.107054 -
BMJ Case Reports Jan 2021In this paper, we report the psychological and emotional experience of a patient who regained vision after over a decade of vision loss. The negative psychological...
In this paper, we report the psychological and emotional experience of a patient who regained vision after over a decade of vision loss. The negative psychological implications of blindness are well recognised and there is a robust link between visual impairment and low mood and depressive symptoms. Although uncommon, low mood and depressive symptoms have been reported in patients whose sight has been restored, and lack of research gives rise to the possibility their prevalence may be grossly under-recognised in such patient groups. The effects can be so severe that patients may revert to living in darkness in mimicry of their previous lifestyle, effectively obviating the sight-restoring surgery. Healthcare professionals have a responsibility to address this traditionally neglected need by facilitating social, psychological and medical interventions that may ease the return to vision.
Topics: Adjustment Disorders; Adult; Blindness; Corneal Transplantation; Depression; Humans; Middle Aged; Postoperative Complications; Social Interaction; Time Factors; Treatment Outcome; Vision, Ocular
PubMed: 33431454
DOI: 10.1136/bcr-2020-237603 -
European Journal of Psychotraumatology 2021: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of...
: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic. : This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic. : Self-report data from a web-based sample ( = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland. : The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%. : High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population's mental health.
Topics: Adjustment Disorders; Adult; Anxiety Disorders; COVID-19; Depression; Female; Humans; Male; Pandemics; Poland; Psychological Trauma; SARS-CoV-2; Stress Disorders, Post-Traumatic; Surveys and Questionnaires
PubMed: 34992743
DOI: 10.1080/20008198.2020.1860356 -
The Journal of International Medical... Jan 2022Children with acute lymphoblastic leukemia (ALL) may be at increased risk of psychiatric disorders. This study analyzed the incidence of psychiatric disorders in...
OBJECTIVE
Children with acute lymphoblastic leukemia (ALL) may be at increased risk of psychiatric disorders. This study analyzed the incidence of psychiatric disorders in children with ALL in South Korea.
METHODS
Using nationwide claims data for January 2009 to March 2016, we identified three major psychiatric disorders (depression, anxiety and stress/adjustment disorder) among children diagnosed with ALL. We analyzed the incidence of psychiatric disorders before and after ALL diagnosis.
RESULTS
Overall, 2160 children diagnosed with ALL were identified. Seventy-five children (3.5%) were diagnosed with at least one major psychiatric disorder from 1 year before ALL diagnosis to the last follow-up point (range: 42.5-111.5 months). Of these, 70 (93.3%) patients were identified after ALL diagnosis, with the incidence peaking 1 year after ALL diagnosis. Depression, anxiety and stress/adjustment disorders were diagnosed in 30 (1.4%), 15 (0.7%) and 30 (1.4%) patients, respectively.
CONCLUSIONS
Among pediatric patients with ALL, most psychiatric disorders were identified after the diagnosis of leukemia, and psychiatric disorder incidence differed according to patient age and time since ALL diagnosis. Timely screening for and proper management of mental disorders are needed during all stages of ALL treatment.
Topics: Adjustment Disorders; Anxiety Disorders; Child; Humans; Longitudinal Studies; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Republic of Korea
PubMed: 35086376
DOI: 10.1177/03000605221075223 -
Frontiers in Psychiatry 2021Among the different types of heavy use of mental health services, frequent inpatient admission in acute care units of individuals unable to return to their usual...
Among the different types of heavy use of mental health services, frequent inpatient admission in acute care units of individuals unable to return to their usual environment refers to as revolving-door (RD). RD in prisoners is related to increased violence (acted and supported) and suicidal recidivism. We explored the determinants of RD in 200 inmates from the Swiss-French speaking areas who were admitted to the sole acute psychiatric care unit for all of the Swiss-French counties, located in Geneva. The Cuzick's test for trend across ordered groups, Kruskal-Wallis test and oneway ANOVA were used to compare demographic and clinical variables between single (one admission, = 100), frequent (3-7, = 69) and RD (more than 8, = 31) during a 12 months period. In addition, univariate and multivariable ordered logistic regression modes were built to examine the determinants of RD. The sample included 27 women (mean age: 31.2 years) and 173 men (34.5 years) who were admitted during the period 2014-2019. The vast majority were single (65%) with low level of education (<6 years, 78%). Suicidal behavior was the more frequent reason for admission (57%). Psychiatric history was positive in 77.5% of cases and in 54.5% of cases there was at least one episode of inpatient psychiatric care. The more frequent ICD-10 psychiatric diagnosis in the last admission were psychotic disorder (38%), personality disorder (29.5%) and adjustment disorder (19.5%). In contrast, depressive episodes (7%) and bipolar disorder (4.5%) were rare. Group comparison showed that the presence of court-ordered treatments, suicidal behavior, personality and psychotic disorders was associated with significantly increased frequency of RD use. In univariate models, the same factors were positively associated with RD, the highest odds ratio being found for court-ordered treatments (5.77) and personality disorders (2.14). In contrast, the diagnosis of adjustment disorders was related to decreased RD use (OR 0.25). Court-ordered treatments and personality disorders were the only factors to predict RD in multivariable regression models. These findings suggest that acute psychiatric care in these patients did not depend of environmental stressors but rather represents the expression of a long-lasting vulnerability related to their psychological profile and criminal status.
PubMed: 33935830
DOI: 10.3389/fpsyt.2021.626773 -
Journal of Rehabilitation Medicine Aug 2020To examine the psychological, social, behavioural and injury-related factors impacting functional outcome in patients with ankle or lower limb fracture one year...
OBJECTIVE
To examine the psychological, social, behavioural and injury-related factors impacting functional outcome in patients with ankle or lower limb fracture one year post-operation.
METHODS
In this prospective study 66 patients with ankle or lower leg fracture were recruited and followed up one year post-operation. Possible associations between predictors and functional outcome were explored by regression analyses. Functional outcome was assessed with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score.
RESULTS
Linear regression models revealed that smoking and elevated symptoms of adjustment disorder were associated with lower functional outcome one year post-operation. Fracture type, depressive symptoms and quality of relationship had no effect on functional outcome. A second linear regression revealed that preoccupations were correlated with functional outcome.
CONCLUSION
Smoking and symptoms of adjustment disorder, specifically preoccupations, are associated with functional outcome one year post-operation in patients recovering from ankle or lower leg fractures. The results support the notion that differences in functional recovery are attributable to psychological and behavioural factors rather than to fracture type. Psychological, fracture-specific, symptoms play a role in functional recovery rather than general affective symptoms.
Topics: Adjustment Disorders; Adolescent; Adult; Aged; Ankle Injuries; Female; Fractures, Bone; Humans; Leg Injuries; Male; Middle Aged; Prospective Studies; Smoking; Time Factors; Treatment Outcome; Young Adult
PubMed: 32495846
DOI: 10.2340/16501977-2701