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Clinical Obstetrics and Gynecology Sep 2018The perinatal period is a vulnerable time for the acute onset and recurrence of psychiatric illness. Primary care providers are opportunely positioned to intervene for... (Review)
Review
The perinatal period is a vulnerable time for the acute onset and recurrence of psychiatric illness. Primary care providers are opportunely positioned to intervene for women who present with mood decompensation, excessive anxiety, or psychosis during the perinatal period. Owing to increased screening efforts in obstetrical clinics and amount of contact during the perinatal period, obstetricians may be able to identify patients who need treatment before their symptoms become severe. In this article, we address imminent and emergent psychiatric symptoms in the perinatal period including management and risk reduction to help obstetrician/gynecologists treat and/or refer patients as clinically appropriate.
Topics: Aggression; Depression, Postpartum; Emergencies; Female; Humans; Obsessive-Compulsive Disorder; Pregnancy; Pregnancy Complications; Psychomotor Agitation; Psychotic Disorders; Puerperal Disorders; Risk Factors; Suicidal Ideation
PubMed: 29794819
DOI: 10.1097/GRF.0000000000000377 -
Developmental Medicine and Child... Apr 2007Failure to attain handwriting competency during the school-age years often has far-reaching negative effects on both academic success and self-esteem. This complex... (Review)
Review
Failure to attain handwriting competency during the school-age years often has far-reaching negative effects on both academic success and self-esteem. This complex occupational task has many underlying component skills that may interfere with handwriting performance. Fine motor control, bilateral and visual-motor integration, motor planning, in-hand manipulation, proprioception, visual perception, sustained attention, and sensory awareness of the fingers are some of the component skills identified. Poor handwriting may be related to intrinsic factors, which refer to the child's actual handwriting capabilities, or extrinsic factors which are related to environmental or biomechanical components, or both. It is important that handwriting performance be evaluated using a valid, reliable, standardized tool combined with informal classroom observation and teacher consultation. Studies of handwriting remediation suggest that intervention is effective. There is evidence to indicate that handwriting difficulties do not resolve without intervention and affect between 10 and 30% of school-aged children. Despite the widespread use of computers, legible handwriting remains an important life skill that deserves greater attention from educators and health practitioners.
Topics: Agraphia; Brain; Child; Child, Preschool; Handwriting; Humans; Kinesthesis; Occupational Therapy; Proprioception; Psychomotor Disorders; Remedial Teaching
PubMed: 17376144
DOI: 10.1111/j.1469-8749.2007.00312.x -
Journal of Medical Toxicology :... Jul 2021The USA is in an opioid epidemic, with an increased number of individuals taking psychoactive drugs while executing the tasks of everyday life, including operating a... (Review)
Review
INTRODUCTION
The USA is in an opioid epidemic, with an increased number of individuals taking psychoactive drugs while executing the tasks of everyday life, including operating a motor vehicle. The pharmacology of opioids has been widely studied, but the effects of opioids on psychomotor function, driving performance, and the risk of motor vehicle collision remain less clear. Clinicians are faced with the challenge of controlling patient pain while also reconciling conflicting messages from the literature about how safe it is for their patients taking opioids to engage in potentially dangerous routine tasks.
DISCUSSION
This review assesses the current literature regarding opioids as they relate to neurocognitive function, driving performance, and accident risk. Manuscripts are categorized by study context and subject matter: controlled experimental administration, illicit use, prescription use, retrospective forensic toxicology, and polydrug consumption.
CONCLUSION
Illicit use, initiation of therapy, and opioid use in combination with other psychoactive medications are contexts most clearly associated with impairment of driving-related functions and/or operation of a motor vehicle. Clinicians should counsel patients on the risk of impairment when initiating therapy, when co-prescribing opioids and other psychoactive drugs, or when a patient is suspected of having an opioid use disorder.
Topics: Accidents, Traffic; Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Female; Humans; Male; Middle Aged; Opioid-Related Disorders; Psychomotor Disorders; Retrospective Studies; United States
PubMed: 33403571
DOI: 10.1007/s13181-020-00819-y -
BMJ (Clinical Research Ed.) Dec 2000
Topics: Antipsychotic Agents; Humans; Psychomotor Disorders; Schizophrenia
PubMed: 11099266
DOI: 10.1136/bmj.321.7273.1360 -
BMC Psychiatry Jul 2022Although psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are...
BACKGROUND
Although psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are lacking. Psychomotor retardation is sometimes assessed through direct patient observations by clinicians or through a clinical observation grid, in the absence of a standardized psychomotor assessment. In this pilot study, we evaluated the feasibility of standardized psychomotor examination of patients with major depressive disorder (MDD) and detailed a psychomotor semiology in these patients.
METHODS
We used a standardized psychomotor assessment to examine 25 patients with MDD and 25 age- and sex-matched healthy controls (HC) and compared their psychomotor profiles. Using standardized tests, we assessed muscle tone and posture, gross motor skills, perceptual-motor skills, and body image/organization. Clinical assessments of depressive symptoms (levels of psychomotor retardation, anxiety, and self-esteem) comprised this detailed psychomotor examination.
RESULTS
All participants were examined using the standardized psychomotor assessment. The main results of the psychomotor examination highlighted low body image of MDD participants (p < 0.001). Significant differences between groups were found in passive muscle tone, posture, emotional control, jumping, manual dexterity, walking, and praxis. Among these psychomotor variables, body image, passivity, jumping and rhythm scores predicted an MDD diagnosis.
CONCLUSIONS
Beyond the psychomotor retardation known to be present in MDD patients, this examination revealed an entire psychomotor symptomatology characterized by elevated muscle tone, poor body image associated with poor self-esteem, slowness in global motor skills and manual praxis, and poor rhythmic adaptation. In light of these results, we encourage clinicians to consider using a standardized tool to conduct detailed psychomotor examination of patients with depressive disorders.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT04031937 , 24/07/2019.
Topics: Case-Control Studies; Depressive Disorder, Major; Female; Humans; Male; Pilot Projects; Psychomotor Disorders; Self Concept
PubMed: 35841086
DOI: 10.1186/s12888-022-04086-9 -
Psychogeriatrics : the Official Journal... Jun 2011Creutzfeldt-Jakob disease (CJD) is a progressive, degenerative, and fatal disease of the central nervous system. It is caused by abnormal accumulation of prion proteins...
Creutzfeldt-Jakob disease (CJD) is a progressive, degenerative, and fatal disease of the central nervous system. It is caused by abnormal accumulation of prion proteins and is characterized mainly by progressive dementia, myoclonus, and cerebellar, pyramidal, and extrapyramidal findings. Psychiatric symptoms may also accompany CJD and are often the first signs of the disease. The incidence of CJD is approximately 1 in 1 000 000. In certain cases, a diagnosis can be made by demonstrating the accumulation of pathological prion proteins. However, in many cultures brain biopsies or post-mortem evaluations are not welcomed by either the patients or their relatives. In these cases, the importance of additional diagnostic tools increases. Herein, we report on a CJD patient who first consulted a psychiatrist with early psychiatric symptoms. The patient developed neurological symptoms later and was subsequently diagnosed as sporadic CJD based on clinical and laboratory findings rather than brain biopsy. Repeated electroencephalograms (EEG) played a pivotal role in our evaluation of the patient. This case is an interesting presentation of CJD both because of the timing of the symptoms and because of the typical EEG findings that led to the diagnosis.
Topics: Aged; Brain; Creutzfeldt-Jakob Syndrome; Diagnosis, Differential; Disease Progression; Electroencephalography; Fatal Outcome; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Neurologic Examination; Phosphopyruvate Hydratase; Psychomotor Disorders; Signal Processing, Computer-Assisted
PubMed: 21707861
DOI: 10.1111/j.1479-8301.2011.00361.x -
Postgraduate Medical Journal Feb 2001There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience... (Review)
Review
There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience clinically significant anxiety. This anxiety may be a psychological reaction to the stress of the illness or may be related to the neurochemical changes of the disease itself. Antiparkinsonian drugs may have a role in the pathogenesis of the anxiety. The anxiety disorders in Parkinson's disease patients appear to be clustered in the panic disorder, phobic disorder, and generalised anxiety disorder areas. The degree of comorbidity between anxiety and depression in patients with Parkinson's disease is in excess of that found in patients without the disease and anxiety in combination with depression may represent a specific depressive subtype in Parkinson's disease. As yet, there is no trial evidence as to the treatment of anxiety in patients with Parkinson's disease.
Topics: Aged; Anti-Anxiety Agents; Antiparkinson Agents; Anxiety Disorders; Humans; Levodopa; Parkinson Disease; Prevalence; Psychomotor Disorders
PubMed: 11161073
DOI: 10.1136/pmj.77.904.89 -
Schizophrenia Bulletin Jul 2007Psychomotor slowing (PS) is a cluster of symptoms that was already recognized in schizophrenia by its earliest investigators. Nevertheless, few studies have been... (Review)
Review
Psychomotor slowing (PS) is a cluster of symptoms that was already recognized in schizophrenia by its earliest investigators. Nevertheless, few studies have been dedicated to the clarification of the nature and the role of the phenomenon in this illness. Moreover, slowed psychomotor functioning is often not clearly delineated from reduced processing speed. The current, first review of all existing literature on the subject discusses the key findings. Firstly, PS is a clinically observable feature that is most frequently established by neuropsychological measures assessing speed of fine movements such as writing or tasks that require rapid fingertip manipulations or the maintenance of maximal speed over brief periods of time in manual activities. Moreover, the slowed performance on the various psychomotor measures has been demonstrated independent of medication and has also been found to be associated with negative symptoms and, to a lesser extent, with positive and depressive symptoms. Importantly, performance on the psychomotor tasks proved related to the patients' social, clinical, and functional outcomes. Several imaging studies showed slowed performance to coincide with dopaminergic striatal activity. Finally, conventional neuroleptics do not improve the patients' PS symptoms, in contrast to the atypical agents that do seem to produce modestly improving effects.
Topics: Antipsychotic Agents; Humans; Psychomotor Disorders; Psychomotor Performance; Reaction Time; Schizophrenia
PubMed: 17093141
DOI: 10.1093/schbul/sbl051 -
Progress in Neuro-psychopharmacology &... Mar 2011Psychomotor retardation is a long established component of depression that can have significant clinical and therapeutic implications for treatment. Due to its negative... (Review)
Review
Psychomotor retardation is a long established component of depression that can have significant clinical and therapeutic implications for treatment. Due to its negative impact on overall function in depressed patients, we review its biological correlates, optimal methods of measurement, and relevance in the context of therapeutic interventions. The aim of the paper is to provide a synthesis of the literature on psychomotor retardation in depression with the goal of enhanced awareness for clinicians and researchers. Increased knowledge and understanding of psychomotor retardation in major depressive disorder may lead to further research and better informed diagnosis in regards to psychomotor retardation. Manifestations of psychomotor retardation include slowed speech, decreased movement, and impaired cognitive function. It is common in patients with melancholic depression and those with psychotic features. Biological correlates may include abnormalities in the basal ganglia and dopaminergic pathways. Neurophysiologic tools such as neuroimaging and transcranial magnetic stimulation may play a role in the study of this symptom in the future. At present, there are three objective scales to evaluate psychomotor retardation severity. Studies examining the impact of psychomotor retardation on clinical outcome have found differential results. However, available evidence suggests that depressed patients with psychomotor retardation may respond well to electroconvulsive therapy (ECT). Current literature regarding antidepressants is inconclusive, though tricyclic antidepressants may be considered for treatment of patients with psychomotor retardation. Future work examining this objective aspect of major depressive disorder (MDD) is essential. This could further elucidate the biological underpinnings of depression and optimize its treatment.
Topics: Antidepressive Agents, Tricyclic; Depression; Depressive Disorder, Major; Electroconvulsive Therapy; Female; Humans; Magnetic Resonance Imaging; Male; Psychiatric Status Rating Scales; Psychomotor Disorders; Transcranial Magnetic Stimulation
PubMed: 21044654
DOI: 10.1016/j.pnpbp.2010.10.019 -
Neuropsychopharmacology : Official... Jan 2017Motivational and motor deficits are common in patients with depression and other psychiatric disorders, and are related to symptoms of anhedonia and motor retardation.... (Review)
Review
Motivational and motor deficits are common in patients with depression and other psychiatric disorders, and are related to symptoms of anhedonia and motor retardation. These deficits in motivation and motor function are associated with alterations in corticostriatal neurocircuitry, which may reflect abnormalities in mesolimbic and mesostriatal dopamine (DA). One pathophysiologic pathway that may drive changes in DAergic corticostriatal circuitry is inflammation. Biomarkers of inflammation such as inflammatory cytokines and acute-phase proteins are reliably elevated in a significant proportion of psychiatric patients. A variety of inflammatory stimuli have been found to preferentially target basal ganglia function to lead to impaired motivation and motor activity. Findings have included inflammation-associated reductions in ventral striatal neural responses to reward anticipation, decreased DA and DA metabolites in cerebrospinal fluid, and decreased availability, and release of striatal DA, all of which correlated with symptoms of reduced motivation and/or motor retardation. Importantly, inflammation-associated symptoms are often difficult to treat, and evidence suggests that inflammation may decrease DA synthesis and availability, thus circumventing the efficacy of standard pharmacotherapies. This review will highlight the impact of administration of inflammatory stimuli on the brain in relation to motivation and motor function. Recent data demonstrating similar relationships between increased inflammation and altered DAergic corticostriatal circuitry and behavior in patients with major depressive disorder will also be presented. Finally, we will discuss the mechanisms by which inflammation affects DA neurotransmission and relevance to novel therapeutic strategies to treat reduced motivation and motor symptoms in patients with high inflammation.
Topics: Animals; Corpus Striatum; Dopamine; Humans; Inflammation; Mental Disorders; Motivation; Motor Activity; Psychomotor Disorders
PubMed: 27480574
DOI: 10.1038/npp.2016.143