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https://www.readbyqxmd.com/read/29352532/the-impact-of-severe-mental-disorders-and-psychotropic-medications-on-sexual-health-and-its-implications-for-clinical-management
#1
Angel L Montejo, Laura Montejo, David S Baldwin
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action...
February 2018: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
https://www.readbyqxmd.com/read/29350128/between-a-rock-a-bye-and-a-hard-place-mood-disorders-during-the-peripartum-period
#2
Michael Thomson, Verinder Sharma
Mood disorders including major depressive disorder and bipolar disorder are common during and after pregnancy. Timely identification and appropriate management of mood episodes is essential to maximize maternal well-being and minimize adverse outcomes. Failure to do so results in maternal suffering and impaired child bonding, and has the potential for devastating outcomes including suicide and infanticide. Women are routinely screened for unipolar depression during or after pregnancy but not for bipolar disorder, in spite of the fact that childbirth is associated with a major risk for onset or exacerbation of bipolar disorder...
December 2017: CNS Spectrums
https://www.readbyqxmd.com/read/29348993/delayed-presentation-of-cerebral-air-embolism-from-a-left-atrial-esophageal-fistula-a-case-report-and-review-of-the-literature
#3
Catherine Peterson, Clay Elswick, Vicki Diaz, R Shane Tubbs, Marc Moisi
Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus. This case describes a 42-year-old male with recent cardiac ablation procedure at an outside hospital for refractory atrial fibrillation (A-fib) who presented with altered mental status, dyspnea and diaphoresis...
November 15, 2017: Curēus
https://www.readbyqxmd.com/read/29345690/clozapine-induced-myocarditis
#4
COMMENT
Tanuka Datta, Allen J Solomon
Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29338277/assessment-of-inpatient-psychiatric-readmission-risk-among-patients-discharged-on-an-antipsychotic-polypharmacy-regimen-a-retrospective-cohort-study
#5
Esad Boskailo, Aldin Malkoc, Dustin B McCurry, Jacob Venter, David Drachman, Gilbert M Ramos
OBJECTIVE: Patients are frequently prescribed multiple antipsychotic medications, leading to higher healthcare costs and increased risk for side effects. The efficacy of multiple versus single antipsychotics to prevent acute relapse, measured by incidence of inpatient readmission, is investigated in Arizona, USA. METHOD: A retrospective chart review compared socio-demographic and clinical data from 1,010 patients discharged on a single and 377 discharged on multiple antipsychotic medications...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29334291/prevalence-and-risk-factors-of-hyperprolactinemia-among-patients-with-various-psychiatric-diagnoses-and-medications
#6
Fahad D Alosaimi, Ebtihaj O Fallata, Mohammed Abalhassan, Abdulhadi Alhabbad, Nasser Alzain, Bandar Alhaddad, Mohammed Z Alassiry
OBJECTIVES: Hyperprolactinemia is a common adverse event associated with psychotropic medications (mainly antipsychotics) used in the management of schizophrenia and bipolar disorders. The aim of this study was to estimate the prevalence of hyperprolactinemia in psychiatric patients and to evaluate its association with various psychiatric diagnoses and the use of various psychotropic medications. METHODS: A cross-sectional observational study was conducted between July 2012 and June 2014...
January 15, 2018: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/29328360/metabolic-side-effects-in-patients-using-atypical-antipsychotic-medications-during-hospitalization
#7
Gül Dikeç, Leyla Baysan Arabaci, Gülçin Bölük Uzunoglu, Selin Demet Mizrak
The current research evaluated metabolic side effects in inpatients (N = 271) using atypical antipsychotic medications in a psychiatric hospital in Turkey between June and December 2016. Data were collected via an information form created after reviewing the literature at the time of patients' hospitalization and discharge. According to the analysis, 73.8% of patients stated they experienced side effects from antipsychotic medications and 20.7% of patients experienced weight gain. A statistical difference was detected among body mass index, waist circumference, diastolic blood pressure, and heart rate during patient hospitalization and discharge...
January 11, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29320364/cardiometabolic-effects-of-psychotropic-medications
#8
REVIEW
Oluchi Abosi, Sneha Lopes, Samantha Schmitz, Jess G Fiedorowicz
Background Many psychiatric disorders including schizophrenia, bipolar disorder and major depression convey an excess burden of cardiovascular morbidity and mortality. The medications used to treat these conditions may further adversely affect cardiovascular risk and exacerbate health disparities for vulnerable populations. There is a clinical need to appreciate the cardiometabolic adverse effects of psychotropic medications. Methods This paper reviews the most relevant cardiometabolic effects of psychotropic medications, organized around the components of metabolic syndrome...
January 10, 2018: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/29316894/access-to-primary-and-specialized-somatic-health-care-for-persons-with-severe-mental-illness-a-qualitative-study-of-perceived-barriers-and-facilitators-in-swedish-health-care
#9
Elisabeth Björk Brämberg, Jarl Torgerson, Anna Norman Kjellström, Peder Welin, Marie Rusner
BACKGROUND: Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness...
January 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29306047/unified-protocol-for-the-discontinuation-of-long-term-serotonin-reuptake-inhibitors-in-obsessive-compulsive-disorder-study-protocol-and-methods
#10
Christina L Boisseau, Steven A Rasmussen
Obsessive-compulsive disorder (OCD) is chronic psychiatric disorder associated with high rates of functional impairment and decreased quality of life. Although serotonin reuptake inhibitors have demonstrated efficacy in the treatment of OCD, little data is available to guide clinicians on how to manage these medications long-term. Cognitive-behavioral approaches provide a promising avenue for helping OCD patients discontinue maintenance SRIs while minimizing the potential for symptom worsening. This manuscript describes the rationale and methods for pilot feasibility study designed to a unified, cognitive-behavioral strategy for discontinuing long-term SRIs in OCD...
January 3, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29297112/relationship-among-hiv-related-stigma-mental-health-and-quality-of-life-for-hiv-positive-patients-in-tehran
#11
Mehrnaz Rasoolinajad, Nasrin Abedinia, Ahmad Ali Noorbala, Minoo Mohraz, Banafsheh Moradmand Badie, Abdulqader Hamad, Leyla Sahebi
People living with HIV/AIDS (PLHA) face several challenges in terms of the medical management of their disease. Alongside this are stigma, discrimination and psychosocial issues associated with HIV infection. In this study, the relationships associated with HIV-related stigma, mental health and quality of life for HIV-positive patients were investigated. This cross-sectional study examined a sample of 450 HIV positive patients from the Infectious Diseases and Behavioral Health Clinic of Imam Khomeini Hospital in the city of Tehran, Iran...
January 2, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29286589/are-psychiatric-inpatients-at-risk-of-developing-wernicke-s-encephalopathy-being-identified-and-adequately-treated
#12
Medhat Guirguis, Stephen Manning, Marina Chavez, Jessica Nelson, Regina Baronia, Sailatha Bobba, Jafreen Ahmed, Ijeoma Ajufo
Objective: Wernicke's encephalopathy is caused by thiamine deficiency and occurs predominantly in alcohol-dependent individuals but also develops in those who are malnourished due to other reasons including medical and psychiatric disorders. This study examined the frequency rate and management of Wernicke's encephalopathy in alcohol-dependent and non-alcohol-dependent patients admitted to a psychiatric hospital. Methods: Data were retrospectively collected from electronic medical records of psychiatric inpatients admitted to a teaching hospital located in Texas between September 2013 and March 2014...
December 28, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29261480/best-practices-in-managing-child-and-adolescent-behavioral-health-emergencies
#13
Vera Feuer, Joshua Rocker, Babar M Saggu, Jason M Andrus
Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies...
January 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29260296/lithium-associated-hypercalcemia-pathophysiology-prevalence-management
#14
Adrian D Meehan, Ruzan Udumyan, Mathias Kardell, Mikael Landén, Johannes Järhult, Göran Wallin
BACKGROUND: Lithium-associated hypercalcemia (LAH) is an ill-defined endocrinopathy. The aim of the present study was to determine the prevalence of hypercalcemia in a cohort of bipolar patients (BP) with and without concomitant lithium treatment and to study surgical outcomes for lithium-associated hyperparathyroidism. METHODS: Retrospective data, including laboratory results, surgical outcomes and medications, were collected from 313 BP treated with lithium from two psychiatric outpatient units in central Sweden...
December 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29250737/a-prospective-observational-study-of-problematic-oral-cannabinoid-use
#15
Mark A Ware, Marc O Martel, Roman Jovey, Mary E Lynch, Joel Singer
BACKGROUND: Despite evidence supporting the benefits of cannabinoids for symptom control across a wide range of medical conditions, concerns have been raised regarding the potential misuse and/or problematic use of cannabinoids (CBs). OBJECTIVE: The first objective of this study was to examine the incidence of problematic prescription cannabinoid use (PPCBU) over a 12-month period among patients initiating cannabinoid therapy. The second objective was to examine the factors associated with PPCBU...
December 17, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/29240508/medical-complications-of-bulimia-nervosa
#16
Philip S Mehler, Anne O'Melia, Carrie Brown, Dennis Gibson, Jeff Hollis, Patricia Westmoreland
Bulimia nervosa is a psychiatric disorder with many different medical sequelae. This article reviews the principal medical complications associated with bulimia nervosa, and emphasizes the importance of a timely approach to diagnosis and management.
December 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29228982/electroconvulsive-therapy-for-manic-state-with-mixed-and-psychotic-features-in-a-teenager-with-bipolar-disorder-and-comorbid-episodic-obsessive-compulsive-disorder-a-case-report
#17
Olof Rask, Klara Suneson, Eva Holmström, Beata Bäckström, Björn Axel Johansson
BACKGROUND: Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder...
December 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29226228/seminar-program-for-postgraduate-specialty-training-in-general-practice-proposal-for-a-5-year-thematic-catalogue
#18
Susanne Sommer, Erika Baum, Julia Magez, Jean-Francois Chenot, Gesine Weckmann, Jost Steinhäuser, Susanne Heim, Dagmar Schneider, Stephan Fuchs
Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany. Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians) has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience) among all German university departments of General Practice and two non-university teaching institutions, identified via the internet...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29225582/significant-need-for-a-french-network-of-expert-centers-enabling-a-better-characterization-and-management-of-treatment-resistant-depression-fondation-fondamental
#19
Antoine Yrondi, Djamila Bennabi, Emmanuel Haffen, Marion Garnier, Frank Bellivier, Thierry Bourgerol, Vincent Camus, Thierry D'Amato, Olivier Doumy, Frédéric Haesebaert, Jérôme Holtzmann, Christophe Lançon, Philippe Vignaud, Fanny Moliere, Isabel Nieto, Raphaëlle Marie Richieri, Philippe Domenech, Corentin Rabu, Luc Mallet, Liova Yon, Laurent Schmitt, Florian Stephan, Guillaume Vaiva, Michel Walter, Pierre-Michel Llorca, Philippe Courtet, Marion Leboyer, Wissam El-Hage, Bruno Aouizerate
Background: Major depression is characterized by (i) a high lifetime prevalence of 16-17% in the general population; (ii) a high frequency of treatment resistance in around 20-30% of cases; (iii) a recurrent or chronic course; (iv) a negative impact on the general functioning and quality of life; and (v) a high level of comorbidity with various psychiatric and non-psychiatric disorders, high occurrence of completed suicide, significant burden along with the personal, societal, and economic costs...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29224571/-worried-to-death-the-assessment-and-management-of-anxiety-in-patients-with-advanced-life-limiting-disease-a-national-survey-of-palliative-medicine-physicians
#20
N Atkin, V Vickerstaff, B Candy
BACKGROUND: Anxiety adversely affects quality of life and is common in adults with advanced life-limiting disease. There are no UK-wide guidelines on the assessment and management of anxiety in this specific population and there is little evidence regarding drug treatments. This study aimed to explore how palliative care physicians assess and manage anxiety in their patients, and to identify barriers encountered. METHODS: A cross-sectional survey was undertaken of all physicians working in specialist palliative care in the UK who were members of the Association for Palliative Medicine...
December 11, 2017: BMC Palliative Care
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