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Medical presentations of psychiatric disease

Eduard Vieta, Michael Berk, Thomas G Schulze, André F Carvalho, Trisha Suppes, Joseph R Calabrese, Keming Gao, Kamilla W Miskowiak, Iria Grande
Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease. Psychiatric and nonpsychiatric medical comorbidities are common in patients and might also contribute to increased mortality. Bipolar disorders are some of the most heritable psychiatric disorders, although a model with gene-environment interactions is believed to best explain the aetiology...
March 8, 2018: Nature Reviews. Disease Primers
Astrid Nehlig
Most individuals adjust their caffeine intake according to the objective and subjective effects induced by the methylxanthine. However, to reach the desired effects, the quantity of caffeine consumed varies largely among individuals. It has been known for decades that the metabolism, clearance, and pharmacokinetics of caffeine is affected by many factors such as age, sex and hormones, liver disease, obesity, smoking, and diet. Caffeine also interacts with many medications. All these factors will be reviewed in the present document and discussed in light of the most recent data concerning the genetic variability affecting caffeine levels and effects at the pharmacokinetic and pharmacodynamic levels that both critically drive the level of caffeine consumption...
April 2018: Pharmacological Reviews
Clinton G Lauritsen, Abigail L Chua, Stephanie J Nahas
PURPOSE OF REVIEW: Menopause is a life-changing event in numerous ways. Many women with migraine hold hope that the transition to the climacteric state will coincide with a cessation or improvement of migraine. This assumption is based mainly on common lay perceptions as well as assertions from many in the healthcare community. Unfortunately, evidence suggests this is far from the rule. Many women turn to a general practitioner or a headache specialist for prognosis and management. A natural instinct is to manipulate the offending agent, but in some cases, this approach backfires, or the concern for adverse events outweighs the desire for a therapeutic trial, and other strategies must be pursued...
March 6, 2018: Current Treatment Options in Neurology
Maria Pia Giannoccaro, Anna Bartoletti-Stella, Silvia Piras, Alfonsina Casalena, Federico Oppi, Giovanni Ambrosetto, Pasquale Montagna, Rocco Liguori, Piero Parchi, Sabina Capellari
BACKGROUND: In 1969, Dazzi and Finizio reported the second observation of frontotemporal dementia (FTD) - amyotrophic lateral sclerosis (ALS) association in a large Italian kindred affected by an autosomal dominant form of ALS with high penetrance, frequent bulbar onset, and frequent cognitive decline. OBJECTIVE: To expand the original characterization of this family and report the link with the C9orf72 repeat expansion (RE). METHODS: We followed or reviewed the medical records of thirteen patients belonging to the original family and performed genetic analyses in four individuals...
2018: Journal of Alzheimer's Disease: JAD
Marwan Abouljoud, Michael Ryan, Anne Eshelman, Kelly Bryce, Michelle T Jesse
Integration of health psychologists into specialty care is a shift in the tertiary care construct that addresses all aspects of a patient's presentation, including psychiatric/social history, psychological well-being, and behavioral contributions to the disease process, assuring both optimal health outcomes and cost-effectiveness in a financially challenging healthcare environment. In this paper, we discuss leadership perspectives (physician and psychologists) on the factors involved in integrating a health psychologist into a busy tertiary care environment...
February 21, 2018: Journal of Clinical Psychology in Medical Settings
Jing Huang, Danwei Zhao, Zhixiong Liu, Fangkun Liu
Cancer is a major public health problem and one of the leading contributors to the global disease burden. The high cost of development of new drugs and the increasingly severe burden of cancer globally have led to increased interest in the search and development of novel, affordable anti-neoplastic medications. Antipsychotic drugs have a long history of clinical use and tolerable safety; they have been used as good targets for drug repurposing. Being used for various psychiatric diseases for decades, antipsychotic drugs are now reported to have potent anti-cancer properties against a wide variety of malignancies in addition to their antipsychotic effects...
February 1, 2018: Cancer Letters
Tanya T Nguyen, Tomasz Kosciolek, Lisa T Eyler, Rob Knight, Dilip V Jeste
Schizophrenia and bipolar disorder are among the leading causes of disability, morbidity, and mortality worldwide. In addition to being serious mental illnesses, these disorders are associated with considerable systemic physiological dysfunction, including chronic inflammation and elevated oxidative stress. The advent of sophisticated sequencing techniques has led to a growing interest in the potential role of gut microbiota in human health and disease. Advances in this area have transformed our understanding of a number of medical conditions and have generated a new perspective suggesting that gut microbiota might be involved in the development and maintenance of brain/mental health...
January 31, 2018: Journal of Psychiatric Research
Dave Whaley, John Spain, Teresa Overman, Vincent Valinotti
Background: Over the past two decades, changes in mission and expectations of deployed medical assets are requiring adaptations of pharmacy services. Specifically, the Department of Defense (DOD)-deployed contractors in theater are now eligible for varying levels of care from DOD-deployed assets. Pharmacy must now stock and maintain a complex medication footprint. This new requirement makes the attempt to retrograde a long established deployed pharmacy difficult and presents new challenges...
January 1, 2018: Military Medicine
Ragnar Nesvåg, Jørgen G Bramness, Marte Handal, Ingeborg Hartz, Vidar Hjellvik, Svetlana Skurtveit
BACKGROUND: Antipsychotic drug use among children and adolescents is increasing, and there is growing concern about off-label use and adverse effects. The present study aims to investigate the incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorder in Norwegian children and adolescents. METHODS: We obtained data on mental disorders from the Norwegian Patient Registry on 0-18 year olds who during 2009-2011 were diagnosed for the first time with schizophrenia-like disorder (International Classification of Diseases, 10th revision codes F20-F29), bipolar disorder (F30-F31), or severe depressive episode with psychotic symptoms (F32...
January 20, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Jelmer Alsma, Jens van de Wouw, Korné Jellema, Sophie M Coffeng, Els Tobback, Liesbeth Delesie, Crispijn L van den Brand, Dirk Vogelaers, An Mariman, Peter de Paepe, Jan L van Saase, Anne Weiland
OBJECTIVE: The objective of this study was to assess the incidence and characteristics of patients presenting with physical symptoms that remain medically unexplained at the emergency department (ED). PATIENTS AND METHODS: A retrospective chart study was carried out in three hospitals in The Netherlands and Belgium. All patients (age>18 years) visiting the ED in 4 selected weeks in 2013 at the Erasmus University Medical Center (Erasmus MC) in Rotterdam, The Netherlands, and 1 selected week in 2013 at the Haaglanden Medical Center, Westeinde HMC in The Hague, The Netherlands, and the University Hospital Ghent (UZG), Belgium were included...
January 22, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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
František Nehaj, Marianna Kubašková, Michal Mokáň, Juraj Sokol, Vladimír Nosáľ, Kamil Zeleňák, Marián Mokáň
Wilson disease (WD) belongs to autosomal recessive genetic metabolic disorders with gene mutation ATP7B located on 13th chromosome. The enzyme ATPase plays an important role in WD. It facilitates excretion of copper into bile. This gene is responsible for modification of apoceruloplasmin. In this disease, it leads to insufficient release of copper from organism and accumulation of copper in organs such as liver, brain which can cause dysfunction of a certain organ. According to specific symptoms, we can divide WD into psychiatric, neurologic or hepatic form...
2018: Vnitr̆ní Lékar̆ství
Stephanie Perin, Karra D Harrington, Yen Ying Lim, Kathryn Ellis, David Ames, Robert H Pietrzak, Adrian Schembri, Stephanie Rainey-Smith, Olivier Salvado, Simon M Laws, Ralph N Martins, Victor L Villemagne, Christopher C Rowe, Colin L Masters, Paul Maruff
BACKGROUND: Relationships between depression and Alzheimer's disease (AD) may become clearer if studied in preclinical AD where dementia is not present. METHOD: The aim of this study was to evaluate prospectively, relationships between brain amyloid-β (Aβ), depressive symptoms and screen positive depression in cognitively normal (CN) older adults. Depressive symptoms were measured with the Geriatric Depression Inventory (GDS-15) in CN adults from the Australian Imaging Biomarkers and Lifestyle (AIBL) study without depression at baseline and classified as having abnormally high (Aβ+; n = 136) or low (Aβ-; n = 449) Aβ according to positron emission tomography at 18-month intervals over 72 months...
January 3, 2018: Journal of Affective Disorders
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
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
Lauren C Strazzulla, Eddy Hsi Chun Wang, Lorena Avila, Kristen Lo Sicco, Nooshin Brinster, Angela M Christiano, Jerry Shapiro
Alopecia areata (AA) is a common, inflammatory, nonscarring type of hair loss. Significant variations in the clinical presentation of AA have been observed, ranging from small, well-circumscribed patches of hair loss to a complete absence of body and scalp hair. Patients affected by AA encompass all age groups, sexes, and ethnicities, and may experience frustration with the unpredictable nature of their disease for which there is currently no definitive treatment. The cause of AA remains incompletely understood, though it is believed to result-at least in part-from a loss of immune privilege in the hair follicle, autoimmune-mediated hair follicle destruction, and the upregulation of inflammatory pathways...
January 2018: Journal of the American Academy of Dermatology
Eleonora Borges Gonçalves, Tania Aparecida Marchiori de Oliveira Cardoso, Clarissa Lin Yasuda, Fernando Cendes
Objectives To assess depressive disorders in patients with mesial temporal lobe epilepsy (MTLE) refractory to medical treatment. Methods Adult patients with refractory MTLE completed two questionnaires (Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory (BDI) had a semi-structured psychiatric interview and a high resolution MRI scan. For complete neuropsychiatric diagnosis, as per International Classification of Diseases (ICD-10), the results were combined with clinical history and additional information from the patients' family...
January 1, 2017: Journal of International Medical Research
Ryan Verity, Andrew Kirk, Megan E O'Connell, Chandima Karunanayake, Debra G Morgan
INTRODUCTION: In an effort to better understand why cognitively normal patients were referred to a memory clinic, we sought to identify features of "worried well" patients to better identify those more likely to be cognitively normal. METHODS: In total, 375 consecutive patients referred by primary care practitioners to a Rural and Remote Memory Clinic were categorized into two groups based on their neurologic diagnosis, "worried well" (cognitively normal, N=81) or "other" (patients with any neurologic diagnosis, N=294)...
March 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Raul Martínez-Fernández, Rafael Rodríguez-Rojas, Marta Del Álamo, Frida Hernández-Fernández, Jose A Pineda-Pardo, Michele Dileone, Fernando Alonso-Frech, Guglielmo Foffani, Ignacio Obeso, Carmen Gasca-Salas, Esther de Luis-Pastor, Lydia Vela, José A Obeso
BACKGROUND: Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. METHODS: This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain...
January 2018: Lancet Neurology
Stania Kamara, Anna Walder, Jennifer Duncan, Antoinet Kabbedijk, Peter Hughes, Andrew Muana
Problem: Reported levels of mental health and psychosocial problems rose during the 2014-2015 Ebola virus disease outbreak in Sierra Leone. Approach: As part of the emergency response, existing plans to create mental health units within the existing hospital framework were brought forward. A nurse-led mental health and psychosocial support service, with an inpatient liaison service and an outpatient clinic, was set up at the largest government hospital in the country...
December 1, 2017: Bulletin of the World Health Organization
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