International Journal of Psychiatry in Clinical Practice最新文献

{"title":"Factors associated with sick leave duration in patients suffering from major depressive disorder initiating antidepressant treatment: a real-world evidence study in Germany and Spain.","authors":"Miquel Roca,&nbsp;Annalisa Bonelli,&nbsp;Agnese Cattaneo,&nbsp;Alessandro Comandini,&nbsp;Giorgio Di Dato,&nbsp;Franca Heiman,&nbsp;Valeria Pegoraro,&nbsp;Siegfried Kasper,&nbsp;Hans-Peter Volz,&nbsp;Diego Palao","doi":"10.1080/13651501.2022.2092515","DOIUrl":"https://doi.org/10.1080/13651501.2022.2092515","url":null,"abstract":"<p><strong>Objective: </strong>To describe MDD patients starting antidepressant (AD) treatment by pharmacological approach and identify factors associated with a longer sick leave (SL) duration.</p><p><strong>Methods: </strong>Retrospective study on IQVIA German Disease Analyser (specialists) and Spanish Longitudinal Patient Database (general practitioners and specialists). MDD patients initiating AD treatment between July 2016-June 2018 were grouped by therapeutic approach (AD monotherapy <i>vs.</i> combination/switch/add-on) and their characteristics were analysed descriptively. Multiple logistic regression models were run to evaluate factors affecting SL duration (i.e., >30 days).</p><p><strong>Results: </strong>One thousand six hundred and eighty-five patients (monotherapy: 58%; combination/switch/add-on: 42%) met inclusion criteria for Germany, and 1817 for Spain (monotherapy: 83%; combination/switch/add-on: 17%). AD treatment influenced SL duration: combination/switch/add-on patients had a 2-fold and a 4-fold risk of having >30 days of SL than monotherapy patients, respectively in Germany and Spain. Patients with a gap of time between MDD diagnosis and AD treatment initiation had a higher likelihood of experiencing a longer SL both in Germany and Spain (38% higher likelihood and 6-fold risk of having >30 days of SL, respectively).</p><p><strong>Conclusions: </strong>A careful and timely selection of AD treatment approach at the time of MDD diagnosis may improve functional recovery and help to reduce SL, minimising the socio-economic burden of the disease.Key pointsThe major depressive disorder has a substantial impact on work absenteeism.The present study aimed to describe MDD patients starting antidepressant (AD) treatment depending on the pharmacological approach and to identify factors associated with longer sick leave (SL) duration.Patients receiving AD monotherapy had a lower likelihood of having more than 30 days of sick leave than those receiving AD combination/switch/add-on.Patients for whom a gap of time between MDD diagnosis and initiation of AD treatment was observed, showed a higher likelihood of having more than 30 days of sick leave.Because findings from this analysis relied on secondary data, the authors would like to claim the urgency of conducting prospective observational studies that further investigate the effect that different AD therapeutic approaches and timely initiation of treatment might exert on patients' recovery.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"59-68"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matrix metalloproteinase-3 serum levels in schizophrenic patients.","authors":"Michal Ordak,&nbsp;Malgorzata Libman-Sokolowska,&nbsp;Tadeusz Nasierowski,&nbsp;Bogna Badyra,&nbsp;Leszek Kaczmarek,&nbsp;Elzbieta Muszynska,&nbsp;Magdalena Bujalska-Zadrozny","doi":"10.1080/13651501.2022.2057332","DOIUrl":"https://doi.org/10.1080/13651501.2022.2057332","url":null,"abstract":"<p><strong>Objectives: </strong>It has been reported that matrix metalloproteinase, MMP-3 may play a significant role in the pathophysiology of mental disorders. However, there are no data on the level of MMP-3 in people suffering from schizophrenia, or its influence on the mental state of these people. The aim of this study was to investigate the effect of an antipsychotic treatment on the blood levels of MMP-3, as well as investigating its relationship with insight into schizophrenia.</p><p><strong>Methods: </strong>Thirty people with schizophrenia were included in the study. The concentration of MMP-3 in the blood serum was assessed using enzyme-linked immunosorbent assay. Insight into the disease was assessed using the Beck Cognitive Insight Scale.</p><p><strong>Results: </strong>The antipsychotic treatment applied decreased the levels of MMP-3 in patients with schizophrenia (<i>p</i> = 0.005), however, the statistically significant interaction (<i>p</i> = 0.02) indicates that the decrease only concerned men. There was also a statistically significant correlation between the level of MMP-3 and insight into the disease (<i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>MMP-3 may be associated with gender, treatment and symptoms in schizophrenic patients.KEY POINTSMMP3 could be used as a potential biomarker for schizophrenia.The level of MMP-3 decreased due to the applied antipsychotic treatment.The higher the level of MMP-3 in a group of people with schizophrenia, the better insight into their disease.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"27 1","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9508728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the efficacy of aripiprazole as an add-on to valproate with other second-generation antipsychotics in acute mania symptoms in manic patients in Iran.","authors":"Zeinab Sadat Ayatollahi,&nbsp;Mehran Shayganfard,&nbsp;Hamidreza Jamilian,&nbsp;Anita Alaghmand","doi":"10.1080/13651501.2022.2030758","DOIUrl":"https://doi.org/10.1080/13651501.2022.2030758","url":null,"abstract":"<p><strong>Background: </strong>Given the great importance of treating patients with bipolar disorder, the aim of this study was to compare the efficacy of aripiprazole with other second-generation antipsychotics in relieving acute symptoms of mania.</p><p><strong>Materials and methods: </strong>In this study, 50 patients with bipolar I disorder, manic episode, were divided into two groups receiving aripiprazole (<i>n</i> = 25) and other second-generation antipsychotics (risperidone, olanzapine, and quetiapine) (<i>n</i> = 25) for 6 weeks. The disease severity was evaluated and compared according to YMRS and CGI criteria.</p><p><strong>Results: </strong>The mean severity of mania according to YMRS and CGI, at week 0 in comparison with weeks 2, 4 and 6 in both groups was significantly different (<i>p</i> < 0.0001) and the treatment with Aripiprazole at week 2 (<i>p</i> < 0.0001) and 4 (<i>p</i> = 0.0002) was significantly better than the other second-generation antipsychotics. The two groups also showed an overall improvement in CGI-based results at weeks 4 and 6 (<i>p</i> = 0.002). In addition, the efficacy index for aripiprazole at weeks 4 (<i>p</i> = 0.011) and 6 (<i>p</i> < 0.0001) as well as disease improvement in the second (<i>p</i> < 0.0001) and fourth (<i>p</i> = 0.026) weeks after treatment were better than the other second-generation antipsychotics.</p><p><strong>Conclusions: </strong>Aripiprazole and other second-generation antipsychotics, 2 weeks after initiation of treatment, significantly reduced mania severity in patients with bipolar disorder, however, aripiprazole seems to be more efficient and faster for controlling mania in patients with bipolar disorder.KEY POINTSAripiprazole and other second-generation antipsychotics, 2 weeks after initiation of treatment, significantly reduced mania severity in patients with bipolar disorder.Comparison between the two drugs, aripiprazole showed a more beneficial role in the second and fourth weeks than second-generation antipsychotics.Due to the fact that the possible mechanisms involved in the role of aripiprazole have not been considered compared to other antipsychotics in patients with bipolar disorder, there is a need for more extensive studies in this field.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 4","pages":"363-369"},"PeriodicalIF":3.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10374474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable reliability and acceptability of telepsychiatry and face-to-face psychiatric assessments in the emergency room setting.","authors":"Moises Bistre,&nbsp;Alzbeta Juven-Wetzler,&nbsp;Daniel Argo,&nbsp;Igor Barash,&nbsp;Gregory Katz,&nbsp;Ronen Teplitz,&nbsp;Muhamad-Musa Said,&nbsp;Yoav Kohn,&nbsp;Omer Linkovski,&nbsp;Renana Eitan","doi":"10.1080/13651501.2021.1979586","DOIUrl":"https://doi.org/10.1080/13651501.2021.1979586","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the reliability and acceptability of psychiatric interviews using telepsychiatry and face-to-face modalities in the emergency room setting.</p><p><strong>Methods: </strong>In this prospective observational feasibility study, psychiatric patients (<i>n</i> = 38) who presented in emergency rooms between April and June 2020, went through face-to-face and videoconference telepsychiatry interviews in a non-randomised varying order. Interviewers and a senior psychiatry resident who observed both interviews determined diagnosis, recommended disposition and indication for involuntary admission. Patients and psychiatrists completed acceptability post-assessment surveys.</p><p><strong>Results: </strong>Agreement between raters on recommended disposition and indication for involuntary admission as measured by Cohen's kappa was 'strong' to 'almost perfect' (0.84/0.81, 0.95/0.87 and 0.89/0.94 for face-to-face vs. telepsychiatry, observer vs. face-to-face and observer vs. telepsychiatry, respectively). Partial agreement between the raters on diagnosis was 'strong' (Cohen's kappa of 0.81, 0.85 and 0.85 for face-to-face vs. telepsychiatry, observer vs. face-to-face and observer vs. telepsychiatry, respectively).Psychiatrists' and patients' satisfaction rates, and psychiatrists' perceived certainty rates, were comparably high in both face-to-face and telepsychiatry groups.</p><p><strong>Conclusions: </strong>Telepsychiatry is a reliable and acceptable alternative to face-to-face psychiatric assessments in the emergency room setting. Implementing telepsychiatry may improve the quality and accessibility of mental health services.Key pointsTelepsychiatry and face-to-face psychiatric assessments in the emergency room setting have comparable reliability.Patients and providers report a comparable high level of satisfaction with telepsychiatry and face-to-face modalities in the emergency room setting.Providers report a comparable level of perceived certainty in their clinical decisions based on telepsychiatry and face-to-face psychiatric assessments in the emergency room setting.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"228-233"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39473278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of antineuronal antibodies and 8-OHdG in mothers of children with autism spectrum disorder: a case-control study.","authors":"Şermin Bilgen Ulgar,&nbsp;Hamza Ayaydın,&nbsp;Hakim Çelik,&nbsp;İsmail Koyuncu,&nbsp;Adnan Kirmit","doi":"10.1080/13651501.2021.1993925","DOIUrl":"https://doi.org/10.1080/13651501.2021.1993925","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of our study was to investigated the anti-Yo, anti-Hu, anti-Ri, anti-amphiphysin antibody levels and 8-OHdG in mothers of children with autism.</p><p><strong>Methods: </strong>This study included 60 participants, 33 of whom were healthy mothers of 3-12-year-old children diagnosed with autism spectrum disorder (ASD) and the 27 others who constituted the control group, were healthy mothers with age-matched healthy children. Two groups were examined for plasma anti-Yo, anti-Hu, anti-amphiphysin and anti-Ri antibodies and, 8-OHdG levels. The participants were asked to accomplish a sociodemographic data form. The severity of ASD symptoms was evaluated according to the Childhood Autism Rating Scale (CARS).</p><p><strong>Results: </strong>Anti-amphiphysin antibody levels and anti-Ri antibody positivity were significantly higher in the case group (<i>p</i> = 0.001; <i>p</i> = 0.027, respectively). The two groups did not significantly differ in terms of anti-Yo and anti-Hu antibody levels and in terms of 8-OHdG levels (<i>p</i> = 0.065; <i>p</i> = 0.099; <i>p</i> = 0.490, respectively). The two groups did not significantly differ in terms of sociodemographic data (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>According to the our study, maternal antineuronal antibodies, such as anti-amphiphysin and anti-Ri, may contribute to the risk of childhood autism. Studies with larger samples are needed.KEY POINTSMaternal factors associated with autism should be investigated in order to create early diagnosis and treatment opportunities for autism.Based on the importance of immunological and cerebellar pathologies in autism aetiology, we aimed to investigate antineuronal antibodies in mothers of children with autism.Maternal antineuronal antibodies, such as anti-amphiphysin and anti-Ri, may contribute to the risk of childhood autism.High anti-amphiphysin antibody levels in mothers of children with autism may also occur against the amphiphysin in the structure of the SrGAP3 gene, which is associated with autism.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"244-250"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39554194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care utilisation in treatment-resistant depression: a Swedish population-based cohort study.","authors":"Philip Brenner,&nbsp;Adam Nygren,&nbsp;David Hägg,&nbsp;Mikael Tiger,&nbsp;Marguerite O'Hara,&nbsp;Lena Brandt,&nbsp;Johan Reutfors","doi":"10.1080/13651501.2021.2003405","DOIUrl":"https://doi.org/10.1080/13651501.2021.2003405","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to patients with depression not meeting TRD criteria.</p><p><strong>Methods: </strong>Nationwide Swedish registers were used to identify patients 18-69 years old with incident depression and antidepressant treatment. Patients were followed prospectively and defined as having TRD at start of the third distinct consecutive treatment episode. Each of the 16,329 identified TRD patients were matched with five comparators with depression not meeting criteria for TRD. Main outcome measure was total number of inpatient days and outpatient visits, and secondary outcome was HCU in connection with a main diagnosis of depression or suicide attempt.</p><p><strong>Results: </strong>TRD patients had a significantly higher risk of all-cause inpatient care than comparators (first year adjusted risk ratio [aRR] 3.03 [95%CI 3.01-3.05], years 1-3 aRR 2.15 [2.13-2.16]). This was more pronounced when the main diagnosis was depression (first year aRR 4.41 [4.36-4.45]), and after suicide attempt (first year aRR 4.43 [4.26-4.60]). Outpatient visits were also markedly more frequent for patients with TRD (first year aRR 2.05 [2.03-2.07]). Higher HCU among TRD patients persisted throughout follow-up.</p><p><strong>Conclusions: </strong>Patients with TRD may have a twofold to fourfold higher HCU than other patients with depression.KEYPOINTSThis register-based prospective study investigated health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to other patients with depression.Patients with TRD had a two to fourfold higher HCU regarding all measured outcomes, including inpatient hospital days and outpatient visits.The elevated HCU persisted for more than three years, although decreasing gradually. This should correspond to increased costs and individual burden for patients with TRD.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"251-258"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39682277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial 3.","authors":"Siegfried Kasper","doi":"10.1080/13651501.2022.2128578","DOIUrl":"https://doi.org/10.1080/13651501.2022.2128578","url":null,"abstract":"It is my great pleasure to welcome you to the third issue of the International Journal of Psychiatry in Clinical Practice in 2022. In this issue’s highlight, Volz et al. review available literature in order to aid in the operationalisation and epidemiology of subsyndromal generalised anxiety disorder. The result of this meticulous systematic review reveal that subsyndromal anxiety disorder poses a notable burden of disease to a large number of individuals. Additionally, authors propose a unified definition of subthreshold GAD. Polat et al. assessed the validity and reliability of the Turkish version of the self-evaluation of negative symptoms scale (SNS). Authors successfully indicate adequate internal consistency and a confirmatory five-factor structure akin to the original SNS. Bistre et al. examined comparable reliability and acceptability of telepsychiatry and face-to-face psychiatric assessments in the emergency room setting. In their prospective observational feasibility study, researchers illustrate that telepsychiatry is a well-grounded option to traditional face-to-face assessments. This finding is particularly interesting, as the rising trend of online treatment may allow for more remote psychiatric practices. In a meta-analysis, Khraisat et al. explored the pooled prevalence of mental disorders among COVID-19 survivors. Results indicate that not only were psychological sequelae evident amongst mentioned patient group, but spanned a variety of disorders and symptoms such as anxiety, depression, psychological distress, and sleep disorders. In a case-control study, Ulgar and colleagues evaluated antineuronal antibodies and 8-OHdG in mothers of children with autism spectrum disorder. Findings suggest that anti-amphiphysin and anti-RI antibody positivity appear to be significantly lower in the control as compared to the case group. Specifically, these results elucidate the role of antineuronal antibodies as potential risk-factors for childhood autism. Brenner and colleagues investigated the health care utilisation (HCU) in treatment-resistant depression (TRD) in a Swedish population-based cohort study. Patients suffering from treatment-resistant depression were matched with patients that do not fulfil the criteria for TRD. Not only did increased HCU occur significantly more often among patients with TRD (2 – 4 higher), but findings persisted longer for the TRD group than the nonTRD group. In an attempt to research the effects of electroconvulsive therapy (ECT) non nitrosative stress and oxidative DNA damage parameters in patients with a depressive episode, Karaya gmurlu et al. found that while ECT can decrease non nitrosative stress, it might increase oxidative DNA damage in individuals with depression. Plunkett and colleagues bridge the gap in research by quantitively evaluating dignity, coercion and involuntary psychiatric care in a study of involuntary and voluntary psychiatry inpatients in Dublin, Ireland. As previously not found in qua","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"219-220"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from 4 centres in Italy.","authors":"Massimiliano Beghi,&nbsp;Silvia Ferrari,&nbsp;Riccardo Brandolini,&nbsp;Ilaria Casolaro,&nbsp;Matteo Balestrieri,&nbsp;Chiara Colli,&nbsp;Carlo Fraticelli,&nbsp;Rosaria Di Lorenzo,&nbsp;Giovanni De Paoli,&nbsp;Alessandra Nicotra,&nbsp;Livia Pischiutta,&nbsp;Enrico Tedeschini,&nbsp;Giulio Castelpietra","doi":"10.1080/13651501.2021.1980588","DOIUrl":"https://doi.org/10.1080/13651501.2021.1980588","url":null,"abstract":"<p><p><b>Objectives:</b> An observation of the Emergency Room (ER) admissions during the lockdown.<b>Methods:</b> We monitored admissions to the ER requiring psychiatric evaluation during the 2020 lockdown (March 9^th-May 3^rd, 2020) compared to the same period of 2019, in four sites of Northern Italy (ASST Lariana, AUSL Modena, ASU Friuli Centrale and AUSL Romagna). Number of admissions, baseline demographic and clinical variables were extracted from the clinical databases.<b>Results:</b> A 20.0% reduction of psychiatric referrals was observed across the sites (24.2% in ASST Lariana, 30.5% in AUSL Modena, 12.0% in ASU Friuli Centrale and 14.5% in AUSL Romagna). This reduction peaked at 41.5% in the first month of the lockdown. Being homeless as well as with a dual diagnosis (OR 1,67, CI: 1.02-2.74), while living in a residential facility and admission for a depressive episode Being homeless (OR 2.50, CI: 1.36-4.61) and having a dual diagnosis (OR 1,67, CI: 1.02-2.74) were significantly associated with an increase in ER admission, while living in a residential facility (OR 0.48, CI: 0.31-0.74), having a depressive episode (OR 0.36, CI: 0.18-0.73) and a diagnosis of anxiety disorder (OR 0.60, CI: 0.36-0.99) were significantly associated with a decrease.<b>Conclusions:</b> During lockdown, a decrease in psychiatric referrals was observed.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"316-320"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotic symptoms prior or concomitant to diagnosis of multiple sclerosis: a systematic review of case reports and case series.","authors":"Michel Sabe,&nbsp;Othman Sentissi","doi":"10.1080/13651501.2021.1973506","DOIUrl":"https://doi.org/10.1080/13651501.2021.1973506","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine the clinical features of psychotic symptoms preceding or concomitant to multiple sclerosis (MS) diagnosis.</p><p><strong>Method: </strong>From the 1st to 10th of January 2020 a systematic review was conducted through an electronic search of different databases. Results were limited to English, French, German, Italian and Spanish language articles.</p><p><strong>Results: </strong>We identified 599 titles, and included 32 cases from case-report and case series. One case report from our department was added. The mean age of first psychiatric symptoms was 25.8 ± 10.2 years, the mean age of MS diagnosis was 31.2 ± 10.7 years and the mean delay until MS diagnosis was 2.7 ± 3 years. Most reported symptoms were delusions (81%), auditory hallucinations (59%) and visual hallucinations (50%). Upon the MS diagnosis, immunosuppressive therapy was significantly more effective for psychotic symptoms than antipsychotics (OR = 9.0; 95%CI: 2.15-37; <i>p</i> = 0.002). Diffuse periventricular lesions were found in 95.6% of cases, with mostly temporal or frontal predominant lesions. In cases affected by predominant temporal lesions, 83% of cases presented visual hallucinations (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Poor response or resistance to antipsychotics treatment should alert clinicians on the need to consider a differential diagnosis. Considering the impact of delay in MS diagnosis further research regarding this subject is warranted.KEY POINTSInsight into the occurrence of psychotic symptoms in multiple sclerosis (MS) is mainly limited to case reports and case series.Delay in MS management between initial psychotic symptoms and the MS diagnosis is 2.73 ± 3 years and 0.8 ± 1.2 years for patients presenting a first episode of psychosis.The resistance and poor response to antipsychotics found in most cases (75%) were associated with an excellent improvement (95%) of both psychiatric and neurologic symptoms with corticosteroids.Prospective studies are needed to investigate the spectrum of psychosis in MS.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"287-293"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39388499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subsyndromal generalised anxiety disorder: operationalisation and epidemiology - a systematic literature survey.","authors":"Hans-Peter Volz,&nbsp;Julia Saliger,&nbsp;Siegfried Kasper,&nbsp;Hans-Jürgen Möller,&nbsp;Erich Seifritz","doi":"10.1080/13651501.2021.1941120","DOIUrl":"https://doi.org/10.1080/13651501.2021.1941120","url":null,"abstract":"<p><p>The diagnosis of anxiety disorders, like other psychiatric disorders also, is operationalised since the introduction of diagnostic manuals. The diagnostic criteria of Generalised Anxiety Disorder (GAD) have been tightened in the last decades. This leads to the exclusion of patients with a high level of anxiety, but not fulfilling certain of the GAD-criteria, from effective treatment. Such so-called subsyndromal, subthreshold or subclinical GAD-states, however, often exhibit a comparable burden of disease like the full syndromal disorder and often tend to develop into the full syndromal disorder. The purpose of this review is - beside systematically reporting the papers found in respective data bases from 2013 onwards - to summarise the relevant data regarding definitions, epidemiology and consequences of subsyndromal anxiety states in order to give a comprehensive review.</p>","PeriodicalId":14351,"journal":{"name":"International Journal of Psychiatry in Clinical Practice","volume":"26 3","pages":"277-286"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13651501.2021.1941120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39226267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}