Mental Illness最新文献

{"title":"Quality of Life in Persons with Schizophrenia.","authors":"Zack Cernovsky","doi":"10.4081/mi.2017.7052","DOIUrl":"https://doi.org/10.4081/mi.2017.7052","url":null,"abstract":"De-institualization had been greatly facilitated by novel antipsychotics. Our goal is now to foster an independent life style of the discharged schizophrenic patients. Their subjective views and satisfaction can be statistically assessed via Kilian’s empowerment questionnaire, Bergold’s inventory, or the measures of quality of life. Their medication compliance can hopefully be also enhanced by further pharmacological studies, including also those of herbal preparations such as cannabidiol or ginseng. Our goal is to improve the quality of life of persons diagnosed with psychiatric illness. De-institutionalization movement in psychiatry in 1960s was originally driven by the hope to free the patients from highly contained institutionalized environments. At that time, certain charismatic psychiatrists such as Franco Basaglia insisted that the symptoms such as the word salad, flat affect, the vacant stares, the repetitive gestures and movements would, in fact, abate when the patient benefits from the freedom of living outside, within the community.1 The critics of the de-institionalization pointed out that the patients with schizophrenia and those with bipolar illness were being dumped into the neighborhoods, many of them becoming homeless, or victims of assaults or of suicides, or found themselves in jails.2 Their symptoms had not disappeared. Families of former inpatients felt overwhelmed by having to assume an intensive homecare without outside help, except when their financial situation enabled them to pay for inpatient treatments in private psychiatric hospitals. The antipsychiatric movement often criticized pharmacology as essentially controlling and poisonous, however, it has been also noted in several studies that symptoms such as dyskinesia and parkinsonism occur even in patients never exposed to antipsychotic medication.3 Over more recent decades, the new generation antipsychotics and the network of halfway houses made the process of re-integration into the community less aversive both for the patients and for their families. In particular, with clozapine, the back wards with treatment resistant patients or even entire hospitals were emptied by a few particularly skilled pharmacotherapists, e.g., Charles Byrne in Ireland or Kola Oyewumi in Ontario, in a manner that greatly reduced the severity of symptoms and enhanced the patients’ quality of life. Kilian4 emphasized that the goal of modern psychiatry is to foster an independent lifestyle and autonomous dealing with the illness, as exemplified by the concept of empowerment. Kilian’s team developed a 33-item questionnaire to measure this concept in psychiatric outpatients. The questionnaire covers important aspects of the patient’s life, including financial situation, living arrangements, work activity, social life, participation in therapy, insight, acceptance of illness, medication management, free time activities, political activism, sense of hope, self-efficacy, and family relationships. ","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/mi.2017.7052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34935225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stop Caretaking the Borderline or Narcissist: How to End the Drama and Get on with Life","authors":"Peter G. Bota, Ela Miropolskiy, Vy Nguyen","doi":"10.4081/MI.2017.6985","DOIUrl":"https://doi.org/10.4081/MI.2017.6985","url":null,"abstract":"Those who suffer from Narcissistic Personality Disorder or from Borderline Personality Disorder (Henceforth to be referred to as NPD and BPD individually and as BP/NP as a group) tend to employ an array of both normal and abnormal defense mechanisms, which are automatic mental responses designed to protect the ego from stress, anxiety or conflict. However, these defense mechanisms are extremely harmful to those who live with the BP/NP, and occasionally, those mechanisms will draw a well-meaning person into a degrading and crazy-making relationship, henceforth referred to as Caretaking. Stop Caretaking the Borderline or Narcissist: How to End the Drama and Get on with Life by Margalis Fjelstad is selfhelp book for those who are trapped in a dysfunctional and self-destructive relationship with loved ones who have borderline or narcissistic personality disorders. In first section of the book, titled Understanding the Caretaker Role, Fjelstad provides the reader with the tools to identify whether he or she is or acts like a Caretaker (with a recommended Caretaker Test in the appendix), as compared to merely an altruist, and whether a loved one is a BP/NP, along with an overview of borderline and narcissistic personality disorders using a biopsychosocial and casework based approach from the author’s own experiences as a psychotherapist who specializes in the relationships of BP/NPs. She helps the layperson understand these disorders by using accessible terms, specific examples, and DSM IV criteria. Fjelstad then explains the Caretaker term, or someone who gives up their identity to meet the emotional needs of a borderline or narcissistic loved one, and points out some typical feelings of a Caretaker and the different types of Caretakers. Fjelstad then helps the reader understand how wellmeaning individuals can become Caretakers and continue to stay in this role out of fear, obligation, and guilt. By focusing on the emotional, cognitive, behavioral, and relationship distortions of Caretakers within their relationship to the BP/NP, she shows readers how caretaking inevitably leads to an endless cycle of relationship chaos, selfneglect, and despair. She ends with saying that the BP/NP cannot be changed and so any improvement must come from the Caretaker’s side, starting with letting go of the hope that Caretaking will work. In the middle section of the book, titled Letting go of Caretaking, Fjelstad provides readers with guidance on how to break free of the caretaker role even if they choose to continue their relationship with the BP/NP. It describes the process of healing from being a caretaker using Elizabeth KublerRoss’s stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance, also including three more specifically for Caretakers: Setting Boundaries, Letting Go, and Rebuilding; all of this is director toward moving a Caretaker to Self-Care. Readers learn to stop trying to change their loved ones with BPD or NPD and instead focus on skil","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83881130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Schizophrenia: Living and Working with a Serious Mental Illness","authors":"Peter G. Bota, S. Fraser, R. Groysman","doi":"10.4081/MI.2017.6782","DOIUrl":"https://doi.org/10.4081/MI.2017.6782","url":null,"abstract":"Schizophrenia happens to some of us; however, it affects all of us... Beyond Schizophrenia by Marjorie L Baldwin is an excruciatingly honest revelation about personal victories and defeats in overcoming our society’s failures to rehabilitate a patient with schizophrenia. Mrs. Baldwin’s incredible courage in exposing her son’s illness offers a diverse understanding of the misery that schizophrenia brings into the lives of patients and their families and friends. A bold protest against discrimination of people affected by this most stigmatized condition, her book may appeal to anyone who aspires to help those craving hope and guidance on the complicated path to sanity. The book itself is designed to serve many purposes: to reduce the strong stigma against the mentally ill, to promote activism for reform in the broken mental health system, and to provide hope for the families. While the previous few decades have held many incredible advancements in the treatment of schizophrenia, efforts to rehabilitate patients back into labor market have not caught up to the promise of new treatments. Marjorie L. Baldwin, a well-respected labor economist who specializes in labor market discrimination against the disabled, starts her book chronicling the history of the mental health system as we know it today, from the age of permanent institutionalization to the creation of effective antipsychotics. She unearths many discrepancies in the delivery of the mental health system, focusing especially on abject failure of community care and prevention, as exemplified by her son’s devastation. The author’s personal and professional experiences offer the reader priceless practical solutions in navigating the contradictory and labyrinthine system. Mrs. Baldwin suggests a valuable tool for rehabilitation in schizophrenia: employment. It permits a degree of confidence and independence, relieves some of the burdens upon families, and provides a new identity as normal people with normal jobs in their eyes and the eyes of society. The successful reintegration of the author’s son into society gives hope to those diagnosed with schizophrenia and their long-suffering caretakers.","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86763480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Adherence Among Nigerians with Schizophrenia: Correlation Between Clinico-Demographic Factors and Quality of Life.","authors":"Oluseun P Ogunnubi,&nbsp;Andrew T Olagunju,&nbsp;Olatunji F Aina,&nbsp;Njideka U Okubadejo","doi":"10.4081/mi.2017.6889","DOIUrl":"https://doi.org/10.4081/mi.2017.6889","url":null,"abstract":"<p><p>Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL) in a sample of Nigerians with schizophrenia. This descriptive cross-sectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on <i>MINI International Neuropsychiatric Interview</i>. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with <i>Morisky Medication Adherence Questionnaire</i>, and participants completed the <i>World Health Organization Quality of Life Scale-BREF</i>. The mean age of participants was 38.54 (±11.30) years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2%) considered their overall QoL to be good, 97 (60.6%) considered theirs to be fair, while 18 (11.2%) reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (<i>r</i>=-0.175), health satisfaction (r=-0.161), physical (r=-0.186) and psychological domain (r=-0.175). Again, participant's age (r=-0.190) and age of onset of illness (r=-0.172) correlated negatively with medication non-adherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155). The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication non-adherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.</p>","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/mi.2017.6889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34974479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Cognition in Schizophrenia.","authors":"Thammanard Charernboon,&nbsp;Jayanton Patumanond","doi":"10.4081/mi.2017.7054","DOIUrl":"https://doi.org/10.4081/mi.2017.7054","url":null,"abstract":"<p><p>Impairments in social cognitions in schizophrenia are increasingly reported in the last decade but only a few studies have come from Asia. The objective of the study was to evaluated emotion perception, theory of mind and social knowledge in people with schizophrenia compared to healthy controls. Participants were 36 clinically stable outpatients with schizophrenia and 36 normal controls with comparable age and level of education. We administered general neurocognition test (the Addenbrooke's Cognitive Examination), emotion perception (the Faces Test), theory of mind (the Eyes Test) and social knowledge (the Situational Features Recognition Test; SFRT). Schizophrenia patients displayed obvious impairment in all three social cognition domains <i>i.e.</i> the Faces Test [13.7 (2.9) <i>vs</i> 15.7 (1.9), P=0.001], the Eyes Test [18.9 (4.4) <i>vs</i> 23.5 (4.4), P<0.001] and SFRT [0.85 (0.09) <i>vs</i> 0.9 (0.05), P=0.002]. The performances on three social cognition tests did not correlate with positive symptoms. Only the Faces Test seemed to be related to negative symptoms. The results demonstrated that there are deficits of social cognitions in schizophrenia even in a clinically stable population.</p>","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/mi.2017.7054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34974480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability among Attendees with Schizophrenia in a Nigerian Hospital: Further Evidence for Integrated Rehabilitative Treatment Designs","authors":"A. Olagunju, D. Adegbaju, R. Uwakwe","doi":"10.4081/mi.2016.6647","DOIUrl":"https://doi.org/10.4081/mi.2016.6647","url":null,"abstract":"Evidence-based rehabilitative treatment is constrained due to limited knowledge about disability and its related factors among individuals with schizophrenia across West Africa. This study aims to investigate the pattern of disability, and the associated factors among individuals with schizophrenia. One hundred consecutively recruited consenting participants were subjected to designed questionnaire to inquire about their demographic and illness-related variables. This was followed by the administration of Structured Clinical Interview for DSM-IV-TR Axis I Disorders and Brief Psychiatric Rating Scale to confirm the diagnosis of schizophrenia and rate severity of symptoms respectively in them. In addition, the World Health Organisation Disability Assessment Scale II (WHODAS-II) was used to assess for disability in all participants. Different degrees of disability based on WHODAS-II mean score of 27.02±3.49 were noted among individuals with schizophrenia, and affectation of domains of disability like self care, getting along with others, life activities and participation in the society among others were observed. In addition, high level of disability was significantly associated with younger adults in the age group 18-44 years (P=0.007), unemployment status (P=0.003), remittance source of income (P=0.034) and ethnicity (P=0.017); conversely, less number of children (P=0.033), less amount spent on treatment (P<0.001) and lower BPRS score (P<0.001) correlated negatively with high level of disability. In spite of clinical stability following treatment, individuals with schizophrenia were disabled to varied degrees, and socioeconomic as well as illness-related factors constituted important correlates. Integration of rehabilitation along with social intervention into treatment design to reduce disability is implied, and further research is also warranted.","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75268458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lady with Erotic Preference for Diapers","authors":"Z. Cernovsky, Y. Bureau","doi":"10.4081/mi.2016.6687","DOIUrl":"https://doi.org/10.4081/mi.2016.6687","url":null,"abstract":"A patient in her 20s was referred to us for psychological assessment due to her depression and suicide attempts. She mentioned being anorgasmic except when diapered and emphasized her erotic preference for diapers. Her childhood included maternal deprivation in an impecunious family headed by an irritable physically disabled father on social assistance. Given the maternal deprivation in childhood, her erotic fixation on diapers parallels the emotional attachment to diapers observed by Harlow in mother deprived infant monkeys. Etiological hypotheses should also include the paradigm of avoidance learning from theories of behavior therapy. Our patient does not wish to change her sexual preference: in such cases, fetishism is not considered as an illness by DSM5. However, she needs to be treated for pathological levels of depression with suicidal ideation and low self-esteem.","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76343388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beat Depression to Stay Healthier and Live Longer: A Guide for Older Adults and their Families","authors":"Peter G. Bota, S. Fraser, A. Novac","doi":"10.4081/MI.2016.6563","DOIUrl":"https://doi.org/10.4081/MI.2016.6563","url":null,"abstract":"Americans are living longer and longer, with many more people in the present day living to 80, 90, or even 100. However, these golden years are being tainted for many older adults by the dark specter of depression. Studies have shown that the aged are more susceptible to depression, with up to 9.1% of older adults having depressive disorders in 2010. The medical system habitually undertreats or neglects these individuals. Often, the few older adults willing to seek care are unable to get it. Additionally, more than half of all geriatric depression cases are individuals who are suffering their first episode of depression, making them less likely to seek treatment. In Beat Depression to Stay Healthier and Live Longer: A Guide for Older Adults and Their Families, Dr. Gary S. Moak suggests that family members and doctors need to step up in detecting depression early and in encouraging the elderly to accept treatment. Dr. Moak is a geriatric psychiatrist and has produced this book out of his more than 30 years of experience to address the epidemic and pernicious phenomenon of geriatric depression. He has written this book in a style mixing self-help with the caution and knowledge of sound medical advice. It takes a tone which resembles the demeanor of a psychiatrist advising a patient to choose a certain path, while using humor to lighten the gravity of the subject matter.3 The book is written especially for sufferers of geriatric depression and their families. The book is divided into three parts with multiple subchapters. It starts with a preface which details the author’s career and the issue that brought the author to write this book: the statistic that 20% of the elderly have depression which commonly goes ignored and untreated. Dr. Moak tries to make the reader understand the gravity of geriatric depression by utilizing two end-of-life case studies and a statistical comparison to Alzheimer’s disease. In the first section, the author attempts to break down the many myths around depression. He especially addresses the common qualm of older adults towards treatment, specifically the belief that depression is the product of one’s own mind. The author argues compellingly that depression is not merely an expected reaction to sad circumstances, as popular culture would indicate, but a disease of the brain which extinguishes the will to live and love of life from an individual. Using medical statistics, Dr. Moak debunks stigmatizing paradigms of depression, which are especially present in the elderly, such as the idea of depression being a normal part of aging, a sign of senility, a disease of a weak mind, or a permanent state that cannot improve for elderly patients. In the second chapter, he explains in layman’s terms the subtle difference between the idea that geriatric depression is caused by the nature of old age, and the truth that depression in the aged is a byproduct of the gradual decline of the brain induced by aging. According to research, ge","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87855730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Health Without Mental Health","authors":"C. Vladu, A. Novac, Adrian Preda, R. Bota","doi":"10.4081/mi.2016.6609","DOIUrl":"https://doi.org/10.4081/mi.2016.6609","url":null,"abstract":"Mental Illness 2016; volume 8:6609 No health without mental health Cristina Vladu, Andrei Novac, Adrian Preda, Robert G. Bota University of California, Irvine, CA, USA Two hundred years ago, the term psychiatry was introduced (psyche-soul and iatros-physi- cian) to designate a medical specialty that would attend to those with mental illness. 1 At that time psychiatric conditions were recog- nized as being at the border of medicine, phi- losophy and theology. We are now ushering in an era in which psychiatry and primary care are creating a new alliance. We live in a world of postmodern psychiatry in which numerous previous structures and roles are being chal- lenged. Postmodernism and neo-pragmatism have brought us deconstruction. 2 It applies to many a change that modern research and new demands of society have exerted on contempo- rary psychiatry. Public opinion about mental illness has changed. New patient populations have emerged. The emphasis on multidiscipli- nary approaches has often lagged behind. Today the complexity of psychiatry among all other medical specialties is rarely recognized. A rather reductionistic over-identification with neuroscience has often been professed and a simplistic acceptance that a part is in fact the whole has been too often purported. Yet unquestionable remains the fact that psychi- atric morbidity and disability outweigh the burden of other medical conditions and that our patients are the same people seen in pri- mary care settings for most medical condi- tions. As a consequence, a heavy burden is paid by the world community. It is then on this note that the World Psychiatric Association Congress in Bucharest, Romania, June 24-27, entitled: Primary Care Mental Health: Innovation and Transdisciplinarity, stands out among most other international conferences of the past year. Recognizing the urgency to addressissues of health policy globally, the 2015 World Psychiatric Association International Congress presented the following resolutions, which were approved by the participants and will be forwarded to the United Nations: 3 «WHEREAS, cardiovascular and mental dis- orders lead in the global burden of non-commu- nicable diseases; WHEREAS, most mental disor- ders are attended to in primary care; WHEREAS, mental disorders account for 30-45% of the global burden of disability; WHEREAS, 50% of mental disorders exist by age 14, and 75% by age 24; WHEREAS, these disorders result in billions of dollars of negative economic consequences across low-, middle-, and high-income nations; WHEREAS, significant global health systems fragmentation diminishes access to care and its effectiveness; WHEREAS, more research into the brain and into the determinants of health is needed; WHEREAS, effective treatments for mental disorders exist for most cases; and WHEREAS, the collaboration and integration of primary care, mental health, and public health is proven to enhance access, quality, and sus- tainability [...] NOW BE IT RESOLVED T","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84294695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium, Caused by Suspending Treatment of Hypothyroidism","authors":"Alejandro Hernández-Sandí, David Quirós-Baltodano, Michelle Oconitrillo-Chaves","doi":"10.4081/mi.2016.6787","DOIUrl":"https://doi.org/10.4081/mi.2016.6787","url":null,"abstract":"Delirium, or acute confusional syndrome, is a set of symptoms whose care involves not only psychiatry, but also many other medical specialties. Being as how the syndrome is caused by multiple factors, it is important to recognize each risk factor affecting the patient in order to anticipate and prevent it. In case of diagnosis, identifying and treating the root cause that triggered is important, given that it has a high rate of comorbidity and an elevated cost of medical care. We describe a case where a patient with hypothyroidism began suffering from delirium due to an abrupt discontinuation of levothyroxine treatment. Previously, the patient was seemingly healthy. After the medical treatment was interrupted, sensory processing and behavior were altered, and symptoms fluctuated, for a short period of time, showing disorientation and memory and language impairment.","PeriodicalId":44029,"journal":{"name":"Mental Illness","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87839109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}