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PubMedDate not supplied

[Psychiatric disorders induced by drug dependence other than alcohol].

Most of psychoactive substances abuse or dependence disorders are associated to another psychiatric disorders. Depression, anxiety and psychotic disorders are the more frequent comorbid disorders. Psychiatric comorbidity is induced by acute consumption of psychoactive agents, chronic consumption or withdrawal. Psychiatric disorders are more frequent when patient are assessed immediately after the withdrawal. Main biological factors implicated in the pathophysiology of psychiatric disorders associated to dependence disorders are: increase in norepinephrine activity, during withdrawal, activation of locus coeruleus, kinding induced by repeated withdrawals. Psychotic disorders in opiate dependent patients can be induced by withdrawals. These psychotic disorders are more often described after methadone discontinuation. Consumption of cocaine can provocate paranoid delusions. Phenylcyclidine provocates sensorial distortion or delusive disorders resembling schizophrenia. Flash backs, following withdrawal realized brief and transient psychotic disorders. They can occur up to one year after the end of the intoxication. The occurrence of depression in dependent patients is frequent. Depressed patients are at risk for suicide. Retrospective studies showed that near of 40% of the subjects died from suicide have presented alcohol or drug abuse or dependence. Withdrawal from opiates provocates depression. Clinical picture included apathy, blunting of the affects, sadness and loss of interest. Cocaine consumption provocates manic-like disinhibition at the beginning of the intoxication. Long term consumption and withdrawal increase the risk of depression.

Humans↗
PubMed2005

Alteration of sleep microstructure in psychiatric disorders.

Macrostructure describes the temporal organization of sleep based on successive epochs of conventional length, while microstructure, which is analyzed on the basis of the scoring of phasic events, provides additional important dynamic characteristics in the evaluation of both normal and pathological sleep processes. Relationships between sleep, sleep disorders, and psychiatric disorders are quite complex, and it clearly appears that both the macrostructure and the microstructure of sleep are valuable physiologically and clinically. Psychiatric patients often complain about their sleep, and they may show sleep abnormalities that increase with the severity of their illness. Changes in the occurrence and frequency of phasic events during sleep may be associated with specific psychiatric disorders, and may provide valuable information for both diagnosis and prognosis of these disorders.

Circadian Rhythm↗
PubMed2025

A genome-wide analysis of the shared genetic risk architecture of complex neurological and psychiatric disorders.

Although neurological and psychiatric disorders have historically been considered to reflect distinct pathogenic entities, recent findings suggest shared pathophysiological mechanisms. However, the extent to which these heritable disorders share genetic influences remains unclear. Here we performed a comprehensive analysis of genome-wide association study data, involving nearly 1 million cases across ten neurological diseases and ten psychiatric disorders, to compare their common genetic signal and biological associations. Using complementary statistical tools, we demonstrate that a large set of common genetic variants impacts the risk of multiple neurological and psychiatric disorders, even in the absence of genetic correlations. Furthermore, genome-wide association studies on psychiatric disorders consistently implicate neuronal biology, whereas neurological diseases are associated with diverse neurobiological processes. Together, this study elucidates the genetic relationship between complex neurological and psychiatric disorders, indicating a larger degree of genetic pleiotropy than previously recognized. The findings have implications for disease classification, precision medicine and clinical practice.

Humans↗
PubMed1994

Intermediate care programs for inmates with psychiatric disorders.

Inmates with psychiatric disorders are a growing and difficult to manage population in federal and state prisons. An exploratory study was done of New York State's Intermediate Care Programs for inmates with psychiatric disorders. The study assessed whether there was a reduction in disruptive and harmful behaviors, and in the correctional restrictions and mental health services used to address those behaviors, among admissions to programs. Data came from corrections and mental health records of 209 inmates who had been in the program and prison for at least six months. Significant reductions were found in very serious rules infractions, suicide attempts, correctional discipline, and three mental health services: crisis care, seclusion, and hospitalization.

Female↗
PubMedDate not supplied

[Psychiatric disorders of environmental outpatients--results of the standardized psychiatric interview (CIDI) from the German multi-center study on Multiple Chemical Sensitivity (MCS)].

BACKGROUND: A nationwide, environmental outpatient-based multi-center two-phase study on Multiple Chemical Sensitivity (MCS) was conducted from 1999 until 2004. The aim of the study was to characterize more precisely the health-complaints relevant for the MCS-phenomenon. A standardized psychiatric interview (CIDI), used to identify frequency, character and duration of psychiatric disorders and their chronological relation to the environment-related health complaints of the patients, formed part of the extensive diagnostic procedure. METHOD: 251 (86.3%) of the 291 attendees of the environmental outpatient departments in Aachen, Berlin, Bredstedt, Freiburg, Giessen and Munich, were examined using the German version (M-CIDI/DIA-X) of the Composite International Diagnostic Interview. RESULTS: 83.7% (lifetime prevalence rate) fulfilled the diagnostic criteria of at least one psychiatric disorder, with the 12-month and 4-week prevalence rates being 76.5% and 64.5%, respectively. Environmental outpatients, in all prevalence periods, had significantly higher rates of psychiatric disorders than the comparable general population. Somatoform disorders were most frequently diagnosed, followed by depressive and phobic disorders. For 81.2% of the patients the psychiatric disorder started long before the environment-related health complaints (average 17 years). CONCLUSIONS: This study confirms the results of earlier studies, i.e. that patients with environment-related health complaints suffer from psychiatric disorders more frequently than the general population. The high environmental outpatients really suffer from psychosomatic complaints, but attribute the causes to the environment. Application of specific therapeutic regimen is recommended for those patients, whose psychiatric disorders are safeguarded diagnostically and for whom a relevant exposure is unlikely.

Adult↗
PubMed1990

Familial risk factors and the familial aggregation of psychiatric disorders.

All major psychiatric disorders aggregate in families. For most disorders, both genes and environmental factors play an important role in this aggregation. While recent work has tended to concentrate on the importance of genetic factors, this report focuses on the potential importance of environmental risk factors which themselves aggregate in families. In particular, this article examines how much of the familial aggregation of a psychiatric disorder may result from the familial aggregation of a risk factor. The model is illustrated and then applied to putative familial risk factors for schizophrenia and depression. The results of the model suggest that if parental loss and exposure to pathogenic rearing practices are true risk factors for depression, then they could account for a significant proportion of the familial aggregation of depression. By contrast, the model predicts that even if obstetric injury and low social class are true risk factors for schizophrenia, they together would account for only a very small proportion of the tendency for schizophrenia to aggregate in families.

Depressive Disorder↗
PubMed2002

Stress activation of glutamate neurotransmission in the prefrontal cortex: implications for dopamine-associated psychiatric disorders.

In most psychiatric disorders, stress is the major nongenomic factor that contributes to the expression or exacerbation of acute symptoms, recurrence or relapse after a period of remission, and treatment outcome. Delineation of mechanisms by which stress contributes to these processes is fundamental to understanding the disease process and for improving outcome. In this article, evidence is reviewed to indicate that many central aspects of stress response, including activation of the hypothalmic-pituitary-adrenal (HPA) axis and dopamine neurotransmission, are modulated, and in some cases mediated, by glutamate neurotransmission in the prefrontal cortex (PFC). It is suggested that activation of glutamatergic neurotransmission in the PFC presents a common mechanism by which stress influences normal and abnormal processes that sustain affect and cognition. Although monoamines, in particular dopamine, have been considered the major culprits in the adverse effects of stress in disorders such as addiction and schizophrenia, it is likely that in a vulnerable brain with an underlying PFC pathophysiology, abnormal stress-activated monoaminergic neurotransmission is secondary to anomalies in cortical glutamate neurotransmission. Thus, understanding the contribution of glutamate-mediated processes to stress response through the use of experimental models that involve disrupted PFC function can provide insights to the fundamental pathophysiology of stress-sensitive psychiatric disorders and lead to novel strategies for treatment and prevention.

Amygdala↗
PubMedDate not supplied

Links between drug and alcohol misuse and psychiatric disorders.

Substance use is common in a wide range of psychiatric disorders. Psychiatric disorder can increase the risks of such use developing into a substance use disorder. Conversely, substance use disorders are frequently accompanied by psychiatric symptoms. In some people such symptoms indicate formal psychiatric disorder. Whatever the causes, comorbidity may complicate treatment and resolution of both disorders, often presenting as a vicious circle that is difficult to break.

Alcoholism↗
PubMed1982

Hysterectomy and psychiatric disorder: II. Demographic psychiatric and physical factors in relation to psychiatric outcome.

One hundred and fifty-six patients with menorrhagia of benign origin were interviewed before hysterectomy, and again six months (n = 147) and 18 months (n = 148) after the operation. Psychiatric outcome, measured in terms of PSE cases detected at 18 months, was strongly associated with pre-operative mental state, neuroticism, previous psychiatric history, and family psychiatric history. No association was found with organic pathology in the uterus, bilateral oophorectomy or demographic variables.

Adult↗
PubMed1999

Fatigue and psychiatric disorder: different or the same?

BACKGROUND: Fatigue and psychiatric symptoms are common in the community, but their association and outcome are sparsely studied. METHOD: A total of 1177 patients were recruited from UK primary care on attending their general practitioner. Fatigue and psychiatric disorder was measured at three time points with the 12-item General Health Questionnaire and the 11-item Fatigue Questionnaire. RESULTS: Total scores for fatigue and psychiatric disorder did not differ between the three time points and were closely correlated (r around 0.6). The association between non-co-morbid ('pure') fatigue and developing psychiatric disorder 6 months later was the same as that for being well and subsequent psychiatric disorder. Similarly, having non-co-morbid psychiatric disorder did not predict having fatigue any more than being well 6 months previously. Between 13 and 15% suffered from non-co-morbid fatigue at each time point and 2.5% suffered from fatigue at two time points 6 months apart. Less than 1% of patients suffered from non-co-morbid fatigue at all three time points. CONCLUSIONS: The data are consistent with the existence of 'pure' independent fatigue state. However, this state is unstable and the majority (about three-quarters) of patients become well or a case of psychiatric disorder over 6 months. A persistent, independent fatigue state lasting for 6 months can be identified in the primary-care setting, but it is uncommon of the order of 2.5%. Non-co-morbid (pure) fatigue did not predict subsequent psychiatric disorder.

Adolescent↗
PubMed1996

Somatized psychiatric disorder presenting as palpitations.

BACKGROUND: Psychiatric disorder is underdiagnosed in primary care practice, often because it is somatized and the patient reports only physical symptoms. Palpitations are among the symptoms that often are somatized. METHODS: We studied prospectively 125 consecutive medical outpatients referred for ambulatory electrocardiographic monitoring to evaluate a chief complaint of palpitations. They completed an in-person research interview at the time of monitoring and a telephone follow-up interview 3 months later. The referring physicians completed questionnaires about their patients before receiving the results of the monitoring and again 3 months later. RESULTS: Forty-three patients had clinically significant cardiac arrhythmias. Twenty-four (29%) of the remaining 82 patients had a current psychiatric disorder, and 20 of these patients (83%) had major depression or panic disorder. These patients were significantly younger and more disabled, somatized more, and had more hypochondriacal concerns about their health than did patients who had no psychiatric disorder. Their palpitations were more likely to last longer than 15 minutes, were accompanied by more ancillary symptoms, and were described as more intense. At 3-month follow-up, about 90% of the patients in both groups continued to experience palpitations. Symptoms of somatization, hypochondriacal concerns, and impairment of intermediate activities had improved in both groups, but remained higher in patients with psychiatric disorder than in patients without psychiatric disorder. During the follow-up interval, patients with psychiatric disorder had more emergency department visits. The physicians of patients with psychiatric disorder were more likely to ascribe the palpitations to anxiety or depression, and ordered fewer laboratory tests on them, but few patients who had not already been in psychiatric treatment were referred or started on psychotropic medication. CONCLUSIONS: Physicians are aware of a psychiatric component to the clinical presentation of palpitation, but this observation does not result in psychiatric treatment or referral in most cases.

Adult↗
PubMed1998

Sleep disorders presenting as psychiatric disorders.

In summary, disordered sleep can present in a complex and atypical fashion in which the primary sleep-related component may not be immediately apparent. A high index of suspicion serves the clinician well in these cases. A careful and systematic evaluation of sleep often proves to be rewarding in terms of diagnostic accuracy and improved treatment outcome.

Adolescent↗
PubMed2001

Parental concordance and comorbidity for psychiatric disorder and associate risks for current psychiatric symptoms and disorders in a community sample of juvenile twins.

In this report we characterize associations between parental psychiatric disorders and children's psychiatric symptoms and disorders using a population-based sample of 850 twin families. Juvenile twins are aged 8-17 years and are personally interviewed about their current history of DSM-III-R conduct, depression, oppositional-defiant, overanxious, and separation anxiety disorders using the CAPA-C. Mothers and fathers of twins are personally interviewed about their lifetime history of DSM-III-R alcoholism, antisocial personality disorder, generalized anxiety disorder, major depression, panic disorder/agoraphobia, social phobia, and simple phobia using a modified version of the SCID and the DIS. Generalized least squares and logistic regression are used to identify the juvenile symptoms and disorders that are significantly associated with parental psychiatric histories. The specificity of these associations is subsequently explored in a subset of families with maternal plus parental psychiatric histories with a prevalence > 1%. Parental depression that is not comorbid or associated with a different spousal disorder is associated with a significantly elevated level of depression and overanxious disorder symptoms and a significantly increased risk for overanxious disorder. Risks are higher for both symptomatic domains in association with maternal than paternal depression, and highest in association with maternal plus paternal depression. Risks for otherjuvenile symptoms and disorders index the comorbid and spousal histories with which parental depression is commonly associated. Paternal alcoholism that is not comorbid or associated with a maternal disorder is not significantly associated with current psychiatric symptoms or disorders in offspring. Risks for oppositional-defiant or conduct symptoms/disorders in the offspring of alcoholic parents index parental comorbidity and/or other spousal histories.

Adolescent↗
PubMed1993

Otago Women's Health Survey 30-month follow-up. I: Onset patterns of non-psychotic psychiatric disorder.

Women who showed new psychiatric morbidity after a 30-month follow-up of a random community sample of New Zealand women were compared with those who were free of psychiatric disorder at follow-up. There were 25 new cases among the 215 women who were originally not psychiatric cases and who were re-interviewed. Using the weighted back population data to obtain prevalence figures for the general population, 6.9% became new cases over the two and a half years. Those who developed psychiatric disorder initially showed more psychiatric symptoms at a subdiagnostic level. Baseline factors that preceded the onset of psychiatric disorder were being separated or divorced, coming from a large family, having poor social networks, living alone, having few social role responsibilities such as paid employment or motherhood, and having poor physical health. An additional cross-sectional association at follow-up was poor financial security. Good social networks were closely linked with the number of a woman's social roles and appeared to protect her against the onset of psychiatric disorder. Consistent with the initial cross-sectional study, the follow-up data provide no support for marriage and child-care being risk factors for female psychiatric disorder. However, in New Zealand, these factors indicate social integration and are associated with superior mental health.

Adolescent↗
PubMed2005

HIV & psychiatric disorders.

HIV infection and psychiatric disorders have a complex relationship. Being HIV infected could result in psychiatric disorders as a psychological consequence of the infection or because of the effect of the HIV virus on the brain. Disorders may be as varied as depression, post-traumatic stress disorders, AIDS phobias, grief and the whole gamut of cognitive disorders. In addition, several psychiatric conditions may predispose individuals to acquiring HIV infection as a consequence of their influence on behaviour. There is also strong evidence of the relationship of substance use disorders and severe mental illnesses with HIV infection. HIV related psychiatric disorders also offer a challenge to clinicians in issues of differential diagnosis and management. Majority of the work in India has focused on substance use and HIV, and to a lesser extent on the psychiatric effects of HIV infection. Given the magnitude of the problem in the country and the multiple physical and psychological stressors that persons with HIV face in India, more research is needed.

Anti-HIV Agents↗