Psiquiatria Biologica最新文献

There is an association between intestinal dysbiosis, the gut–brain axis and mental health. PubMed, Embase and Web of Science were searched for analysing clinical trials in which microbiota modulators are used in mental health disorders for this systematic review. An evaluation of each study was made using CONSORT and only eight articles were suitable for this analysis: five were in depressive patients, and only one corresponded to either schizophrenia, attention-deficit/hyperactivity disorder or Alzheimer's disease. It is possible to conclude that microbiota modulators might be effective coadjuvants in traditional antidepressant or antipsychotic drugs treatment. However, the heterogeneity of interventions, small sample size, lack of intestinal microbiota assessment and symptoms auto report should be addressed before a conclusion can be made. PROSPERO registration number: CRD42020202938.

Postpartum psychosis is an uncommon mental disease that occurs in 1 of every 1000 pregnant women after delivery. The clinical spectrum is wide, including sleeping problems, affective and psychotic symptoms associated with delusions related to her newborn and his environment. It has been related to the bipolar affective disorder and it is included as a brief psychotic disorder in the DSM-V for mental diseases. The clinical case of a 20-year old woman is described in a public hospital in Medellín, Colombia, whom after giving cesarean delivery for a complicated pre-eclampsia presents a postpartum hemorrhage and then a postpartum psychosis associated with prodromal symptoms, with no previous history of a mental disease. This entity is poorly diagnosed because there is a lack of awareness about it, and it represents a psychiatric urgency that must be treated accordingly. Lithium is the first line in the treatment that literature reports.

Introduction

The purpose of this work is to carry out a systematic review of the studies on incident depression in the elderly population and associated risk factors.

Material and methods

Comprehensive search in several bibliographic databases in English and Spanish. Inclusion of longitudinal studies in the general population over 65 years of age, which analyze incident depression, and include the study of one or more risk factors.

Results

A total of 7,009 articles were found, 28 met all the inclusion criteria. The mean incidence of depression in the elderly was 9.78%. The most consistent risk factors for incident depression in this population are those related to cardiovascular factors.

Conclusion

Future studies are necessary that allow to deepen the study of other factors, as well as the development of preventive strategies based on the control of risk factors and the promotion of protective factors.

First psychotic episode in a patient with Noonan syndrome. A case report Noonan syndrome is a genetic disease characterised by phenotypic facial abnormalities, short stature, heart and chest wall malformations, delayed neurodevelopment, infertility, and blood dyscrasias. Diagnosis is clinical, with subsequent genetic confirmation. At the psychopathological level, patients with this syndrome present cognitive problems, delayed language development and attention problems in childhood, and impaired affective functioning in adulthood. We present the case of a 39-year-old male with a first psychotic episode, with prominently positive symptoms, in the context of a previous diagnosis of Noonan syndrome.

Introduction and objective

The COVID-19 pandemic has sown a feeling of fear and uncertainty throughout the world, generating emotional distress that could favor the appearance of mental illnesses. Minors are a more vulnerable group based on their age, studies, pre-existing mental illness, family finances or close relatives affected by COVID-19. This article aims to highlight the emotional and psychological impact on minors in the eastern area of Valladolid during the lockdown for COVID-19.

Methods

194 parents were interviewed by telephone survey from April 20 to May 15, 2020, providing information about the effects of quarantine on minors.

Results

50% of the participants were diagnosed with hyperkinetic disorders. The clinical situation of the minors remained unremarkable in 51.4% (rigid period of lockdown) and 47.4% (flexible period). 11% of patients used electronic devices >8h a day during flexibilization, compared to 3.9% during the rigid period. Regarding biological rhythms, up to 34% of patients (rigid period) and 40.7% (flexible period) went to bed after midnight. 25.2% of the patients during the rigid period confirmed an increase in appetite. Only 2.58% of minors expressed high concern about COVID-19.

Conclusion

Lockdown due to COVID-19 has involved a global impact on minors. In general terms, the parents perceived a greater impact on the emotional and behavioral state of their children during the rigid period, without objectifying major changes after the flexibilization of lockdown.

Delusions are one of the most complex symptoms of schizophrenic psychosis. The two-factor approach — one of the most popular approaches to the etiology of delusions in current neuropsychiatry — proposes the existence of experiential (factor 1) and cognitive (factor 2) alterations that, in interaction, would lead to the production of the symptom. One of the most referred cognitive alterations within this explanatory framework is the jumping to conclusions bias (JTC), namely, the tendency to arrive at conclusions without having sufficient evidence for them. This article offers a narrative review that, after clarifying the explanatory structure of the two-factor model, examines and critically evaluates the evidence used by the approach to stablish the JTC bias as one of the main cognitive alterations in the process of formation of delusions in psychosis and therefore, as empirical support in favor of the approach.

Objectives

The objective of this article is to review, through the presentation of a case report, the symptoms, diagnosis and treatment of delirious mania.

Case report

We present a 36-year-old woman diagnosed with bipolar I disorder who was admitted to psychiatry ward for presenting an abrupt episode consisting of irritability, restlessness, expansiveness, behavioral disturbances and incoherent speech. During admission, the patient was observed to have a global worsening consisting of deterioration in attention, orientation and memory, confusion, fluctuation of the symptoms and alterations in psychomotor skills.

Results

Delirious mania presents abruptly with manifest, psychotic and confusional symptoms, and can be complicated by catatoniform symptoms. Organic causes of the condition should be ruled out as well as a performing a differential diagnosis with other neuropsychiatric syndromes. First-line treatment consists of benzodiazepines and ECT.

Conclusions

Recognizing delirious mania is relevant to establish early treatment and avoid derived complications, morbidity and mortality.

Objective

Delirium is the most frequent neuropsychiatric complication in patients with a severe condition caused by COVID-19. We present an atypical case from a clinical and phenomenological point of view, and we reflect on the involved etiological mechanisms.

Clinical case

55-year-old male, active physician, first admitted into the conventional hospitalization unit and is clinically stable after being admitted into the Intensive Care Unit for pneumonia caused by severe COVID-19. He presents an atypical delirium with very significant memory and language disorders, which are measured psychometrically, while maintaining a good attention and alertness level. The rest of the complementary tests carried out are normal or not very conclusive.

Results

The evolution during his admission is good and the recovery complete after one month of being discharged from the hospital.

Conclusions

The atypical presentation and clinical evolution of this framework of delirium allow us to raise the question of the direct neuroinvasive role of COVID-19 in this case.

Objective

Paragangliomas are rare neuroendocrine tumors. Occasionally they secrete catecholamines in sufficient quantities to cause symptoms. The majority of the cases, with the resection of the tumor, the psychotic symptoms disappeared and that is associated with the decreased levels of catecholamines.

Clinical case

We report the case of 56-year-old women with residual schizophrenia who started with acute symptoms characterized by palpitations, dyspnea, headache and facial rubbing with no response to antihypertensive treatment. At the same time she suddenly had positive psychosis symptoms, after a long time with residual and negative symptoms.

Conclusions

With the presentation of this case we want to highlight the signs that suggest the autonomic instability in psychosis patients, and how crucial is excluding underlying somatic conditions. We also examine the possible relationships between neural crest cell tumor that secrete catecholamines and schizophrenia.

Introduction

The prevalence of psychiatric disorders is higher in people with epilepsy than in the general population, especially affective disorders, anxiety, and psychosis.

Case report

A ten-year-old male with behavioural disorder and disorganization, admitted to the psychiatric ward for differential diagnosis. During his stay, he had an episode of vomiting followed by loss of consciousness. The EEG showed normal background activity with right-sided fronto-temporal dysfunction signs. The MRI featured loss of volume of the right hippocampal gyrus. Other diagnostic tests showed no alterations. Treatment with lacosamide was introduced. This was followed by clinical improvement, and a diagnosis of behavioural disorder due to mesial temporal sclerosis was established.

Discussion

Temporal epilepsy due to hippocampal sclerosis is one of the most common causes of secondary generalised seizures, and is associated with deficits in emotion processing and facial emotion recognition, semantic and episodic memory, and executive and visual-motor dysfunction.