Neurology Psychiatry and Brain Research最新文献

Background

Many children present with uncontrollable outbursts that present diagnostic challenges. Disruptive mood dysregulation disorder (DMDD) is a diagnosis that may capture their behavior. We examined the prevalence of DMDD in a series of 100 child discharges from inpatient care after the introduction of DSM-5 and in 100 children who received diagnoses of mood or bipolar disorder NOS prior to the advent of DSM-5.

Methods

All children were re-diagnosed with a retrospective chart review procedure. In the first sample, 100 consecutive discharges were reviewed. In the second study, children seen prior to the release from DSM-5 had their charts reviewed. The reviews addressed the presence of DMDD, as well as other conditions that may be co-morbid with DMDD.

Results

18 of the 100 consecutively discharged children (18 %) received a retrospective diagnosis of DMDD and 9 (50 %) received a comorbid diagnosis of major depression. Only 4 of the 18 children had a discharge diagnosis of DMDD. For the 100 children with NOS diagnoses prior to DSM-5, 37 (37 %) received retrospective diagnosis of DMDD. The major specific feature of DMDD was the higher frequency of temper outbursts. Longer length of stay and higher discharge GAF scores were also seen

Discussion

DMDD was present in approximately the same proportion of children as previous studies, in samples admitted before and after DSM-5. Clinical diagnoses of mood disorders NOS are common in children who meet criteria for DMDD and DMDD diagnoses still do not appear to be given to many children who meet the criteria.

Background

Co-morbidty of physical diseases increase the functional disability and mortality of psychiatric patients. The majority of causes attributed to psychiatric patients mortality are due to various co-morbid medical conditions. Screening and early intervention of these conditions in these froups of patients has paramount importance. However, there are limited studies on the comorbidity of physical and mental disorders among psychiatry patients in Ethiopia. Therefore, this study is meant to provide essential data for future interventions.

Objective

To assess the medical comorbidity among psychiatric patients treated at Jimma University Medical Center, Southwest Ethiopia

Methods

A five years retrospective review of hospital records was performed. Data were extracted using a structured template of data extraction on a wide range of potential factors. Multivariate logistic regression analysis was used to identify associated factors and significance was declared at P-value < 0.05.

Result

A total of 2117 patient charts were reviewed, and the prevalence of comorbid physical illness was 29.1 % with 95 % CI (27.30, 31.10). The most prevalent comorbid physical illnesses were infectious disease (33.9 %) and disease of the genitourinary system (25.3 %). In the multivariate analysis, age greater than 50, history of the previous admission, duration of psychiatric treatment, and anti-depressant significantly associated with medical comorbidity whereas, government employee and substance/psychiatric comorbidity were less likely associated with comorbid physical illness at p < 0.05.

Conclusion

A significant proportion of psychiatric patients suffering from comorbid physical illness. As a result, psychiatric patients need early detection and interventions for medical comorbid conditions.

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, this highly transmissible virus has since spread rapidly around the world. Though respiratory complication is the primarily reported manifestation though rare, yet serious neurological complications are being frequently reported in the literature. In selected coronavirus disease-2019 (COVID-19) cases neurologic complications may manifest as seizures. In this paper, we have reviewed current literature on seizures linked with SARS- COV 2 infection including published or pre-print original articles, review articles, and case reports. We have discussed the electroencephalogram (EEG), imaging, and Cerebrospinal fluid (CSF) findings in patients with COVID-19 presenting with seizure. We will be concluding the paper by briefly discussing the three mechanisms by which seizures can develop in patients infected with SARS- COV 2 - (a) Direct Mechanism (b) Indirect Mechanism and (c) Exacerbation of Seizure in Patients with Epilepsy (PWE). Our aim is to update the physicians working with COVID-19 patients about this potential complication and hope that understanding of these proposed mechanisms can provide an opportunity for the physicians for early diagnosis or even better, help prevent this complication.

Dysphagia affects more than 50 % of stroke survivors. The most common consequences of post-stroke dysphagia are malnutrition, dehydration, aspiration pneumonia, choking, limited quality of life, increased mortality and morbidity rate. Patients with post-stroke dysphagia should be identified as soon as possible so that special measures can be taken to avoid these consequences. The objectives of our study were to evaluate the prevalence of post-stroke dysphagia in a tertiary care hospital, to analyse the reliability of predicting risk factors for dysphagia and to determine the stroke locations and brain regions respectively connected with post-stroke dysphagia. We included 207 patients who presented with acute stroke and were admitted to Department of Neurology – Stroke Unit from September 2016 to September 2017. Forty-three percent of patients had post-stroke dysphagia. We investigated patient's age, gender, arterial hypertension, diabetes mellitus, atrial fibrillation, previous statin therapy, severity of stroke and localisation of stroke as possible predicting factors for post-stroke dysphagia.

Our results showed that the only reliable predicting factor for post-stroke dysphagia was the location of the brain lesion, which according to our study were Brodmann areas 4, 8, 24, 30 and pons lesions.

Objectives

Spata19 was one of genes involved in neurogenesis, which mutated in some psychiatric disorders. In the current study, using Spata19 knockout mice, we showed the effect of this gene inactivation on some behaviors of mice.

Methods

Twenty-four wild-type (WT) and global Spata19 knockout (KO) mice were divided into four groups (Male: WT, n = 9 (6) | Male: KO, n = 5| Female: WT, n = 6| Female: KO, n = 4 (3)). Four of them died during the study. The behavior of these mice was compared with Open Field, Novel Object Recognition, Social Interaction Test and Forced Swimming Test. In these tests, respectively, time spent in centers and locomotor activity, number of smells, fighting and number of stops were evaluated.

Results

Spata19 gene inactivation had not any effect on the behavior of the female mice but in male mice showed greater locomotor activity and time spent in center of arena in the open field test, different coping behavior in Forced Swimming Test, aggressive behavior in Social Interaction Test and cognitive impairment in Novel Object Recognition. This behavioral difference in male KO vs. other mice was significant with a p-value less than 0.05.

Conclusions

The results showed that gene inactivation was involved in the development of behavioral disorders in males.

Background

Bipolar Disorder (BD) is a severe mental disease with a considerable reduction in life quality and high mortality. Self-management interventions and Cognitive behavior therapy (CBT) are the most widely investigated psychological treatments for BD. However, recovery rates are low and only small to moderate effect sizes have been found. Metacognitive therapy is a relatively new treatment for mental disorders based on Wells and Matthews’ transdiagnostic model of emotional disorder – the Self-Regulatory Executive Function (S-REF).

Method

MCT was delivered to three Danes with a diagnosis of BD ascertained using the SCID (Structured Clinical Interview for DSM). An A–B design with Multiple baseline measures was conducted and the effects associated with treatment was examined at post-treatment and follow-up and 6 and 12 months. The primary outcome was Beck’s Depression Inventory II (BDI-II), rumination time and change in metacognitive beliefs were also assessed using the Cognitive Attentional Syndrome Scale (CAS 1).

Results/conclusion

The results demonstrated improvements in depressive symptoms, rumination time and metacognitive beliefs after 7–12 sessions of MCT. Two out of three patients needed 1–3 booster sessions after approximately six months follow-up. However, the effects persisted at 12- months follow-up and all patients were recovered and did not meet the BD diagnosis according to the SCID. Limitations to the findings include the small number of participants and a decreasing baseline score in two of the participants. Nevertheless, it appears that metacognitive therapy is a feasible treatment for BD that might have potential positive effects. Larger studies and randomized controlled trials are now needed to investigate this further.

Purpose

Neuropsychiatric disorders following stroke, including depression and anxiety, are often associated with long-term disability. Neurotrophic factors play an important role in the pathophysiology of many neurodegenerative and neuropsychiatric disorders. In the current study, we investigated a potential participation of neurotrophic factors in stroke-associated behavioral and pathological changes 14 days after ischemia.

Methods

Transient global cerebral ischemia was induced by bilateral occlusion of common carotid arteries (BCCAo) in C57BL/6 mice. Neurological evaluation was performed daily up to 14 days after induction. The Open Field (OF) and Elevated Plus Maze (EPM) tests were performed. After behavioral tests, brains from sham and ischemic mice were removed and processed to evaluate histopathology and immunomarcation for cleaved caspase-3 as well as the neurotrophic factors brain-derived neurotrophic factor (BDNF), glial cell line derived neurotrophic factor (GDNF), and neural growth factor (NGF) by ELISA.

Results

Ischemic animals presented anxiety-like behavior and histopathological alterations mainly characterized by formation of small necrotic cavities surrounded by penumbra zone and neuropil vacuolation in the frontal cortex, ischemic neurons in the hippocampus and gliosis in the midbrain. Some immunopositive neurons for cleaved caspase-3 were observed in the penumbra by immunohistochemical analysis. Higher levels of NGF were found in the brain of BCCAo mice compared with sham animals. Similar concentrations of BDNF and GDNF were detected in both groups.

Conclusion

Our results suggested the participation of NGF in anxiety-like behavior at 14 days after induction of experimental cerebral ischemia and reperfusion.

Background

The lifetime risk of suicide is significantly higher in patients with schizophrenia than in the general population. It has been suggested that insight is an important risk factor for suicidality in schizophrenia, but only in the presence of feelings of hopelessness and demoralization more generally.

Methods

This study set out to investigate these assumptions in a sample of patients diagnosed with schizophrenia (n = 81) with the Structured Clinical Interview for DSM-IV Axis I. We hypothesized that there would be a positive association between insight in schizophrenia, measured by the Insight Scale for Psychosis, and suicidality among these patients, measured by the Beck Scale for Suicide Ideation. Furthermore, we expected demoralization, measured by the Demoralization Scale, to mediate the association between insight and suicidality.

Results

With regard to the association between insight and suicidality, only the dimension awareness of illness was significantly positively associated with suicidality (r = .34, p ≤ .01**). Demoralization fully mediated the relationship between awareness of illness and suicidality (Sobel test z = 1.93, p < .05).

Limitations

This was a cross-sectional study in a relatively small sample, based on self-report questionnaires only.

Conclusions

This study emphasizes the importance of recognizing and treating demoralization features in schizophrenia.

The physiological processes involved in cognitive neurology are highly complex, spanning a wide range of inter-related temporal and spatial scales. The complexity of relationship between brain cerebrospinal fluid (CSF) space changes and patient prognosis in melancholic depression is well suited to quantitative approaches as it provides challenges and opportunities for new developments. The purpose of this article is to come up with present mathematical trends in the clinical outcome of depressive patients, which can trigger off challenges that lie in the field ahead. To be more specific, mathematical models have been the main focus in the study, that are capable of addressing critical questions associated with intracranial neoplasms and brain tumours, their growth and patient-specific differential diagnosis. Also, the explicit interactions between the brain-delivered neurotrophic factor (BDNF) Val66Met gene and early-life stress (ELS) exposure in brain have been established through differential equation models.