Annals of Clinical Psychiatry最新文献

Background: Anxiety and depression have been reported to complicate the course of stroke. This study evaluated the association of anxiety and depression independently on ischemic vs non-ischemic stroke.

Methods: A cross-sectional survey of 4,983,807 admissions for acute stroke from 1994 to 2013 in the National Inpatient Sample compared stroke patients with depression and anxiety to stroke patients with no psychiatric comorbidities. The database was operationalized based on the inclusion/exclusion criteria approved by the Southern Illinois University School of Medicine Institutional Review Board.

Results: Patients with anxiety and depression were more likely to have an ischemic stroke (OR 1.64; 95% CI, 1.61 to 1.68) vs a non-ischemic stroke (OR 1.25; 95% CI, 1.23 to 1.27). Inpatient mortality was significantly less in both the depression and anxiety groups compared to the control group.

Conclusions: Psychiatric disorders (anxiety and depression) may increase the risk of ischemic stroke; however, depressed and anxiety patients with ischemic stroke were less likely to die from stroke. Further well-designed studies are necessary to explore these findings.

Background: Incontinence (urinary or fecal) is not included in DSM-5 criteria for catatonia or in most catatonia rating scales. However, there is a historical basis for the inclusion or consideration of incontinence as a catatonic sign.

Methods: We performed a review of the literature and found references to urinary disturbances and fecal incontinence in 19th- and 20th-century literature. We did a computerized literature review using the terms "catatonia," "catatonic," and "incontinence."

Results: We highlight 2 cases in which urinary or fecal incontinence was a presenting or predominant feature of catatonia. Clinical improvement was associated with improvement in incontinence.

Conclusions: These preliminary findings suggest that urinary and fecal incontinence may be an uncommon presentation of catatonia. Furthermore, incontinence may improve at the same time catatonia improves with treatment. The neural circuitry that controls micturition and the sphincter involves neural pathways and multiple neurotransmitters. Catatonia can cause a reemergence of involuntary or reflex maturation, leading to urinary incontinence. This may lead to the need for additional custodial care for patients. Thus, the detection and monitoring of urinary and fecal incontinence may help us better understand the pathophysiology and impairment associated with catatonia.

Background: Impaired insight into illness is a common feature of schizophrenia. Improved insight is associated with better treatment adherence and clinical outcomes. At the same time, improving insight has been suggested to increase depressive symptoms and diminish quality of life. The aim of this study was to examine the associations between impaired insight and degree of subjective happiness, perceived level of success, and life satisfaction in patients with schizophrenia spectrum disorders.

Methods: A total of 108 participants with schizophrenia or schizoaffective disorder were included. Data for this study were obtained from our group's previous investigation that examined the relationship between impaired insight and visuospatial attention. Insight into illness was measured by the VAGUS scale, which assesses general illness awareness, accurate symptom attribution, awareness of the need for treatment, and awareness of the negative consequences attributable to the illness.

Results: Our results revealed no association among the VAGUS average and subscale scores and degree of subjective happiness, perceived level of success, and life satisfaction.

Conclusions: Our study suggests that insight into illness is not related to subjective happiness, life satisfaction, or perceived level of success in patients with schizophrenia, which is in contrast to previous reports that demonstrate an association between insight into illness and depression.

Background: A systematic diagnostic mental health assessment was conducted with first-year students at Paul Quinn College, a small historically Black college/university (HBCU) in Dallas, Texas.

Methods: A sample of 128 students was assessed with the Mini-International Neuropsychiatric Interview for DSM-5 and the Childhood Trauma Questionnaire.

Results: Nearly one-third of students were diagnosed with a current psychiatric disorder, most commonly substance use disorders (17%) and major depressive disorder (9%). Despite these findings, few students had ever received psychiatric treatment, and considering their substantial trauma histories, few developed posttraumatic stress disorder, reflecting protective factors in the HBCU.

Conclusions: The prevalence of psychiatric disorders in this HBCU study is consistent with findings of studies conducted at predominately White institutions. However, the relatively low access to treatment of these HBCU students suggests relevant mental health care disparities in this population. Further research is needed to develop interventions designed to help connect HBCU students to mental health care.

Background: Little is known about smoking habits and disorders among homeless populations. Previous research has not generally differentiated tobacco use from tobacco use disorders in this population. Known associations of tobacco use and morbidity and mortality in general populations may also apply to homeless populations.

Methods: A 2-year longitudinal prospective study of 255 homeless individuals examined tobacco use and tobacco use disorders in association with other psychiatric disorders and service use and homeless outcomes.

Results: The majority of the sample used tobacco daily and had a tobacco use disorder, characteristics that changed little over the 2-year follow-up period. Tobacco use disorder was associated with greater substance, medical, and psychiatric service use during the 2 follow-up years. However, tobacco use was not associated with change in housing status over the 2-year follow-up period. Cessation of tobacco use was associated with cessation of alcohol use.

Conclusions: Smoking is a major health issue for homeless populations. This study found that smoking status was unassociated with the achievement of stable housing. In addition, homeless people who smoke were found to be more likely to use health care services, indicating a potential source of intervention for smoking cessation.