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Mameniškienė R, Kizlaitienė R, Kaladytė Lokominienė R, Puteikis K. Belief in omens and superstitions among patients with chronic neurological disorders. Front Public Health 2024; 12:1331254. [PMID: 38525335 PMCID: PMC10958788 DOI: 10.3389/fpubh.2024.1331254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Chronic neurological disorders may affect various cognitive processes, including religiosity or superstitious belief. We investigated whether superstitious beliefs are equally prevalent in patients with Parkinson's disease (PD), people with epilepsy (PWE), patients with multiple sclerosis (MS) and healthy controls (HCs). Methods From late 2014 to early 2023 we conducted a cross-sectional in-person anonymous paper-based survey at the tertiary clinic of Vilnius University Hospital Santaros Klinikos among outpatients and HCs by asking them to ascribe meaning or report belief for 27 culturally adapted statements (9 omens and 18 superstitions). The sum of items that a respondent believes in was labeled the superstition index (SI). The SI was compared between groups by means of the Kruskal-Wallis (H) test and negative binomial regression modeling. A two-step cluster analysis was performed to discern different subgroups based on answers to the items of the SI. Results There were 553 respondents who completed the questionnaire (183 PWE, 124 patients with PD, 133 with MS and 113 HCs). Complete SI scores were collected for 479 (86.6%) participants and they were lower in patients with PD (n = 96, Md = 1, IQR = 0-5.75) in comparison to those with epilepsy (n = 155, Md = 6, IQR = 1-14), MS (n = 120, Md = 4, IQR = 0-12) or HCs (n = 108, Md = 4.5, IQR = 1-10), H (3) = 26.780, p < 0.001. In a negative binomial regression model (n = 394, likelihood ratio χ2 = 35.178, p < 0.001), adjusted for sex, place of residence, income and education, female sex was the only characteristic associated with the SI (β = 0.423, OR = 1.526, 95% CI = 1.148 to 2.028). Both female sex (β = 0.422, OR = 1.525, 95% CI = 1.148 to 2.026) and Parkinson's disease (β = -0.428, OR = 0.652, 95% CI = 0.432 to 0.984) were significant predictors of the SI when age was removed from the model. Two-step cluster analysis resulted in individuals with PD being grouped into "extreme non-believer," "non-believer" and "believer" rather than "non-believer" and "believer" clusters characteristic for PWE, patients with MS and HCs. Conclusion Our study suggests that individuals with PD believe in less superstitions than patients with MS, PWE or HCs. The results of this investigation should be independently confirmed after adjusting for PD-specific variables.
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Affiliation(s)
- Rūta Mameniškienė
- Centre for Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rasa Kizlaitienė
- Centre for Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Yuruk D, Ozger C, Garzon JF, Nakonezny PA, Vande Voort JL, Croarkin PE. A retrospective, naturalistic study of deep brain stimulation and vagal nerve stimulation in young patients. Brain Behav 2024; 14:e3452. [PMID: 38468454 PMCID: PMC10928335 DOI: 10.1002/brb3.3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/15/2023] [Accepted: 02/06/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION Invasive neuromodulation interventions such as deep brain stimulation (DBS) and vagal nerve stimulation (VNS) are important treatments for movement disorders and epilepsy, but literature focused on young patients treated with DBS and VNS is limited. This retrospective study aimed to examine naturalistic outcomes of VNS and DBS treatment of epilepsy and dystonia in children, adolescents, and young adults. METHODS We retrospectively assessed patient demographic and outcome data that were obtained from electronic health records. Two researchers used the Clinical Global Impression scale to retrospectively rate the severity of neurologic and psychiatric symptoms before and after patients underwent surgery to implant DBS electrodes or a VNS device. Descriptive and inferential statistics were used to examine clinical effects. RESULTS Data from 73 patients were evaluated. Neurologic symptoms improved for patients treated with DBS and VNS (p < .001). Patients treated with DBS did not have a change in psychiatric symptoms, whereas psychiatric symptoms worsened for patients treated with VNS (p = .008). The frequency of postoperative complications did not differ between VNS and DBS groups. CONCLUSION Young patients may have distinct vulnerabilities for increased psychiatric symptoms during treatment with invasive neuromodulation. Child and adolescent psychiatrists should consider a more proactive approach and greater engagement with DBS and VNS teams that treat younger patients.
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Affiliation(s)
- Deniz Yuruk
- Research Fellow in the Department of Psychiatry and PsychologyMayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and ScienceRochesterMinnesotaUSA
| | - Can Ozger
- Department of Psychiatry and PsychologyMayo Clinic Children's Research Center, and Mayo Clinic Depression Center, Mayo ClinicRochesterMinnesotaUSA
| | - Juan F. Garzon
- Research Fellow in the Department of Psychiatry and PsychologyMayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and ScienceRochesterMinnesotaUSA
| | - Paul A. Nakonezny
- Department Of Population And Data SciencesUT Southwestern Medical CenterDallasTexasUSA
| | - Jennifer L. Vande Voort
- Department of Psychiatry and PsychologyMayo Clinic Children's Research Center, and Mayo Clinic Depression Center, Mayo ClinicRochesterMinnesotaUSA
| | - Paul E. Croarkin
- Department of Psychiatry and PsychologyMayo Clinic Children's Research Center, and Mayo Clinic Depression Center, Mayo ClinicRochesterMinnesotaUSA
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Butler M, Abdat Y, Zandi M, Michael BD, Coutinho E, Nicholson TR, Easton A, Pollak TA. Mental health outcomes of encephalitis: An international web-based study. Eur J Neurol 2024; 31:e16083. [PMID: 37797295 PMCID: PMC11236046 DOI: 10.1111/ene.16083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND PURPOSE Acute encephalitis is associated with psychiatric symptoms. Despite this, the extent of mental health problems following encephalitis has not been systematically reported. METHODS We recruited adults who had been diagnosed with encephalitis of any aetiology to complete a web-based questionnaire. RESULTS In total, 445 respondents from 31 countries (55.1% UK, 23.1% USA) responded. Infectious encephalitis constituted 65.4% of cases, autoimmune 29.7%. Mean age was 50.1 years, 65.8% were female, and median time since encephalitis diagnosis was 7 years. The most common self-reported psychiatric symptoms were anxiety (75.2%), sleep problems (64.4%), mood problems (62.2%), and unexpected crying (35.2%). Self-reported psychiatric diagnoses were common: anxiety (44.0%), depression (38.6%), panic disorder (15.7%), and posttraumatic stress disorder (PTSD; 21.3%). Severe mental illnesses such as psychosis (3.3%) and bipolar affective disorder (3.1%) were reported. Self-reported diagnosis rates were broadly consistent with results from the Psychiatric Diagnostic Screening Questionnaire. Many respondents also reported they had symptoms of anxiety (37.5%), depression (28.1%), PTSD (26.8%), or panic disorder (20.9%) that had not been diagnosed. Rates of psychiatric symptoms did not differ between autoimmune and infectious encephalitis. In total, 37.5% respondents had thought about suicide, and 4.4% had attempted suicide, since their encephalitis diagnosis. More than half of respondents (53.5%) reported they had no, or substandard, access to appropriate mental health care. High rates of sensory hypersensitivities (>75%) suggest a previously unreported association. CONCLUSIONS This large international survey indicates that psychiatric symptoms following encephalitis are common and that mental health care provision may be inadequate. We highlight a need for proactive psychiatric input.
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Affiliation(s)
- Matt Butler
- Neuropsychiatry Research and Education GroupKing's College LondonLondonUK
| | - Yasmin Abdat
- Neuropsychiatry Research and Education GroupKing's College LondonLondonUK
| | - Michael Zandi
- Department of NeuroinflammationUniversity College London Queen Square Institute of NeurologyLondonUK
| | - Benedict D. Michael
- Department of Clinical Infection, Microbiology, and ImmunologyUniversity of LiverpoolLiverpoolUK
| | - Ester Coutinho
- Neuropsychiatry Research and Education GroupKing's College LondonLondonUK
- Center for Neuroscience and Cell BiologyUniversity of CoimbraCoimbraPortugal
| | | | - Ava Easton
- Department of Clinical Infection, Microbiology, and ImmunologyUniversity of LiverpoolLiverpoolUK
- Encephalitis SocietyMaltonUK
| | - Thomas A. Pollak
- Neuropsychiatry Research and Education GroupKing's College LondonLondonUK
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Rodrigues JFR, Rodrigues LP, de Araújo Filho GM. Alzheimer's Disease and Suicide: An Integrative Literature Review. Curr Alzheimer Res 2024; 20:758-768. [PMID: 38409712 DOI: 10.2174/0115672050292472240216052614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Suicide has been described in patients with Alzheimer's disease. Some promising medications for treating Alzheimer's disease have had their studies suspended because they increase the risk of suicide. Understanding the correlations between suicide and Alzheimer's disease is essential in an aging world. METHODS A search was carried out on electronic websites (PubMed and Scielo) using the MeSH Terms "suicide" and "Alzheimer" (1986-2023). Of a total of 115 articles, 26 were included in this review. RESULTS Depression and the allele ε4 of Apolipoprotein (APOE4) were demonstrated to be the main risk factors for suicide in patients with Alzheimer's disease. CONCLUSION Adequately delineating which elderly people are vulnerable to suicide is important so that new treatments for Alzheimer's disease can be successful. This review showed a need for new studies to investigate the interface between Alzheimer's disease and suicide.
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Affiliation(s)
- Juliano Flávio Rubatino Rodrigues
- Faculdade de Medicina de Marília (FAMEMA), Marília, SP, Brazil
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil
- Unimed Bauru Cooperativa de Trabalho Médico, Bauru, SP, Brazil
| | - Livia Peregrino Rodrigues
- Faculdade de Medicina de Barbacena (FAME), Barbacena, MG, Brazil
- Faculdade de Medicina da Universidade de Marília (UNIMAR), Marília, SP, Brazil
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Le Bozec M, Tebeka S, Dubertret C, Sleurs D, Mhanna E, Le Strat Y. The association of stroke with mental and physical disorders in US adults: A nationally representative study. J Psychiatr Res 2023; 168:45-51. [PMID: 37897836 DOI: 10.1016/j.jpsychires.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
Stroke has been linked to various physical and mental disorders, with both stroke and its comorbidities significantly impacting public health. In this population-based study, we evaluate the relationships between stroke, physical conditions, mental disorders, and their effect on quality of life. Data were gathered from a nationally representative sample of 36,309 civilian participants aged 18 years and older in the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined the prevalence of past-year stroke, its sociodemographic characteristics, and its associations with past-year mental disorders (according to the DSM-5) and physical conditions. Furthermore, we explored the connections between stroke and health-related quality of life, accounting for comorbidities. The past 12-month stroke prevalence was estimated at 0.82%. Participants with stroke exhibited a significantly higher past 12-month mental disorder prevalence than those without stroke. Specifically, individuals with stroke faced a higher risk of mood disorders, anxiety disorders, tobacco use disorder, and opioid use disorder compared to those without stroke. Stroke was also positively associated with 24 out of the 27 physical conditions assessed in this study. Participants with stroke experienced lower mental and physical quality of life compared to those without stroke. Stroke was significantly related to numerous mental and physical disorders. The association of stroke with diminished health-related quality of life was not only mediated by these comorbidities but should also be considered as inherently linked to stroke itself.
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Affiliation(s)
- Manon Le Bozec
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France.
| | - Sarah Tebeka
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Caroline Dubertret
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - David Sleurs
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Elsa Mhanna
- Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Yann Le Strat
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
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Clawson W, Waked B, Madec T, Ghestem A, Quilichini PP, Battaglia D, Bernard C. Perturbed Information Processing Complexity in Experimental Epilepsy. J Neurosci 2023; 43:6573-6587. [PMID: 37550052 PMCID: PMC10513075 DOI: 10.1523/jneurosci.0383-23.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023] Open
Abstract
Comorbidities, such as cognitive deficits, which often accompany epilepsies, constitute a basal state, while seizures are rare and transient events. This suggests that neural dynamics, in particular those supporting cognitive function, are altered in a permanent manner in epilepsy. Here, we test the hypothesis that primitive processes of information processing at the core of cognitive function (i.e., storage and sharing of information) are altered in the hippocampus and the entorhinal cortex in experimental epilepsy in adult, male Wistar rats. We find that information storage and sharing are organized into substates across the stereotypic states of slow and theta oscillations in both epilepsy and control conditions. However, their internal composition and organization through time are disrupted in epilepsy, partially losing brain state selectivity compared with controls, and shifting toward a regimen of disorder. We propose that the alteration of information processing at this algorithmic level of computation, the theoretical intermediate level between structure and function, may be a mechanism behind the emergent and widespread comorbidities associated with epilepsy, and perhaps other disorders.SIGNIFICANCE STATEMENT Comorbidities, such as cognitive deficits, which often accompany epilepsies, constitute a basal state, while seizures are rare and transient events. This suggests that neural dynamics, in particular those supporting cognitive function, are altered in a permanent manner in epilepsy. Here, we show that basic processes of information processing at the core of cognitive function (i.e., storage and sharing of information) are altered in the hippocampus and the entorhinal cortex (two regions involved in memory processes) in experimental epilepsy. Such disruption of information processing at the algorithmic level itself could underlie the general performance impairments in epilepsy.
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Affiliation(s)
- Wesley Clawson
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
- Allen Discovery Center, Tufts University, Medford, Massachusetts
| | - Benjamin Waked
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Tanguy Madec
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Antoine Ghestem
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Pascale P Quilichini
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Demian Battaglia
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
- University of Strasbourg Institute for Advanced Studies, Strasbourg, France
| | - Christophe Bernard
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
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Hungwe MM, Lowton K. Assessing the prevalence of psychotic symptoms in epileptic patients at a tertiary clinic. S Afr J Psychiatr 2023; 29:2062. [PMID: 37795460 PMCID: PMC10546253 DOI: 10.4102/sajpsychiatry.v29i0.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/25/2023] [Indexed: 10/06/2023] Open
Abstract
Background The International League against Epilepsy (ILAE) defines epilepsy as a brain disorder characterised by an enduring risk to generate seizures with neurobiological, cognitive, psychological and social consequences. Psychotic disorders in epilepsy are a serious psychiatric complication affecting the prognosis, morbidity and mortality of patients. There is a paucity in literature with regard to the prevalence of psychotic symptoms in epileptic patients in low- to middle-income countries. Aim This study aimed to look at the prevalence of psychotic symptoms in epileptic patients at an outpatient clinic using the prodromal questionnaire 16 (PQ-16). Setting The study was conducted at the epilepsy clinic at Charlotte Maxeke Academic Hospital (CMJAH), a tertiary hospital located in Johannesburg, South Africa. Method The PQ-16 was distributed to patients at the epilepsy clinic at CMJAH. Results The study consisted of 121 participants. The prevalence of patients found to be at high risk of psychosis (i.e., PQ-16 score > 6) was 61.2% (95% lower confidence interval (LCI): 0.53, upper confidence interval (UCI): 0.70). None of the demographic variables showed significant associations in the percentage of patients found to be at high risk. No association was found between any antiepileptic drug and high risk of psychosis. Conclusion The high prevalence of psychotic like experiences found suggests it is imperative to screen for psychotic disorders in epileptic patients and if required to involve neuropsychiatrists in their management. Contribution This study highlights the importance of assessing psychotic symptoms in epileptic patients and the importance of a multidisciplinary approach in managing these complex patients.
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Affiliation(s)
- Michelle M Hungwe
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karishma Lowton
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Oluwagbemigun K, Anesi A, Vrhovsek U, Mattivi F, Martino Adami P, Pentzek M, Scherer M, Riedel-Heller SG, Weyerer S, Bickel H, Wiese B, Schmid M, Cryan JF, Ramirez A, Wagner M, Nöthlings U. An Investigation into the Relationship of Circulating Gut Microbiome Molecules and Inflammatory Markers with the Risk of Incident Dementia in Later Life. Mol Neurobiol 2023:10.1007/s12035-023-03513-6. [PMID: 37605096 DOI: 10.1007/s12035-023-03513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/15/2023] [Indexed: 08/23/2023]
Abstract
The gut microbiome may be involved in the occurrence of dementia primarily through the molecular mechanisms of producing bioactive molecules and promoting inflammation. Epidemiological evidence linking gut microbiome molecules and inflammatory markers to dementia risk has been mixed, and the intricate interplay between these groups of biomarkers suggests that their joint investigation in the context of dementia is warranted. We aimed to simultaneously investigate the association of circulating levels of selected gut microbiome molecules and inflammatory markers with dementia risk. This case-cohort epidemiological study included 805 individuals (83 years, 66% women) free of dementia at baseline. Plasma levels of 19 selected gut microbiome molecules comprising lipopolysaccharide, short-chain fatty acids, and indole-containing tryptophan metabolites as well as four inflammatory markers measured at baseline were linked to incident all-cause (ACD) and Alzheimer's disease dementia (AD) in binary outcomes and time-to-dementia analyses. Independent of several covariates, seven gut microbiome molecules, 5-hydroxyindole-3-acetic acid, indole-3-butyric acid, indole-3-acryloylglycine, indole-3-lactic acid, indole-3-acetic acid methyl ester, isobutyric acid, and 2-methylbutyric acid, but no inflammatory markers discriminated incident dementia cases from non-cases. Furthermore, 5-hydroxyindole-3-acetic acid (hazard ratio: 0.58; 0.36-0.94, P = 0.025) was associated with time-to-ACD. These molecules underpin gut microbiome-host interactions in the development of dementia and they may be crucial in its prevention and intervention strategies. Future larger epidemiological studies are needed to confirm our findings, specifically in exploring the repeatedly measured circulating levels of these molecules and investigating their causal relationship with dementia risk.
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Affiliation(s)
- Kolade Oluwagbemigun
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, 53115, Bonn, Germany.
| | - Andrea Anesi
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach (FEM), 38098, San Michele all'Adige, Italy
| | - Urska Vrhovsek
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach (FEM), 38098, San Michele all'Adige, Italy
| | - Fulvio Mattivi
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach (FEM), 38098, San Michele all'Adige, Italy
| | - Pamela Martino Adami
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50924, Cologne, Germany
| | - Michael Pentzek
- Institute of General Practice, University Hospital Essen, 45147, Essen, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, 20246, Hamburg-Eppendorf, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103, Leipzig, Germany
| | - Siegfried Weyerer
- Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, 80336, Munich, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, 30625, Hannover, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
| | - John F Cryan
- Department of Anatomy and Neuroscience, Western Gateway Building, University College Cork, Cork, T12 XF62, Ireland
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50924, Cologne, Germany
- German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127, Bonn, Germany
- Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, 78229, USA
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931, Cologne, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127, Bonn, Germany
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, 53115, Bonn, Germany
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Kluger BM, Hudson P, Hanson LC, Bužgovà R, Creutzfeldt CJ, Gursahani R, Sumrall M, White C, Oliver DJ, Pantilat SZ, Miyasaki J. Palliative care to support the needs of adults with neurological disease. Lancet Neurol 2023; 22:619-631. [PMID: 37353280 DOI: 10.1016/s1474-4422(23)00129-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/25/2023]
Abstract
Neurological diseases cause physical, psychosocial, and spiritual or existential suffering from the time of their diagnosis. Palliative care focuses on improving quality of life for people with serious illness and their families by addressing this multidimensional suffering. Evidence from clinical trials supports the ability of palliative care to improve patient and caregiver outcomes by the use of outpatient or home-based palliative care interventions for people with motor neuron disease, multiple sclerosis, or Parkinson's disease; inpatient palliative care consultations for people with advanced dementia; telephone-based case management for people with dementia in the community; and nurse-led discussions with decision aids for people with advanced dementia in long-term care. Unfortunately, most people with neurological diseases do not get the support that they need for their palliative care under current standards of healthcare. Improving this situation requires the deployment of routine screening to identify individual palliative care needs, the integration of palliative care approaches into routine neurological care, and collaboration between neurologists and palliative care specialists. Research, education, and advocacy are also needed to raise standards of care.
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Affiliation(s)
- Benzi M Kluger
- University of Rochester Medical Center, Rochester, NY, USA.
| | - Peter Hudson
- The University of Melbourne, Fitzroy, VIC, Australia; St Vincent's Hospital, Melbourne, Fitzroy, VIC, Australia; Vrije Universiteit Brussel, Brussel, Belgium
| | - Laura C Hanson
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Radka Bužgovà
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | | | - Roop Gursahani
- Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India
| | - Malenna Sumrall
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Charles White
- University of Rochester Medical Center, Rochester, NY, USA
| | | | - Steven Z Pantilat
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Vesic K, Gavrilovic A, Mijailović NR, Borovcanin MM. Neuroimmune, clinical and treatment challenges in multiple sclerosis-related psychoses. World J Psychiatry 2023; 13:161-170. [PMID: 37123101 PMCID: PMC10130959 DOI: 10.5498/wjp.v13.i4.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/16/2023] [Accepted: 03/23/2023] [Indexed: 04/18/2023] Open
Abstract
In recent years, epidemiological and genetic studies have shown an association between autoimmune diseases and psychosis. The question arises whether patients with schizophrenia are more likely to develop multiple sclerosis (MS) later in life. It is well known that the immune system plays an important role in the etiopathogenesis of both disorders. Immune disturbances may be similar or very different in terms of different types of immune responses, disturbed myelination, and/or immunogenetic predispositions. A psychotic symptom may be a consequence of the MS diagnosis itself or a separate entity. In this review article, we discussed the timing of onset of psychotic symptoms and MS and whether the use of corticosteroids as therapy for acute relapses in MS is unfairly neglected in patients with psychiatric comorbidities. In addition, we discussed that the anti-inflammatory potential of antipsychotics could be useful and should be considered, especially in the treatment of psychosis that coexists with MS. Autoimmune disorders could precipitate psychotic symptoms, and in this context, autoimmune psychosis must be considered as a persistent symptomatology that requires continuous and specific treatment.
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Affiliation(s)
- Katarina Vesic
- Department of Neurology, University of Kragujevac, Faculty of Medical Sciences, Kragujevac 34000, Sumadija, Serbia
| | - Aleksandar Gavrilovic
- Department of Neurology, University of Kragujevac, Faculty of Medical Sciences, Kragujevac 34000, Sumadija, Serbia
| | - Nataša R Mijailović
- Department of Pharmacy, University of Kragujevac, Faculty of Medical Sciences, Kragujevac 34000, Sumadija, Serbia
| | - Milica M Borovcanin
- Department of Psychiatry, University of Kragujevac, Faculty of Medical Sciences, Kragujevac 34000, Sumadija, Serbia
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11
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The Presence and Profile of Neurological Conditions and Associated Psychiatric Comorbidities in U.S. Resettled Refugees: A Retrospective Single Center Study. J Immigr Minor Health 2023; 25:365-373. [PMID: 36251204 DOI: 10.1007/s10903-022-01409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 10/24/2022]
Abstract
Refugees are a vulnerable, growing population who confront a myriad of traumas leading to their forced migration. Although psychiatric illnesses of resettled refugees are well-documented, there is a paucity of studies characterizing their neurological disease profiles. This study aimed to characterize the frequency and range of neurological disorders in a sample of resettled refugees receiving care at a community health center in Massachusetts, U.S.A. We performed a retrospective medical record review of adult (≥ 18 years) resettled refugees between May 2001 and December 2012 at a community health center in Northeast Massachusetts. Sociodemographic and clinical characteristics pertaining to neuropsychiatric health were collected from medical records using a standardized data extraction tool. Group comparisons between those with and without neurological illness and associated sociodemographic and psychiatric characteristics were evaluated using χ2 and independent samples two-tailed t-tests. In our sample (n = 779), 53.3% (n = 415) were male and 48.8% (n = 380) were from the African continent. The mean age was 33.2 ± 12.4 years (range 18-85). 36.8% were diagnosed with at least one neurological disorder and 18.1% with more than one neurological illness. The most common diagnoses were headaches (28.3%), sleep disorders (11.2%), cognitive impairment/ dementia (5.5%), and head trauma (5.5%). Exploratory analyses revealed that participants with neurological illness were more likely to be older (p < .001), female (p = .002), and diagnosed with co-morbid psychiatric diagnoses (p < .001) than those without neurological illness. Neurological disorders frequently co-occur with psychiatric comorbidities among U.S. resettled adult refugees. Standard refugee health assessments should incorporate screening and treatment for neurological illnesses.
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12
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Gandy M. The role of psychologists in managing mental health comorbidities in adults with neurological disorders. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2183107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Milena Gandy
- The eCentreClinic, The School of Psychological Sciences, Macquarie University, Sydney, Australia
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13
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Weapons of stress reduction: (R,S)-ketamine and its metabolites as prophylactics for the prevention of stress-induced psychiatric disorders. Neuropharmacology 2023; 224:109345. [PMID: 36427554 DOI: 10.1016/j.neuropharm.2022.109345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
Exposure to stress is one of the greatest contributing factors to developing a psychiatric disorder, particularly in susceptible populations. Enhancing resilience to stress could be a powerful intervention to reduce the incidence of psychiatric disease and reveal insight into the pathophysiology of psychiatric disorders. (R,S)-ketamine and its metabolites have recently been shown to exert protective effects when administered before or after a variety of stressors and may be effective, tractable prophylactic compounds against psychiatric disease. Drug dosing, sex, age, and strain in preclinical rodent studies, significantly influence the prophylactic effects of (R,S)-ketamine and related compounds. Due to the broad neurobiological actions of (R,S)-ketamine, a variety of mechanisms have been proposed to contribute to the resilience-enhancing effects of this drug, including altering various transcription factors across the genome, enhancing inhibitory connections from the prefrontal cortex, and increasing synaptic plasticity in the hippocampus. Promisingly, select data have shown that (R,S)-ketamine may be an effective prophylactic against psychiatric disorders, such as postpartum depression (PPD). Overall, this review will highlight a brief history of the prophylactic effects of (R,S)-ketamine, the potential mechanisms underlying its protective actions, and possible future directions for translating prophylactic compounds to the clinic. This article is part of the Special Issue on 'Ketamine and its Metabolites'.
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14
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Pagonabarraga J, Álamo C, Castellanos M, Díaz S, Manzano S. Depression in Major Neurodegenerative Diseases and Strokes: A Critical Review of Similarities and Differences among Neurological Disorders. Brain Sci 2023; 13:brainsci13020318. [PMID: 36831861 PMCID: PMC9954482 DOI: 10.3390/brainsci13020318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Depression and anxiety are highly prevalent in most neurological disorders and can have a major impact on the patient's disability and quality of life. However, mostly due to the heterogeneity of symptoms and the complexity of the underlying comorbidities, depression can be difficult to diagnose, resulting in limited recognition and in undertreatment. The early detection and treatment of depression simultaneously with the neurological disorder is key to avoiding deterioration and further disability. Although the neurologist should be able to identify and treat depression initially, a neuropsychiatry team should be available for severe cases and those who are unresponsive to treatment. Neurologists should be also aware that in neurodegenerative diseases, such as Alzheimer's or Parkinson's, different depression symptoms could develop at different stages of the disease. The treatment options for depression in neurological diseases include drugs, cognitive-behavioral therapy, and somatic interventions, among others, but often, the evidence-based efficacy is limited and the results are highly variable. Here, we review recent research on the diagnosis and treatment of depression in the context of Alzheimer's disease, Parkinson's disease, and strokes, with the aim of identifying common approaches and solutions for its initial management by the neurologist.
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Affiliation(s)
- Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain
- Centro de Investigación en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain
- Correspondence:
| | - Cecilio Álamo
- Department of Biomedical Sciences (Pharmacology), Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain
| | - Mar Castellanos
- Department of Neurology, A Coruña University Hospital and Biomedical Research Institute, 15006 La Coruña, Spain
| | - Samuel Díaz
- Headaches Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | - Sagrario Manzano
- Department of Neurology, Infanta Leonor University Hospital, 28031 Madrid, Spain
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15
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Sheikhi A, Siassi F, Djazayery A, Guilani B, Azadbakht L. Plant and animal protein intake and its association with depression, anxiety, and stress among Iranian women. BMC Public Health 2023; 23:161. [PMID: 36694166 PMCID: PMC9872399 DOI: 10.1186/s12889-023-15100-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/25/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. METHODS We assumed different sources of dietary protein could have different impacts on mental well-being. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, and Stress Scales (DASS) questionnaire with 21 items. RESULTS After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). While no significant association was seen between plant protein and any of the studied mental disorders. CONCLUSION Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.
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Affiliation(s)
- Ali Sheikhi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box: 1416643931, Tehran, Iran
| | - Fereydoun Siassi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box: 1416643931, Tehran, Iran
| | - Abolghassem Djazayery
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box: 1416643931, Tehran, Iran
| | - Bijan Guilani
- grid.46072.370000 0004 0612 7950Department of Clinical Psychology, University of Tehran, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box: 1416643931, Tehran, Iran. .,Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR, Iran.
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16
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Mapping the common gene networks that underlie related diseases. Nat Protoc 2023:10.1038/s41596-022-00797-1. [PMID: 36653526 DOI: 10.1038/s41596-022-00797-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/21/2022] [Indexed: 01/19/2023]
Abstract
A longstanding goal of biomedicine is to understand how alterations in molecular and cellular networks give rise to the spectrum of human diseases. For diseases with shared etiology, understanding the common causes allows for improved diagnosis of each disease, development of new therapies and more comprehensive identification of disease genes. Accordingly, this protocol describes how to evaluate the extent to which two diseases, each characterized by a set of mapped genes, are colocalized in a reference gene interaction network. This procedure uses network propagation to measure the network 'distance' between gene sets. For colocalized diseases, the network can be further analyzed to extract common gene communities at progressive granularities. In particular, we show how to: (1) obtain input gene sets and a reference gene interaction network; (2) identify common subnetworks of genes that encompass or are in close proximity to all gene sets; (3) use multiscale community detection to identify systems and pathways represented by each common subnetwork to generate a network colocalized systems map; (4) validate identified genes and systems using a mouse variant database; and (5) visualize and further investigate select genes, interactions and systems for relevance to phenotype(s) of interest. We demonstrate the utility of this approach by identifying shared biological mechanisms underlying autism and congenital heart disease. However, this protocol is general and can be applied to any gene sets attributed to diseases or other phenotypes with suspected joint association. A typical NetColoc run takes less than an hour. Software and documentation are available at https://github.com/ucsd-ccbb/NetColoc .
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17
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Khachadourian V, Kodesh A, Levine SZ, Lin E, Buxbaum JD, Bergink V, Sandin S, Reichenberg A, Janecka M. Somatic comorbidities of mental disorders in pregnancy. Eur Psychiatry 2023; 66:e15. [PMID: 36645097 PMCID: PMC9970155 DOI: 10.1192/j.eurpsy.2023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mental and physical health conditions are frequently comorbid. Despite the widespread physiological and behavioral changes during pregnancy, the pattern of comorbidities among women in pregnancy is not well studied. This study aimed to systematically examine the associations between mental and somatic disorders before and during pregnancy. METHOD The study used data from mothers of a nationally representative birth cohort of children born in Israel (1997-2008). We compared the risk of all major somatic disorders (International Classification of Diseases, Ninth Revision) in pregnant women with and without a mental disorder. All analyses were adjusted for maternal age, child's birth year, family socioeconomic status, and the total number of maternal encounters with health services around pregnancy period. RESULTS The analytical sample included 77,030 mother-child dyads, with 30,083 unique mothers. The mean age at child's birth was 29.8 years. Prevalence of diagnosis of mental disorder around pregnancy in our sample was 4.4%. Comorbidity between mental and somatic disorders was two times higher than the comorbidity between pairs of different somatic disorders. Of the 17 somatic disorder categories, seven were positively associated with mental health disorders. The highly prevalent comorbidities associated with mental disorders in pregnancy included e.g. musculoskeletal (OR = 1.30; 95% CI = 1.20-1.42) and digestive system diseases (OR = 1.23; 95% CI = 1.13-1.34). CONCLUSIONS We observed that associations between maternal diagnoses and mental health stand out from the general pattern of comorbidity between nonmental health diseases. The study results confirm the need for screening for mental disorders during pregnancy and for potential comorbid conditions associated with mental disorders.
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Affiliation(s)
- Vahe Khachadourian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
| | - Arad Kodesh
- The School of Public Health, University of Haifa, Haifa, Israel
- Meuhedet Health Services, Tel Aviv, Israel
| | | | - Emma Lin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
| | - Joseph D. Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
| | - Magdalena Janecka
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York10029, USA
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18
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Löscher W, Stafstrom CE. Epilepsy and its neurobehavioral comorbidities: Insights gained from animal models. Epilepsia 2023; 64:54-91. [PMID: 36197310 DOI: 10.1111/epi.17433] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 01/21/2023]
Abstract
It is well established that epilepsy is associated with numerous neurobehavioral comorbidities, with a bidirectional relationship; people with epilepsy have an increased incidence of depression, anxiety, learning and memory difficulties, and numerous other psychosocial challenges, and the occurrence of epilepsy is higher in individuals with those comorbidities. Although the cause-and-effect relationship is uncertain, a fuller understanding of the mechanisms of comorbidities within the epilepsies could lead to improved therapeutics. Here, we review recent data on epilepsy and its neurobehavioral comorbidities, discussing mainly rodent models, which have been studied most extensively, and emphasize that clinically relevant information can be gained from preclinical models. Furthermore, we explore the numerous potential factors that may confound the interpretation of emerging data from animal models, such as the specific seizure induction method (e.g., chemical, electrical, traumatic, genetic), the role of species and strain, environmental factors (e.g., laboratory environment, handling, epigenetics), and the behavioral assays that are chosen to evaluate the various aspects of neural behavior and cognition. Overall, the interplay between epilepsy and its neurobehavioral comorbidities is undoubtedly multifactorial, involving brain structural changes, network-level differences, molecular signaling abnormalities, and other factors. Animal models are well poised to help dissect the shared pathophysiological mechanisms, neurological sequelae, and biomarkers of epilepsy and its comorbidities.
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Affiliation(s)
- Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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19
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Wu Y, Wang R, Liu R, Ba Y, Huang H. The Roles of Histone Modifications in Metal-Induced Neurological Disorders. Biol Trace Elem Res 2023; 201:31-40. [PMID: 35129806 DOI: 10.1007/s12011-022-03134-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/23/2022] [Indexed: 01/11/2023]
Abstract
Increasing research is illuminating the intricate roles of metal ions in neural development as well as neurological disorders, which may stem from misregulation or dysfunction of epigenetic modifiers. Lead (Pb), cadmium (Cd), aluminum (Al), and arsenic were chosen for critical review because they have become serious public health concerns due to globalization and industrialization. In this review, we will introduce various modes of action of metals and consider the role of two posttranslational modifications: histone acetylation and methylation and how each of them affects gene expression. We then summarize the findings from previous studies on the neurological outcomes and histone alterations in response to the metals on each of the previously described histone modifications mechanisms. Understanding metal-induced histone modifications changes could provide better insight on the mechanism through which neurotoxicity occurs, to propose and validate these modifications as possible biomarkers for early identification of neurological damage, and can help model targeted therapies for the diseases of the brain.
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Affiliation(s)
- Yingying Wu
- Department of Environmental Health, College of Public Health, Zhengzhou University, Henan province, Zhengzhou, 450001, China
| | - Ruike Wang
- Department of Environmental Health, College of Public Health, Zhengzhou University, Henan province, Zhengzhou, 450001, China
| | - Rundong Liu
- Department of Environmental Health, College of Public Health, Zhengzhou University, Henan province, Zhengzhou, 450001, China
| | - Yue Ba
- Department of Environmental Health, College of Public Health, Zhengzhou University, Henan province, Zhengzhou, 450001, China
| | - Hui Huang
- Department of Environmental Health, College of Public Health, Zhengzhou University, Henan province, Zhengzhou, 450001, China.
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20
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Launders N, Kirsh L, Osborn DPJ, Hayes JF. The temporal relationship between severe mental illness diagnosis and chronic physical comorbidity: a UK primary care cohort study of disease burden over 10 years. Lancet Psychiatry 2022; 9:725-735. [PMID: 35871794 PMCID: PMC9630158 DOI: 10.1016/s2215-0366(22)00225-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite increased rates of physical health problems in people with schizophrenia, bipolar disorder, and other psychotic illnesses, the temporal relationship between physical disease acquisition and diagnosis of a severe mental illness remains unclear. We aimed to determine the cumulative prevalence of 24 chronic physical conditions in people with severe mental illness from 5 years before to 5 years after their diagnosis. METHODS In this cohort study, we used the UK Clinical Practice Research Datalink (CPRD) to identify patients aged 18-100 years who were diagnosed with severe mental illness between Jan 1, 2000, and Dec 31, 2018. Each patient with severe mental illness was matched with up to four individuals in the CPRD without severe mental illness by sex, 5-year age band, primary care practice, and year of primary care practice registration. Individuals in the matched cohort were assigned an index date equal to the date of severe mental illness diagnosis in the patient with severe mental illness to whom they were matched. Our primary outcome was the cumulative prevalence of 24 physical health conditions, based on the Charlson and Elixhauser comorbidity indices, at 5 years, 3 years, and 1 year before and after severe mental illness diagnosis and at the time of diagnosis. We used logistic regression to compare people with severe mental illness with the matched cohort, adjusting for key variables such as age, sex, and ethnicity. FINDINGS We identified 68 789 patients diagnosed with a severe mental illness between Jan 1, 2000, and Dec 31, 2018, and we matched them to 274 827 patients without a severe mental illness diagnosis. In both cohorts taken together, the median age was 40·90 years (IQR 29·46-56·00), 175 138 (50·97%) people were male, and 168 478 (49·03%) were female. The majority of patients were of White ethnicity (59 867 [87·03%] patients with a severe mental illness and 244 566 [88·99%] people in the matched cohort). The most prevalent conditions at the time of diagnosis in people with severe mental illness were asthma (10 581 [15·38%] of 68 789 patients), hypertension (8696 [12·64%]), diabetes (4897 [7·12%]), neurological disease (3484 [5·06%]), and hypothyroidism (2871 [4·17%]). At diagnosis, people with schizophrenia had increased odds of five of 24 chronic physical conditions compared with matched controls, and nine of 24 conditions were diagnosed less frequently than in matched controls. Individuals with bipolar disorder and other psychoses had increased odds of 15 conditions at diagnosis. At 5 years after severe mental illness diagnosis, these numbers had increased to 13 conditions for schizophrenia, 19 for bipolar disorder, and 16 for other psychoses. INTERPRETATION Elevated odds of multiple conditions at the point of severe mental illness diagnosis suggest that early intervention on physical health parameters is necessary to reduce morbidity and premature mortality. Some physical conditions might be under-recorded in patients with schizophrenia relative to patients with other severe mental illness subtypes. FUNDING UK Office For Health Improvement and Disparities.
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Affiliation(s)
- Naomi Launders
- Division of Psychiatry, University College London, London, UK
| | - Leiah Kirsh
- Division of Psychiatry, University College London, London, UK
| | - David P J Osborn
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Joseph F Hayes
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
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21
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Spreadbury JH, Young A, Kipps CM. A Comprehensive Literature Search of Digital Health Technology Use in Neurological Conditions: Review of Digital Tools to Promote Self-management and Support. J Med Internet Res 2022; 24:e31929. [PMID: 35900822 PMCID: PMC9377435 DOI: 10.2196/31929] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 03/13/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of digital health technology to promote and deliver postdiagnostic care in neurological conditions is becoming increasingly common. However, the range of digital tools available across different neurological conditions and how they facilitate self-management are unclear. OBJECTIVE This review aims to identify digital tools that promote self-management in neurological conditions and to investigate their underlying functionality and salient clinical outcomes. METHODS We conducted a search of 6 databases (ie, CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, and the Cochrane Review) using free text and equivalent database-controlled vocabulary terms. RESULTS We identified 27 published articles reporting 17 self-management digital tools. Multiple sclerosis (MS) had the highest number of digital tools followed by epilepsy, stroke, and headache and migraine with a similar number, and then pain. The majority were aimed at patients with a minority for carers. There were 5 broad categories of functionality promoting self-management: (1) knowledge and understanding; (2) behavior modification; (3) self-management support; (4) facilitating communication; and (5) recording condition characteristics. Salient clinical outcomes included improvements in self-management, self-efficacy, coping, depression, and fatigue. CONCLUSIONS There now exist numerous digital tools to support user self-management, yet relatively few are described in the literature. More research is needed to investigate their use, effectiveness, and sustainability, as well as how this interacts with increasing disability, and their integration within formal neurological care environments.
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Affiliation(s)
- John Henry Spreadbury
- Faculty of Medicine, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Alex Young
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Christopher Myles Kipps
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
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22
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Oestreich LKL, O'Sullivan MJ. Transdiagnostic In Vivo Magnetic Resonance Imaging Markers of Neuroinflammation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:638-658. [PMID: 35051668 DOI: 10.1016/j.bpsc.2022.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 05/13/2023]
Abstract
Accumulating evidence suggests that inflammation is not limited to archetypal inflammatory diseases such as multiple sclerosis, but instead represents an intrinsic feature of many psychiatric and neurological disorders not typically classified as neuroinflammatory. A growing body of research suggests that neuroinflammation can be observed in early and prodromal stages of these disorders and, under certain circumstances, may lead to tissue damage. Traditional methods to assess neuroinflammation include serum or cerebrospinal fluid markers and positron emission tomography. These methods require invasive procedures or radiation exposure and lack the exquisite spatial resolution of magnetic resonance imaging (MRI). There is, therefore, an increasing interest in noninvasive neuroimaging tools to evaluate neuroinflammation reliably and with high specificity. While MRI does not provide information at a cellular level, it facilitates the characterization of several biophysical tissue properties that are closely linked to neuroinflammatory processes. The purpose of this review is to evaluate the potential of MRI as a noninvasive, accessible, and cost-effective technology to image neuroinflammation across neurological and psychiatric disorders. We provide an overview of current and developing MRI methods used to study different aspects of neuroinflammation and weigh their strengths and shortcomings. Novel MRI contrast agents are increasingly able to target inflammatory processes directly, therefore offering a high degree of specificity, particularly if used in conjunction with multitissue, biophysical diffusion MRI compartment models. The capability of these methods to characterize several aspects of the neuroinflammatory milieu will likely push MRI to the forefront of neuroimaging modalities used to characterize neuroinflammation transdiagnostically.
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Affiliation(s)
- Lena K L Oestreich
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia.
| | - Michael J O'Sullivan
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Institute of Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia; Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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(R)-ketamine as prophylactic and therapeutic drug for neurological disorders: beyond depression. Neurosci Biobehav Rev 2022; 139:104762. [PMID: 35779628 DOI: 10.1016/j.neubiorev.2022.104762] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/15/2022] [Accepted: 06/28/2022] [Indexed: 12/11/2022]
Abstract
Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. The increasing social and economic burdens of neurological disorders are driven by global population growth and aging. Depression is a common psychiatric symptom in numerous neurological disorders. It is also a risk factor for Alzheimer's disease (AD) and other dementias, Parkinson's disease (PD), and stroke. The rapid-acting and sustained antidepressant actions of (R,S)-ketamine for severe depression was accidentally discovered. Interestingly, (R)-ketamine has greater potency and longer-lasting antidepressant-like effects than (S)-ketamine in rodents. Importantly, its side effects in rodents and humans are lower than those of (R,S)-ketamine and (S)-ketamine. Furthermore, (R)-ketamine could elicit beneficial actions in various rodent models of neurological disorders, including PD, multiple sclerosis (MS), and stroke. In this article, we review the potential of (R)-ketamine as a prophylactic or therapeutic drug for neurological disorders including AD and other dementias, PD, MS, and stroke.
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Christensen J, Dreier JW, Sun Y, Linehan C, Tomson T, Marson A, Forsgren L, Granbichler CA, Trinka E, Illiescu C, Malmgren K, Kjellberg J, Ibsen R, Jennum PJ. Estimates of epilepsy prevalence, psychiatric co-morbidity and cost. Seizure 2022; 107:162-171. [PMID: 35811222 DOI: 10.1016/j.seizure.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study estimated epilepsy prevalence, psychiatric co-morbidity and annual costs associated with epilepsy. METHODS We used Danish national health registers to identify persons diagnosed with epilepsy and psychiatric disorders, and persons using antiseizure medication and persons using drugs for psychiatric disorders. We calculated the prevalence of epilepsy and co-morbid psychiatric disorders in Denmark on December 31, 2016, using information on epilepsy and psychiatric disorders based on combinations of hospital contacts and use of antiseizure and psychoactive medication. Further, direct and indirect annual costs associated with epilepsy were calculated using individual-level data from a range of socioeconomic registers. RESULTS There were 5,044,367 persons alive and living in Denmark on December 31, 2016, including 33,628 persons with at least one hospital contact with epilepsy in the previous five years (epilepsy prevalence 0.67% (0.69% males; 0.65% females)). Among these persons with epilepsy, we identified 12,562 (37.4%) persons with a psychiatric disorder or use of drugs used for psychiatric disorders as compared with 801,052 (15.9%) persons in the general population. The estimated total annual individual net costs associated with epilepsy was €30,683. Compared with prevalence estimates on December 31, 2006, the prevalence of epilepsy on December 31, 2016, was slightly higher in the older population and slightly lower in children CONCLUSIONS: Population estimates from national registers provide epilepsy prevalence estimates of approximately 0.6-0.7% - similar to previous reviews of epilepsy prevalence. In addition, the national sample allowed idenitfication of high prevalence of psychiatric disorders and high societal costs associated with epielspy.
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Something new and something blue: Responses to novelty in a rodent model of depression and epilepsy comorbidity. Physiol Behav 2022; 249:113778. [PMID: 35278474 DOI: 10.1016/j.physbeh.2022.113778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/27/2022] [Accepted: 03/08/2022] [Indexed: 11/20/2022]
Abstract
A bidirectional comorbidity exists between depression and epilepsy such that patients with epilepsy are at higher risk for developing depression, and vice versa. Each of these conditions individually can be complicated by behavioral effects that worsen quality of life, but less is known about these interactions within the comorbidity of depression and epilepsy. The SwLo rat has been selectively bred for depression-relevant behaviors and exhibits enhanced limbic seizure susceptibility. This study sought to characterize the effects of novelty and stress on the SwLo rodent model of this comorbidity. It was hypothesized that SwLo rats would exhibit altered responses to novelty, reflected in hyperactivity-, anxiety-, sensation seeking-, and/or compulsive behaviors, and that this would be exacerbated with stress. Compared to the SwHi rat (their depression- and epilepsy-resistant counterparts), SwLo rats showed increased entries in all areas of the Open Field Test and spent significantly more time in the light compartment of the Light-Dark Box. SwLo rats also had a significantly higher number of rearing behaviors in the inner squares of the Open Field Test, the closed arms of the Elevated Plus Maze, and both areas of the Light-Dark Box. They demonstrated increased Nestlet shredding but showed no difference in a marble burying task or in latency to consume food in a novelty suppressed feeding task. Interestingly, restraint stress showed little effect on these behaviors, despite increasing corticosterone levels. Combined, these results suggest an increase in exploratory sensation seeking and hypervigilant information-gathering behaviors in the SwLo rat that are not dependent on corticosterone levels. This shows the utility of this model for studying behavioral effects of comorbid depression and epilepsy and allows for their use in identifying underlying mechanisms or screening treatment strategies for this complex comorbidity.
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Begasse De Dhaem O, Aldana SI, Kanner AM, Sperling M, French J, Nadkarni SS, Hope OA, O'Brien T, Morrison C, Winawer M, Minen MT. Association Between Migraine Comorbidity and Psychiatric Symptoms Among People With Newly Diagnosed Focal Epilepsy. J Neuropsychiatry Clin Neurosci 2022; 34:182-187. [PMID: 34961330 DOI: 10.1176/appi.neuropsych.21050124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about psychiatric symptoms among patients with migraine and newly diagnosed focal epilepsy. The investigators compared symptoms of depression, anxiety, and suicidality among people with newly diagnosed focal epilepsy with migraine versus without migraine. METHODS The Human Epilepsy Project is a prospective multicenter study of patients with newly diagnosed focal epilepsy. Depression (measured with the Center for Epidemiologic Studies Depression Scale), anxiety (measured with the 7-item Generalized Anxiety Disorder scale), and suicidality scores (measured with the Columbia-Suicide Severity Rating Scale [C-SSRS]) were compared between participants with versus without migraine. Data analysis was performed with the Kolmogorov-Smirnov test for normality assessment, the Mann-Whitney U test, chi-square test, and linear regression. RESULTS Of 349 patients with new-onset focal epilepsy, 74 (21.2%) had migraine. There were no differences between the patients without migraine versus those with migraine in terms of age, race, and level of education. There were more women in the group with migraine than in the group without migraine (75.7% vs. 55.6%, p=0.0018). The patients with epilepsy and comorbid migraine had more depressive symptoms than the patients with epilepsy without migraine (35.2% vs. 22.7%, p=0.031). Patients with epilepsy with comorbid migraine had more anxiety symptoms than patients with epilepsy without migraine, but this relation was mediated by age in logistic regression, with younger age being associated with anxiety. Comorbid migraine was not associated with C-SSRS ideation or behavior. CONCLUSIONS Among a sample of patients with newly diagnosed focal epilepsy, 21.2% had migraine. Migraine comorbidity was associated with higher incidence of depressive symptoms. Future studies should be performed to better assess these relationships and possible treatment implications.
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Affiliation(s)
- Olivia Begasse De Dhaem
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Sandra India Aldana
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Andres Miguel Kanner
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Michael Sperling
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Jacqueline French
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Siddhartha S Nadkarni
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Omotola A Hope
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Terry O'Brien
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Chris Morrison
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Melodie Winawer
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
| | - Mia T Minen
- New York-Presbyterian Hospital/Columbia University, New York (Begasse De Dhaem); Office of Science and Research, New York University Langone Health, New York (Aldana); Division of Epilepsy, Miller School of Medicine, University of Miami, Miami (Kanner); Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia (Sperling); New York University School of Medicine, Comprehensive Epilepsy Center, New York University Langone Health, New York (French, Nadkarni, Morrison); Department of Neurology, McGovern Medical School, University of Texas Health Science Center-Houston (Hope); The Central Clinical School, Monash University, Melbourne, Victoria, Australia (O'Brien); Gertrude H. Sergievsky Center, Columbia University, New York (Winawer); and Departments of Neurology and Population Health, New York University Langone Health, New York (Minen)
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Wei T, Guo Z, Wang Z, Li C, Zhu W, Zheng Y, Yin Y, Mi Y, Xia X, Hou H, Tang Y. Five Major Psychiatric Disorders and Alzheimer’s Disease: A Bidirectional Mendelian Randomization Study. J Alzheimers Dis 2022; 87:675-684. [PMID: 35367968 DOI: 10.3233/jad-220010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Extensive studies put forward the association between Alzheimer’s disease (AD) and psychiatric disorders; however, it remains unclear whether these associations are causal. Objective: We aimed to assess the potential causal relationship between major psychiatric disorders and AD. Methods: A bidirectional two-sample Mendelian randomization (MR) was applied to evaluate potential causality between five psychiatric disorders and AD by selecting the single-nucleotide polymorphisms from the genome-wide association studies as instrumental variables. Inverse-variance weighted (IVW) method was used as the main analyzing approach to estimate possible causal effects, alternative methods including MR-Egger, the MR pleiotropy residual sum and outlier, and leave-one-out analysis method were implemented as sensitivity analyzing approaches to ensure the robustness of results. Results: All forward and reverse MR analyses consistently suggested absent causal relations between psychiatric disorders and AD risk [forward IVW: ORADHD, 1.030, 95% CI, 0.908–1.168, p = 0.674; ORanxiety disorders, 0.904, 95% CI, 0.722–1.131, p = 0.377; ORASD, 0.973, 95% CI, 0.746–1.272, p = 0.846; ORBIP, 1.033, 95% CI, 0.925–1.153, p = 0.564; and ORschizophrenia, 1.039, 95% CI, 0.986–1.095, p = 0.156; reverse IVW: ORADHD, 0.993, 95% CI, 0.954–1.034, p = 0.746; ORanxiety disorders, 1.000, 95% CI, 0.999–1.000, p = 0.898; ORASD, 1.001, 95% CI, 0.962–1.042, p = 0.949; ORBIP, 0.997, 95% CI, 0.966–1.028, p = 0.831; and ORschizophrenia, 1.013, 95% CI, 0.978–1.051, p = 0.466]. Conclusion: There is no significant evidence supporting the causal association between the five major psychiatric disorders and AD.
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Affiliation(s)
- Tao Wei
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Zheng Guo
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, 8 Australia
| | - Zhibin Wang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Cancan Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian China
| | - Wei Zhu
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Yulu Zheng
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, 8 Australia
| | - Yunsi Yin
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Yingxin Mi
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Xinyi Xia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
| | - Haifeng Hou
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, 8 Australia
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian China
| | - Yi Tang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical
- Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
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Zheng F, Wang L, Zeng Z, Wu S. International Technologies on Prevention and Treatment of Neurological and Psychiatric Diseases: Bibliometric Analysis of Patents. JMIR Ment Health 2022; 9:e25238. [PMID: 35191849 PMCID: PMC8905476 DOI: 10.2196/25238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/02/2021] [Accepted: 10/15/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Neurological and psychiatric disorders are serious and expensive global public health problems. Therefore, exploring effective intervention technologies plays an important role in improving patients' clinical symptoms and social functions, as well as reducing medical burden. OBJECTIVE The aim of this study is to analyze and summarize the key new technologies and innovative development trends witnessed globally for neurological illness and psychiatric disorders by mining the relevant patent data. METHODS A bibliometric analysis was conducted on patent applications, priority countries, main patentees, hot technologies, and other patent information on neurological and psychiatric disorders, revealing the current situation along with the trend of technology development in this field. RESULTS In recent years, inventions and innovations related to neurological and psychiatric diseases have become very active, with China being the largest patent priority country. Of the top patent holders, Visicu (headquartered in the United States) is the leader. The distribution of patent holders in China remains relatively scattered, with no monopoly organization at present. Global technologies on neurological illness and psychiatric disorders are mainly concentrated around A61B (diagnosis, surgery, and identification). CONCLUSIONS This paper analyzed and summarized the key new technologies and global innovative development trends of neurological and psychiatric diseases by mining the relevant patent data, and provides practical references and research perspectives for the prevention and treatment of the aforesaid diseases.
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Affiliation(s)
- Fuhao Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou, China.,Public Health School of Fujian Medical University, Fuzhou, China
| | - Ling Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Zhaonan Zeng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Siying Wu
- Public Health School of Fujian Medical University, Fuzhou, China
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Al Kiyumi H, Al-Huseini S, Mirza H, Al Balushi N, Al-Risi K, Al Toubi A, Al Hosni A, Al-Mashaikhi T, Al Balushi R, Al-Adawi S. Depressive Symptoms and Its Correlate Among Children with Epilepsy at Single-center Study in Oman. Oman Med J 2022; 36:e329. [PMID: 35024176 PMCID: PMC8722311 DOI: 10.5001/omj.2021.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/07/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives Epilepsy is the most common neurological disorder in children and comorbid depression is common. This study aimed to assess the frequency of depressive symptoms along with demographic and clinical factors in children diagnosed with epilepsy in a tertiary care institution in Oman. Methods This cross-sectional study was conducted between June 2016 and August 2018 and included children (n = 75) aged 6–12 years old attending the epilepsy clinic at Sultan Qaboos University Hospital, Oman. The cohort constituted of children with epilepsy (CWE) following up at a dedicated unit. We used the Center for Epidemiologic Studies Depression Scale for Children to assess the presence of depressive symptoms. Associated factors, including history of seizure in the last three months, compliance with antiepileptic medications, and type of epilepsy were also examined. Results Depressive symptoms were endorsed in 52.0% of CWE and 96.0% were compliant to medications. Recurrent seizures were present in the last three months among 48.0% of the CWE. The type of epilepsy was significantly associated with the presence of depressive symptoms. Conclusions Depression is prevalent among Omani CWE. Certain clinical factors appeared to increase the risk of depression among this population. The findings of this study fill a gap in the existing literature and call for further work aiming to explore possible tailored recognition and CWE.
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Affiliation(s)
- Hamood Al Kiyumi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Salim Al-Huseini
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Hassan Mirza
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Naser Al Balushi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Khalid Al-Risi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Alsalt Al Toubi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Amira Al Hosni
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Talal Al-Mashaikhi
- Department of Neurology and Epileptology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rola Al Balushi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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30
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Sinnarajah A, Feldstain A, Wasylenko E. Responding to requests for hastened death in patients living with advanced neurologic disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 190:217-237. [PMID: 36055717 DOI: 10.1016/b978-0-323-85029-2.00002-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A request for hastened death can mean many things, from an emotional plea for help with unmet needs to a request for legal provision of chemically induced hastened death. Regardless of whether the clinician supports legally available hastened death, knowing how to respond to requests for hastened death is important. Responding in an empathic and open manner will strengthen the therapeutic relationship between the patient and clinician. Suggested scripts on how to respond are provided. A framework for assessing the patient's preparation at various stages in the decisional journey is suggested. Additional factors including caring for the family and involving other healthcare providers are discussed. Last, there is some exploration of ethics considerations and a summary of legal chemically induced hastened death availability internationally.
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Affiliation(s)
- Aynharan Sinnarajah
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Medicine, Queen's University, Kingston, ON, Canada.
| | - Andrea Feldstain
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Psychosocial Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Eric Wasylenko
- Department of Oncology, University of Calgary, Calgary, AB, Canada; John Dossetor Health Ethics Centre, University of Alberta, Edmonton, AB, Canada
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Varone G, Boulila W, Lo Giudice M, Benjdira B, Mammone N, Ieracitano C, Dashtipour K, Neri S, Gasparini S, Morabito FC, Hussain A, Aguglia U. A Machine Learning Approach Involving Functional Connectivity Features to Classify Rest-EEG Psychogenic Non-Epileptic Seizures from Healthy Controls. SENSORS (BASEL, SWITZERLAND) 2021; 22:s22010129. [PMID: 35009675 PMCID: PMC8747462 DOI: 10.3390/s22010129] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/04/2021] [Accepted: 12/17/2021] [Indexed: 06/01/2023]
Abstract
Until now, clinicians are not able to evaluate the Psychogenic Non-Epileptic Seizures (PNES) from the rest-electroencephalography (EEG) readout. No EEG marker can help differentiate PNES cases from healthy subjects. In this paper, we have investigated the power spectrum density (PSD), in resting-state EEGs, to evaluate the abnormalities in PNES affected brains. Additionally, we have used functional connectivity tools, such as phase lag index (PLI), and graph-derived metrics to better observe the integration of distributed information of regular and synchronized multi-scale communication within and across inter-regional brain areas. We proved the utility of our method after enrolling a cohort study of 20 age- and gender-matched PNES and 19 healthy control (HC) subjects. In this work, three classification models, namely support vector machine (SVM), linear discriminant analysis (LDA), and Multilayer perceptron (MLP), have been employed to model the relationship between the functional connectivity features (rest-HC versus rest-PNES). The best performance for the discrimination of participants was obtained using the MLP classifier, reporting a precision of 85.73%, a recall of 86.57%, an F1-score of 78.98%, and, finally, an accuracy of 91.02%. In conclusion, our results hypothesized two main aspects. The first is an intrinsic organization of functional brain networks that reflects a dysfunctional level of integration across brain regions, which can provide new insights into the pathophysiological mechanisms of PNES. The second is that functional connectivity features and MLP could be a promising method to classify rest-EEG data of PNES form healthy controls subjects.
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Affiliation(s)
- Giuseppe Varone
- Department of Neuroscience and Imaging, University G. d’Annunzio Chieti e Pescara, 66100 Chieti, Italy
| | - Wadii Boulila
- Robotics and Internet-of-Things Laboratory, Prince Sultan University, Riyadh 12435, Saudi Arabia;
- RIADI Laboratory, University of Manouba, Manouba 2010, Tunisia
| | - Michele Lo Giudice
- Department of Science Medical and Surgery, University of Catanzaro, 88100 Catanzaro, Italy; (M.L.G.); (S.N.); (S.G.); (U.A.)
| | - Bilel Benjdira
- Robotics and Internet-of-Things Laboratory, Prince Sultan University, Riyadh 12435, Saudi Arabia;
- SE & ICT Lab, LR18ES44, ENICarthage, University of Carthage, Tunis 2035, Tunisia
| | - Nadia Mammone
- DICEAM Department, University “Mediterranea” of Reggio Calabria, 89100 Reggio Calabria, Italy; (N.M.); (C.I.); (F.C.M.)
| | - Cosimo Ieracitano
- DICEAM Department, University “Mediterranea” of Reggio Calabria, 89100 Reggio Calabria, Italy; (N.M.); (C.I.); (F.C.M.)
| | - Kia Dashtipour
- School of Computing, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (K.D.); (A.H.)
| | - Sabrina Neri
- Department of Science Medical and Surgery, University of Catanzaro, 88100 Catanzaro, Italy; (M.L.G.); (S.N.); (S.G.); (U.A.)
| | - Sara Gasparini
- Department of Science Medical and Surgery, University of Catanzaro, 88100 Catanzaro, Italy; (M.L.G.); (S.N.); (S.G.); (U.A.)
- Regional Epilepsy Center, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli” of Reggio Calabria, 89124 Reggio Calabria, Italy
| | - Francesco Carlo Morabito
- DICEAM Department, University “Mediterranea” of Reggio Calabria, 89100 Reggio Calabria, Italy; (N.M.); (C.I.); (F.C.M.)
| | - Amir Hussain
- School of Computing, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (K.D.); (A.H.)
| | - Umberto Aguglia
- Department of Science Medical and Surgery, University of Catanzaro, 88100 Catanzaro, Italy; (M.L.G.); (S.N.); (S.G.); (U.A.)
- Regional Epilepsy Center, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli” of Reggio Calabria, 89124 Reggio Calabria, Italy
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Disability and life satisfaction in neurological disorders: The role of depression and perceived cognitive difficulties. Gen Hosp Psychiatry 2021; 73:16-23. [PMID: 34508992 DOI: 10.1016/j.genhosppsych.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study assessed factors associated with disability and life satisfaction in a large cohort of 2246 Australian adults with neurological disorders who completed an online survey of mental health and wellbeing. It was hypothesised that depressive symptoms and perceived cognitive difficulties would be significantly associated with both outcomes, even after controlling for significant demographic/medical covariates (e.g., age, marital-status, employment, multi-morbidity, medication). Differences in profiles of four neurological subgroups (i.e., multiple sclerosis; n = 738, epilepsy; n = 672, Parkinson's disease; n = 263, and Acquired Bran Injury; n = 278) were explored. METHODS Multiple hierarchical linear regressions were run using cross-sectional data. RESULTS Depressive symptoms made a significant and large unique contribution to higher levels of disability (β = 0.333, p < .001), and poorer life satisfaction (β = -0.434, p < .001), in the overall sample and across all four neurological subgroups (β = 0.349 to 0.513, p < .001) Greater perceived cognitive difficulties were associated with disability in the overall sample (β = 0.318, p < .001) and across all neurological subgroups (β = 0.231 to 0.354, p < .001), but only life satisfaction in epilepsy (β = -0.107, p = 006). CONCLUSIONS The findings underscore the importance of managing psychological/neuropsychiatric comorbidities in neurological disorders.
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Bauer PR, Tolner EA, Keezer MR, Ferrari MD, Sander JW. Headache in people with epilepsy. Nat Rev Neurol 2021; 17:529-544. [PMID: 34312533 DOI: 10.1038/s41582-021-00516-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
Epidemiological estimates indicate that individuals with epilepsy are more likely to experience headaches, including migraine, than individuals without epilepsy. Headaches can be temporally unrelated to seizures, or can occur before, during or after an episode; seizures and migraine attacks are mostly not temporally linked. The pathophysiological links between headaches (including migraine) and epilepsy are complex and have not yet been fully elucidated. Correct diagnoses and appropriate treatment of headaches in individuals with epilepsy is essential, as headaches can contribute substantially to disease burden. Here, we review the insights that have been made into the associations between headache and epilepsy over the past 5 years, including information on the pathophysiological mechanisms and genetic variants that link the two disorders. We also discuss the current best practice for the management of headaches co-occurring with epilepsy and highlight future challenges for this area of research.
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Affiliation(s)
- Prisca R Bauer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
| | - Else A Tolner
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mark R Keezer
- Research Centre of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.,School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Josemir W Sander
- Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands.,NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont St Peter, UK
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34
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Keynejad RC, David AS. Psychiatric Morbidity and Its Prognosis in Posterior Reversible Encephalopathy Syndrome. J Neuropsychiatry Clin Neurosci 2021; 32:385-388. [PMID: 32283992 DOI: 10.1176/appi.neuropsych.19080184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinically and radiologically diagnosed disorder distinguished by subcortical vasogenic cerebral edema. To date, its presentation has been described through summarized neurological categories, such as seizures, headaches, "confusion," and "altered mental function." This retrospective case series identified all cases of clinically confirmed, radiologically diagnosed PRES resulting in treatment in a large teaching hospital from 2010 to 2019. The authors conducted a search for the term "reversible encephalopathy" in the hospital clinical radiology information system, followed by an audit of scan reports and clinical records. The most common reasons for psychiatric referral were addictions, acute psychosis, depression, suicidality, and treatment refusal. Multidisciplinary staff should consider PRES as a rare, organic differential diagnosis for acute mental state changes. Physicians should be aware of elevated rates of post-PRES psychiatric symptoms and consider whether psychiatric consultation may enhance recovery.
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Affiliation(s)
- Roxanne C Keynejad
- Department of Health Service and Population Research, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London (Keynejad); and UCL Institute of Mental Health, Division of Psychiatry, Faculty of Brain Sciences, University College London, London (David)
| | - Anthony S David
- Department of Health Service and Population Research, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London (Keynejad); and UCL Institute of Mental Health, Division of Psychiatry, Faculty of Brain Sciences, University College London, London (David)
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35
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Solly EJ, Clough M, Foletta P, White OB, Fielding J. The Psychiatric Symptomology of Visual Snow Syndrome. Front Neurol 2021; 12:703006. [PMID: 34393980 PMCID: PMC8362098 DOI: 10.3389/fneur.2021.703006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/28/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: To characterise the psychiatric symptoms of visual snow syndrome (VSS), and determine their relationship to quality of life and severity of visual symptoms. Methods: One hundred twenty-five patients with VSS completed a battery of questionnaires assessing depression/anxiety, dissociative experiences (depersonalisation), sleep quality, fatigue, and quality of life, as well as a structured clinical interview about their visual and sensory symptoms. Results: VSS patients showed high rates of anxiety and depression, depersonalisation, fatigue, and poor sleep, which significantly impacted quality of life. Further, psychiatric symptoms, particularly depersonalisation, were related to increased severity of visual symptoms. The severity/frequency of psychiatric symptoms did not differ significantly due to the presence of migraine, patient sex, or timing of VSS onset (lifelong vs. later onset). Conclusion: Psychiatric symptoms are highly prevalent in patients with VSS and are associated with increased visual symptom severity and reduced quality of life. Importantly, patients with lifelong VSS reported lower levels of distress and milder self-ratings of visual symptoms compared to patients with a later onset, while being equally likely to experience psychiatric symptoms. This suggests that the psychiatric symptoms of VSS are not solely due to distress caused by visual symptoms. While no consistently effective treatments are available for the visual symptomology of VSS, psychiatric symptoms offer an avenue of treatment that is likely to significantly improve patient quality of life and ability to cope with visual symptoms.
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Affiliation(s)
- Emma J Solly
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Meaghan Clough
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Paige Foletta
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Owen B White
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC, Australia
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36
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Küpeli Akkol E, Tatlı Çankaya I, Şeker Karatoprak G, Carpar E, Sobarzo-Sánchez E, Capasso R. Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases. Front Pharmacol 2021; 12:669638. [PMID: 34054540 PMCID: PMC8155682 DOI: 10.3389/fphar.2021.669638] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/16/2021] [Indexed: 12/14/2022] Open
Abstract
Psychiatric disorders are frequently encountered in many neurological disorders, such as Alzheimer’s and Parkinson diseases along with epilepsy, migraine, essential tremors, and stroke. The most common comorbid diagnoses in neurological diseases are depression and anxiety disorders along with cognitive impairment. Whether the underlying reason is due to common neurochemical mechanisms or loss of previous functioning level, comorbidities are often overlooked. Various treatment options are available, such as pharmacological treatments, cognitive-behavioral therapy, somatic interventions, or electroconvulsive therapy. However oral antidepressant therapy may have some disadvantages, such as interaction with other medications, low tolerability due to side effects, and low efficiency. Natural compounds of plant origin are extensively researched to find a better and safer alternative treatment. Experimental studies have shown that phytochemicals such as alkaloids, terpenes, flavonoids, phenolic acids as well as lipids have significant potential in in vitro and in vivo models of psychiatric disorders. In this review, various efficacy of natural products in in vitro and in vivo studies on neuroprotective and their roles in psychiatric disorders are examined and their neuro-therapeutic potentials are shed light.
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Affiliation(s)
- Esra Küpeli Akkol
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - Irem Tatlı Çankaya
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | | | - Elif Carpar
- Department of Psychiatry, Private French La Paix Hospital, Istanbul, Turkey
| | - Eduardo Sobarzo-Sánchez
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile.,Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, Potici, Italy
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37
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Porras Segovia A, Guerrero-Jiménez M, Carrillo de Albornoz Calahorro CM, Gutierrez-Rojas L. Psychosis and Dandy-Walker syndrome: a case report and review of the literature. Gen Psychiatr 2021; 34:e100254. [PMID: 33937630 PMCID: PMC8054076 DOI: 10.1136/gpsych-2020-100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 11/03/2022] Open
Abstract
Dandy-Walker syndrome (DWS) is a group of brain malformations which sometimes present with psychotic symptoms. We present the case of a patient diagnosed with Dandy-Walker variant who presented with schizophrenia-like psychosis. A man in his 30s was admitted to an acute psychiatric unit presenting with persecutory delusions, auditory hallucinations and violent behaviour. The MRI performed showed the typical alterations of Dandy-Walker variant: vermian hypoplasia and cystic dilatation of the fourth ventricle. He also suffered from mild intellectual disability. After being treated with olanzapine 10 mg/d for a month, his psychotic symptoms greatly improved and he was discharged. In conclusion, DWS may cause psychosis through a dysfunction in the circuit connecting prefrontal, thalamic and cerebellar areas. The association between these two conditions may contribute to the understanding of the aetiopathogenesis of schizophrenia.
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38
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Insights into the Pathophysiology of Psychiatric Symptoms in Central Nervous System Disorders: Implications for Early and Differential Diagnosis. Int J Mol Sci 2021; 22:ijms22094440. [PMID: 33922780 PMCID: PMC8123079 DOI: 10.3390/ijms22094440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
Abstract
Different psychopathological manifestations, such as affective, psychotic, obsessive-compulsive symptoms, and impulse control disturbances, may occur in most central nervous system (CNS) disorders including neurodegenerative and neuroinflammatory diseases. Psychiatric symptoms often represent the clinical onset of such disorders, thus potentially leading to misdiagnosis, delay in treatment, and a worse outcome. In this review, psychiatric symptoms observed along the course of several neurological diseases, namely Alzheimer’s disease, fronto-temporal dementia, Parkinson’s disease, Huntington’s disease, and multiple sclerosis, are discussed, as well as the involved brain circuits and molecular/synaptic alterations. Special attention has been paid to the emerging role of fluid biomarkers in early detection of these neurodegenerative diseases. The frequent occurrence of psychiatric symptoms in neurological diseases, even as the first clinical manifestations, should prompt neurologists and psychiatrists to share a common clinico-biological background and a coordinated diagnostic approach.
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39
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Kritikos J, Alevizopoulos G, Koutsouris D. Personalized Virtual Reality Human-Computer Interaction for Psychiatric and Neurological Illnesses: A Dynamically Adaptive Virtual Reality Environment That Changes According to Real-Time Feedback From Electrophysiological Signal Responses. Front Hum Neurosci 2021; 15:596980. [PMID: 33643010 PMCID: PMC7906990 DOI: 10.3389/fnhum.2021.596980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/18/2021] [Indexed: 02/03/2023] Open
Abstract
Virtual reality (VR) constitutes an alternative, effective, and increasingly utilized treatment option for people suffering from psychiatric and neurological illnesses. However, the currently available VR simulations provide a predetermined simulative framework that does not take into account the unique personality traits of each individual; this could result in inaccurate, extreme, or unpredictable responses driven by patients who may be overly exposed and in an abrupt manner to the predetermined stimuli, or result in indifferent, almost non-existing, reactions when the stimuli do not affect the patients adequately and thus stronger stimuli are recommended. In this study, we present a VR system that can recognize the individual differences and readjust the VR scenarios during the simulation according to the treatment aims. To investigate and present this dynamically adaptive VR system we employ an Anxiety Disorder condition as a case study, namely arachnophobia. This system consists of distinct anxiety states, aiming to dynamically modify the VR environment in such a way that it can keep the individual within a controlled, and appropriate for the therapy needs, anxiety state, which will be called "desired states" for the study. This happens by adjusting the VR stimulus, in real-time, according to the electrophysiological responses of each individual. These electrophysiological responses are collected by an external electrodermal activity biosensor that serves as a tracker of physiological changes. Thirty-six diagnosed arachnophobic individuals participated in a one-session trial. Participants were divided into two groups, the Experimental Group which was exposed to the proposed real-time adaptive virtual simulation, and the Control Group which was exposed to a pre-recorded static virtual simulation as proposed in the literature. These results demonstrate the proposed system's ability to continuously construct an updated and adapted virtual environment that keeps the users within the appropriately chosen state (higher or lower intensity) for approximately twice the time compared to the pre-recorded static virtual simulation. Thus, such a system can increase the efficiency of VR stimulations for the treatment of central nervous system dysfunctions, as it provides numerically more controlled sessions without unexpected variations.
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Affiliation(s)
- Jacob Kritikos
- Department of Bioengineering, Imperial College London, South Kensington Campus, London, United Kingdom
| | - Georgios Alevizopoulos
- Psychiatric Clinic, Agioi Anargyroi General Oncological Hospital of Kifisia, Athens, Greece
| | - Dimitris Koutsouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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40
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Joshi N, Onaivi ES. Psychiatric Disorders and Cannabinoid Receptors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1264:131-153. [PMID: 33332008 PMCID: PMC10810008 DOI: 10.1007/978-3-030-57369-0_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
With the increasing global use of medical and adult recreational use of cannabis and cannabinoids, this chapter provides overview of evidence from animal and human studies on psychiatric disorders and cannabinoid receptors. We review and present evaluation of the relationship between changes in the ECS and psychiatric disorders. Evidence suggests the existence of a relationship between changes in components of the ECS, and some of the symptoms present in psychiatric disorders. Both CB1Rs and CB2Rs are components of the endocannabinoid system with different cellular and tissue localization patterns that are differentially expressed in the CNS and PNS and are emerging targets for the treatment of number psychiatric disorders. As cannabis preparations are widely used for recreation globally, it is predictable that cannabis use disorders (CUDs) will increase and there is currently no available treatment for CUDs. Although major advances have been reported from cannabinoid and ECS research, there are gaps in scientific knowledge on long-term consequences of cannabis use. Adolescent and cannabis use during pregnancy presents further challenges, and more research will uncover the signaling pathways that couple the gut microbiota with the host ECS. Development of cannabis and cannabinoid nanomedicine for nanotherapy will certainly overcome some of the shortcomings and challenges in medicinal and recreational use of cannabis and cannabinoids. Thus, nanotechnology will allow targeted delivery of cannabinoid formulations with the potential to elevate their use to scientifically validated nanotherapeutic applications as the field of cannabis nanoscience matures.
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Affiliation(s)
- Neal Joshi
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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41
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Yang W, Xiao L, Yuan Z, Huang H, Xiang Y, Liu Z, Nan C, Wang H, Wang G. Anxiety and Depression in Patients With Physical Diseases and Associated Factors: A Large-Scale Field Survey in General Hospitals in China. Front Psychiatry 2021; 12:689787. [PMID: 34393853 PMCID: PMC8359676 DOI: 10.3389/fpsyt.2021.689787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction: To investigate the characteristic of anxiety and depression among patients in general hospitals, and explore the degree of the clinical symptoms and correlated social economic factors. Methods: This is a cross-sectional survey of anxiety and depression in patients with physical diseases, who were suspected of depression and anxiety based on their clinical performance by their physicians and PHQ ≧ 8, from various clinical departments of 57 general hospitals in China. Data regarding demographic characteristics and clinical characteristics were collected. Social and psychological factors and the severity of anxiety or depression were collected through self-rating scales. Finally, we used multivariate logistic regression to identify the factors associated with anxiety and depression in patients with physical diseases. Results: A total of 2,105 (84.6%) valid and completed questionnaires were returned. The proportion of anxiety, depression, combined depression and anxiety, either anxiety or depression among the patients with physical diseases from all clinical departments was 63.3, 75.1, 57.1, and 81.2% respectively. Further regression analysis indicated that gender, monthly income, specific physical diseases, personality traits, social supports and life negative events were related factors of both anxiety and depression. Conclusions: Anxiety and depression were common in patients with physical diseases, with a high proportion of co-morbidity of anxiety and depression. Females, patients with cancer, poor social support and negative life events reported more severe anxiety and depression. The results may help to understand the present situation of anxiety and depression in general hospitals in china, and identify the patients with high risk of depression and anxiety.
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Affiliation(s)
- Wanlin Yang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Xiao
- Hubei Institute of Neurology and Psychiatry Research, Wuhan, China
| | - Zhiyong Yuan
- Computer College of Wuhan University, Wuhan, China
| | - Huan Huang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yilei Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Cai Nan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Institute of Neurology and Psychiatry Research, Wuhan, China
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42
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Abstract
Introduction: Hallucinations in Parkinson's disease are common, can complicate medication management and significantly impact upon the quality of life of patients and their carers.Areas covered: This review aims to examine current evidence for the management of hallucinations in Parkinson's disease.Expert opinion: Treatment of hallucinations in Parkinson's disease should be both individualized and multifaceted. Screening, education, medication review and the avoidance of common triggers are important. For well-formed visual hallucinations, acetylcholinesterase inhibitors are recommended first-line. Refractory or severe symptoms may require the cautious use of atypical antipsychotics. Antidepressants may be beneficial in the appropriate setting. Unfortunately, current therapies for hallucinations offer only limited benefits and future research efforts are desperately required to improve the management of these challenging symptoms.
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Affiliation(s)
- Alice Powell
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, the University of Sydney, Camperdown, Australia.,Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, Australia
| | - Elie Matar
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, the University of Sydney, Camperdown, Australia
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, the University of Sydney, Camperdown, Australia
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43
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Evolving evidence on a link between the ZMYM3 exceptionally long GA-STR and human cognition. Sci Rep 2020; 10:19454. [PMID: 33173136 PMCID: PMC7655811 DOI: 10.1038/s41598-020-76461-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023] Open
Abstract
The human X-linked zinc finger MYM-type protein 3 (ZMYM3) contains the longest GA-STR identified across protein-coding gene 5′ UTR sequences, at 32-repeats. This exceptionally long GA-STR is located at a complex string of GA-STRs with a human-specific formula across the complex as follows: (GA)8-(GA)4-(GA)6-(GA)32 (ZMYM3-207 ENST00000373998.5). ZMYM3 was previously reported among the top three genes involved in the progression of late-onset Alzheimer’s disease. Here we sequenced the ZMYM3 GA-STR complex in 750 human male subjects, consisting of late-onset neurocognitive disorder (NCD) as a clinical entity (n = 268) and matched controls (n = 482). We detected strict monomorphism of the GA-STR complex, except of the exceptionally long STR, which was architecturally skewed in respect of allele distribution between the NCD cases and controls [F (1, 50) = 12.283; p = 0.001]. Moreover, extreme alleles of this STR at 17, 20, 42, and 43 repeats were detected in seven NCD patients and not in the control group (Mid-P exact = 0.0003). A number of these alleles overlapped with alleles previously found in schizophrenia and bipolar disorder patients. In conclusion, we propose selective advantage for the exceptional length of the ZMYM3 GA-STR in human, and its link to a spectrum of diseases in which major cognition impairment is a predominant phenotype.
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44
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Kumar M, Thakur AK. Neurological manifestations and comorbidity associated with COVID-19: an overview. Neurol Sci 2020; 41:3409-3418. [PMID: 33052573 PMCID: PMC7556575 DOI: 10.1007/s10072-020-04823-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/10/2020] [Indexed: 01/08/2023]
Abstract
First in 2002, severe acute respiratory syndrome coronavirus (SARS-CoV), second in 2012, Middle East respiratory syndrome coronavirus (MERS-CoV), and now the third in the December 2019, emergence of tremendously pathogenic and large-scale epidemic novel coronavirus (SARS-CoV-2) has brought the worst conditions into the human inhabitants of the twenty-first century. The SARS-CoV-2 uses the resembling receptor, angiotensin-converting enzyme 2 (ACE2) as that for SARS-CoV, and mainly feasts through the respiratory tract. The ACE2 receptor appearances have been also detected upon glial cells and neurons, which makes them a potential target of SARS-CoV-2 disease (COVID-19). Consequently, cells expressing ACE2, apart from lung and cardiovascular tissue, neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 systemic infection as well as its central nervous system (CNS) comorbidities. Investigation of the neurological manifestations of COVID-19 is a step towards better understanding the SARS-CoV-2 infections, inhibiting the additional spread and treating patients affected by this pandemic. In this concern, more clinical examinations for CNS involvement of SARS-CoV-2 are warranted. In this article, we have reviewed the neurological characteristic features of COVID-19 patients, latent neurotropic mechanisms of SARS-CoV-2 involvement in the comorbidity associated with CNS disorders, and neurological manifestations associated with COVID-19. Therefore, in the perspective of COVID-19 pandemic, clinicians and healthcare workers should be aware of a wide spectrum of neurological manifestations associated with COVID-19 along with their signs and symptoms for initial diagnosis and isolation of the patients.
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Affiliation(s)
- Mukesh Kumar
- Neuropharmacology Research Laboratory, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, 110 017, India.,Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Government of India, Ghaziabad, Uttar Pradesh, 201 002, India
| | - Ajit Kumar Thakur
- Neuropharmacology Research Laboratory, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, 110 017, India.
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45
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Leu C, Bautista JF, Sudarsanam M, Niestroj LM, Stefanski A, Ferguson L, Daly MJ, Jehi L, Najm IM, Busch RM, Lal D. Neurological disorder-associated genetic variants in individuals with psychogenic nonepileptic seizures. Sci Rep 2020; 10:15205. [PMID: 32938993 PMCID: PMC7495430 DOI: 10.1038/s41598-020-72101-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022] Open
Abstract
Psychogenic nonepileptic seizures (PNES) are diagnosed in approximately 30% of patients referred to tertiary care epilepsy centers. Little is known about the molecular pathology of PNES, much less about possible underlying genetic factors. We generated whole-exome sequencing and whole-genome genotyping data to identify rare, pathogenic (P) or likely pathogenic (LP) variants in 102 individuals with PNES and 448 individuals with focal (FE) or generalized (GE) epilepsy. Variants were classified for all individuals based on the ACMG-AMP 2015 guidelines. For research purposes only, we considered genes associated with neurological or psychiatric disorders as candidate genes for PNES. We observe in this first genetic investigation of PNES that six (5.88%) individuals with PNES without coexistent epilepsy carry P/LP variants (deletions at 10q11.22-q11.23, 10q23.1-q23.2, distal 16p11.2, and 17p13.3, and nonsynonymous variants in NSD1 and GABRA5). Notably, the burden of P/LP variants among the individuals with PNES was similar and not significantly different to the burden observed in the individuals with FE (3.05%) or GE (1.82%) (PNES vs. FE vs. GE (3 × 2 χ2), P = 0.30; PNES vs. epilepsy (2 × 2 χ2), P = 0.14). The presence of variants in genes associated with monogenic forms of neurological and psychiatric disorders in individuals with PNES shows that genetic factors are likely to play a role in PNES or its comorbidities in a subset of individuals. Future large-scale genetic research studies are needed to further corroborate these interesting findings in PNES.
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Affiliation(s)
- Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA.
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK.
| | - Jocelyn F Bautista
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Monica Sudarsanam
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Lisa-Marie Niestroj
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, DE, 50931, USA
| | - Arthur Stefanski
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Lisa Ferguson
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Psychiatry & Psychology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Mark J Daly
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Institute of Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Lara Jehi
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Imad M Najm
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Robyn M Busch
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Psychiatry & Psychology, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA.
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, DE, 50931, USA.
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A feasibility trial of an internet-delivered psychological intervention to manage mental health and functional outcomes in neurological disorders. J Psychosom Res 2020; 136:110173. [PMID: 32623193 DOI: 10.1016/j.jpsychores.2020.110173] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/15/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Mental health and cognitive difficulties are highly prevalent across neurological disorders and significantly contribute to poorer patient outcomes. Unfortunately, access to effective psychological services for these comorbidities are limited. To determine whether a novel transdiagnostic internet-delivered psychological intervention, the Wellbeing Neuro Course, was feasible, acceptable and efficacious a single-group feasibility open trial was employed. METHODS The Wellbeing Neuro Course, targets mental health and cognitive difficulties, across a variety of neurological disorders. It is comprised of six online lessons, based on Cognitive Behavioural Therapy and Compensatory Cognitive Rehabilitation, delivered over 10 weeks and provided with weekly support from a mental health professional via email and telephone. 105 adults with diagnoses of either epilepsy, multiple sclerosis, Parkinson's disease and/or acquired brain injury, underwent the intervention. RESULTS The intervention was found to be highly acceptable with high intervention completion and levels of satisfaction (>95%). There was evidence of clinically significant improvements in primary outcomes (within-group Cohen's d; average reductions) of depression (d = 0.93; avg. reduction ≥36%), anxiety (ds = 0.66, avg. reduction ≥36%), and disability (ds ≥ 0.49; avg. reduction ≥23%) at post-intervention, maintained at 3-month follow-up. For secondary outcomes there were significant improvements in fatigue severity and perceived cognitive difficulties of attention, planning and prospective memory. Findings were achieved with minimal clinician time, highlighting its public health potential. CONCLUSION This open trial provides preliminary evidence the Wellbeing Neuro Course is acceptable and reduces symptoms of depression, anxiety and disability in neurological disorders. Future controlled trials of the intervention are now needed. TRIAL REGISTRATION ACTRN12617000581369.
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Alexander-Bloch AF, Raznahan A, Shinohara RT, Mathias SR, Bathulapalli H, Bhalla IP, Goulet JL, Satterthwaite TD, Bassett DS, Glahn DC, Brandt CA. The architecture of co-morbidity networks of physical and mental health conditions in military veterans. Proc Math Phys Eng Sci 2020; 476:20190790. [PMID: 32831602 DOI: 10.1098/rspa.2019.0790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 06/03/2020] [Indexed: 11/12/2022] Open
Abstract
Co-morbidity between medical and psychiatric conditions is commonly considered between individual pairs of conditions. However, an important alternative is to consider all conditions as part of a co-morbidity network, which encompasses all interactions between patients and a healthcare system. Analysis of co-morbidity networks could detect and quantify general tendencies not observed by smaller-scale studies. Here, we investigate the co-morbidity network derived from longitudinal healthcare records from approximately 1 million United States military veterans, a population disproportionately impacted by psychiatric morbidity and psychological trauma. Network analyses revealed marked and heterogenous patterns of co-morbidity, including a multi-scale community structure composed of groups of commonly co-morbid conditions. Psychiatric conditions including posttraumatic stress disorder were strong predictors of future medical morbidity. Neurological conditions and conditions associated with chronic pain were particularly highly co-morbid with psychiatric conditions. Across conditions, the degree of co-morbidity was positively associated with mortality. Co-morbidity was modified by biological sex and could be used to predict future diagnostic status, with out-of-sample prediction accuracy of 90-92%. Understanding complex patterns of disease co-morbidity has the potential to lead to improved designs of systems of care and the development of targeted interventions that consider the broader context of mental and physical health.
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Affiliation(s)
- Aaron F Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.,Department of Child and Adolescent Psychiatry and Behavioral Science, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Armin Raznahan
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Intramural Program, Bethesda, MA, USA
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel R Mathias
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Harini Bathulapalli
- US Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven, CT, USA.,Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
| | - Ish P Bhalla
- National Clinician Scholars Program, University of California, Los Angeles, CA, USA
| | - Joseph L Goulet
- US Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven, CT, USA.,Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
| | | | - Danielle S Bassett
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.,Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA, USA.,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.,Santa Fe Institute, Santa Fe, NM, USA
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Cynthia A Brandt
- US Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven, CT, USA.,Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
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Abstract
BACKGROUND Epilepsy and mental illness share similar problems in terms of stigma, as a result of centuries of superstition, ignorance and misbeliefs. Stigma leads not only to discrimination and civil and human rights violations but also to poor access to healthcare and non-adherence or decreased adherence to treatment, ultimately increasing morbidity and mortality. Despite continuous efforts in fighting stigma in these conditions, there is very limited knowledge on the phenomenon of double stigma, meaning the impact of having two stigmatised conditions at the same time. AIMS To discuss double stigma in mental health with special reference to epilepsy. METHOD Articles were identified through searches in PubMed up to 31 October 2019 using the search terms 'epilepsy', 'psychiatric disorders', 'stigma' and additional material was identified from the authors' own files and from chosen bibliographies. RESULTS Double stigma is gaining attention for other stigmatised medical conditions, such as HIV, however, the literature on epilepsy is almost non-existent and this is quite astonishing given that one in three people with epilepsy have a lifetime diagnosis of a psychiatric condition. Felt (perceived) stigma and psychiatric disorders, particularly depression, create a vicious circle in epilepsy maintaining both, as depression correlates with stigma and vice versa as well as epilepsy and depression serving as bidirectional risk factors. This phenomenon has no geographical and economic boundaries as similar data have been reported for low-income and high-income countries. CONCLUSIONS Governments and policymakers as well as health services, patients' organisations, families and the general public need to be aware of the phenomenon of double stigma in order to develop campaigns and interventions tailored for these patients.
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Affiliation(s)
- Marco Mula
- Institute of Medical and Biomedical Education, St George's University of London, UK; and the Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, UK
| | - Kenneth R Kaufman
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, USA; and Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
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49
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Raja A, Trivedi PD, Dhamoon MS. Discharge against medical advice among neurological patients: Characteristics and outcomes. Health Serv Res 2020; 55:681-689. [PMID: 32578887 DOI: 10.1111/1475-6773.13306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To study characteristics and outcomes of patients with stroke, traumatic brain injury (TBI), and epilepsy with discharge against medical advice (DAMA). DATA SOURCES/STUDY SETTING Retrospective analysis of the 2013 Nationwide Readmissions Database, a nationally representative inpatient administrative dataset. STUDY DESIGN Associations between predictors and DAMA at index admission were analyzed using adjusted logistic models. We examined 30-day all-cause readmissions. DATA COLLECTION METHODS Patients aged ≥18 years at index admission for International Classification of Diseases-9 diagnosis code of epilepsy, TBI, or stroke were included. PRINCIPAL FINDINGS Discharge against medical advice occurred in 1998/58278 patients (3.43 percent) in the epilepsy group, 1762/211 213 (0.83 percent) in the stroke group, and 1289/74 652 (1.73 percent) in the TBI group. Factors consistently associated with increased likelihood of DAMA included lower age, male sex, non-Medicare and nonprivate insurance, lower socioeconomic status, and behavioral risk factors (smoking history, alcohol history, and drug use). The crude 30-day all-cause readmission rate for those with DAMA from their index admission was 16.4 percent for the stroke cohort, 13.9 percent for epilepsy, and 13.4 percent for TBI. DAMA at index admission was significantly associated with increased risk of 30-day all-cause readmission among all groups (adjusted odds ratio 1.79, 95% CI: 1.65-1.94, P < .0001). CONCLUSIONS Age, sex, insurance status, socioeconomic status, and behavioral factors were associated with DAMA in neurological patients. Further research is needed to develop interventions to reduce DAMA in high-risk groups.
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Affiliation(s)
- Aishwarya Raja
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York
| | - Parth D Trivedi
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York
| | - Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York
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50
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Schmid M, Michaud L, Bovio N, Guseva Canu I. Prevalence of somatic and psychiatric morbidity across occupations in Switzerland and its correlation with suicide mortality: results from the Swiss National Cohort (1990-2014). BMC Psychiatry 2020; 20:324. [PMID: 32571249 PMCID: PMC7310107 DOI: 10.1186/s12888-020-02733-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations. METHODS We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide. RESULTS Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide. CONCLUSION Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.
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Affiliation(s)
- M. Schmid
- grid.9851.50000 0001 2165 4204Center for Primary Care and Public Health (Unisanté), University of Lausanne, Département Sante, Travail, Environnement (DSTE), Biopôle, Route de la Corniche, 2, 1066 Epalinges-Lausanne, Switzerland ,grid.150338.c0000 0001 0721 9812Geneva University Hospital, Geneva, Switzerland
| | - L. Michaud
- grid.8515.90000 0001 0423 4662Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
| | - N. Bovio
- grid.9851.50000 0001 2165 4204Center for Primary Care and Public Health (Unisanté), University of Lausanne, Département Sante, Travail, Environnement (DSTE), Biopôle, Route de la Corniche, 2, 1066 Epalinges-Lausanne, Switzerland
| | - I. Guseva Canu
- grid.9851.50000 0001 2165 4204Center for Primary Care and Public Health (Unisanté), University of Lausanne, Département Sante, Travail, Environnement (DSTE), Biopôle, Route de la Corniche, 2, 1066 Epalinges-Lausanne, Switzerland
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