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Angelico G, Salvatorelli L, Vecchio GM, Mazzucchelli M, Rosano GN, Poidomani S, Magro GG. Solitary fibrous tumor occurring at unusual sites: A clinico-pathological series of 31 cases with emphasis on its wide morphological spectrum. Pathol Res Pract 2024; 255:155207. [PMID: 38394808 DOI: 10.1016/j.prp.2024.155207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/27/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
Solitary fibrous tumor (SFT) is a relatively rare mesenchymal fibroblastic tumor occurring most commonly in adults with no gender predilection. Although the pathological diagnosis of SFT is usually straightforward, some difficulties may occasionally arise mainly due to the wide morphological spectrum exhibited by this tumor. In the present paper we aimed to evaluate the unusual clinicopathological features in a series of 31 SFTs arising from parenchymal organs, superficial soft tissues and deep soft tissues. Our results emphasize that SFTs may occur anywhere, including unusual sites such as periosteum of the thoracic spine, mesorectal tissue, hepatic hilum, paravescial space, kidney and breast. Moreover, a wide morphological spectrum was observed in tumors included in our series. The most striking morphological features observed included: extensive lipomatous component, myxoid stromal changes, epithelioid cell component, metaplastic mature bone, neurofibroma-like, myxofibrosarcoma-like and pseudoalveolar-like areas. Additionally, multinucleated giant cells and sarcomatous dedifferentiation were also identified. Our paper emphasizes that SFT may occur in unusual anatomical locations and exhibits a wide morphological spectrum. Pathologists must be aware of these features to avoid confusion with other benign and malignant neoplasms that may show overlapping morphological features.
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Affiliation(s)
- Giuseppe Angelico
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Lucia Salvatorelli
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giada Maria Vecchio
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Manuel Mazzucchelli
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Giovanni Nunzio Rosano
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Simone Poidomani
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy
| | - Gaetano Giuseppe Magro
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, 95123 Catania, Italy.
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Shaji SA, E G A, Bahuleyan B, Noushad F, Vincent SJ, Suresh A, Radhakrishnan A. SREDA: An Uncommon and Misleading EEG Rhythm. Neurodiagn J 2023; 63:245-251. [PMID: 37819725 DOI: 10.1080/21646821.2023.2249773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/16/2023] [Indexed: 10/13/2023]
Abstract
Subclinical Rhythmic Electroencephalographic Discharges of Adults (SREDA) is a benign EEG variant characterized by sharply contoured rhythmic theta activity occurring bilaterally with maximum activity over the parietal or the posterior head region. These paroxysms are not associated with any objective or subjective clinical manifestations. SREDA, the rarest and last reported benign EEG pattern with no known clinical significance yet, is detailed in this case report. We provide the case of a gentleman with epilepsy who underwent vEEG recording in our lab. The described case is interesting due to its EEG characteristics as well as its clinical picture, which misled us for at least a while. It provides an illustration of how over interpretation of normal EEG patterns may result in an incorrect diagnosis.
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Affiliation(s)
- Sheba Anna Shaji
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
| | - Aparna E G
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
| | - Biji Bahuleyan
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
| | - Fathima Noushad
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
| | - Sanu J Vincent
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
| | - Aswathy Suresh
- Comprehensive Epilepsy Care Center Medical Trust Hospital Ernakulam, India
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Zhou R, Zhang H, He S, Li Y, Xu G, Huang J, Wang H, Wang Q, Li B, Wang X, Chen N, Li F, Li X, Liu M, Peng D. A Study of Individualized Diagnosis and Treatment for Depression with Atypical Features (iDoT-AFD): study protocol for a randomized clinical trial and prognosis study. Trials 2023; 24:308. [PMID: 37143128 PMCID: PMC10161548 DOI: 10.1186/s13063-023-07317-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) with atypical features, namely depression with atypical features (AFD), is one of the most common clinical specifiers of MDD, closely associated with bipolar disorder (BD). However, there is still a lack of clinical guidelines for the diagnosis, treatment, and prognosis of AFD. Our study mainly focuses on three issues about how to identify AFD, what is the appropriate individualized treatment for AFD, and what are the predictive biomarkers of conversion to BD. METHODS The Study of Individualized Diagnosis and Treatment for Depression with Atypical Features (iDoT-AFD) is a multicenter, prospective, open-label study consisting of a 12-week randomized controlled trial (RCT) and a continued follow-up until 4 years or reaching the study endpoint. It is enrolling 480 patients with AFD (120 per treatment arm), 100 patients with BD, and 100 healthy controls (HC). Multivariate dimension information is collected including clinical features, cognitive function, kynurenine pathway metabolomics, and multimodal magnetic resonance imaging (MRI) data. Firstly, multivariate informatics analyses are performed to recognize patients with AFD from participants including the first-episode and recurrent atypical depression, patients with BD, and patients with HC. Secondly, patients with atypical depression are randomly allocated to one of the four treatment groups including "single application of selective serotonin reuptake inhibitor (SSRI) or serotonin-noradrenaline reuptake inhibitor (SNRI)", "SSRI/SNRI combined with mood stabilizer," "SSRI/SNRI combined with quetiapine (≥ 150 mg/day)," or "treatment as usual (TAU)" and then followed up 12 weeks to find out the optimized treatment strategies. Thirdly, patients with atypical depression are followed up until 4 years or switching to BD, to explore the risk factors of conversion from atypical depression to BD and eventually build the risk warning model of conversion to BD. DISCUSSION The first enrolment was in August 2019. The iDoT-AFD study explores the clinical and biological markers for the diagnosis, treatment, and prognosis of AFD and further provides evidence for clinical guidelines of AFD. TRIAL REGISTRATION ClinicalTrials.gov NCT04209166. Registered on December 19, 2019.
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Affiliation(s)
- Rubai Zhou
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, China
| | - Shen He
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Guiyun Xu
- Department of Affective Disorders, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinsong Huang
- Dalian Seventh People's Hospital, Dalian, Liaoning, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Qian Wang
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| | - Biao Li
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | | | - Ningning Chen
- Department of Affective Disorders, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fang Li
- Dalian Seventh People's Hospital, Dalian, Liaoning, China
| | - Xiaosa Li
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Mengjun Liu
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, China.
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Shi Y, Peng D, Zhang C, Mellor D, Wang H, Fang Y, Wu Z. Characteristics and symptomatology of major depressive disorder with atypical features from symptom to syndromal level. J Affect Disord 2023; 333:249-256. [PMID: 37086803 DOI: 10.1016/j.jad.2023.04.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE To explore clinical characteristics and symptomatology of major depressive disorder (MDD) with atypical features based on DSM criteria or only reversed vegetative symptoms. METHOD A total of 3187 patients who met DSM-IV TR criteria for MDD were enrolled. Demographics and symptomatology covering multiple symptom domains were assessed and compared between three groups of cases: those who met DSM criteria for atypical specifier (the DAD group), those who had at least one reversed vegetative symptoms (hypersomnia or hyperphagia) (the SAD group) without meeting DSM atypical specifier criteria, and those without any reversed vegetative symptoms (the NAD group). RESULTS The DAD and SAD group accounted for 4.4 % and 14.4 % of the participants, respectively. The DAD cases were characterized by a highest proportion of hospitalizations, longest duration of current episode and worst quality of life. The DAD and SAD cases were more likely to adopt unhealthy behaviors (smoking and alcohol drinking). Most depressive symptoms related to higher illness severity and treatment resistance were more frequent in the DAD cases, followed by the SAD cases, and least frequent in the NAD cases. LIMITATIONS A cross-sectional design and a non-validated questionnaire were used. CONCLUSIONS The findings support the role of DSM defined atypical depression as a valid MDD subtype and provide evidence for clinical utility of the simplified approach of defining atypical features based on only reversed vegetative symptoms. This has implications for illness screening, public health, suicide prevention and better treatment planning for depressed individuals with atypical features even below syndromal level.
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Affiliation(s)
- Yifan Shi
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yiru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
| | - Zhiguo Wu
- Shanghai Yangpu District Mental Health Center, Shanghai, China; Clinical Research Centre in Mental Health, Shanghai University of Medicine & Health Sciences, China.
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Jose P, Rajan N, Kommu PPK, Krishnan L. Dengue and scrub typhus co-infection in children: Experience of a teaching hospital in an endemic area. Indian J Public Health 2022; 66:292-294. [PMID: 36149107 DOI: 10.4103/ijph.ijph_2052_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Dengue fever and scrub typhus are considered an endemic disease in the Indian subcontinent. The epidemiology and clinical presentations are complex and vary each year. Objective The objective of this study was to estimate the prevalence of coinfection with scrub typhus in children diagnosed with dengue fever. Methods A retrospective hospital-based, cross-sectional study was done in the Department of Pediatrics of a teaching hospital in Puducherry. All children (0-14 years) who had enzyme-linked immunosorbent assay (ELISA) reported scrub typhus among those diagnosed with dengue fever (NS1Ag or immunoglobulin M ELISA positivity) during 2012-2016. Medical records with incomplete data were excluded from the study. Odds ratio was calculated to find out the association of coinfections. An independent t-test was used to find out the statistical significance. P < 0.05 was considered statistically significant. Results Atypical features of dengue were present in 250/318 (78.6%) children. Coinfections were seen in 62/318 (19.4%) children. Scrub typhus was the most common (n = 51/62, 82.2%). The chance of scrub typhus in a dengue serology-positive child is significant when the symptoms are atypical or protracted (OR- 2.6, P = 0.033). Conclusion High index of suspicion should be present in endemic dengue and scrub typhus coinfection.
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Affiliation(s)
- Priya Jose
- Associate Professor, Department of Paediatrics, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Nishanth Rajan
- Associate Professor, Department of Paediatrics, Pondicherry Institute of Medical Sciences, Puducherry, India
| | | | - Lalitha Krishnan
- Professor and HOD, Department of Paediatrics, Pondicherry Institute of Medical Sciences, Puducherry, India
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Abstract
Pilomatrixoma is an uncommon, benign tumor with differentiation towards both the hair matrix and cells arising in the cortex, most frequently appearing in the first or second decade of life. In rare instances, pilomatrixomas can show malignant transformation. Pilomatrix carcinoma is extremely uncommon and has traditionally been considered a tumor of low malignant potential; however, a high local recurrence rate has been reported. There is a paucity of literature on these lesions, with only a few reports describing the spectrum of malignant changes seen in these lesions. In this case report, we present a case of pilomatrixoma in an adult patient showing atypical features. While the tumor is small, there are focal features that suggest progression to malignancy, but do not fulfill the criteria for pilomatrix carcinoma. These focal atypical features include a focal infiltrative pattern at the periphery, with a variable cytological atypia and an increased mitotic rate, up to five mitotic events/high-power field. Irregular foci of central necrosis (comedonecrosis) were present in several lobules. Some of the features identified were similar to a subset of pilomatrixoma, known as “proliferating pilomatrixoma.” However, our case did not have the diffuse changes or larger size that has been frequently reported in “proliferating pilomatrixoma.” In conclusion, given the lack of focality of the changes, the lesion in our case is best described as a pilomatricoma with atypical features. Furthermore, our case may highlight the need to ensure close clinical follow-up for these lesions with unexpected atypical features that raise concern of recurrence and malignant transformation.
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Affiliation(s)
- Meina Missak
- Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Aaron Haig
- Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Manal Gabril
- Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Alturkustani M, Li D, Byers JT, Szymanski L, Parham DM, Shi W, Wang LL. Histopathologic features of alveolar capillary dysplasia with misalignment of pulmonary veins with atypical clinical presentation. Cardiovasc Pathol 2020; 50:107289. [PMID: 32949727 DOI: 10.1016/j.carpath.2020.107289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022] Open
Abstract
Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare neonatal lung disease with fatal outcome. Typically, respiratory symptoms present in the first 24 hours of life and patients die within the neonatal period. Atypical, delayed clinical presentations and/or longer survival have also been reported. Here, we studied the clinicopathologic relationship of ACD/MPV by examining 16 cases of ACD/MPV, focusing on atypical features. Based on the presence of diffuse vs. focal/patchy ACD/MPV histopathologic changes, we divided the cases into classic and nonclassic pathology groups. MPV was found in all ACD/MPV. Ten of 16 cases exhibited classic diffuse abnormalities, while 6 of 16 had a nonclassic focal/patchy distribution. However, among 7 patients with atypical clinical features, only 2 had nonclassic pathology, while 4 out of 9 clinically typical cases had nonclassic ACD/MPV pathology. Marked intrapulmonary aberrant arteriovenous vessels were present in all atypical cases. In conclusion, clinical presentation is not always correlated with histopathology in ACD/MPV. Atypical ACD/MPV should be suspected in any infants with fulminant pulmonary hypertension. Abnormal pulmonary veins and aberrant intraseptal vessels are the most important clues for diagnosis. Additional studies are needed for further elucidation of diagnostic histological criteria of atypical ACD/MPV and to explore its pathogenesis.
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Affiliation(s)
- Murad Alturkustani
- Department of Pathology and Laboratory medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Duo Li
- Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joshua T Byers
- Department of Pathology and Laboratory medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Linda Szymanski
- Department of Pathology and Laboratory medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - David M Parham
- Department of Pathology and Laboratory medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Wei Shi
- Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Larry L Wang
- Department of Pathology and Laboratory medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
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Shin C, Ko YH, Shim SH, Kim JS, Na KS, Hahn SW, Lee SH. Efficacy of Buspirone Augmentation of Escitalopram in Patients with Major Depressive Disorder with and without Atypical Features: A Randomized, 8 Week, Multicenter, Open-Label Clinical Trial. Psychiatry Investig 2020; 17:796-803. [PMID: 32750760 PMCID: PMC7449841 DOI: 10.30773/pi.2020.0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/02/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study investigated the treatment response and cognitive enhancement effects of buspirone augmentation of escitalopram in patients with major depressive disorder (MDD), according to atypical feature subtypes of MDD. METHODS An 8 week, randomized, parallel-controlled, open-label study was conducted. The Columbia Atypical Depression Diagnostic Scale was administered to evaluate atypical features. Patients were assigned randomly to the buspirone augmentation or non-buspirone groups. Symptom severity and cognitive function were evaluated using the 17-item Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Beck Depression Inventory, Beck Anxiety Inventory, digit span test, word fluency test, and Trail Making Tests A and B. RESULTS A total of 89 patients were recruited. There were no significant differences in the measures between the groups; however, among the MDD patients without atypical features, the digit span and word fluency tests were improved by treatment. In the MDD patients without atypical features, the buspirone augmentation group showed a significant improvement on the digit span test compared to the non-buspirone group. CONCLUSION Buspirone augmentation did not demonstrate significant benefits in MDD patients; however, buspirone augmentation showed greater efficacy for the improvement of cognitive function in MDD patients without atypical features. Our study suggests that atypical features are an important factor for cognitive enhancement in buspirone augmentation treatment in patients with MDD.
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Affiliation(s)
- Cheolmin Shin
- Department of Psychiatry, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Sang-Woo Hahn
- Department of Psychiatry, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.,Clinical Emotion and Cognition Research Laboratory, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
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Abstract
Charles Bonnet Syndrome (CBS) is a common cause of visual hallucinations seen in elderly people with visual impairment. Well-formed visual hallucinations in clear consciousness with preserved insight are commonly reported in literature. We report a case of CBS having multisensory hallucinations. An elderly patient with visual impairment fulfilling the criteria of CBS presents with various modalities of hallucinations viz. visual, auditory and tactile hallucinations improved completely with low dose of antipsychotics. Atypical features are common in CBS and thus often make it difficult to diagnose this condition.
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Affiliation(s)
- Sukanto Sarkar
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Eswaran Subramanium
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Kirti Nath Jha
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Ohayon MM, Roberts LW. Challenging the validity of the association between oversleeping and overeating in atypical depression. J Psychosom Res 2015; 78:52-7. [PMID: 25450239 DOI: 10.1016/j.jpsychores.2014.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 09/12/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE In this study, we used a strict definition of hypersomnia and tested if the association between overeating-hypersomnia remained positive and significant. Hypersomnia was present if the total sleep time was close to 10h per day or was at least 2h longer than in normothymic periods. METHODS Cross-sectional study using the adult general population of California and New York. The sample was composed of 6694 individuals aged between 18 and 96years. Participants were interviewed by telephone using the Sleep-EVAL system. The interviews included various sleep and health topics and the assessment of DSM-IV sleep and psychiatric disorders. RESULTS The one-month prevalence of major depressive episode was 6.1%, including a one-month prevalence of atypical depression of 1.6%, in this sample. Atypical depression subjects had a greater number of depressive symptoms and a longer duration of the current depressive episode than the other depressive subjects. Depressive subjects with hypersomnia slept longer (8h, 29min) than the other depressive subjects (6h, 36min) and longer than the subjects "getting too much sleep" (6h, 48min). Furthermore, hypersomnia was not associated with overeating while "getting too much sleep" showed a positive association with overeating. CONCLUSIONS Hypersomnia needs to be evaluated using a strict definition. Otherwise, it leads to an overestimation of this symptom in major depressive episode subjects and to a false association with overeating.
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Affiliation(s)
- Maurice M Ohayon
- Chief of the Division of Public Mental Health and Population Sciences, Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.
| | - Laura Weiss Roberts
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.
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