Psychiatry Commons^™

Mental Health Or Cardiac Health. Is There A Reason To Choose? Cardiac Arrhythmias Induced By Atomoxetine And Methylphenidate, Gabriel Cismaru, Viorel Lupu

Journal of Mind and Medical Sciences

The current treatment of Attention Deficit Disorder and Attention Deficit with Hyperactivity consists mainly in the administration of Straterra (Atomoxetine) Concerta and Ritalin (Methylphenidate). The FDA warned that the products might increase systolic, diastolic blood pressure, and lead to ventricular arrhythmias. Arrhythmic events and sudden cardiac death were described in adults with preexistent heart disease. However, studies on children have failed to demonstrate a clear association between the arrhythmic events and these drugs, as demonstrated in adults. What should the attitude of the pediatric psychiatrist be towards the administration of these products? What examination should be made by the psychiatrist …

Neuropsychological Symptoms Related To The Covid-19 Pandemic Experienced By The General Population And Particularly By The Healthcare Personnel, Alina Zorina Stroe, Alexandru Floris Stuparu, Silviu Docu Axelerad, Daniel Docu Axelerad, Aurelia Moraru

Journal of Mind and Medical Sciences

Undoubtedly, the outbreak of COVID-19 still represents an overanxious event for both society and population. The fear of getting infected is ubiquitous in the time of the pandemic. The population presented worrying thoughts related to the fact that the health care system was not able to provide enough services during the COVID-19 pandemic. The number of the hospital beds and ventilators was insufficient in order to ensure enough care, considering the increased number of COVID-19 cases that were admitted to the hospitals. Furthermore, people were fearful about the possibility of the global economy becoming decimated. The fright and also the …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

An Innovative Non-Pharmacologic Treatment For Delusional Misidentification In Persons With Major Neurocognitive Disorder, Anne E Adams, Jennifer Rittereiser, Alisha Garcia, Melany Sattler, James M Ellison

Department of Psychiatry and Human Behavior Faculty Papers

Misidentification delusions are false, fixed beliefs that assign an incorrect identity to a previously familiar or unfamiliar person or place. Such delusions are common in several neuropsychiatric disorders and place a particular burden on individuals with Major Neurocognitive Disorder and their caregivers. No standard pharmacologic or non-pharmacologic treatment approaches have been shown to be consistently effective in addressing this problem. We describe two caregiver-care recipient dyads in which an innovative non-pharmacologic, digital intervention reduced delusional misidentification, improved care recipient behavior, and decreased caregiver burden.

Language Tasks And The Network Control Role Of The Left Inferior Frontal Gyrus, John D Medaglia, Denise Y Harvey, Apoorva S Kelkar, Jared P Zimmerman, Joely A Mass, Danielle S Bassett, Roy H Hamilton

Department of Neurology Faculty Papers

Recent work has combined cognitive neuroscience and control theory to make predictions about cognitive control functions. Here, we test a link between whole-brain theories of semantics and the role of the left inferior frontal gyrus (LIFG) in controlled language performance using network control theory (NCT), a branch of systems engineering. Specifically, we examined whether two properties of node controllability, boundary and modal controllability, were linked to semantic selection and retrieval on sentence completion and verb generation tasks. We tested whether the controllability of the left IFG moderated language selection and retrieval costs and the effects of continuous θ burst stimulation …

Valproic Acid Autoinduction: A Case-Based Review, Sean Bennett, Mujeeb U. Shad

School of Medicine Faculty Research

Although valproic acid (VPA) induces the metabolism of multiple other drugs, the clinical reports of VPA autoinduction are rare. A comprehensive literature search yielded only one published case series, which provided the rationale to conduct a review of the published cases along with a new case of VPA autoinduction. Although there may be myriad of reasons for lack of published cases of VPA autoinduction, potential underreporting may be one of the core reasons. Lack of understanding into the highly complex metabolism of VPA may also make it difficult to recognize and report VPA autoinduction. However, it is important to mention …

Cognitive And Behavioral Domains That Reliably Differentiate Normal Aging And Dementia In Down Syndrome, Jordan P. Harp, Lisa M. Koehl, Kathryn L. Van Pelt, Christy L. Hom, Eric Doran, Elizabeth Head, Ira T. Lott, Frederick A. Schmitt

Neurology Faculty Publications

Primary care integration of Down syndrome (DS)-specific dementia screening is strongly advised. The current study employed principal components analysis (PCA) and classification and regression tree (CART) analyses to identify an abbreviated battery for dementia classification. Scale- and subscale-level scores from 141 participants (no dementia n = 68; probable Alzheimer’s disease n = 73), for the Severe Impairment Battery (SIB), Dementia Scale for People with Learning Disabilities (DLD), and Vineland Adaptive Behavior Scales—Second Edition (Vineland-II) were analyzed. Two principle components (PC1, PC2) were identified with the odds of a probable dementia diagnosis increasing 2.54 times per PC1 unit increase and by …

Psychological Problems Among Patients With Chronic Medical Disorders During The Covid-19 Pandemic, Ali Akbar Asadi-Pooya, Seyed Ali Nabavizadeh, Saeid Sadeghian, Mina Shahisavandi, Zohreh Barzegar, Abdullah Nezafat, Nahid Ashjazadeh, Hamed Bazrafshan Drissi, Ali Sahraian

Department of Neurology Faculty Papers

The aim of the current study was to investigate the rates of stress, anxiety, and depression among people in south Iran (a group from the general population without a history of any chronic medical problems, and cohorts of patients were recruited from epilepsy, diabetes, and cardiac disease clinics). We surveyed a sample of people during September 2020: a group of the general population without a history of any chronic medical problems, people with epilepsy, people with diabetes mellitus (DM), and people with cardiac problems. The survey included four general questions and two COVID-19 specific questions [contracting COVID-19, relatives with COVID-19]. …

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Integrating Telepsychiatry Services In A Care Setting In Kenya: A Case Report, Frank Njenga, Linnet Ongeri, Anna Nguithi, Jacqueline Anundo, Maryann Mugane, Zawadi Kimari, Gathoni Mbugua, Cushny Kaigwa, Lukoye Atwoli

Internal Medicine, East Africa

Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa.

Structural Atrophy Of The Right Superior Frontal Gyrus In Adolescents With Severe Irritability, Ji-Woo Seok, Sahil Bajaj, Brigette S. Vaughan, Arica Lerdahl, William Garvey, Alexandra Bohn, Ryan Edwards, Christopher J. Kratochvil, James Blair, Soonjo Hwang

Journal Articles: Psychiatry

Severe irritability is common in youths with psychiatric disorders and results in significant dysfunction across domains (academic, social, and familial). Prior structural MRI studies in the pediatric population demonstrated that aberrations of cortical thickness (CT) and gray matter volume (GMV) in the fronto-striatal-temporal regions which have been associated with irritability. However, the directions of the correlations between structural alteration and irritability in the individual indices were not consistent. Thus, we aim to address this by implementing comprehensive assessments of CT, GMV, and local gyrification index (LGI) simultaneously in youths with severe levels of irritability by voxel-based morphometry and surface-based morphometry. …

Epilepsy In Older People In Sub-Saharan Africa: A Systematic Review, Martha Sajatovic

Faculty Scholarship

Background: Over one-fourth of new onset epilepsy occurs after age 60. However, the burden of epilepsy and other seizure disorders among this special population in Africa is largely unknown, despite a growingnumber of elderly persons on the continent. This study aimed to assess the prevalence and risk factors for epilepsy among persons aged 60 years or older in Africa. Methods: We conducted a systematic review by searching MEDLINE (via) and EMBASE databases from inception to 30th October 2020. Primary researches reporting prevalence or incidence of seizures or epilepsy in older persons (≥60 years) were included. Review articles were excluded. Results: …

Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis

Dissertations

Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.

Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

Mental Disorders Among Health Care Workers At The Early Phase Of Covid-19 Pandemic In Kenya; Findings Of An Online Descriptive Survey, Edith Kamaru Kwobah, Ann Mwangi, Kirtika Patel, Thomas Mwogi, Robert Kiptoo, Lukoye Atwoli

Internal Medicine, East Africa

Background: Healthcare workers responding to the Corona Virus Pandemic (COVID-19) are at risk of mental illness. Data is scanty on the burden of mental disorders among Kenyan healthcare workers responding to the pandemic that can inform mental health and psychosocial support. The purpose of this study was to establish the frequency and associated factors of worry, generalized anxiety disorder, depression, posttraumatic stress disorder and poor quality of sleep among Kenyan health care workers at the beginning of COVID-19 pandemic.

Methods: We conducted an online survey among 1,259 health care workers in Kenya. A researcher developed social demographic questionnaire and several …

Acute Psychosis With Recurrent Neurocysticercosis: A Case Presentation, Nasir F. Siddique, Kristy A. Fisher, Joshua Chang, Clara L. Alvarez Villalba

HCA Healthcare Journal of Medicine

Neurocysticercosis, a parasitic infection of the central nervous system (CNS) caused by the Taenia solium cestode, presents clinically with a large and diverse spectrum of symptomatology, dependent upon lesion number, locale and ensuing inflammatory response. To this date, there are only two documented cases of psychosis presenting in patients with neurocysticercosis, both of which were published in India. This case presentation depicts the first documented case of Psychotic Disorder Due to Another Medical Condition: Neurocysticercosis in the United States. The authors postulate that the atypical presentation of the neuropsychiatric instability with the aberrant recurrence of neurocysticercosis is predominantly attributable to …

Covid-19 And Older Adults With Bipolar Disorder: Problems And Solutions, Martha Sajatovic

Faculty Scholarship

No abstract provided.

Sleeve Gastrectomy Improves Metabolic Syndrome In Psychologically Stable Patients With Schizophrenia, Irene Chen

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Archid R, Archid N, Meile T, Hoffman J, Wulff D, Teufel M, Muthig M, Quante M, Konigsrainer A, Lange J. Patients with schizophrenia do not demonstrate worse outcome after sleeve gastrectomy: a short-term cohort study. Obesity Surgery. 2019;29:506-510. https://doi.org/10.1007/s11695-018-3578-0

for a patient with schizophrenia and obesity.

Impact Of Psychotropic Medications On Electrical Cardiac Conduction In The Emergency Department: A Best Practice Review, Juliann Hatt

Doctor of Nursing Practice Final Manuscripts

Abstract Background: The effects of psychotropic drugs on cardiac repolarization have increasingly gained attention in research and clinical practice over the last 2 decades. The absolute risk of cardiac arrhythmia, such as the polymorphic ventricular tachycardia, Torsades de Pointes (TdP), is low (14 per 10,000 patients/year) and sudden cardiac death as a consequence of all cardiac arrhythmias is less frequent (Braillon et al., 2017). TdP can occur at therapeutic doses of second-generation antipsychotics and antidepressants and with a corrected Q-T (QTc) interval >500 ms. Many psychotropic medications can delay cardiac repolarization thereby producing prolonged QTc in the electrocardiogram (ECG). Emergency …

Predicting Propofol-Induced Burst Suppression Using An Individualized Model-Based Approach Over Repeated Treatments, Jason C. Huang

Utah Space Grant Consortium

Our group is investigating the antidepressant effects of high-dose propofol, but dosing propofol to induce standardized changes in EEG activity (“burst suppression”) is challenging due to limited knowledge of each subject’s pharmacokinetics (PK) and pharmacodynamics (PD). In this paper, we approximated PK-PD models for propofol-induced burst suppression (PIBS), based on multiple subjects over repeated treatments. We then applied these models to predict BSR in each subject’s repeated treatment, then evaluate their predictive performances. We hypothesized that predicting BSR from a greater number of previous treatments would improve performance, but our current results are not conclusive enough to validate the hypothesis. …