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Communication Skills in Palliative Care
Published in Margaret O’Connor, Sanchia Aranda, Susie Wilkinson, Palliative Care Nursing, 2018
Annabel Pollard, Kathleen Swift
Psychological distress in persons with terminal illness is a significant clinical problem. If the concerns of such people remain hidden, distress can be manifested as a more serious affective disorder. Such affective disorders can include a spectrum of depressive, anxiety, adjustment, and grief reactions. Among cancer patients, for example, studies have consistently indicated that about 30% of people experience an affective disorder as a result of diagnosis and/or treatment (Derogatis et al. 1983; Razavi et al. 1990). The risk of developing an affective disorder appears to be positively correlated with the complexity of treatment interventions, adverse side-effects, and various unidentified concerns (Devlen et al. 1987). ‘About 30% of cancer patients experience an affective disorder as a result of diagnosis and/or treatment.’
Mental retardation
Published in Ben Green, Problem-based Psychiatry, 2018
Failing to make the correct diagnosis of a mental illness and attributing abnormal speech and behaviour to the mental retardation itself may lead to a person not receiving the necessary and correct treatment for his or her illness. Drug treatment in this population is just as useful as in any other. The presentation of the illness may be modified by the degree of mental impairment, however. Affective disorders may present in terms of increased or reduced motor activity, rather than specific complaints of sadness or elation. Altered eating and sleeping patterns, sexual indiscretions, mood lability, self-harm and attacks on others may all be signs. Schizophrenia may present with bizarre behaviour, poverty of thought, thought blocking, mannerisms and preoccupation with internal fantasy (although care is needed to distinguish this from normal fantasy). Various organic processes can overlie the original mental retardation. Cognitive decline in a Down’s person must raise the suspicion of a superimposed dementia. Epilepsy (or antiepileptics!) may cause confusional states. Self-harm may be a manifestation of out-of-control phenylketonuria.
Psychiatric Diagnosis: The State of the Art
Published in Mark S. Gold, R. Bruce Lydiard, John S. Carman, Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
Robert Moreines, Irl Extein, Mark S. Gold
The focus of this section will be on two neuroendocrine challenge tests — the DST and the TRH test — which have been shown to be useful markers for major depression and with which our group has considerable experience. We will review and summarize the use of these tests, as well as present some of our own data on these two tests in affective disorders.
Epigenetic modulation: Research progress on histone acetylation levels in major depressive disorders
Published in Journal of Drug Targeting, 2023
Yuan Meng, Juan Du, Ning Liu, Yuanyuan Qiang, Lifei Xiao, Xiaobing Lan, Lin Ma, Jiamei Yang, Jianqiang Yu, Guangyuan Lu
Depression, or depressive disorder, is one of the most severe mental illnesses and a common multi-cause disease. It presents a variety of symptoms and signs, including physical aspects such as sleep disturbance, changes in appetite, fatigue, psychomotor retardation, and agitation, as well as feelings of worthlessness, guilt, inattention, self-harm thoughts, and even suicidal tendencies. The onset, progression, and outcome of depression are all influenced by biological, psychological, and social variables, although the exact aetiology is still unknown. It is characterised by its high morbidity, disability, suicide, and recurrence rates, and is known as the ‘first psychological killer’. Mood or affective disorders refer to a set of clinical symptoms based on depressive mood and self-situation, with depression being their primary symptom. Depression is one of the main global sources of illness burden and a significant public health issue [1]. According to the latest statistics released by the World Health Organisation, more than 300 million people (an estimated 322 million people, 4.4%) have depression worldwide [2, 3], and this number has increased by more than 18% between 2005 and 2015. A recent report from the China Mental Health Survey showed that the lifetime prevalence of depressive disorder in China was approximately 6.9%, and the lifetime prevalence of major depressive disorder was approximately 3.9%, with women being more commonly affected than men (2.5% and 1.7%, respectively) [4].
Perinatal photoperiod associations with diabetes and chronotype prevalence in a cross-sectional study of the UK Biobank
Published in Chronobiology International, 2021
Philip Lewis, Peter Morfeld, Judith Mohren, Martin Hellmich, Thomas C. Erren
In conclusion, this study identifies perinatal photoperiod characteristics associations with DM prevalence and chronotype in a cross-sectional study of the UK Biobank, and it provides further evidence compatible with the validity of the more general PLICCS hypothesis. Adding to this is that potential effect modification of associations with DM by ethnicity and chronotype are observed, which are pertinent to inter-individual variation in the human CTS. If the observations herein are indeed co-determining DM, understanding multifaceted PLICCS effects may become a novel shortcut to changing disease risk – including, but likely not limited to, DM, cancer (Lewis et al. 2020a), and depression (Devore et al. 2018). Subsequently, perinatal photoperiod may turn out to be an important effect modifier of disease risk, which may have to be included as a covariate in other studies of association with various disease endpoints. In time, preventive strategies, similar in method to light treatment against seasonal affective disorder, may be worth researching to improve the health of offspring in later life. Initially, of course, two study lines appear imperative: First, further studies are needed to confirm, and further explore, perinatal photoperiod associations with CTS-associated traits as well as later life health and disease; second, further investigations into the hypothesized circadian imprinting mechanism are warranted.
Glutamatergic dysregulation in mood disorders: opportunities for the discovery of novel drug targets
Published in Expert Opinion on Therapeutic Targets, 2020
Panek Małgorzata, Kawalec Paweł, Malinowska Lipień Iwona, Tomasz Brzostek, Pilc Andrzej
Affective disorders are a group of mental disorders that severely impact mood and its related functions [1]. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published in 2013, the main types of mood disorders include major depressive disorder (MDD), seasonal affective disorder, bipolar I disorder (previously known as manic depression), bipolar II disorder, cyclothymic disorders, disruptive mood dysregulation disorder, persistent depressive disorder, and premenstrual dysphoric disorder. The group also encompasses depression or bipolar disorder (BD) that is caused by the use of medications, drugs or substances or by a medical condition or an illness [2]. Overall, mood disorders can lead to difficulty in keeping up with daily tasks and demands of everyday life. They are one of the most common mental diseases and one of the major causes of disability worldwide [1,3].