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Mood and Anxiety Disorders
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Tricia L. Chandler, Fredrick Dombrowski
While children, adolescents, and adults can develop depression, major depressive disorder has been thought to occur more often as a first episode in adolescents, with 15% to 20% of teens developing MDD, and 10% to 20% of adolescents will additionally develop lower levels of depressive symptoms, even if these are not clinically identified (Avenevoli et al., 2008; Lewinsohn & Essau, 2002). PDD often begins in adolescence as well, with 50% of those beginning prior to age 21 (Klein et al., 2006; Klein, 2010). PDD is quite common, with statistics suggesting between 2.5% and 6% of the population has the disorder (Kessler et al., 2005c). Due to its chronic nature, PDD can lead to poor outcomes for recovery (Klein, 2010). The lifetime prevalence of developing MDD is 17% of the population (Kessler et al., 2003, 2005c, 2007). Females are twice as likely as males to develop depressive symptoms, and these disorders seem to be the most prevalent from adolescence to elder years (Hasin et al., 2005; Nolan-Hoeksema & Hilt, 2009; Nolen-Hoeksema, 2012).
Movement disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Dementia occurs more commonly in people with PD than age-matched control subjects. It has been estimated that around 75% of people with PD will eventually develop some degree of cognitive impairment and it has been detected in two-thirds of people with PD after a mean time of 3.5 years from diagnosis.24,25 People with early hallucinations or an akinetic-rigid or symmetrical onset pattern are at an elevated risk.24 These latter features are often seen in dementia with Lewy bodies (DLB) and suggest a common mechanism. The major distinction between PD dementia (PDD) and DLB is the timing of onset of symptoms. In the latter condition, motor and cognitive features must occur within one year of each other to meet diagnostic criteria (see page 186). The PDD pattern of cognitive deficit is very similar to that of DLB.26 Both PDD and DLB are associated with Lewy bodies in the cerebral cortex. They appear to be differing presentations of the same pathological process and are sometimes grouped together under the label ‘Lewy body dementias'. Given the older age of most people with PD and the prevalence of AD (see page 105) in this age group, it is reasonable to assume that a number of people diagnosed with PDD will have AD-type cerebral pathology. An autopsy study found AD pathology in the brains of 33% of people with PD.27 Conditions such as PSP (see page 188) may also be misdiagnosed as PDD.
Radiotherapy Physics
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
Andrea Wynn-Jones, Caroline Reddy, John Gittins, Philip Baker, Anna Mason, Greg Jolliffe
Most radiotherapy treatments are delivered using external beam MV X-rays, although electron beams and kV energy X-rays are also used for treating superficial tumours. The choice of treatment modality depends on the position of the target in the patient, guided by considering how the energy of the radiation beam needs to be deposited. Typically, 6–10 MV photons are used for deep-seated tumours as these will give the required penetration depth and acceptable surface dose. A fundamental property of MV beams is that the position of maximum dose occurs a few centimetres below the surface, with the actual depth dependent on the nominal beam energy. In terms of treatment, this is termed the skin sparing effect. The skin sparing effect is beneficial as it can reduce the effect of radiation beam entry in skin tissue. If skin dose is not controlled, reactions of the skin to radiation can be so severe that the patient’s treatment must be paused for the skin to recover. Measurement of Percentage Depth Dose (PDD) curves provides a means of quantifying the position of the maximum dose in water. As a Clinical Scientist, you may be involved with explaining PDD measurements to other staff groups to help with treatment modality and energy choice for a given clinical situation.
Treatment for cognitive and neuropsychiatric non-motor symptoms in Parkinson’s disease: current evidence and future perspectives
Published in Expert Review of Neurotherapeutics, 2023
Elisa Mantovani, Chiara Zucchella, Andreas A. Argyriou, Stefano Tamburin
PD-MCI is a risk factor for the development of PD-dementia (PDD) [42,50,51,56], which is characterized by multidomain cognitive impairment severe enough to compromise ADLs [57]. Behavioral symptoms such as apathy, changes in personality and mood, hallucinations, delusions, and excessive daytime sleepiness may be associated, but are not required for PDD diagnosis. The prevalence of PDD increases from 17% at 5 years after diagnosis [58] to 46% at 10 years, and 83% at 20 years [59–61]. PDD is associated with high morbidity and mortality, and anticipating death by 4 years on average [62]. Cognitive changes in PDD have been linked to the dysfunction of multiple neurotransmitter systems, i.e., dopaminergic, serotoninergic, noradrenergic, cholinergic, and glutamatergic system [63] (Table 1).
Staging of cognitive impairment in Parkinson’s disease: validity of Quick Dementia Rating System
Published in Disability and Rehabilitation, 2022
Aysan Mahmoudi Asl, Maryam Mehdizadeh, Parvin Raeesi Roudbari, Hajar Mehdizadeh, Seyed-Amirhasan Habibi, Javad Niazi Khatoon, Ghorban Taghizadeh
Parkinson’s disease (PD) is the second most common neurodegenerative disorder following Alzheimer’s disease. Cognitive impairment is a common clinical complication in the course of PD [1,2], which is associated with increased burden on caregivers, decreased quality of life, increased risk of institutionalization, and enhanced mortality rate [3]. It ranges from PD mild cognitive impairment (PD-MCI) to PD dementia (PDD) [2]. PD-MCI, a risk factor for developing dementia, is a heterogeneous condition affecting different domains of cognition but not the daily function of the patients. However, PDD is severe enough to affect working or social functions [4–6] and it is an important factor for decreased life expectancy in these patients [7]. Therefore, cognitive evaluation and screening is an essential component of assessing PD patients in both clinical and research settings.
Initial support for a behavioral skills training package with computer-based instruction to teach conversation skills to adults with autism spectrum disorders, with an assessment of socially meaningful behavior change
Published in Evidence-Based Communication Assessment and Intervention, 2021
Nicole C. Groskreutz, Mark P. Groskreutz
Participants: The experimenters recruited five adults aged 17–33 years by sending study information to organizations supporting adults with developmental disabilities. All participants had a diagnosis of autism, Asperger’s syndrome, or Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). Participants needed to express an interest in improving conversation skills. In addition, during one-on-one meetings, experimenters assessed participant communication skills to verify the length of utterance and identify potential target behaviors (i.e. appropriate communication excesses and/or deficits). For inclusion, participants were required (a) to use at least four-word responses to common social questions or interaction topics and (b) to have at least three potential target behaviors. The authors noted that they limited target behaviors to those that “would not require the [conversational] peer to present an evocative situation” (p. 316). That is, behaviors targeted for intervention were those such as “physical proximity” and “distracting nonvocal behavior” that did not rely on the conversation partner doing something specific for the behavior to occur in response to. This was done to allow for conversation practice sessions to occur with other study participants in addition to “neurotypical (NT)” peers.