China
Africa
Explore chapters and articles related to this topic
Depression
Published in Henry J. Woodford, Essential Geriatrics, 2022
Psychotic depression refers to the association of depression with delusions, paranoia and/or auditory hallucinations. Delusions may be mood-congruent (inadequacy, guilt, nihilism) or incongruent (non-depressive themes). This seems to occur more commonly in older people.4 Such people are at an increased risk of self-harm. They should be managed by specialists and may require a combination of antidepressant and antipsychotic medications, or electroconvulsive therapy (ECT).
Diseases of the Nervous System
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
Lithium therapy of manic patients cautions the association of water changes with the disease process.94 Total body water and intracellular water are increased by lithium. Total body potassium is elevated in manic patients and reduced in depressed patients during lithium therapy. Electrolyte shifts occur in adrenocortical insufficiency as well as in hyperactivity; therefore, the changes in water and mineral metabolism in affective disorders may represent changes of adrenocortical activity in these diseases. This relationship has been further confirmed by the investigations of 17-hydroxycorticosteroid excretion in depressed patients. Several patients who attempted or committed suicide showed significantly higher corticoid excretion than other depressed patients, particularly during the last week before suicide. Patients with psychotic depression produce increased quantities of cortisol during illness; these high levels return to normal during recovery. Psychotic depression is associated with increased serum and urine levels of 17-hydroxycorticosteroids, whereas these are normal in reactive depression. The role of a depressor substance was suggested a long time ago,205 and the participating of the acetylcholine system was also raised.310 Mineral metabolism is controlled by the regulatory action of hormones from the adrenal cortex and posterior pituitary and with the autonomic centers in the diencephalon. This suggests that changes in mineral metabolism are linked with neurotransmitter amines. Norepinephrine is also associated with depressive reactions.98
Depression
Published in Jane Higgs, Gill Wakley, Ruth Chambers, Clare Gerada, Demonstrating your Clinical Competence in Depression, Dementia, Alcoholism, Palliative Care and Osteoporosis, 2018
Jane Higgs, Gill Wakley, Ruth Chambers, Clare Gerada
About half the people who have major depression experience a further depressive episode in the following 10 years. Mild to moderate depression: sufferers have depressive symptoms and some functional impairment. Many recover in the short term, and about half have recurrent symptoms.Severe depression: sufferers have depressive symptoms plus agitation or psychomotor retardation and somatic symptoms. Common unexplained somatic complaints can include: headaches, chest pains, difficulty in breathing, difficulty in swallowing, nausea, vomiting, abdominal pain, lower back pain, skin rashes, frequent urination, diarrhoea, skin and muscle discomfort.Psychotic depression: sufferers have hallucinations, delusions or both in addition to their depressive symptoms.
Integrating Loss and Processing Grief in Psychotherapy of Psychosis
Published in Psychiatry, 2023
Jeremy M. Ridenour, Jay A. Hamm, Courtney N. Wiesepape, Paul H. Lysaker
Future studies might consider how integrating the experience of loss and processing of grief for persons who have suffered an initial psychotic episode and for those who have accumulated more loss through the experience of chronic psychosis might increase the person’s metacognitive ability and capacity to regulate emotions. Treatment that explicitly addresses grief and loss for persons suffering from an initial psychotic episode might also explore whether this intervention might decrease the likelihood of post-psychotic depression (Guerrero-Jiménez et al., 2022). Other targeted outcomes could include researching how processing grief might allow for people to accept their need for medication and thus improve medication adherence (Buchman-Wildbaum et al., 2020). Some persons with psychosis who cannot face and grieve the reality of their symptoms are also unable to truly accept their need to take medications that can cause unwanted side effects. Finally, given that grief and loss are universal to the human experience, attending to these issues might be one way for both therapist and patient to combat the pervasive stigma that has been frequently overlooked for people experiencing psychosis. It is an open empirical question whether receiving therapy focused on grief and loss would contribute to lower levels of internalized stigma, which are particularly high in samples of people diagnosed with schizophrenia (Burke et al., 2016).
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2021
David A. Bellows, Noel C.Y. Chan, John J. Chen, Hui-Chen Cheng, Peter W. MacIntosh, Jenny A. Nij Bijvank, Michael S. Vaphiades, Sui H. Wong, Xiaojun Zhang
Clinical lycanthropy is one of the delusional misidentification syndromes, which are characterised by patients misidentifying a person, place, or object, and also include Capgras syndrome, Fregoli syndrome, reduplicative paramnesia, and intermetamorphosis. Clinical lycanthropy is a syndrome in which the patient has the delusional belief of turning into a wolf. Lesions localised in the right hemisphere and frontal lobe are reported in lesion-related delusional misidentification syndromes, but wider networks may be involved. The authors report a 12-year-old pubescent adolescent born in France, who exhibited delusional ideas of wolf metamorphosis. He often heard werewolves telling him to ‘join the pack’. He often looked at himself in the mirror, believing that his eyes had changed colour and his teeth had lengthened. His mother had discovered deliberately torn trousers. The authors conducted a review on PubMed of cases of lycanthropy and cyanthropy (dog transformation) of adolescents aged younger than 20 years. They detected four patients ages 17–19. Diagnoses reported were schizophrenia, psychotic depression, and mania. It had not been previously reported as occurring during early adolescence.
Clinical features and predictors of non-response in severe catatonic patients treated with electroconvulsive therapy
Published in International Journal of Psychiatry in Clinical Practice, 2021
Beniamino Tripodi, Margherita Barbuti, Martina Novi, Gianluca Salarpi, Giuseppe Fazzari, Pierpaolo Medda, Giulio Perugi
BDZs are the first-choice treatment for catatonia, with a remission rate of 70–80% (Sienaert et al. 2014). A longer duration of illness, the presence of mutism, and certain symptoms like third-person auditory hallucinations are reported as possible predictors of non-response to BDZ treatment (Ungvari et al. 1999; Narayanaswamy et al. 2012). ECT should be initiated in catatonic patients who are refractory/partially responsive to BDZs; it should also be considered first-line treatment in patients with malignant catatonia, neuroleptic malignant syndrome (NMS), delirious mania or severe catatonic excitement (Bush et al., 1996; Sienaert et al. 2014). If the underlying condition warrants ECT, e.g., psychotic depression, this treatment may become the first therapeutic choice. ECT is an indicated treatment option with regard to mood disorder, particularly for patients with high suicidality and severe drug-resistant depressive, manic or mixed states, but also for patients with delirium or catatonic features (Kennedy et al. 2009; Perugi et al. 2020). ECT is effective in approximately 85% of catatonic patients (Hawkins et al. 1995; Luchini et al. 2015; Leroy et al. 2018), although almost no randomised controlled trails have been conducted on this topic. In seven retrospective reviews of medical records, totalling 222 patients, mostly resistant to BDZs, high response rates to ECT were confirmed (Sienaert et al. 2014). Very few studies have been conducted to address the question of possible predictors of non-response to ECT, especially in patients with catatonia (Raveendranathan et al. 2012).