Why are children and adolescents referred for psychiatric assessment without fulfiling diagnostic criteria for any psychiatric disorder?

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Gyöngyvér Dallos ◽  
Ágnes Keresztény ◽  
Mónika Miklósi ◽  
Júlia Gádoros ◽  
Judit Balázs
Keyword(s):  
Psychiatric Disorder ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Psychiatric Assessment

How often is multiple sclerosis mistaken for a psychiatric disorder?

1988 ◽  
Vol 18 (3) ◽  
pp. 733-736 ◽  
Author(s):  
K. Skegg ◽  
P. A. Corwin ◽  
D. C. G. Skegg
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Diagnostic Criteria ◽  
Diagnostic Error ◽  
Physical Symptoms ◽  
The Other ◽  
Psychiatric Diagnoses ◽  
Psychiatric Disturbance ◽  
Psychiatric Assessment ◽  
Early Symptoms

SynopsisIn a defined population of 112000, an attempt was made to discover every patient with multiple sclerosis. Using strict diagnostic criteria, 91 patients were identified. A search of psychiatric records for the same population revealed that 15 (16%) of these patients were referred to psychiatrists between the onset of their symptoms and the diagnosis of multiple sclerosis. Ten (11 %) were seen with symptoms attributable to multiple sclerosis. These symptoms were recognized as neurological in only two cases, while the other eight patients received a variety of psychiatric diagnoses.Possible reasons for diagnostic error included the subjective nature of many early symptoms, histrionic behaviour, and psychiatric disturbance which drew attention away from physical symptoms. The results underline the caution needed when patients with physical symptoms are referred for psychiatric assessment.

Abstract P088: Obesity, Hypertension and Insulin Resistance in a Primary Pediatric Setting in Southern Italy

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Giampaolo De Filippo ◽  
Domenico Rendina ◽  
Domenico Viggiano ◽  
Antonio Fasolino ◽  
Paola Sabatini ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Southern Italy ◽  
Serum Insulin ◽  
High Density Lipoproteins ◽  
Obese Children ◽  
Campania Region

Background: Obesity is the main risk factor for essential hypertension (EH) in childhood. The O.Si.Me. study (Obesity and Metabolic Syndrome in children and adolescents) evaluated the prevalence of metabolic syndrome (MetS) and its constitutive traits in a sample of obese children and adolescents living in Campania, southern Italy. Patients and methods: Four hundred and fifteen children and adolescents consecutively referred to the National Health Service participating Outpatient Clinics for minor health problems and found to have a Body Mass Index (BMI) Z-score > 2.0 were enrolled in the study. The entire sample was screened for MetS, which was defined as the presence of at least 2 of the following alterations in addition to obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and EH. The present analysis evaluated the clinical characteristics of the O.Si.Me subgroup of EH participants (systolic and/or diastolic BP ≥ 95 th percentile for age, gender and height) as compared with normotensive participants. Results: The prevalence of EH in the O.Si.Me population was 23.6 % (98/415, 48M and 50F.) and two-thirds of the EH participants met the MetS diagnostic criteria. The EH participants featured serum insulin and HOMA-IR levels significantly higher compared with normotensive ones (11.6±0.6 vs. 9.5±0.4 μIU/ml, p = 0.014; 2.6±0.1 vs. 2.2±0.1, p = 0.028 for insulin and HOMA-IR, respectively). These differences were common to boys and girls and remained significant after correction for age, pubertal stage, body weight, length, BMI, gestational age at birth, duration of breastfeeding and anthropometric parental parameters. Accordingly, children and adolescents with EH had a a relative risk of being insulin resistant (defined as a HOMA-IR ≥2.5) significantly greater compared to those without. Moreover, they exhibited higher serum creatinine levels (53.8±7.1 vs. 35.4±6.8 μmol/l, p=0.025) accounting for gender and body weight. Conclusions: More than a quarter of obese children and adolescents meet the diagnostic criteria for EH in the Campania region in southern Italy. These obese boys and girls have an increased prevalence of insulin resistance and apparently an initial reduction in renal function compared with obese children and adolescents with normal BP.

scholarly journals METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS. DEFINITION. DIAGNOSTIC CRITERIA

2016 ◽  
pp. 103-109 ◽  
Author(s):  
I. N. Zakharova ◽  
S. I. Malyavskaya ◽  
T. M. Tvorogova ◽  
S. V. Vasilieva ◽  
Y. A. Dmitrieva ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Diagnostic Criteria

Psychiatric Assessment of Children and Adolescents

2011 ◽  
pp. 206-214
Author(s):  
Harriet L. Macmillan ◽  
Jan E. Fleming ◽  
Ellen Jamieson
Keyword(s):  
Children And Adolescents ◽  
Psychiatric Assessment

scholarly journals ICTs Supportive and Therapeutic Contribution in Psychoemotional Disorders in Childhood and Adolescence

2018 ◽  
Vol 6 (2) ◽  
pp. 69
Author(s):  
Lizeta N. Bakola ◽  
Nikolaos D. Rizos ◽  
Athanasios S. Drigas
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Mental Illnesses ◽  
Childhood And Adolescence ◽  
School Aged Children ◽  
Clinically Significant ◽  
Made In ◽  
Normative Variation

<p>This paper aims at reviewing the supportive and therapeutic contribution of ICTs on the most common psychoemotional disorders of childhood and adolescence. The various approaches to classifying behavioral and emotional dysregulations in children and adolescents have been reviewed and the boundaries between normative variation and clinically significant presentations have been determined. Furthermore, we present the major categories of mental illnesses in children and adolescents investigating the etiology, the diagnostic criteria, the epidemiology and treatments by critically reviewing the outcomes of relevant studies. The findings indicate that significant steps have been made in this field, but it is vital to underline the need for more extended investigation in school aged children and adolescents for this purpose.</p>

Diversion from Custody. I: Psychiatric Assessment at the Magistrates' Court

1993 ◽  
Vol 162 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Philip L. A. Joseph ◽  
Mark Potter
Keyword(s):  
Psychiatric Disorder ◽  
Hospital Admission ◽  
Patient Treatment ◽  
Initial Assessment ◽  
Psychiatric Assessment ◽  
Mentally Disordered ◽  
The Mean

The homeless mentally disordered defendant facing minor charges poses considerable problems regarding appropriate disposal. Psychiatric assessment may be required in order to facilitate the court's decision, but this is often available only after remand in custody. A psychiatric assessment service based at two inner-London magistrates' courts is described. Over 18 months, 201 defendants were referred. They were predominantly male, single, and of no fixed abode, suffering from serious psychiatric disorder; these defendants had often received previous in-patient treatment, frequently as detained patients. They typically were recidivists charged with minor offences. Following initial assessment, 25% were admitted to hospital, 50% were released, and 25% returned to custody. The Crown Prosecution Service discontinued 29% of cases. For those admitted directly to hospital, the mean (s.d.) time from arrest to hospital admission was 5.8 (6.8) days, significantly quicker than with prison-based assessments.

scholarly journals COMPARISON OF DIFFERENT CRITERIA IN THE PREVALENCE OF METABOLIC SYNDROME IN STUDENTS FROM PARANAVAÍ, PARANÁ

2019 ◽  
Vol 37 (3) ◽  
pp. 332-337 ◽  
Author(s):  
Flávio Ricardo Guilherme ◽  
Matheus Amarante do Nascimento ◽  
Carlos Alexandre Molena-Fernandes ◽  
Vânia Renata Guilherme ◽  
Stevan Ricardo dos Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Public And Private ◽  
Significant Difference ◽  
Low Hdl ◽  
The Difference

ABSTRACT Objective: To investigate the difference in the proportion of students with metabolic syndrome, diagnosed according to different criteria. Methods: The sample consisted of 241 students (136 boys and 105 girls) aged 10 to 14 years, from public and private schools in Paranavaí, Paraná. We used three distinct diagnostic criteria for metabolic syndrome, considering the presence of at least three of the following risk factors: increased waist circumference, hypertension, fasting hyperglycemia, low HDL-C, and elevated triglycerides. Results: The prevalence of metabolic syndrome found was 1.7% (confidence interval of 95% - 95%CI 0-3.3) for the IDF criterion; 3.3% (95%CI 1.0-5.6) for Cook; and 17.4% (95%CI 12.6-22.3) for Ferranti. Analyzing the criteria in pairs, the agreement between IDF and Cook was 97.5% (k=0.95); between IDF and Ferranti, 83.4% (k=0.67); and between Cook and Ferranti, 85.9% (k=0.72). Onlyone student (0.4%) was diagnosed with metabolic syndrome solely by the IDF criterion, while 34 (14.1%) were diagnosed exclusively by Ferranti. The comparison of the three criteria showed that Ferranti presented the highest proportion of metabolic syndrome (p<0.001), and Cook had a greater proportion than IDF (p<0.001). Conclusions: We found a significant difference in the proportion of metabolic syndrome in the three criteria. The choice of which criterion to use can compromise not only the percentage of metabolic syndrome prevalence but also interfere in strategies of intervention and prevention in children and adolescents with and without metabolic syndrome, respectively.

Multiple sclerosis presenting as a pure psychiatric disorder

1993 ◽  
Vol 23 (4) ◽  
pp. 909-914 ◽  
Author(s):  
Keren Skegg
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Diagnostic Criteria ◽  
Large Population ◽  
Population Based ◽  
Population Based Study ◽  
Mental Symptoms

SynopsisUsing strict diagnostic criteria, 91 patients with multiple sclerosis (MS) were identified in a defined population of 112000. Of these patients, 29 were found to have been referred to a psychiatrist at least once. Their psychiatric records were searched for cases of MS presenting as a pure psychiatric disorder. Only 18 of the 30 psychiatric referrals before the diagnosis of MS involved purely mental symptoms, and there was no reason to suppose most of them to be related to MS. This study highlighted the problem of how to define a true psychiatric presentation of MS. The uncovering of two likely candidates among a population-based sample of 91 supported the existence of such a phenomenon, but it was concluded that the only way to ascertain how often purely mental symptoms might be the first manifestation of MS would be to conduct a large population-based study with controls.

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