scholarly journals Management of Depression Associated with HIV/AIDS and Antiretrovial Therapy

2006 ◽  
Vol 17 (suppl d) ◽  
pp. 5D-9D
Author(s):  
Mark Halman
Keyword(s):  
Major Depression ◽  
Psychiatric Symptoms ◽  
Social Withdrawal ◽  
Case Reports ◽  
Meta Analysis ◽  
Neuropsychiatric Symptoms ◽  
Medical Illness ◽  
Open Label ◽  
Antiretroviral Adherence ◽  
Hiv Aids

Depressed mood is a common psychiatric complaint in persons with HIV/AIDS, with a meta-analysis indicating that the rates of depression within this group may be as high as double that of the general population. Depression may result from a biological diathesis to mood disorders, a physiological reaction to a medical illness or its treatment, and/or a psychological reaction to challenging life circumstances. Associated symptoms include sleep, energy and appetite disturbances; social withdrawal; diminished capacity to experience pleasure; diminished concentration; feelings of worthlessness, shame and guilt; and recurrent thoughts of death, including suicidal ideation. The emotionally and physically painful state of major depression is associated with decreased antiretroviral adherence and poorer HIV/AIDS disease outcomes. Neuropsychiatric symptoms have been reported with several of the medications taken by patients with HIV/AIDS, including lamivudine, zidovudine, interferon and, most notably, efavirenz. However, data from several sources demonstrate that neuropsychiatric symptoms associated with efavirenz use are generally transient, with onset early after treatment initiation, peaking after one week and decreasing over the first one to four months of treatment. Recent comparative studies have not found elevated incident rates of major depression in patients treated with efavirenz, but they have confirmed the typical neuropsychiatric symptoms reported in earlier open-label studies and case reports. Becoming skilled in the management of depression and psychiatric symptoms is integral to the provision of comprehensive care for patients with HIV/AIDS.

scholarly journals Management of Depression and Related Neuropsychiatric Symptoms Associated with HIV/AIDS and Antiretroviral Therapy

2001 ◽  
Vol 12 (suppl c) ◽  
pp. 9C-19C ◽  
Author(s):  
Mark Halman
Keyword(s):  
Antiretroviral Therapy ◽  
Major Depression ◽  
Depressed Mood ◽  
Negative Impact ◽  
Neuropsychiatric Symptoms ◽  
Significant Risk ◽  
Psychiatric Evaluation ◽  
Medical Illness ◽  
Wide Range ◽  
Hiv Aids

Persons with HIV/AIDS may experience a wide range of neuropsychiatric symptoms, including depressed mood, anxiety, irritability, suicidal ideation, agitation and insomnia. These symptoms may be related to psychosocial stressors, biological diathesis to psychiatric syndromes, HIV-related medical illness and/or the medications used in the treatment of HIV/AIDS. Depressed mood is the most common neuropsychiatric complaint in persons with HIV/AIDS seeking psychiatric evaluation. Prevalence rates of major depression in persons with HIV/AIDS have been reported to range between 22% and 45%. Despite the high prevalence, major depression remains underdiagnosed in patients with HIV/AIDS. Depression has a significant impact on quality of life, has a negative impact on antiretroviral adherence and is a significant risk factor for suicide. With the advent of highly active antiretroviral therapy, HIV/AIDS has evolved into a chronic, manageable illness. The management of mental health concerns and neuropsychiatric symptoms has, therefore, become an integral part of comprehensive HIV/AIDS care. Clinical experience to date suggests that psychiatric syndromes in persons with HIV/AIDS and treatment-emergent neuropsychiatric side effects related to antiretroviral medications can be successfully managed using standard psychiatric interventions. The present article focuses on the treatment and management of major depression, including the choice of antidepressants and potential drug interaction considerations. Management of related symptoms of agitation and sleep disturbances are also reviewed.

scholarly journals Neuropsychological profile of a male psychiatric patient with a Morgagni-Stewart-Morel syndrome

2014 ◽  
Vol 27 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Aksel Hansen ◽  
Liliana Engelhardt ◽  
Wolfgang Pleschutznig ◽  
Gerhard Dammann ◽  
Stephanie Vietze
Keyword(s):  
Case Report ◽  
Psychiatric Patient ◽  
Neuropsychological Tests ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Pain Syndrome ◽  
Admission Diagnosis ◽  
Neuropsychological Profile ◽  
Definition Of

In 1765 Giovanni Morgagni described a syndrome consisting of hyperostosis frontalis interna (HFI), obesity and hirsutism. In 1928 Stewart and in 1930 Morel added neuropsychiatric symptoms, e.g. depression and dementia, which led to the definition of the Morgagni-Stewart-Morel Syndrome (MSM). Although mostly women were characterized in literature no gender specifity is demanded. This case report presents the rare case of a 66 year old male psychiatric patient with Morgagni-Stewart-Morel Syndrome. The patient complained of loss of concentration and difficulties with activities of daily living. Admission diagnosis was an opioid misuse on the basis of a chronic pain syndrome. In this case report we are describing clinical features, the patient history and technical (MRI) and neuropsychological tests. Although severe psychiatric symptoms and neuropsychological deficits are commonly seen in these patients, our patient showed only mild symptoms. This case reports shows the possibility of a male patient with MSM. If MSM is a separate entity or just an epiphenomena of hormone dysregulation should be investigated in further studies.

scholarly journals Acute Psychosis in a Child with Severe Dengue

2018 ◽  
Vol 37 (3) ◽  
pp. 273-275
Author(s):  
Ruchika Bhatnagar ◽  
Premlochan Prasad
Keyword(s):  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Adult Population ◽  
Febrile Illness ◽  
Recovery Phase ◽  
Severe Dengue ◽  
Age Group ◽  
Acute Psychosis ◽  
Pediatric Age Group

Dengue fever is emerging as an important cause of acute febrile illness with neuropsychiatric symptoms in adult population especially in endemic areas. Numerous case reports and review articles have already been published in past emphasizing on neurological manifestations in dengue but sufficient data on psychiatric symptoms in pediatric age group is still lacking. Acute psychosis in recovery phase of severe dengue is an uncommon phenomenon, thus rarely reported.

Effects of risperidone on behavioral and psychological symptoms associated with dementia in clinical practice

2005 ◽  
Vol 17 (4) ◽  
pp. 605-616 ◽  
Author(s):  
Alexander Kurz ◽  
Susanne Schwalen S ◽  
Andreas Schmitt
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Psychiatric Symptoms ◽  
Psychological Symptoms ◽  
Social Withdrawal ◽  
Safety Evaluation ◽  
Point Scale ◽  
Open Label ◽  
Open Label Study ◽  
Behavioral And Psychological Symptoms

Background: Risperidone significantly improves behavioral and psychological symptoms of dementia (BPSD), including aggression, agitation and psychosis, as shown by randomized, placebo-controlled trials.MethodsAn 8-week, multicenter, naturalistic, open-label study was carried out to examine whether the benefits of risperidone apply to clinical practice. A total of 4499 patients were treated with risperidone at flexible doses chosen by physicians, and were included in the safety evaluation. Of these, 3909 patients met the intended study criteria (at least 65 years of age, dementia, and the presence of BPSD) and were included in the efficacy analyses.Results:At the end of the study (after 8 weeks of treatment), risperidone (average final dose 1.6 mg/day) significantly improved all symptoms studied (agitation, aggressiveness, disturbance of the sleep–wake rhythm, social withdrawal, suspiciousness and delusions) as rated by physicians on a five-point scale of severity. On a four-point scale of global efficacy, more than 90% of patients were rated improved by both physicians and caregivers after 8 weeks of treatment. A significant improvement in sleep-wake cycle disturbances was also noted. A total of 422 adverse events were documented in 346 of the 4499 patients (7.7%); these included insufficient efficacy (2.6%), extrapyramidal symptoms (0.89%), deterioration of psychiatric symptoms (0.73%), sedation (0.56%), gastrointestinal disturbances (0.49%), cardiovascular disorders (0.38%), and cerebrovascular adverse events (0.36%).Conclusions: Risperidone is an effective and well-tolerated treatment for BPSD in routine clinical practice.

scholarly journals Disrupted reward processing in Parkinson’s disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysis

2021 ◽  
pp. jnnp-2021-327762
Author(s):  
Harry Costello ◽  
Alex J Berry ◽  
Suzanne Reeves ◽  
Rimona S Weil ◽  
Eileen M Joyce ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Reinforcement Learning ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Neuropsychiatric Symptoms ◽  
Reward Processing ◽  
Option Valuation ◽  
Healthy Controls ◽  
Within Subjects

BackgroundNeuropsychiatric symptoms are common in Parkinson’s disease (PD) and predict poorer outcomes. Reward processing dysfunction is a candidate mechanism for the development of psychiatric symptoms including depression and impulse control disorders (ICDs). We aimed to determine whether reward processing is impaired in PD and its relationship with neuropsychiatric syndromes and dopamine replacement therapy.MethodsThe Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published up to 5 November 2020. Studies reporting reward processing task performance by patients with PD and healthy controls were included. Summary statistics comparing reward processing between groups were converted to standardised mean difference (SMD) scores and meta-analysed using a random effects model.ResultsWe identified 55 studies containing 2578 participants (1638 PD and 940 healthy controls). Studies assessing three subcomponent categories of reward processing tasks were included: option valuation (n=12), reinforcement learning (n=37) and reward response vigour (n=6). Across all studies, patients with PD on medication exhibited a small-to-medium impairment versus healthy controls (SMD=0.34; 95% CI 0.14 to 0.53), with greater impairments observed off dopaminergic medication in within-subjects designs (SMD=0.43, 95% CI 0.29 to 0.57). Within-subjects subcomponent analysis revealed impaired processing off medication on option valuation (SMD=0.57, 95% CI 0.39 to 0.75) and reward response vigour (SMD=0.36, 95% CI 0.13 to 0.59) tasks. However, the opposite applied for reinforcement learning, which relative to healthy controls was impaired on-medication (SMD=0.45, 95% CI 0.25 to 0.65) but not off-medication (SMD=0.28, 95% CI −0.03 to 0.59). ICD was the only neuropsychiatric syndrome with sufficient studies (n=13) for meta-analysis, but no significant impairment was identified compared tonon-ICD patients (SMD=−0.02, 95% CI −0.43 to 0.39).ConclusionReward processing disruption in PD differs according to subcomponent and dopamine medication state, and warrants further study as a potential treatment target and mechanism underlying associated neuropsychiatric syndromes.

Neuropsychiatric Side-Effects of Lidocaine: Examples from the Treatment of Headache and a Review

Cephalalgia ◽  
2009 ◽  
Vol 29 (5) ◽  
pp. 496-508 ◽  
Author(s):  
R Gil-Gouveia ◽  
PJ Goadsby
Keyword(s):  
Side Effects ◽  
Clinical Presentation ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Alternative Therapy ◽  
Intravenous Lidocaine ◽  
Refractory Headache ◽  
Neuropsychiatric Toxicity ◽  
Neuropsychiatric Side Effects

Lidocaine has been used in treatment of patients with refractory headache. Personal observations of neuropsychiatric toxicity in these patients led us to review our cases and the literature systematically for lidocaine side-effects, especially neuropsychiatric symptoms. In our series of 20 patients, side-effects were observed in all, the most frequent being neuropsychiatric (75%) and cardiological (50%). When reviewing published series on intravenous lidocaine use, reports of side-effects range from 0 to 100%, with neuropsychiatric symptoms being reported in 1.8–100%. Thirty-six case reports of lidocaine-induced psychiatric symptoms were also analysed. Psychiatric symptoms of toxicity were similar in most patients, despite their differing ages, pathologies, co-therapies and lidocaine dosages. In conclusion, lidocaine neuropsychiatric toxicity has a well-recognized stereotypical clinical presentation that is probably unrecognized in headache series. As lidocaine represents an emerging alternative therapy in headache, particularly in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, clinicians and patients should be aware of the extent of this problem.

scholarly journals Disrupted reward processing in Parkinson's Disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Harry Costello ◽  
Alex Berry ◽  
Suzanne Reeves ◽  
Rimona S. Weil ◽  
Eileen Joyce ◽  
...  
Keyword(s):  
Reinforcement Learning ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Neuropsychiatric Symptoms ◽  
Reward Processing ◽  
Option Valuation ◽  
Healthy Controls ◽  
Ovid Medline ◽  
Significant Impairment ◽  
Within Subjects

Background: Neuropsychiatric symptoms are common in Parkinsons disease (PD) and predict poorer outcomes. Reward processing dysfunction is a candidate mechanism for the development of psychiatric symptoms including depression and impulse control disorders (ICD). We aimed to determine whether reward processing is impaired in PD and its relationship with neuropsychiatric syndromes and dopamine replacement therapy. Methods: The Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published up to November 5th, 2020. Studies reporting reward processing task performance by PD patients and healthy controls were included. Summary statistics comparing reward processing between groups were converted to standardized mean difference (SMD) scores and meta-analysed using a random effects model. Results: We identified 55 studies containing 2578 participants (1,638 PD and 940 healthy controls). Studies assessing three subcomponent categories of reward processing tasks were included: Option Valuation (n=12), Reinforcement Learning (n=37) and Reward Response Vigour (n=6). Across all studies, PD patients on medication exhibited a small-to-medium impairment versus healthy controls (SMD=0.34; 95%CI 0.14-0.53), with greater impairments observed off dopaminergic medication in within-subjects designs (SMD=0.43, 95%CI 0.29-0.57). Within-subjects subcomponent analysis revealed impaired processing off medication on Option Valuation (SMD=0.57, 95%CI 0.39-0.75) and Reward Response Vigour (SMD=0.36, 95%CI 0.13-0.59) tasks. However, the opposite applied for Reinforcement Learning, which relative to healthy controls was impaired on-medication (SMD=0.45, 95%CI 0.25-0.65) but not off-medication (SMD=0.28, 95%CI -0.03-0.59). ICD was the only neuropsychiatric syndrome with sufficient studies (n=13) for meta-analysis, but no significant impairment was identified compared to non-ICD patients (SMD=-0.02, 95%CI -0.43-0.39). Conclusion: Reward processing disruption in PD differs according to subcomponent and dopamine medication state and warrants further study as a potential treatment target and mechanism underlying associated neuropsychiatric syndromes.

Death Anxiety in Persons With HIV/AIDS: A Meta-Analysis

2010 ◽  
Author(s):  
Audrey K. Miller ◽  
Brittany L. Lee ◽  
Craig E. Henderson
Keyword(s):  
Death Anxiety ◽  
Meta Analysis ◽  
Hiv Aids

Thrombosis in Cancer Patients Treated with Hematopoietic Growth Factors - A Meta-Analysis

1996 ◽  
Vol 75 (02) ◽  
pp. 368-371 ◽  
Author(s):  
T Barbul ◽  
G Finazzi ◽  
A Grassi ◽  
R Marchioli
Keyword(s):  
Cancer Patients ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Hematopoietic Growth Factors ◽  
Patients With Cancer ◽  
Cytotoxic Treatment ◽  
Pertinent Data ◽  
Thrombotic Complications ◽  
Vascular Occlusions

SummaryHematopoietic colony-stimulating factors (CSFs) are largely used in patients with cancer undergoing cytotoxic treatment to accelerate neutrophil recovery and decrease the incidence of febrile neutropenia. Clinical practice guidelines for their use have been recently established (1), taking into account clinical benefit, but also cost and toxicity. Vascular occlusions have been recently reported among the severe reactions associated with the use of CSFs, in anedoctal case reports (2, 3), consecutive case series (4) and randomized clinical trial (5, 6). However, the role of CSFs in the pathogenesis of thrombotic complications is difficult to ascertain, because pertinent data are scanty and widely distributed over a number of heterogenous investigations. We report here a systematic review of relevant articles, with the aims to estimate the prevalence of thrombosis associated with the use of CSFs and to assess if this rate is significantly higher than that observed in cancer patients not receiving CSFs.

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