Vitamin B12Deficiency and Psychiatric Illness

1967 ◽  
Vol 113 (496) ◽  
pp. 252-256 ◽  
Author(s):  
R. Shulman
Keyword(s):  
Causal Relationship ◽  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Critical Evaluation ◽  
Pernicious Anaemia ◽  
Neurological Symptoms ◽  
Vitamin B ◽  
Mental Symptoms

Many psychiatric symptoms have been described in pernicious anaemia, including depression, manic excitement, paranoid states, confusional episodes, and dementia. Although vitamin B12deficiency is known to produce neurological symptoms there is much less certainty about its role in producing mental symptoms. Despite this uncertainty, it has been asserted that carrying out vitamin B12assays on psychiatric patients will enable doctors to cure for good severe disabling disease which otherwise may end in chronicity (Edwinet al., 1966). Routine examinations to exclude pernicious anaemia have been advocated for all psychiatric patients (Strachan and Henderson, 1965; Hunter and Matthews, 1965). A prudent preliminary is a critical evaluation of the causal relationship between vitamin B12deficiency and individual psychiatric syndromes.

Serum Vitamin B12 Levels in Indian Psychiatric Patients

1970 ◽  
Vol 117 (541) ◽  
pp. 699-704 ◽  
Author(s):  
V. S. Jathar ◽  
S. P. Patrawalla ◽  
D. R. Doongaji ◽  
D. V. Rege ◽  
R. S. Satoskar
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Peripheral Blood ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Serum Vitamin ◽  
Pernicious Anaemia ◽  
Vitamin B ◽  
Mental Symptoms ◽  
Low Serum

It is known that pernicious anaemia is sometimes associated with mental symptoms which improve following vitamin B12 therapy (Eilenberg, 1960; Holmes, 1956; Smith, 1960). Further, it has been pointed out that such mental symptoms can occur years before the development of anaemia and no definite relationship exists between them and the severity of anaemia (Smith, 1960). Cases have been described with a variety of psychiatric symptoms and low serum vitamin B12 levels without any neurological manifestation or abnormality of peripheral blood and bone marrow. Since pernicious anaemia is due to vitamin B12 deficiency it is suspected that B12 deficiency is responsible for the mental symptoms, and serum B12 assays have been advocated routinely in psychiatric patients (Strachan and Henderson, 1965; Hunter and Matthews, 1965).

A Survey of Vitamin B12 Deficiency in an Elderly Psychiatric Population

1967 ◽  
Vol 113 (496) ◽  
pp. 241-251 ◽  
Author(s):  
R. Shulman
Keyword(s):  
Psychiatric Patients ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Vitamin B ◽  
Cerebral Lesions ◽  
Mental Symptoms ◽  
B12 Deficiency ◽  
The Subject ◽  
Wassermann Reaction

For many years, cases of pernicious anaemia associated with mental symptoms have been described, and interest in these symptoms was renewed following the introduction of liver therapy (Richardson, 1929; Phillips, 1931). Interest later appeared to decline, so that MacDonald Holmes (1956), almost 20 years after the last important clinical review of the subject, could comment with justification that although the cerebral lesions of pernicious anaemia had been recognized for more than a century they were still much less familiar than the lesions which occurred in the spinal cord and peripheral nerves. Since then vitamin B12 deficiency as a cause of mental symptoms has given rise to increasing interest, and this is reflected in recent suggestions that serum vitamin B12 assays should be carried out routinely in psychiatric patients and might be more informative nowadays than the routine Wassermann reaction (Strachan and Henderson, 1965; Hunter and Matthews, 1965).

Neurological symptoms in schizophrenia: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S573-S573
Author(s):  
S. Benavente López ◽  
N. Salgado Borrego ◽  
M.I. de la Hera Cabero ◽  
I. Oñoro Carrascal ◽  
L. Flores ◽  
...  
Keyword(s):  
Case Report ◽  
Aggressive Behavior ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Neurological Symptoms ◽  
Behavioral Disturbances ◽  
Atypical Symptoms ◽  
Sexual Disinhibition ◽  
Competing Interest ◽  
New Diagnosis

IntroductionPatients with epilepsy and schizophrenia could present atypical clinical presentations with neurological symptoms that are not frequently presented in schizophrenia.Case ReportWe report the case of a 41-year-old male who was diagnosed of schizophrenia and was admitted into a long-stay psychiatric unit. He started at 33 years old with a depressive disorder. After prescribing venlafaxine, symptoms did not remit and the patient started to present apathy, anhedony, impoverished speech, social isolation and blunted affect. Then, the patient started to present behavioral disturbances consisted in regressive behavior, aggressive behavior, inappropriate language, echolalia, sexual disinhibition, impulsivity, worsening of executive functions and soliloquies. A neurological study was made with CT scan and electroencephalography, and no evidences of neurological abnormalities were found. After that, clozapine was prescribed, with an improvement of some symptoms like apathy, anhedony and aggressive behavior, but persisting the impulsivity, regressive behavior, inappropriate language, sexual disinhibition and echolalia.DiscussionPatients with schizophrenia and epilepsy could not respond appropriately to antipsychotic drugs. In this patient, the psychiatric symptoms more frequently seen in schizophrenia responded well to clozapine, but neurological symptoms did not improve with the standard treatment, causing a severe disability to the patient that was the main reason for his prolonged admission.ConclusionsIt is recommended to make a detailed neurological exploration in all psychiatric patients, in order to explore atypical symptoms and comorbidities that could reveal new diagnosis and therapeutic objectives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment of Severe Psychiatric Illness in a Day Hospital

1989 ◽  
Vol 154 (3) ◽  
pp. 341-347 ◽  
Author(s):  
Francis Creed ◽  
Philip Anthony ◽  
Ken Godbert ◽  
Peter Huxley
Keyword(s):  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Day Treatment ◽  
Psychiatric Patients ◽  
Patient Admission ◽  
Random Allocation ◽  
Day Hospital ◽  
One Year ◽  
Seriously Ill Patients ◽  
Seriously Ill

Severity of psychiatric illness was assessed using standardised clinical and social measures in 69 in-patients and 41 day patients admitted consecutively from the community. Day and in-patients differed little in terms of psychiatric symptoms and social disability, especially if compulsory admissions were excluded. Protection of self or others was a common reason for in-patient admission given by clinicians, who were otherwise prepared to treat seriously ill patients in the day hospital. Very few of the day patients had to be transferred to the in-patient facility, and at three months and one year the two groups showed similar improvements. It is concluded that day treatment is feasible for some seriously ill psychiatric patients, but a random-allocation study is required to assess more completely the efficacy of day treatment, and define the characteristics of those who require in-patient admission.

Schizophrenia-like Psychoses of Epilepsy and Disturbances of Folate and Vitamin B12Metabolism Induced by Anticonvulsant Drugs

1967 ◽  
Vol 113 (501) ◽  
pp. 911-919 ◽  
Author(s):  
E. H. Reynolds
Keyword(s):  
Psychiatric Illness ◽  
Serum Vitamin ◽  
Anticonvulsant Drug ◽  
Megaloblastic Anaemia ◽  
Vitamin B ◽  
Normal Range ◽  
Drug Induced ◽  
Subacute Combined Degeneration ◽  
Epileptic Patients ◽  
Mental Symptoms

Since it was first described by Mannheimer, Pakesch, Reimer and Vetter in 1952 megaloblastic anaemia has come to be recognized as an occasional complication of anticonvulsant drug therapy. More recently a disturbance in folic acid and vitamin B12metabolism has been observed in many non-anaemic drug-treated epileptic patients (Hawkins and Meynell, 1958; Klipstein, 1964; Malpas, Spray and Witts, 1966; Reynolds, Milner, Matthews and Chanarin, 1966a). Reynoldset al.(1966a) found megaloblastic haemopoiesis in 38 per cent. and subnormal serum folates in over 75 per cent. of a series of 54 out-patient epileptics. In addition, serum vitamin B12levels, though still within the normal range, were significantly lower in the megaloblastic group of patients than in controls. They suggested (1) that the anti-folate effects of phenobarbitone, phenytoin and primidone may be related to their therapeutic actions, and (2) that prolonged drug-induced disturbances of folate and vitamin B12metabolism may be responsible for certain side-effects, particularly mental symptoms. The latter possibility is supported by the increasing recognition of psychiatric illness due to vitamin B12deficiency in the absence of anaemia or subacute combined degeneration of the cord. (Langdon, 1905; McAlpine, 1929; Holmes, 1956; Smith, 1960; Edwin, Holten, Norum, Schrumpf and Skaug, 1965; Strachan and Henderson, 1965).

scholarly journals Presenting Psychiatric and Neurological Symptoms and Signs of Brain Tumors before Diagnosis: A Systematic Review

2021 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Fatima Ghandour ◽  
Alessio Squassina ◽  
Racha Karaky ◽  
Mona Diab-Assaf ◽  
Paola Fadda ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neurological Symptoms ◽  
World Health ◽  
Exclusion Criteria ◽  
Comprehensive Description ◽  
Brain Tumor Diagnosis ◽  
Health Organization ◽  
Symptoms And Signs

Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.

The Practice of Community Psychiatric Nursing and Mental Health Social Work in Salford Some Implications for Community Care

1988 ◽  
Vol 152 (6) ◽  
pp. 783-792 ◽  
Author(s):  
K. Wooff ◽  
D. P. Goldberg ◽  
T. Fryers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Health Staff ◽  
Mental Health Staff ◽  
Term Care ◽  
Community Psychiatric ◽  
Wide Range

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

scholarly journals Psychiatric patients at general hospital emergency departments

2020 ◽  
Vol 31 (1) ◽  
pp. 7-14
Author(s):  
Shafquat Waheed ◽  
Md Golam Rabbani ◽  
Abdullah Al Mamun ◽  
Jhunu Shamsun Nahar ◽  
Khaleda Begum ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Psychiatric Illness ◽  
Single Case ◽  
Psychiatric Patients ◽  
Conversion Disorder ◽  
Income Group ◽  
College Hospital ◽  
Cross Sectional ◽  
Total Study Population ◽  
Medical College

A cross-sectional descriptive type of study on 357 patients was carried out in the emergency departments of Dhaka Medical College Hospital (DMCH) and Shahid Sohrawardy Medical College (SSMCH), Dhaka in 2011 to find out the incidence and socio-demographic characteristics of psychiatric morbidities among the patients attended there. The patients were interviewed using GHQ-28 and SCID-I, All GHQ-28 screen positive and 25% of screen negative respondents (total 158) were assessed by SCID-I. Among them 42 (11.76% of all 357 cases) respondents were found with some form of psychiatric illness. Diagnosis of psychiatric illness was significantly higher in those scored 4 or more in GHQ-28. More psychiatric cases were found among 18-25 years age group (50%), male gender (54.76%), urban population (69.05%), Muslims (85.71%), being single (54.76%), patients with secondary level of education (45.24%), housewives (26.19%), members of nuclear families (78.57%), and members of lower-income group. Among these 42 psychiatric cases, 22 were assessed by a psychiatrist who was blind about GHQ-28 score and SCID-I diagnosis. Out of these psychiatrically ill 42 cases, Major Depressive Disorder was in 9 (2.52% of the total study population of 357), Conversion Disorder was in 8 (2.24%) and Anxiety Disorder was in 7 (1.96%) respondents. There were two cases of Bipolar I Disorder and a single case of extrapyramidal side effects (EPSEs) with schizophrenia. Psychiatric illnesses are important issues at the emergency departments which require special attention. Bang J Psychiatry June 2017; 31(1): 7-14

The Reporting of Recent Stress in the Lives of Psychiatric Patients

1970 ◽  
Vol 117 (541) ◽  
pp. 635-643 ◽  
Author(s):  
Richard W. Hudgens ◽  
Eli Robins ◽  
W. Bradford Delong
Keyword(s):  
Life Events ◽  
Psychiatric Illness ◽  
Psychiatric Patients ◽  
Causative Role ◽  
Causal Connection ◽  
Specific Question ◽  
Interpersonal Conflicts ◽  
Positive Evidence ◽  
Medically Ill ◽  
Psychiatric Illnesses

Physicians and patients frequently assume a causal connection between life events and subsequent episodes of psychiatric illness. It seems to ‘make sense’ that an illness which is to some extent manifested by disordered emotions could be caused in part by emotion-producing events. But plausibility alone is no proof of the truth of such an assumption. Realizing this, several investigators have conducted systematic studies of the interrelationships of life events and illnesses, both psychiatric and medical. Such work has been reported by Adamson and Schmale (1), Holmes, et al. (3, 7, 9, 10) Brown and Birley (2) Clayton, et al. (4) Morrison, et al. (11) Murphy, et al. (12, 13) and Hudgens, et al. (8). These authors differed regarding the specific question of whether illnesses may be caused by emotion-producing stress. The first six of the above papers presented positive evidence for such a cause-effect relationship. The last four papers reported that psychiatric patients had significantly more interpersonal conflicts than did well persons or medically ill persons, at least while their psychiatric illnesses were in progress; but the latter authors were unable to find evidence that any type of stress, interpersonal or otherwise, played a causative role in the illnesses. Disagreements among all these workers may be traced to differences in both theoretical approach and methodology.

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