Ethnicity and outcome of psychosis

1999 ◽  
Vol 175 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Nicky Goater ◽  
Michael King ◽  
Eleanor Cole ◽  
Gerard Leavey ◽  
Eric Johnson-Sabine ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Black People ◽  
Incidence Rates ◽  
Psychotic Illness ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome ◽  
Course Of Illness ◽  
The Uk ◽  
Asian People

BackgroundAn excess of psychotic illness in Black people has been found in cross-sectional studies. Little is known about the outcome of psychosis in different ethnic groups in the UK.AimsTo compare the incidence, nature and long-term outcome of psychosis in different ethnic groups.MethodA five-year, prospective study of an epidemiological cohort of people with a first contact for psychosis.ResultsAge-standardised incidence rates for schizophrenia and non-affective psychosis were higher for Black and Asian people than Whites. Stability of diagnosis and course of illness were similar in all ethnic groups. During the fifth year, Black people were more likely than others to be detained, brought to hospital by the police and given emergency injections.ConclusionsThe nature and outcome of psychotic illness is similar in all ethnic groups but Black people experience more adverse contacts with services later in the course of illness.

Prescribing practices of Indian psychiatrists in the treatment of bipolar disorder

2019 ◽  
Vol 53 (5) ◽  
pp. 458-469 ◽  
Author(s):  
YC Janardhan Reddy ◽  
Venugopal Jhanwar ◽  
Rajesh Nagpal ◽  
MS Reddy ◽  
Nilesh Shah ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Maintenance Treatment ◽  
Bipolar Depression ◽  
Mood Stabilizer ◽  
Self Report ◽  
Mood Stabilizers ◽  
Prescribing Practices ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

Objective: The treatment of bipolar disorder is challenging because of its clinical complexity and availability of multiple treatment options, none of which are ideal mood stabilizers. This survey studies prescription practices of psychiatrists in India and their adherence to guidelines. Method: In total, 500 psychiatrists randomly selected from the Indian Psychiatric Society membership directory were administered a face-to-face 22-item questionnaire pertaining to the management of bipolar disorder. Results: For acute mania, most practitioners preferred a combination of a mood stabilizer and an atypical antipsychotic to monotherapy. For acute depression, there was a preference for a combination of an antidepressant and a mood stabilizer over other alternatives. Electroconvulsive therapy was preferred in the treatment of severe episodes and to hasten the process of recovery. Approximately, 50% of psychiatrists prescribe maintenance treatment after the first bipolar episode, but maintenance therapy was rarely offered lifelong. While the majority (85%) of psychiatrists acknowledged referring to various clinical guidelines, their ultimate choice of treatment was also significantly determined by personal experience and reference to textbooks. Limitations: The study did not study actual prescriptions. Hence, the responses to queries in the survey are indirect measures from which we have tried to understand the actual practices, and of course, these are susceptible to self-report and social-desirability biases. This was a cross-sectional study; therefore, temporal changes in responses could not be considered. Conclusion: Overall, Indian psychiatrists seemed to broadly adhere to recommendations of clinical practice guidelines, but with some notable exceptions. The preference for antidepressants in treating depression is contrary to general restraint recommended by most guidelines. Therefore, the efficacy of antidepressants in treating bipolar depression in the context of Indian psychiatrists’ practice needs to be studied systematically. Not initiating maintenance treatment early in the course of illness may have serious implications on the long-term outcome of bipolar disorder.

scholarly journals Physical health monitoring in dementia and associations with ethnicity: a descriptive study using electronic health records

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101080
Author(s):  
Cini Bhanu ◽  
Mary Elizabeth Jones ◽  
Kate Walters ◽  
Irene Petersen ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Physical Health ◽  
Influenza Vaccination ◽  
Ethnic Groups ◽  
Health Monitoring ◽  
Black People ◽  
Good Care ◽  
People With Dementia ◽  
The Uk ◽  
Comorbidity Status

BackgroundGood physical health monitoring can increase quality of life for people with dementia, but the monitoring may vary and ethnic inequalities may exist.AimTo investigate UK primary care routine physical health monitoring for people with dementia by: (a) ethnic groups, and (b) comorbidity status.Design & settingA retrospective cohort study was undertaken using electronic primary care records in the UK.MethodPhysical health monitoring was compared in people with dementia from white, black, and Asian ethnic groups and compared those with ≥1 comorbidity versus no comorbidity, from 1 April 2015 to 31 March 2016. Using the Dementia:Good Care Planning framework and expert consensus, good care was defined as receiving, within 1 year: a dementia review; a blood pressure (BP) check (at least one); a GP consultation (at least one); a weight and/or body mass index (BMI) recording (at least one); and an influenza vaccination.ResultsOf 20 821 people with dementia, 68% received a dementia review, 80% at least one BP recording, 97% at least one GP contact, 48% a weight and/or BMI recording, and 81% an influenza vaccination in 1 year. Compared with white people, black people were 23% less likely and Asian people 16% less likely to have weight recorded (adjusted incidence rate ratio [IRR] = 0.77, 95% confidence interval [CI] = 0.60 to 0.98/0.84, 0.71 to 1.00). People without comorbidities were less likely to have weight recorded (adjusted IRR = 0.74, 95% CI = 0.69 to 0.79) and BP monitored (adjusted IRR = 0.71, 95% CI = 0.68 to 0.75).ConclusionEthnic group was not associated with differences in physical health monitoring, other than weight monitoring. Comorbidity status was associated with weight and BP monitoring. Physical health monitoring in dementia, in particular nutrition, requires improvement.

scholarly journals Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma Has Durable Effect With Low Toxicity: Results From Two Nordic Lymphoma Group Trials With More Than 10 Years of Follow-Up

2018 ◽  
Vol 36 (33) ◽  
pp. 3315-3323 ◽  
Author(s):  
Sandra Lockmer ◽  
Bjørn Østenstad ◽  
Hans Hagberg ◽  
Harald Holte ◽  
Ann-Sofie Johansson ◽  
...  
Keyword(s):  
Optimal Timing ◽  
Indolent Lymphoma ◽  
First Line ◽  
Term Outcome ◽  
Cross Sectional ◽  
Term Survival ◽  
Long Term Outcome ◽  
New Therapy

Purpose For indolent lymphoma, the optimal timing, sequence, and choice of therapeutic regimens remain a matter of debate. In two Nordic Lymphoma Group randomized trials, symptomatic or clearly progressing patients were treated first line with a rituximab-containing regimen without chemotherapy. The purpose of this study was to assess long-term survival, risk of transformation, and need of new therapies. Methods Data were collected at cross-sectional follow-up for 321 patients with indolent lymphoma (84% with follicular lymphomas [FL]) included in one of two Nordic Lymphoma Group trials (accrual 1998 to 1999 and 2002 to 2008). All patients received first-line therapy with one or two cycles of four weekly infusions of rituximab 375 mg/m2, and 148 were randomly allocated to the addition of interferon alfa-2a. Follow-up data were retrieved from initial trial databases and medical records on repeated clinical evaluations. Results At the end of follow-up, 73% of patients were alive, with a median follow-up after random assignment of 10.6 years. Among all, 36% (38% with FL) had never needed chemotherapy. For patients with FL who required new therapy within 24 months because of early disease progression, the 10-year survival rate was 59% versus 81% for those with longer remission. Interferon was not shown to improve long-term outcome. Transformation was diagnosed in 20% of all patients (2.4% per person-year) and in 18% with FL. An additional malignancy was found in 12%. Conclusion Approximately one third of patients with symptomatic indolent lymphoma (30% with FL, 23% without FL) did not need new therapy in the long term after first-line rituximab without chemotherapy. In the entire cohort, 10-year survival was excellent with no major safety issues, which suggests that chemotherapy can be delayed safely in the majority of patients.

scholarly journals Extrauterine Growth Restriction: Definitions and Predictability of Outcomes in a Cohort of Very Low Birth Weight Infants or Preterm Neonates

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1224 ◽  
Author(s):  
Chiara Peila ◽  
Elena Spada ◽  
Francesca Giuliani ◽  
Giulia Maiocco ◽  
Melissa Raia ◽  
...  
Keyword(s):  
Very Low Birth Weight ◽  
Growth Restriction ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome ◽  
Nutritional Interventions ◽  
Definition Of ◽  
Extrauterine Growth Restriction

Extrauterine Growth Restriction (EUGR) refers to inadequate growth during hospitalization. Current definitions for EUGR are varied and can be classified as cross-sectional (weight at a given t-time <10th centile) or longitudinal (weight loss between birth and a given t-time >1SD). Different t-times are also considered in literature, such as 36 weeks of gestational age (GA) or age at discharge. The aim of this study is to investigate whether EUGR could predict the auxological outcome at 24–30 months, and to evaluate the agreement between cross-sectional and longitudinal definitions. In total, 1589 infants with GA <30 weeks or birthweight ≤ 1500 g and without major congenital anomalies were included in this study. Cross-sectional and longitudinal EUGR were calculated at 36 and 40 weeks of GA, at discharge, and at 28 days. The concordance between the two definitions was estimated by Kappa coefficient. At 24–30 months, 803 infants were measured again. The agreement between the two definitions of EUGR was low. Both EUGR and not-EUGR groups were at lower centiles for weight, but at higher centiles for head circumference at 24–30 months than at birth. Longitudinal EUGR was associated with a poorer growth outcome for weight and height circumference than cross-sectional EUGR. No differences were observed for length. An agreed definition of EUGR is highly desirable in clinical practice to assess medical and nutritional interventions in preterm neonates. Based on the results of this study, we recommend the use of the longitudinal evaluation, that proved to better predict the auxological long-term outcome with respect to the cross-sectional one.

Long-term outcome of cardiac function in a population-based cohort of breast cancer survivors: A cross-sectional study

2017 ◽  
Vol 81 ◽  
pp. 56-65 ◽  
Author(s):  
Liselotte M. Boerman ◽  
Saskia W.M.C. Maass ◽  
Peter van der Meer ◽  
Jourik A. Gietema ◽  
John H. Maduro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cardiac Function ◽  
Breast Cancer Survivors ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

First episodes of psychosis in Afro-Caribbean and White people

1998 ◽  
Vol 172 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Noriyoshi Takei ◽  
Rajendra Persaud ◽  
Peter Woodruff ◽  
Ian F. Brockington ◽  
Robin M. Murray
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Care ◽  
Population Based ◽  
Consecutive Series ◽  
White People ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Uk ◽  
First Admission

BackgroundThere have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.MethodWe followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.ResultsNinety-seven per cent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.ConclusionsAfro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.

scholarly journals Effects of Therapy on Urine Neutrophil Gelatinase-Associated Lipocalin in Nondiabetic Glomerular Diseases with Proteinuria

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Amnuay Sirisopha ◽  
Somlak Vanavanan ◽  
Anchalee Chittamma ◽  
Bunyong Phakdeekitcharoen ◽  
Ammarin Thakkinstian ◽  
...  
Keyword(s):  
Complete Remission ◽  
Limited Information ◽  
Urine Ngal ◽  
Term Outcome ◽  
Cross Sectional ◽  
Glomerular Diseases ◽  
Long Term Outcome ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Urine neutrophil gelatinase-associated lipocalin (NGAL) is widely used as a biomarker for acute kidney injury. Cross-sectional studies have shown that NGAL may be elevated in glomerular diseases, but there is limited information on the value of NGAL in predicting treatment response or on the changes of NGAL levels after therapy. We prospectively evaluated the effects of therapy on NGAL in nondiabetic glomerular diseases. Urine NGAL was collected at biopsy and follow-up at 12 months. At baseline, NGAL in glomerular disease patients (n=43) correlated with proteinuria, but not with glomerular filtration rate (GFR). After therapy with renin-angiotensin blockers and/or immune modulating agents, change of NGAL correlated with change of proteinuria, but not with change of GFR. NGAL at baseline was not different between patients in complete remission (CR) at follow-up compared to those not in remission (NR). Compared to baseline, NGAL at follow-up decreased in CR (n=10), but not in NR. Change of NGAL was greater in CR than NR. In conclusion, the change of urine NGAL correlated with the change of proteinuria. Baseline NGAL was not a predictor of complete remission. Future studies will be necessary to determine the role of NGAL as a predictor of long term outcome in proteinuric glomerular diseases.

Rhabdomyosarcoma of the trachea: first reported case treated with proton beam therapy

2012 ◽  
Vol 126 (9) ◽  
pp. 966-969 ◽  
Author(s):  
R Exley ◽  
J M Bernstein ◽  
B Brennan ◽  
M P Rothera
Keyword(s):  
Proton Beam ◽  
World Literature ◽  
Proton Beam Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Conventional Radiotherapy ◽  
The Usa ◽  
History Of ◽  
The Uk

AbstractObjective:We report a case of rhabdomyosarcoma of the trachea in a 14-month-old child, and we present the first reported use of proton beam therapy for this tumour.Case report:A 14-month-old girl presented acutely with a seven-day history of biphasic stridor. Emergency endoscopic debulking of a posterior tracheal mass was undertaken. Histological examination revealed an embryonal rhabdomyosarcoma with anaplasia. Multimodality therapy with surgery and chemotherapy was administered in the UK, and proton beam therapy in the USA.Conclusion:Only three cases of rhabdomyosarcoma of the trachea have previously been reported in the world literature. This is the first reported case of treatment of this tumour with proton beam therapy. Compared with conventional radiotherapy, proton beam therapy may confer improved long-term outcome in children, with benefits including reduced irradiation of the spinal cord.

scholarly journals Comparisons of Costs between Black Caribbean and White British Patients with Advanced Multiple Sclerosis in the UK

2014 ◽  
Vol 2014 ◽  
pp. 1-12
Author(s):  
Wayne Smith ◽  
Paul McCrone ◽  
Cassie Goddard ◽  
Wei Gao ◽  
Rachel Burman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ethnic Groups ◽  
Service Use ◽  
Unit Cost ◽  
Geographical Area ◽  
Population Based ◽  
Cross Sectional ◽  
Black Caribbean ◽  
Significant Difference ◽  
The Uk

Background. Multiple sclerosis (MS) is now more common among black and minority ethnic groups in the UK but little is known about the costs of care amongst different ethnic groups.Objective. This study examined and compared service use and costs for people severely affected with MS from Black Caribbean (BC) and White British (WB) backgrounds in the UK and identified predictors of cost for both groups.Method. Population-based cross-sectional study of 43 BC and 43 WB patients with MS (EDSS ≥ 6) and their informal caregivers recruited from an MS service in southeast London. Interviews collected data on health and social service use and informal care support. Costs were calculated using UK unit cost data. Using regression analyses we compared costs between the ethnic groups and identified possible predictors of cost.Results. The mean (SD) costs for the WB and BC groups were£25,778 (£39,387) and£23,186 (£30,433), respectively. Results identified no significant difference in total cost between the two ethnic groups. The EDSS score alone was a significant predictor of cost.Conclusion. Similar costs between ethnic groups indicate that with regard to this MS service and geographical area, access to care was not affected by ethnicity.

Long-term outcome following extracorporeal membrane oxygenation for congenital diaphragmatic hernia: the UK experience

2004 ◽  
Vol 144 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Peter J Davis ◽  
Richard K Firmin ◽  
Brad Manktelow ◽  
Allan P Goldman ◽  
Carl F Davis ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Membrane Oxygenation ◽  
The Uk
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