Duration of illness and duration of untreated illness in relation to drug response in psychiatric disorders

2011 ◽  
Vol 1 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Alfredo Carlo Altamura ◽  
Massimiliano Buoli ◽  
Marta Serati
Keyword(s):  
Psychiatric Disorders ◽  
Drug Response ◽  
Duration Of Untreated Illness ◽  
Duration Of Illness

scholarly journals Duration of untreated psychiatric illness and its correlations in patients attending a tertiary care psychiatric facility: a cross-sectional study

2013 ◽  
Author(s):  
Swarna Buddha Nayok ◽  
Sathyanarayana MT ◽  
Dhanashree Akshatha H.S.
Keyword(s):  
Psychiatric Illness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Psychiatric Facility ◽  
Cross Sectional ◽  
Duration Of Untreated Illness ◽  
Duration Of Illness ◽  
The Mean ◽  
Pathway To Care

Introduction: Duration of untreated psychiatric illness is an important component of the final pathway to care for patients. Longer the duration of untreated illness, poorer is the prognosis. Aim: To determine the Duration of Untreated Illness (DUI) along with its correlates, to thus evaluate the pathway to care at our setup. Settings and design: A retrospective cross-sectional study including 228 patients with psychiatric illnesses done at a tertiary care general hospital with a psychiatric setup. Materials: Semi-structured proforma for socio-demographic details, psychiatric diagnosis, duration of illness and duration of untreated illness. Statistical analysis: Sociodemographic details were mainly descriptive and categories compared using Pearson’s Chi square test. Results: The mean age of patients was 36.13 years (Standard Deviation (S.D.) 15.06). The mean DUI was 57.53 months (80.21). Excluding patients with Alcohol Dependence Syndrome (ADS), mean duration of illness was 51.58 months (S.D. 75.50) and DUI was 33.77 months (S.D. 49.11). Mean duration of illness for ADS group was 176.19 months (S.D. 101.20) and DUI was 165.90 months (S.D. 103.07). There was significant association of DUI with occupation (P = .039) and residence (P = .006). While 127 (55.70%) of patients showed to a psychiatrist at first, seventy (30.7%) patients went to faith healers first. Conclusion: It took about 5 years on average to reach a psychiatric facility, which was higher in patients with ADS. Awareness regarding illness model of ADS and other psychiatric disorders along treatment availability may improve DUI and lead to better prognosis.

Differences in duration of untreated illness, duration, and severity of illness among clinical phenotypes of obsessive-compulsive disorder

CNS Spectrums ◽  
2014 ◽  
Vol 20 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Beatrice Benatti ◽  
Lucio Oldani ◽  
Gregorio Spagnolin ◽  
A.Carlo Altamura
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Severity Of Illness ◽  
Comorbid Condition ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Clinical Phenotypes ◽  
Duration Of Untreated Illness ◽  
Multiple Phenotypes ◽  
Duration Of Illness ◽  
The Mean

IntroductionObsessive-compulsive disorder (OCD) is a prevalent, disabling, and comorbid condition that is frequently under-recognized and poorly treated. OCD phenotypes may differ in terms of clinical presentation and severity. However, few studies have investigated whether clinical phenotypes differ in terms of latency to treatment (ie, duration of untreated illness[DUI]), duration, and severity of illness. The present study was aimed to quantify the aforementioned variables in a sample of OCD patients.MethodsOne hundred fourteen outpatients with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnosis of OCD were recruited, and their main clinical features were collected. Severity of illness was assessed through the Yale–Brown Obsessive Compulsive Scale (Y-BOCS), and the main phenotypes were identified through the Y-BOCS Symptom Checklist. A one-way analysis of variance (ANOVA) test, followed by a Bonferroni post-hoc test, were performed to compare DUI, duration, and severity of illness across subgroups.ResultsIn the whole sample, the mean DUI exceeded 7 years (87.35±11.75 months), accounting for approximately half of the mean duration of illness (172.2±13.36 months). When subjects were categorized into 4 main clinical phenotypes, respectively, aggressive/checking (n=31), contamination/cleaning (n=37), symmetry/ordering (n=32), and multiple phenotypes (n=14), DUI, duration, and severity of illness resulted significantly higher in the aggressive/checking subgroup, compared to other subgroups (F=3.58, p<0.01; F=3.07, p<0.01; F=4.390, p<0.01).DiscussionIn a sample of OCD patients, along with a mean latency to treatment of approximately 7 years, regardless of the phenotype, patients had spent half of their duration of illness (DI) without being treated. DUI, duration, and severity of illness resulted significantly higher in the aggressive/checking subgroup.

Treatment of psychiatric disorders with valproate: a series of 73 cases

1988 ◽  
Vol 3 (2) ◽  
pp. 81-85 ◽  
Author(s):  
S.L. Mc Elroy ◽  
H.G. Pope ◽  
P.E. Keck ◽  
J.I. Hudson
Keyword(s):  
Major Depression ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Hematologic Toxicity ◽  
Neurologic Disorder ◽  
Neurological Signs ◽  
Duration Of Illness ◽  
Eeg Abnormalities ◽  
Growing Body

SummaryA growing body of literature suggests that the anticonvulsant valproate may be effective in some psychiatric disorders. We evaluated 73 consecutive psychiatric patients without diagnosable neurologic disorder, and refractory to previous medications, who were treated with valproate. The drug appeared: 1) moderately to markedly effective in 59% of patients in the manic phase of bipolar or schizoaffective disorder; 2) largely ineffective in patients with major depression, schizophrenia, and other psychiatric disorders; and 3) well tolerated, with no cases of serious hepatic or hematologic toxicity. Age, sex, duration of illness, presence of psychotic symptoms, and presence of soft neurological signs or CT scan abnormalities did not predict response to valproate; however, nonspecific (nonparoxysmal) EEG abnormalities showed a slight but significant association with response.

Diverse Glial Cell Line-Derived Neurotrophic Factor (GDNF) Support Between Mania and Schizophrenia: A Comparative Study in Four Major Psychiatric Disorders

2015 ◽  
Vol 30 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Z. Tunca ◽  
B. Kıvırcık Akdede ◽  
A. Özerdem ◽  
T. Alkın ◽  
S. Polat ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Psychiatric Disorders ◽  
Cell Line ◽  
Glial Cell ◽  
Obsessive Compulsive Disorder ◽  
Neurotrophic Factor ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Duration Of Illness ◽  
Severity Scores

AbstractBackground:Brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) have essential roles in synaptic plasticity which is involved in pathogenesis and treatment of psychiatric disorders. However, it is not clear whether they act simultaneously during illness states in major psychiatric disorders.Methods:BDNF and GDNF serum levels were measured concomitantly by enzyme-linked immunosorbent assay (ELISA) method in 171 patients diagnosed with schizophrenia (n = 33), bipolar disorder-manic episode (n = 39), bipolar/unipolar depression (n = 64, 24/40) and obsessive-compulsive disorder (n = 35) according to DSM-IV, and 78 healthy volunteers. SCID-I and SCID non-patient version were used for clinical evaluation of the patients and healthy volunteers, respectively. Correlations between the two trophic factor levels, and illness severity scores, duration of illness and medication dosages were studied across different illnesses.Results:While patients had equally lower BDNF levels in all diagnoses, GDNF levels were significantly higher in mania and lower in schizophrenia compared to healthy controls. BDNF levels were negatively correlated to illness severity scores in affective episodes (mania and depression). Longer duration of illness (> 5 years) had an impact on lower GDNF levels in schizophrenia. BDNF levels and antipsychotic drug dosages in schizophrenia, and GDNF levels and antidepressant drug dosages in obsessive-compulsive disorder were positively correlated.Conclusion:Our data confirmed the evidence of equally deficient neuronal support by BDNF in all major psychiatric illnesses, but suggested a diverse glial functioning between schizophrenia and mania.

What's in a model? Network models as tools instead of representations of what psychiatric disorders really are

2019 ◽  
Vol 42 ◽  
Author(s):  
Hanna M. van Loo ◽  
Jan-Willem Romeijn
Keyword(s):  
Psychiatric Disorders ◽  
Network Models ◽  
Model Network

AbstractNetwork models block reductionism about psychiatric disorders only if models are interpreted in a realist manner – that is, taken to represent “what psychiatric disorders really are.” A flexible and more instrumentalist view of models is needed to improve our understanding of the heterogeneity and multifactorial character of psychiatric disorders.

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