scholarly journals Problem-Based Review: Paracetamol Overdose

2011 ◽  
Vol 10 (4) ◽  
pp. 212-215
Author(s):  
Tom Heaps ◽  
Keyword(s):  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Past History ◽  
Previous History ◽  
Past Medical History ◽  
Minute Period ◽  
Normal Diameter ◽  
History Of ◽  
Self Harm ◽  
History Of Depression

A 29-year old male presents to the emergency department 1h after an overdose of cocodamol. He admits to taking approximately 60 x 8/500mg tablets, with alcohol, over a 20 minute period. He has a past history of depression, treated by his GP with citalopram 20mg OD. He has no previous history of deliberate self-harm. His past medical history is otherwise unremarkable and he is not on any additional medications. He drinks approximately 40 units of alcohol per week. Physical examination is unremarkable, his pupils are normal diameter and his Glasgow Coma Scale is 15. He weighs 82kg.

PREVALENCE AND RELATED FACTORS OF POSTNATAL DEPRESSION IN HIV INFECTED WOMEN

2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao
Keyword(s):  
Regression Analysis ◽  
Postpartum Depression ◽  
Hiv Infection ◽  
Postnatal Depression ◽  
Past History ◽  
Depression Scale ◽  
Multivariate Regression Analysis ◽  
Related Factors ◽  
History Of ◽  
History Of Depression

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women

Quality of parenting and vulnerability to depression: results from a family study

1998 ◽  
Vol 28 (1) ◽  
pp. 185-191 ◽  
Author(s):  
C. DUGGAN ◽  
P. SHAM ◽  
C. MINNE ◽  
A. LEE ◽  
R. MURRAY
Keyword(s):  
Mental Illness ◽  
Family Study ◽  
Past History ◽  
Familial Risk ◽  
Self Report ◽  
History Of ◽  
Quality Of Parenting ◽  
Independent Effects ◽  
The Relationship ◽  
History Of Depression

Background. We examined a group of subjects at familial risk of depression and explored the relationship between the perceptions of parents and a history of depression. We also investigated: (a) whether any difference in perceived parenting found between those with and without a past history of depression was an artefact of the depression; and (b) whether the relationship between parenting and depression was explained by neuroticism.Method. We took a sample of first-degree relatives selected from a family study in depression and subdivided them by their history of mental illness on the SADS-L, into those: (a) without a history of mental illness (N=43); and (b) those who had fully recovered from an episode of RDC major depression (N=34). We compared the perceptions of parenting, as measured by the Parental Bonding Instrument (PBI), in these two groups having adjusted for the effect of neuroticism and subsyndromal depressive symptoms. We also had informants report on parenting of their siblings, the latter being subdivided into those with and without a past history of depression.Results. Relatives with a past history of depression showed lower care scores for both mother and father combined compared with the never ill relatives. The presence of a history of depression was associated with a non-significant reduction in the self-report care scores compared to the siblings report. Vulnerable personality (as measured by high neuroticism) and low perceived care were both found to exert independent effects in discriminating between the scores of relatives with and without a history of depression and there was no interaction between them.Conclusion. This study confirmed that low perceived parental care was associated with a past history of depression, that it was not entirely an artefact of having been depressed, and suggested that this association was partially independent of neuroticism.

Suicide in Chronic Schizophrenia

1982 ◽  
Vol 141 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Alec Roy
Keyword(s):  
Suicidal Ideation ◽  
Patient Care ◽  
Past History ◽  
Chronic Schizophrenia ◽  
Controlled Study ◽  
Chronic Schizophrenic ◽  
Duration Of Illness ◽  
History Of ◽  
History Of Depression

SummaryA matched controlled study of 30 chronic schizophrenic suicides is presented. Eighty per cent were male and committed suicide at a mean age of 25.8 years after a mean duration of illness of 4.8 years. Significantly more of the suicides had a chronic relapsing schizophrenic illness; 23.3 per cent committed suicide while in-patients, and 50 per cent of the out-patients committed suicide within three months of discharge from in-patient care. Significantly more of the suicides had a past history of depression (56.6 per cent), were depressed in the last episode of contact (53.3 per cent), had their last admission for depression or suicidal ideation (55.2 per cent) and were unemployed (80 per cent).

Problem-Based Review: Calcium Channel Blocker (CCB) Poisoning

2011 ◽  
Vol 10 (3) ◽  
pp. 153-155
Author(s):  
Tom Heaps ◽  
Keyword(s):  
Emergency Department ◽  
Blood Glucose ◽  
Calcium Channel ◽  
Channel Blocker ◽  
Sinus Bradycardia ◽  
Capillary Blood ◽  
Capillary Blood Glucose ◽  
Past Medical History ◽  
Pr Interval ◽  
History Of

A 56-year-old female presents to the emergency department 6h after taking an overdose of verapamil MR 120mg x 28 capsules. She has a past medical history of hypertension and atrial flutter. On admission her GCS is 15, HR 50/min, BP 100/64, Capillary blood glucose (CBG) 10.2. ECG shows sinus bradycardia with prolongation of the PR interval. You estimate her weight to be 60kg.

A retrospective cohort study describing characteristics of those repeatedly detained under Section 136 of the Mental Health Act over a 5-year period and the association with past abuse

2021 ◽  
pp. 002580242110454
Author(s):  
Laureen Adewusi ◽  
Isabel Mark ◽  
Paige Wells ◽  
Aileen O’Brien
Keyword(s):  
Mental Health ◽  
Past History ◽  
Significant Proportion ◽  
Community Support ◽  
White Ethnicity ◽  
Demographic Profiles ◽  
Mental Health Act ◽  
History Of ◽  
Self Harm ◽  
The Uk

Individuals repeatedly detained under Section 136 (S136) of the Mental Health Act account for a significant proportion of all detentions. This study provides a detailed analysis of those repeatedly detained (‘repeat attenders’) to a London Mental Health Trust, identifying key demographic profiles when compared to non-repeat attenders, describing core clinical characteristics and determining to what degree a past history of abuse might be associated with these. All detentions to the S136 suite at South West London and St George's Mental Health NHS Trust over a 5-year period (2015–2020) were examined. Data were collected retrospectively from electronic records. A total of 1767 patients had been detained, with 81 patients identified as being a ‘repeat attenders’ (having had > = 3 detentions to the S136 suite during the study period). Repeat attenders accounted for 400 detentions, 17.7% of all detentions. Repeat attenders included a higher proportion of females (49.4%, p = 0.0001), compared to non-repeat attenders, and a higher proportion of them were of white ethnicity (85.2%, p = 0.001). 52 (64%) patients reported being a victim of past abuse or trauma. Of repeat attenders who reported past abuse or trauma, a high proportion had diagnoses of personality disorders, with deliberate self-harm as the most common reason for detention. They were more commonly discharged home with community support, rather than considered for hospital admission. In light of these findings, this paper discusses support potential strategies for those most vulnerable to repeated S136 detention, thereby minimising the ever-growing number of S136 detentions in the UK.

Pseudodiagnosis of Pseudoseizure

2020 ◽  
pp. 105-110
Author(s):  
Pat Croskerry
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
The Past ◽  
Autopsy Report ◽  
History Of ◽  
History Of Depression ◽  
Tomography Scan ◽  
Surprising Finding

In this case, a 35-year-old male is brought to a community hospital emergency department by ambulance having suffered an apparent seizure in the street. He is well known to the nurses and physician who see him. He has had several visits for seizures, and he has a history of depression. He has had electroencephalography studies and a computed tomography scan of his head in the past and has had assessments by both neurology and psychiatry. While he is in the department, he has an atypical seizure. There is a consensus among the ED staff that his seizures may be factitious. After a period of observation, he is discharged. Approximately 6 months later, the physician hears that the patient has died and tracks down his autopsy report, which had a surprising finding.

A study of deliberate self-poisoning in a Dublin hospital 1986 – 1990

1994 ◽  
Vol 11 (2) ◽  
pp. 70-72 ◽  
Author(s):  
Fergus Coakley ◽  
Catherine Hayes ◽  
John Fennell ◽  
Zachary Johnson
Keyword(s):  
Past History ◽  
Dublin Hospital ◽  
Psychiatric Inpatient ◽  
Previous History ◽  
Psychiatric Hospitals ◽  
High Rate ◽  
Medical Complication ◽  
Motivating Factors ◽  
History Of ◽  
Low Threshold

AbstractObjective: The study was undertaken to determine the current demographic and clinical features of cases of deliberate self-poisoning (DSP) presenting to an acute general hospital and to compare the findings with previous work in Ireland and elsewhere. Method: Four hundred and sixty seven consecutive admissions for DSP presenting to a Dublin hospital between 1986 and 1990 inclusive were identified retrospectively and the case notes reviewed. Data was collected on age, sex, marital status, past history, date of DSP, drugs used, motivating factors and outcome. Results: The peak age of DSP was 15-24 years. The female:male ratio was 1.5:1. There was an increased incidence of DSP in women in July and August. In 32% there was a previous history of DSP. Benzodiazepines, antidepressants and analgesics/anti-inflammatories were the commonest drugs taken. There was a significant medical complication in 10.5% of cases, but no fatalities. Twenty-five percent of patients were subsequently admitted to psychiatric inpatient care. Conclusions: DSP is an ongoing problem. The summer peak in females may be related to the parenting burden during the summer recess. The high rate of repetition suggests a significant reduction could be achieved with successful strategies for secondary prevention. The high rate of psychiatric in-patient referral may be related to a low threshold for admissions to Irish psychiatric hospitals.

Antidepressant use in Alzheimer's disease patients: results of the REAL.FR cohort

2009 ◽  
Vol 22 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Christophe Arbus ◽  
Virginie Gardette ◽  
Eric Bui ◽  
Christelle Cantet ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Previous History ◽  
Natural Setting ◽  
Antidepressant Prescription ◽  
History Of ◽  
Antidepressant Use ◽  
Clinically Significant ◽  
History Of Depression

ABSTRACTBackground: Psychotropic medication is widely prescribed in clinical practice for the management of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, there have been few pharmaco-epidemiological studies or studies conducted in a natural setting on the real use of antidepressants in AD. The aim of this survey was to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription.Methods: REAL.FR is a four-year, prospective, multi-center study. Baseline data including demographic characteristics, clinical variables and drug intake were obtained. Depressive symptoms were determined using the Neuropsychiatric Inventory (NPI).Results: A total of 686 AD patients were included. Antidepressant treatment was prescribed for 34.8% of patients. Clinically significant depressive symptoms (NPI ≥ 4) were observed in 20.5% of the total population. Although depressed subjects were significantly more likely to be treated with antidepressants than non-depressed subjects (p<0.0001), only 60% of depressed subjects overall were prescribed an antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression.Conclusions: The available data on antidepressant efficacy in BPSD other than depression (in particular, agitation, aggression and, occasionally, psychotic symptoms) do not influence prescription choices. Depressive symptoms may be taken more seriously in the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time.

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