ABSTRACT
The authors reviewed 21 studies dealing with the rate of diagnosed and undiagnosed physical illnesses in the psychiatric patient population. These studies performed by different authors in variable clinical settings with diverse methodology in different locations over a period of 45 years yielded a close concordance. Approximately half of the patients (50.1%) suffered from significant physical illnesses, of these 58.2% were previously undiagnosed. A substantial portion of the physical illnesses (27.1%) produced symptoms showing direct relation to the psychopathology of the patient. These numbers are quite close to those found by authors in earlier research.
Subject(s)
Mental Disorders/physiopathology , Age Factors , Brain/metabolism , Brain/physiopathology , Female , Humans , Immunocompetence , Life Change Events , Male , Mental Disorders/complications , Mental Disorders/metabolism , Psychophysiologic Disorders/complications , Psychophysiologic Disorders/immunology , Psychophysiologic Disorders/metabolism , Sex Factors , Stress, Psychological/complications , Stress, Psychological/immunology , Stress, Psychological/metabolismABSTRACT
Symptoms of significant medical illnesses, in this case subdural hematoma, is easily overlooked in midst of alcohol withdrawal. Unusual symptoms must be regarded with caution.
Subject(s)
Alcohol Withdrawal Delirium/complications , Hematoma, Subdural/complications , Psychoses, Alcoholic/complications , Alcohol Withdrawal Delirium/diagnosis , Diagnosis, Differential , Electroencephalography , Hematoma, Subdural/diagnosis , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
A striking accumulation of new technologies and recent diverse research developments open new insight into the nature of primary dementias. The gene of the familial form of Alzheimer's disease was located in the chromosome 21. By further study of the amyloid protein precursor gene, laboratory diagnosis and eventual treatment of Alzheimer's disease may become a reality. This paper reviews and adds perspective to old and new data on the cortical dementias: Alzheimer's disease and Pick's disease.
Subject(s)
Alzheimer Disease/pathology , Cerebral Cortex/pathology , Aged , Alzheimer Disease/genetics , Atrophy , Chromosomes, Human, Pair 21 , Dementia/pathology , HumansABSTRACT
This article reviews the medical aspects of mental retardation with a focus on classification, types of retardations, evaluation and therapies, and etiology.
Subject(s)
Intellectual Disability/diagnosis , Female , Humans , Inactivation, Metabolic , Infant, Newborn , Intellectual Disability/complications , Intellectual Disability/etiology , Mental Disorders/complications , Pregnancy , Prenatal Diagnosis , Psychotropic Drugs/adverse effects , Seizures/complicationsSubject(s)
Hospitals, Teaching/statistics & numerical data , Hospitals, University/statistics & numerical data , Mental Disorders/therapy , Outpatient Clinics, Hospital/statistics & numerical data , Psychiatric Department, Hospital/statistics & numerical data , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , OntarioSubject(s)
Mental Disorders/epidemiology , Psychiatric Department, Hospital , Adolescent , Adult , Aged , Female , Hospitals, General , Hospitals, University , Humans , Male , Middle Aged , Ontario , Suicide, Attempted/epidemiologyABSTRACT
A case of altered kinetics of amitriptyline in a patient with porto-caval anastomosis and liver cirrhosis who showed an unusually strong sedative response to the drug, is presented. Therapy with tricyclic antidepressants should be initiated with lower doses and adjusted by plasma level monitoring in patients with liver by-pass.
Subject(s)
Amitriptyline/blood , Depressive Disorder/drug therapy , Portacaval Shunt, Surgical , Administration, Oral , Adult , Amitriptyline/administration & dosage , Depressive Disorder/blood , Half-Life , Humans , Kinetics , Liver Cirrhosis, Alcoholic/surgery , Male , Nortriptyline/bloodSubject(s)
Disease/psychology , Mental Disorders/etiology , Adult , Diagnosis, Differential , Female , Humans , Male , Mental Disorders/diagnosis , Middle AgedABSTRACT
Major medical illnesses remain undiagnosed and patients' ailments are being labeled "psychosomatic" at an alarming rate. A careful screening of 2,090 psychiatric clinic patients showed that 43% of this population suffered from one or several physical illnesses. Almost half of the physical illnesses (46%), remained undiagnosed by the referring source. Morbidity in the psychiatric clinic patients far surpassed the expected rate found in the general population. Among others, diabetes mellitus was a frequently overlooked diagnosis and proved, particularly, to produce emotional disturbances. Physicians other than psychiatrists missed one third and psychiatrists one half of the major medical illnesses in patients they referred. Self-referred and social agency--referred patients almost always had undiagnosed physical illnesses. The causes for failing to recognize medical illnesses are discussed. Based on the obtained data, the necessity for a medical orientation on the part of psychiatrist in evaluating all patients is stressed.
Subject(s)
Diagnostic Errors , Mental Disorders/diagnosis , Mental Health Services/standards , Brain Neoplasms/diagnosis , Diabetes Mellitus/diagnosis , Drug-Related Side Effects and Adverse Reactions , Erectile Dysfunction/diagnosis , Female , Humans , Male , Mass Screening , Outpatient Clinics, Hospital/standards , Psychiatric Department, Hospital/standards , Referral and ConsultationSubject(s)
Digoxin/blood , Depression/chemically induced , Digoxin/poisoning , Female , Humans , Middle AgedABSTRACT
During a three-year period 28 fatalities, twice the rate in the general population, were found in a sample of 2,070 psychiatric outpatients. Death occurred in these psychiatric patients approximately 20 years earlier than is expected. All three modalities of death: accidents, suicide, and natural causes, were higher than that in the population at large. Three suicides were thought to be preventable by psychiatric approaches. The importance of the patient's initial visits was stressed. At least four, and possibly five, cases of death were avoidable by appropriate medico-surgical means. The rate of physical illnesses in all three groups was more than 80%, of which one third were inadequately diagnosed by their referring physicians. The importance of the physical evaluation of psychiatric patients was emphasized.
Subject(s)
Mental Disorders/mortality , Accidents , Adolescent , Adult , Aged , Alcoholism/complications , Ambulatory Care , Family Characteristics , Female , Humans , Male , Mental Disorders/therapy , Middle Aged , Morbidity , Ontario , Quality of Health Care , Risk , SuicideABSTRACT
Mood and behavior disorder may appear either due to primary psychiatric disorder or may signify an underlying, frequently undetected, physical pathology. Two instances of malaria falciparum presenting with psychosocial symptomatology are described.
