ABSTRACT
Adolescence is a critical transition period between childhood and adulthood. They experience biological, emotional, and social changes and require constant affection, support, and supervision during this period. Adolescents often face stressors from various sources, which can exacerbate behavioral issues. A 13-year-old boy, born 15 years after marriage by in vitro fertilization (IVF) to parents in their late 40s, was brought to the outpatient department. He had presented with complaints of getting angry, stealing money, lying, and threatening his parents for his demands for the past six months. His behavior intensified during the COVID-19 pandemic due to social isolation and prolonged home confinement. His parents said that lately, he has also gotten difficult to manage at home. He was diagnosed with conduct disorder. Despite initial management with behavioral therapy, the boy experienced frequent exacerbations of symptoms. Further assessment identified parental behavior as a contributing factor to the child's conduct disorder. Interventions incorporating family-focused therapy (FFT) and modifications in parenting techniques were implemented, resulting in an extended period of behavioral remission. Parenting style plays an instrumental role in defining the positive and negative outcomes a child will experience. Hence, the parents were counseled and psycho-educated about effective parenting. This case underscores the crucial role of parenting styles in influencing adolescent behavior and highlights the importance of family-centered interventions in managing behavioral problems during adolescence.
ABSTRACT
Objective: This study aimed to explore the relationship between vitamin D deficiency and comorbid heart disease in adult inpatients with mood disorders (depressive and bipolar disorders). Methods: A cross-sectional investigation was carried out employing the nationwide inpatient dataset, which encompassed 910,561 adult inpatients aged 18 to 50 years diagnosed with depressive and bipolar disorders. Additionally, the sample was categorized based on the presence of comorbid heart disease. We utilized a logistic regression model to assess the odds ratio (OR), pertaining to demographic features and coexisting medical conditions in relation to comorbid heart disease. Results: Comorbid heart disease was present in 1.3% of inpatients with mood disorders; they were middle-aged (mean age 42.7 years) men and White individuals. Inpatients with depressive disorder had a higher risk of comorbid heart disease (OR 1.19, 95% CI 1.15-1.24) compared to those with bipolar disorders. Inpatients with comorbid heart disease had a higher prevalence of medical and psychiatric comorbidities. The prevalence of vitamin D deficiency was 2.3% in mood disorders but higher in those with comorbid heart disease (2.9%). Vitamin D deficiency showed a notable correlation with comorbid heart disease, resulting in a 26% increased risk in the unadjusted regression model (OR 1.26, 95% CI 1.13-1.40). However, after accounting for potential confounding factors, including comorbidities, the risk did not exhibit statistical significance (OR 1.08, 95% CI 0.97-1.21). Among psychiatric comorbidities, trauma-related (OR 1.22, 95% CI 1.17-1.28) and tobacco-related (OR 1.31, 95% CI 1.26-1.37) disorders had a higher risk of association with comorbid heart disease. Conclusion: Middle-aged men with depressive disorders and from low-income families had a higher risk of developing comorbid heart disease. Trauma-related and tobacco-related disorders were associated with an increased risk by 20-30% for comorbid heart disease in inpatients with mood disorders. Vitamin D deficiency was not associated with the risk of comorbid heart disease after controlling demographics and comorbid cardiovascular risk factors.
ABSTRACT
Care for geriatric patients can be difficult due to the complex nature of age-related comorbidities, multiple medications, and cognitive decline; this hardship multiplies when psychiatric illness or dementia are present and often exacerbates existing issues. Millions of lives have been lost in the COVID pandemic, and it has also severely harmed our collective mental health and cognition. The elderly population has felt that this impact the greatest as they are at the highest risk of isolation, cognitive inactivity, loneliness, and depression, all of which are risk factors for dementia. Studies associate loneliness with a 40% increase in the risk of dementia; thus, this pandemic and resulting isolation have likely caused an increase in cognition loss of the elderly. Furthermore, there is a documented bidirectional relationship between COVID-19 and psychiatric illness, both of which increase the likelihood of the other and are associated with worsening mental cognition. We present a case series of two patients with pre-existing psychiatric illness and cognitive decline, both exacerbated by COVID-19 infection, causing further decline in cognition.
ABSTRACT
Objective: Meningioma is the most common type of primary central nervous system and intracranial tumor, and psychiatric changes attributed to meningioma include depression, apathy, psychosis, and personality changes. We present a case of a 59-year-old man with right parietal meningioma who developed mania with psychotic features throughout multiple hospitalizations. Method: Single-case report. Results: The patient originally presented with headache and bilateral lower extremity weakness. He was found to have a large medial sphenoidal wing meningioma and a small right parietal meningioma. The sphenoidal wing meningioma was removed via craniotomy, but the right parietal meningioma was not resected. In the following years, the patient developed symptoms of mania and psychosis which coincided with an increase in size of the right parietal meningioma. Conclusions: Previous studies have linked right parietal meningioma to psychosis, but this case is one of the first to suggest that right parietal meningioma may be associated with the development of mania along with psychotic features.