RESUMO
The aim of this analysis was to investigate the socio-demographic and clinical profile, the effectiveness, and the association of pharmacological treatment in patients who underwent electroconvulsive therapy during the last 10 years in the largest psychiatric hospital in Romania. This study includes 249 patients aged between 18 and 73 years old. Recurrent depression was the most frequent diagnosis for which ECT was performed (T = 96, 38.55%), followed by schizophrenia (T = 72, 28.91%). The most frequent indication for ECT was treatment resistance (T = 154, 61.84%), followed by persistent suicidal ideation (T = 54, 21.68%) and catatonia (T = 42, 16.86%). In 111 (44.60%) cases included in this study, re-hospitalization was required after performing ECT, while 138 (55.40%) participants did not require any further hospital readmissions. Significant differences were found between these groups in terms of socio-demographic data, diagnosis, number of ECT sessions performed, and association of psychotropic medication during and after the procedure, therefore two separate patient profiles were found based on these characteristics. Patients necessitating re-hospitalization post-ECT were mainly males aged 25-44 diagnosed with schizophrenia and underwent a greater number of ECT sessions (7-12), whereas those not requiring re-hospitalization were predominantly females aged 45-64 with recurrent depressive disorder for which 4-6 ECT sessions were performed.
RESUMO
Toxoplasmosis is a pathological condition induced by the parasite, Toxoplasma gondii (T. gondii), which has a notable affinity for the cellular components of the central nervous system. Over the decades, the relationship between toxoplasmosis and the development of psychiatric disorders has generated profound interest within the scientific community. Whether considering immunocompetent or immunocompromised patients, epidemiological studies suggest that exposure to T. gondii may be associated with a higher risk of certain psychiatric disorders. However, there are extensive debates regarding the exact nature of this association and how T. gondii is involved in the pathogenesis of these disorders. Toxoplasmosis has long been considered an asymptomatic infection among immunocompetent patients. However, there appears to be an association between chronic brain infection with T. gondii and alterations in patient neuronal architecture, neurochemistry and behavior. The present review aimed to compile statements and pathophysiological hypotheses regarding the potential association between toxoplasmosis and psychotic disorders. Further research is necessary for understanding the potential relationship of T. gondii infection and psychotic disorders.
RESUMO
Alien hand syndrome (AHS) is an uncommon neurological condition characterized by involuntary, yet seemingly purposeful, movements of a limb, typically an upper extremity, with variable awareness and control by the affected individual. It is associated with a range of peculiar sensations, such as the feeling of limb estrangement, alien control and involuntary mirroring or restraining of movements. AHS indicates a profound disruption in volitional motor control and personal agency. The aetiology of AHS is the dysfunction of critical brain regions secondary to diverse neurological insults, such as tumours, vascular disorders, infarction or neurodegenerative diseases. It is clinically categorized into the parietal and callosal types, depending on the affected region, with manifestations often linked to the specific brain region affected. The callosal type is particularly challenging to diagnose due to its rarity and potential for nonspecific or concealed symptoms amid concurrent brain injuries. Distinguishing AHS from psychiatric disorders is crucial for accurate diagnosis and improved patient outcomes. Further research is imperative for a deeper understanding of the pathophysiology of AHS and the development of effective treatments. AHS predominantly affects adults and is frequently associated with multiple comorbidities. The syndrome is also exemplified by three distinct motor behaviours: Involuntary grasping, inter-manual conflict and limb levitation accompanied by the sensation of an alien limb or the perception of external control over one's movements. It has a generally good prognosis with partial or total recovery following appropriate rehabilitation techniques, including pharmacological and psychological measures.
