bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liaison psychiatry: pathology medical-psychiatric concomitant to the cognitive impairment
Authors: Ledo A.I. , Coullaut-Valera J. , Sanchez I.M. , Soto A. , Lopez I. 
Published: May 2011

Objectives1Determine the prevalence of cognitive impairment in the population to study.2Determine treatment antidemential more prescribed in the population to study.3Determine the drugs more associated with the treatment antidemential.4Determine what is the pathology psychiatric more associated with cognitive impairment.5Determine the profile patient with cognitive impairment.MethodA retrospective and observational study. Sample size of 2628 patients. The criterions for inclusion were: persons admitted to the HCUV in 2006–2010, assisted by the service of liaison psychiatry hospitalized and that gave the informed consent. Was carried out valuation neuropsychological (MMS and CDR). Diagnostic as DSM-IV-TR.ResultsThe prevalence of cognitive impairment was 15.2%.The specialties that most requested the service of psychiatry at link were: internal medicine: 31.6%; Traumatology: 11.9%; 83.6% had been hospitalized for somatic reasons 9,6% for psychiatric reasons. The most common psychiatric pathology was Delirium 32.9%; Adaptive Disorder 30.7%, Cognitive Impairment 15.2%. Out of the 15.2% of patients with dementia, 85% receives specific treatment with at least a drug antidemential. The most used was Citicoline85,3%. In 71% observed concomitantly neuropsychiatric symptoms:Agitation(63,2%), anxiety(6,7%). The main associated treatments were Tiapride(70,1%) and Quetiapina and (21,9%).ConclusionsThe prevalence of cognitive impairment in patients of liaison psychiatry hospitalized in the HCUV is high, 15%. The frequency grows up with age increases as well as the related medical pathology. In the specific treatment have been used mainly:Donepezilo, Rivastigmine [3] Memantine. The evolution of the patients was favorable in 88,9%.
Higher case fatality after cardiovascular event for patients with comorbid psychiatric disease
Authors: Lindelius B. , Bjorkenstam E. , Dahlgren C. , Ljung R. 
Published: May 2011

IntroductionThe National Board of Health and Welfare in Sweden has recently published regional comparisons and assessment o the psychiatric care in Sweden. More than 30 health care quality indicators are used that comprises processes and results of the care for the mentally ill. There are indications that psychiatric patients do not receive adequate treatment of their somatic illness. The study exemplifies that.ObjectivesTo investigate whether patients with mental disorders are more likely to die after being hospitalized for acute myocardial infarction or stroke.AimsTo pinpoint possible disparities in physical health outcomes/mortality among patients with mental illness.MethodPatients were identified in the National Patient Register and Cause of Death Register. Mental illness was defined as having a registered psychiatric main diagnose at least once in the past five years.ResultsIn 2007 30% of the patients in total that had an acute myocardial infarction died witin 28 days. Among patients that also had psychiatric diagnose 44% died within 28 days. Case fatality within 28 days after a stroke was 22% and 34% respectively. There are differences in outcome between the regions.ConclusionsOur study indicates that the case fatality after a cardiovascular event is much higher in patients with comorbid psychiatric disease. Many reasons can be plausible, including bad compliance to treatment. But the higher case fatality might also be an indicator of non-optimal processes within the health care system for mentally ill people.
The levels of anxiety and depressive symptoms in COPD and lung cancer patients
Authors: Karkanias A. , Lekka D. , Giotakis K. , Anagnostopoulou M. , Tselios I. , Louridas A. , Nikoviotis D. , Bratis D. , Tselebis A. , Moussas G. 
Published: May 2011

IntroductionIt is known that patients with chronic and life - threatening diseases often presents anxiety and depressive symptoms.ObjectivesThe comparison of the levels of anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) and in patients with lung cancer.MethodsThe completion of the HADS scale was requested in 42 randomly selected patients (21 with lung cancer and 21 with COPD).ResultsHigher rates appeared in the subscales of anxiety and depression of the HADS (12.88 SD 5.03 and 13.45 SD 5.60, respectively) compared to the general hospitalized patients. Pathological rates of anxiety appeared at the 59.5% of the sample, while pathological rates of depression were found at 45.2%. Patients with lung cancer presented higher total score at HADS against patients with COPD (29.48 SD 9.3 vs 23.19 SD 8.26, t test p < 0. 05). In the subscale of anxiety appeared statistically higher average rate in patients with cancer against patients with COPD (14.43 SD 4.97 vs 11.33 SD 4.33, t test p < 0.05). Among the demographic factors, only age seemed to participate to the anxiety variation.ConclusionsPatients with COPD such as patients with lung cancer are presented with high rates of anxiety and depressive symptoms. Patient's age seems to be a significant factor at the variation of the anxiety symptoms.
Innovative practice. applying academic psychosmatic medicine in rural California
Authors: Ng B. 
Published: May 2011

BackgroundImperial County is designated as medically underserved and one of the poorest counties in CA. Our practice started in 1994 and serves the gap between the County Mental Health Services (CMHS) that treats the severely and chronically ill and the general medical community that faces the unmet need of specialty care for “less” severe patients.MethodsA plan was started to provide both psychiatric care and liaison activities. The community has 2 community general hospitals. Contracts were established with CMHS and private insurers to assure coverage of services. The plan was extended to dialysis units and long term facilities. Systematic collection of consult data was started in 1998.An electronic medical record was established with specific fields designated for research purposes. Working in association with UCSD, we established a number of IRB approved protocols. In addition, we contracted with a number of pharmaceutical companies to become a research site for mult-center trials.ResultsOver 300 consultations were performed yearly. The most common consultations involved assessments of: elderly agitated patients, conservatorship evaluations and suicide attempts.ConclusionPM strategies added value in the provision of psychiatric services and contract negotiation in this rural community. Applying an academic model decreased the gap between CMHS and the medical community. Patients appeared satisfied to see the same psychiatrists at different treatment settings (i.e. general hospital, dialysis unit, NSF). All interventions were covered by the diverse payment sources.
Risk health behavior and psychological reactions after cardiac event
Authors: Nikolic G. , Zikic O. , Tosic S. , Manojlovic S. 
Published: May 2011

IntroductionRisk health behavior can influence coronary syndromes outcome, especially associated with undesirable psychological reactions. Anxiety and depressive syndromes could be associated with higher frequency of smoking, alcohol consumption and lack of physical activity.ObjectivesAssesment of differences in psychological and behavior parameters between acute coronary and healthy controls and influence on 6 months re- hospitalization rate.MethodComparation between K group = 33 of first myocardial infarction patients and E group = 30 healthy persons at baseline and after 6 months. Instruments applied:Semistructured psychiatric interview, M.I.N.I., Beck Anxiety Inventory (BAI) for anxiety level, Beck Depression Inventory (BDI) for depression level, KON-6 sigma Aggression Scale and Holms-Rahe (H-R) Stress Life Events Scale and Questioner for risk health behavior. Parameters differences were assessed by t-test chi square test, for p< 0,05. Regression analysis for 6 months re-hospitalization.ResultsAnxiety-depressive and Anxiety syndromes were present at 23% of K group and 10% of E group. Anxiety level of K group was higher than E: (BAI = 8,15 ± 4,37:4,83 ± 2,60; t = −3,62), for p < 0.01, depression level was also higher (BDI = 8,67 ± 3,94: 4.63 ± 2.04; t = −5,02). Lack of physical exercise, was more present at K group. After 6 months there were 11 rehospitalization in K group. Family history of coronary disease and alcohol consumption had significant influence on 6 months re-hospitaization of infarct patients.ConclusionAnxiety and depression levels are mild in K group. Risk health behavior has been present at bouth groups but alcohol consumption and family disposition are important for re-hospitalization
Intermed self-assessment: developing an instrument to evaluate biopsychosocial complexity
Authors: Piemonte C. , Disavoia A. , Ferrari S. , Simoni E. , Huyse F. , Rigatelli M. 
Published: May 2011

IntroductionINTERMED is a method to assess biopsychosocial case complexity and a screening instrument to identify patients with multiple care needs. It is based on an interview, brief and easy to use, that can be conducted also by a nurse. Various studies in the last 10 years have confirmed its face-validity and reliability as a clinimetric tool. Its self-assessment version (IM-SA) was developed for further implementation in clinical settings.AimTo evaluate language, structure and fluency of the IM-SA questionnaire.MethodsIM-SA, Italian version 1.0, was administered to 25 patients admitted to an internal medicine ward and to other 25 in the waiting room of a Primary Care outpatient clinic. At the end of the questionnaire, nine extra-questions were specifically added to evaluate comprehension and difficulties encountered by patients while filling in the questionnaire.ResultsPatients admitted to the hospital scored higher and were found to be “more complex” (p < .01). 90% of respondents found the questionnaire easy to answer and 96% answered that the structure of the sentences was not too complex. The majority of patients found IM-SA useful and/or interesting. Contradictions in results also were found, suggesting need for improvement of structural and linguistic properties of the tool.ConclusionIM-SA seems to be a feasible and reliable self-assessment method to evaluate biopsychosocial complexity. Further similar studies in different languages are being organized to reach a final version of IM-SA, which will be afterwards compared to the IM professional interview.
Measuring psychological discomfort in severe functional gastrointestinal disorders: Is the Hospital Anxiety Depression (HAD) scale helpful?
Authors: Rodríguez-Urrutia A. , Braquehais M.D. , Accarino A. , Bel M.J. , Quesada M. , Lusilla P. , Parramon G. 
Published: May 2011

IntroductionPatients suffering from Functional Gastrointestinal Disorders (FGD) experience a high degree of psychological discomfort difficult to measure with current psychometric tools.Objectives- To describe the presence of affective symptoms measured with the Hospital Anxiety Depression (HAD) Scale in FGD inpatients.- To analyze the differences in HAD subscales scores between motor functional gastrointestinal disorders (MFGD) and non-motor functional gastrointestinal disorders (NMFGD).Material and method46 inpatients admitted to the Vall d’Hebron Digestive System Research Unit to study the existence of FGD were evaluated from January 2008 to July 2010. All patients completed the HAD scale and results from the two HAD subscales - Anxiety subscale (HAD-A) and Depression subscale (HAD-D)- were analyzed.ResultsThe mean age of the sample was 41.02 ± 16.86 years, 89.1% were women and 10.9% were men. Thirty-one patients met criteria of NMFGD, 13 of MFGD, and 2 did not met criteria of both diagnoses. The mean scores of the HAD were: HAD-A = 8.12 ± 5.23) and HAD-D = 5.20 ± 4.20. MFGD patients’ HAD results were: HAD-A = 7.00 ± 5.74 and HAD-D = 4.55 ± 4.52 while NMGFD HAD results were: HAD-A = 8.21 ± 4.98 and HAD-D = 4.96 ± 3.77. No statistically significant differences were found between both groups.ConclusionsAccording to our findings, MFGD patients do not meet HAD criteria of anxiety or depression while NMFGD patients only fulfill criteria for probable anxiety or depression. New psychometric tools should be developed in the future to study the psychological discomfort these patients usually complain of.
Difficulties in assessing alexithymia in motor and non-motor functional gastrointestinal disorders
Authors: Rodríguez-Urrutia A. , Braquehais M.D. , Accarino A. , Bel M.J. , Quesada M. , Lusilla P. , Parramon G. 
Published: May 2011

IntroductionAlexithymia is said to be an important feature of functional gastrointestinal disorders (FGD). Most studies focus on the presence of alexithymia in patients suffering non-motor FGD (NMFGD) but few studies have analyzed its occurrence in motor FGD (MFGD) patients.Objectives- To describe the presence of alexithymia, measured with the Toronto Alexithymia Scale (TAS-20), in a sample of FGD inpatients.- To analyze the differences in alexithymia, measured with the TAS-20, between MFGD and NMFGD inpatients.Material and method46 inpatients admitted to the Vall d’Hebron Digestive System Research Unit to study the existence of FGD were evaluated from January 2008 to July 2010. All patients completed the Toronto Alexithymia Scale (TAS-20).ResultsThe mean age of the sample was 41.02 ± 16.86 years, 89.1% were women and 10.9% were men. With regard to their diagnostic condition, 31 met criteria of NMFGD, 13 of MFGD, and 2 did not met criteria of both disorders. The mean TAS-20 total score was: 46.24 ± 13.60. MFGD patients obtained a mean score of 45.45 ± 12.53, and patients with NMFGD had a mean score of 45.75 ± 12.53. No statistically significant differences were found between both subtypes with regard to alexithymia.ConclusionsAlexithymia, measured with the TAS-20, may not be present in FGD. Discordances of our results with previous findings in FGD may be due to complex psychosocial factors and to psychometric difficulties in assessing alexithymia in this group of patients.
Case report and discussion on the use of essential fatty acids in the treatment of an organic affective and personality disorder
Authors: Roy B.B. , Rao K.P. 
Published: May 2011

We present the case of Mr CD, who presented to the psychiatric services about 12 years ago with features of Affective instability (short periods of elation, longer periods of depression); Significant self harm and suicidal behaviour; dysfunctional coping mechanisms ; non-compliance with treatment and alcohol dependence. His predominant complaint was that he was unable to feel any emotions. He described his symptoms as “Narcasm” (described by himself as a sense of narcissism and a lack of emotions).He was resistant to treatment with conventional psychotropics.He was investigated and discovered to have abnormalities on MRI scanning. The MRI brain scan showed - Mild global cerebral atrophy, small focal areas of sub-cortical and basal ganglia high signal as well as cerebral white matter lesions, particularly in the right frontal regions. These lesions had progressively worsened between 2006 and 2009.It was formulated that he was suffering from a complex neuropsychiatric illness, which would not fit into any definite diagnostic criteria.He finally improved on a combination of an antipsychotic (Quetiapine) and Essential Fatty Acids (EFAs).Several research papers have demonstrated the role and importance of EFAs in mental illness.It is evident that there are a large number of studies that support the growing evidence of the importance of EFAs in the management of mental disorder. In the case that we have presented, it can be seen that even in complex neuropsychiatric illnesses, EFAs can play a significant and beneficial role in treatment and prognosis.
Pre-procedural and post-procedural anxiety among relatives of coronary angiography patients
Authors: Sayın Y. , Tel H. , Tel H. , Yılmaz M. 
Published: May 2011

IntroductionAs the heart is a vital organ, diagnostic and therapeutic heart procedures can cause fear and anxiety not only in patients, but also among their relatives.ObjectivesThis is a descriptive study conducted to determine pre-procedural and post-procedural coronary angiography anxiety among patients’ relatives.MethodsThe relatives of 141 coronary angiography patients were included in the study. A personal information form and Spielberger's State-Trait Anxiety Inventory were used for data collection.ResultsThe average age of the patients’ relatives who participated in the study was 44.64 ± 13.22 years. 85.8% of the study participants were married and 61.0% were first-degree relatives of the patients. It was found that patients’ relatives had a moderate level of pre-procedural anxiety (mean = 53.333 ± 15.678), and that they had a low level of post-procedural anxiety (mean = 37.184 ± 18.528). State anxiety scores were higher among relatives who were married, and among those related to a patient who underwent a diagnostic procedure and previously underwent coronary surgery. Post-procedural state anxiety scores were higher among participants related to a patient who was recommended to undergo by-pass.ConclusionIt was found that pre-procedural anxiety was higher than post-procedural anxiety among the relatives of patients who underwent coronary angiography. Therefore, prior to angiography, patients’ relatives should be informed about the procedure, and efforts should be made to reduce their anxiety.
Medical consultations of acute psychiatric inpatients: differences due to age
Authors: Serván Rendón- Luna B. , Morón Nozaleda M.D. , Bautista Garrido O. , Machín Vázquez-Illá M. , Trebbau López H. , Montes Montero A. , Marco Martínez J. 
Published: May 2011

IntroductionPatients suffering serious mental diseases have more medical comorbidity and a higher mortality than the general population, something that has important clinical an economical impact. Age is an influential variable in a patient’s clinical course.ObjectivesDescriptive retrospective study from September 2007 to May 2010. Centralized database explotation. Center: San Carlos Clinic Hospital, Madrid. Variables: number of patients, mean age, median stay, number of visits, % resolved in first visit, mortality and delay.Three groups of comparison are established depending on the age: 18–44, 45–75 and > 75 years of age. A p≤0,05 has statistical significance.Results606 patients are included. Table 1 shows all variables for the three groups.ConclusionsStatistical significance exists for all variables analyzed and for every comparison established apart from mortality. Mortality is very low (just one death in group age >75). Group age 45–75 years presents major number of consultations to internal medical liaison Unit. Age is a decisive variable in the clinical course of patients with medical problems.
Takotsubo syndrome: A theoretical review over a clinical case
Authors: Silva-Carvalho F. , Moutinho A. 
Published: May 2011

The clinical case serves as an introductory note to the description of the Takotsubo Syndrome.The Takotsubo Syndrome has gained recent notoriety. It is estimated that this diagnosis is made in 2% of acute coronary syndromes. In up to 75% of the cases, a psychological stressor can be found, usually traumatic, and 25–40% of the patients meet the diagnostic criteria for depressive or anxious pathologies. It presents as an acute coronary syndrome, with pre-cordial pain and dyspnea, and in 90% of the cases there is elevated Troponin I, in average 0.49 ng/mL. There is mild ST-wave elevation and T-wave invertion, mostly on V2 and V3. The ventriculography presents the typical image, with apical ballooning and hypokinesia, that reverse in 20 days, average.The ratio of ß1 and ß2 receptors in the human heart is 4:1, and norepineprhin acts mostly in the former. It is released by the sympathetic terminals in the heart, which are 40% more dense in the basal region. Thus, the catecholaminergic action at the apex is mostly performed by circulating epinephrine, via ß2 receptors. The phenomena that occurs at supra-physiologic levels of epinephrine is called “stimulus trafficking” and results in a net change of intracellular signaling from Gs protein to Gi protein. The effect exists to protect against apoptosis in such conditions, but results in negative inotropism, most evident at the apex, where ß2 receptors are most prevalent.At last, this poster points some pathophysiologic factors in common between anxious pathologies and Takotsubo syndrome.
Behavioral intervention team: A multidisciplinary approach to co-morbidity in hospital level care
Authors: Sledge W.H. , Zimbrean P. , Desan P. , Bozzo J. 
Published: May 2011

IntroductionPsychiatric illness complicates physical medical care and prolongs hospital stay.ObjectivesTo implement and measure the effect of a multidisciplinary (psychiatry, nursing and social work) team in an academic medical center general hospital.AimsTo test the hypotheses that early recognition and management of co-morbid mental illness threatening to interfere with hospital level care for physical illness will reduce the fiscal burden of hospital level care.MethodsBefore and after comparison of patients on three medical units examining conventional consultation liaison approach vs the Behavioral Intervention Team (BIT) on four outcome measures: length of stay (LOS), denied days (uncompensated days waiting on medical service for hospital level care of psychiatry when the patient no longer requires hospital level medical care), constant companion use, and thirty day readmission rate.ResultConsultation liaison patients from August 1, 2008 through June 30, 2009 were compared to BIT patients on the same three units from August 1, 2009 through June 30, 2010; the BIT patients had a lower length of stay (9.99 days vs 11.33 days, Wilcoxon Two Sample Test = 200953, p < .01, two tailed) with a reduction of constant companion use by 8.7%, and elimination of denied days altogether. Thirty day readmission was reduced 2.5% but was not statistically significantly different.Conservative economic analysis demonstrates that the intervention begins to generate a profit when the hospital reached budgeted census at least 3.5% of the time.ConclusionsInterdisciplinary care can be feasible, effective and efficient in a hospital based consultation liaison setting.
The quality of sleep and the quality of life among the elderly people
Authors: Tel H. 
Published: May 2011

IntroductionSleep problems are commonly seen among the elderly people and these problems affect the quality of sleep and the quality of life.ObjectivesThe current research was conducted in order to determine the quality of sleep and the quality of life of the elderly people.MethodsThe research was conducted with 187 elderly people. Personal information form, Pittsburgh Sleep Quality Index and Turkish Version of WHOQOL-Bref-Quality of Life Scale were used for the data collection.ResultsThe ages of the participant individuals ranged from 65 to 83 and mean age was 72.5 ± 5.24. It was determined that all of the elderly people had a bad quality of sleep. There was a significant negative correlation between areas of the quality of life and the quality of sleep. It was found out that scores of all of the areas of the quality of life were low among the elderly who were illiterate and had a chronic physical disease and that their quality of sleep was worse. The widowed and women had lower scores in physical, psychological and social areas of the quality of life scale and their quality of sleep was worse.ConclusionsThe quality of sleep and the quality of life are closely interrelated among the elderly people. A decrease in the quality of sleep causes a decrease in the quality of life. The quality of sleep should be continued by ensuring sleep hygiene among the elderly people and thus the quality of life should be increased.