Psychotic acute episode - comorbidity or complication of endocrine. disorders to teenager

Size: px
Start display at page:

Download "Psychotic acute episode - comorbidity or complication of endocrine. disorders to teenager"

Transcription

1 Psychotic acute episode - comorbidity or complication of endocrine disorders to teenager GEORGIANA ALINA TOCACI 1, CARMEN IOANA TRUŢESCU 1 ABSTRACT: The nervous and endocrine systems are in a strong functional interrelationship. The nervous system releases chemical agents that can act as local mediators or circulating hormones. A number of hormones can act as functional mediators in the central nervous system. There are known a number of level alterations of neurohormonal and neuromodulator concentrations in the systemic circulation or in the cerebrospinal fluid in a series of mental disorders. Although anxiety and depression are the most common psychiatric symptoms associated with endocrinopathies, hormonal imbalances can mimic other psychiatric disorders such as dysthymic disorder, mania or psychotic episodes. Key words: psychosis, thyroiditis, Basedow-Graves, teenager REZUMAT: Sistemul nervos şi endocrin sunt într-o interdependenţă funcţională puternică. Sistemul nervos eliberează agenţi chimici, care pot acţiona ca mediatori locali sau hormoni care circulă. O serie de hormoni pot acţiona ca mediatori funcţionali în sistemul nervos central. Sunt cunoscute o serie de modificari de concentraţii la nivel neurohormonal şi neuromodulator în circulaţia sistemică sau în lichidul cefalorahidian intr-o serie de tulburări mentale. Deşi anxietatea şi depresia sunt cele mai frecvente simptome psihiatrice, dezechilibrele hormonale pot mima si alte tulburări psihiatrice, cum sunt tulburările distimice, episoadele psihotice sau mania. 1 MD, resident in Child and Adolescent Psychiatry, Child and Adolescent Psychiatry Department, Prof. Dr. Al. Obregia Hospital of Psychiatry, Bucharest

2 Cuvinte cheie: psihoza, tiroidita, Basedow-Graves, adolescent The reasons for hospitalization: D.V. is a patient aged 14 years that was brought by her parents for: auditory hallucinations ( there are more voices that are talking to me, they are mischievous, sometimes they talk about me, they say that is over, that I'm done ); olfactory hallucinations ( I feel an odor ); interoceptive hallucinations ( I cannot eat I have something yellow in my stomach, something that don t let me eat and don t want to leave from there ); delusions of persecution ( I m afraid of people, I do not want to go to school, not to sting me someone ); social isolation ( I m not in the mood to see someone, I want you to leave me alone, I want to sit alone ). Of the family history we keep in mind that on maternal line there is a third degree relative with post-traumatic mental disorder triggered in adolescence (death of her mother). Personal physiological history: First child coming from a pregnancy affirmative normal until birth, weight at birth=2900g, APGAR=7 (child with surrounded cord blood which required about 48 hours of O 2 -therapy). She was discharged after 5-6 days with good further adaptation. The psychomotor development in stages of age was normal. Personal pathological history: The patient was diagnosed a year ago with Basedow- Graves disease and was treated with Carbimazol 5mg 1 pill a day at the beginning of psychiatric manifestations. Living and working conditions: The patient is a student of a prestigious high school with good academic results. She lives with her parents being their only child; although she has her own room which she has arranged with her mother, for several months she sleeps with her mother, saying that she cannot sleep alone. History: From the anamnesis we notice that social withdrawal has gradually begun about two months, but symptoms have increased in the last 3 weeks. Parents connects the beginning of the manifestations by an incident with traumatic potential for their daughter (her

3 boyfriend proposed her to maintain intimate relationships, however she refused him, but this gesture shocked her). At the beginning, 3 weeks ago the patient was hospitalized to the pediatric department where she was investigated and were denied various organic disorders. Psychic examination: On admission, the patient came accompanied by her mother. Mimics and gestures, less mobile, were in accordance with ideas. The general aspect was of a careful teenage girl, proper hygiene, but her mother said: She was more stylish, more elegant, she make up, now she is just so just needs. The patient seemed scared, she looked suspicious to other people. Mental contact was made with difficulty, slowness in responding to questions and she repeatedly said: I wish to stay in one place, I do not want to see anyone, I do not want anyone to ask me anything, I have the impression that people want to hurt me, it s like a fear. From historical data provided by the parents we noted that: at the beginning she said that she s afraid of people, that she has a fear, she wants to go with someone at school. She was no longer so cheerful, she was more solitary and quiet Then she started to feel sick from the stomach, with nausea and the refusal to eat. The patient had perception disorders: auditory and interoceptive hallucinations, pathological illusions: I hear more voices. They are like some evil women. Sometimes they talk to me, say that it's over with me, that I'm ready They, sometimes talk to me, especially at night, it s not a dream, I am awake. I m afraid of them. The description of voices was often accompanied by neurovegetative manifestations (clammy hands, pallor, sweating) and heat sensation, by sick starting from the stomach and ending in her fingertips; I heard an evil bird, she was at my window, I was afraid of her, I knew it was something bad, but I don t know what it was ; Sometimes I feel an unpleasant smell that my mother doesn t feel. It's always the same and it takes a lot.if I eat I feel that I have something round and yellow in my stomach, something that makes me sick, I cannot get rid of him.

4 Attention: spontaneous hiperprosexia ( she is always attentive to what is heard, sometimes she senses the door creaking and she slightly trembling ), voluntary hipoprosexia ( no longer focus on anything, it seems that nothing interests her, says her mother). Memory: We observed fixed hipomnezia; the evocation was made with difficulty. Mind disorders were mainly qualitative: injury and persecution delusions ( people want to hurt me, my classmates are bad, and they want to sting me ). Poorly spontaneous speech, limited to simple sentences or words, the patient could answer with slowness to the questions, bradilalia. Thinking is marked by the presence of persecution ideation, tracking and injury, and also, by a high degree of suspicious and interpretation. The patient said: People want to hurt me, I m afraid, I do not want to see anyone, children stab me, I don t want to go to school. Activity / Affectivity: patient with anhedonia and low reversal affection for mother. From history we note that the beginning of the symptoms is connected by family with the existence of a tense emotional situation related to the teenage relationship breakup with her boyfriend. The disposal of the patient is fluctuating, moving from sadness, with tendency to verbal negativism, to dysphoria, related to the presence of changes in perception. The patient said: When I hear those voices I run, I sit alone, I put my hands to ears, I want to get rid of all, not to hear them. I am afraid of them. We also note the tendency to behaviors with self destruction character and she explained them later: I want to die, I no longer support to be so he told me to cut my veins and I pulled the cannula cap I want to die The appetite was greatly reduced, with significant weight loss (5 kg before hospitalization and another 5 kg after the time of admission to psychiatry). The patient said: I don t eat it flows a taste of food and an unpleasant smell in my mouth, I rather not eat, I better receive perfusion, I better die

5 Patient had been complaining that he could not have a peaceful sleep: I have a restless sleep about 3 weeks, a dream a lot and bad, I do not rest, and those voices it s not a dream I m in bed, but I can t sleep. During hospitalization the paraclinic explorations have been continued, as it follows: Neurological exam (within in normal limits) and EEG exam (with low voltage trail without epileptiform abnormalities) and MRI performed later led to the exclusion of the organic disorders. MRI showed a left superior cerebellar herniation, relevant but not pathological. Endocrinology exam showed changes in antibodies: Anti- TPO = 238Ui/ml (<34) and Anti-thyroglobulin = 482Ui/ml (<115), generating the suspicion of chronic autoimmune thyroiditis and the decision to discontinue treatment with Carbimazol. Because of the possibility of certain demyelinisations in endocrine diseases it was, also made a cerebral CT scan which was normal, without significant abnormalities. Positive diagnosis: Axis I: Psychotic acute episode Axis II: Without significant items Axis III: Basedow-Graves disease Axis IV: Without significant items Axis V: GAF=40 (severe difficulties in social and professional functioning) Differential diagnosis: A. Organic disorders: were both denied by specific tests performed in our clinic, as well as earlier in the pediatric department, tumoral modifications, but also,

6 possible intoxication or type of infectious diseases (EEG, cerebral IRM, abdominal ultrasonographie, blood tests). B. Psychiatric disorders: -Psychiatric disorders in other endocrine diseases: it was considered that psychic symptoms can be partially explained by endocrine disorders, in the context of normal values of thyroid hormones. -Affective disorders: are difficult to infirmed at the time of presentation of this case. The installation sequence of symptoms is suggestive of an acute psychotic episode, although the evolution of the patient may be a mixed affective disorder. -Posttraumatic stress disorder and Dissociative disorder considered because of the emotional stressor event that the patient mentioned, was invalidated by a detailed history that has showed that social retraction, the ideation of persecution and anhedonia started before the mentioned incident; the symptoms were continuous and were not time intervals with normal psychological functioning. More than that, the patient had a favorable evolution and good tolerance under antipsychotic medication. -Social phobia: that could be taken into account from symptom onset was invalidated, the intensity of events leading to reconsideration diagnose, refusal to go to school appearing in the context of thought disorders. -Disharmonious personality development, considering all behavior and interrelation features, although some of criterion lacks ( the patient is under 18). Treatment During the first days after admission, the evolution was favorable, with almost complete remission of positive symptoms. She said: I m not so sleepy, I feel anxious, I have a fear, I d better stay in blanket. During hospitalization the patient presented urinating difficulties and decided to decrease the dose and then even change the treatment schedule, replacing the tricyclic antidepressant with one of SSRI class (sertraline), and then, even replacing the initial antipsychotic with another atypical antipsychotic (olanzapine).

7 The treatment was performed in first phase with butyrophenones which has been associated with tricyclic antidepressant, with favorable evolution in the first days, followed by the appearance of secondary reactions that generated the requirement change of treatment schedule. We choose for a combination of atypical antipsychotics drug class that was associated with antidepressant medication (SSRI) and mood stabilizers. Under this treatment schedule the evolution was slowly favorable with complete normalization of appetite, but with persistence of dispositional changes and thought disorders. Prognosis Positive prognostic factors were: Absence of other psychiatric disorders (first episode), Intensive positive symptoms (hallucinations, delusions), Existence of an adequate family support, Female gender. Negative prognostic factors could be related to the early onset as well as the premorbid personality: patient withdrawn without too many friends. Mother said that her friends were with her only for interest and that she does not actually have a real friend. In conclusion, we want to emphasize the particularity of the presented case, given by comorbidity with endocrine disorders which may be clinically expressed by psychiatric symptoms, putting problems to the clinician in the phase of differential diagnosis. Urinating difficulties secondary appeared in response to treatment, although rare, have created the requirement of therapeutic change, which significantly influenced the evolution of patient treatment.

8

GENERAL BEHAVIOR INVENTORY Self-Report Version Never or Sometimes Often Very Often

GENERAL BEHAVIOR INVENTORY Self-Report Version Never or Sometimes Often Very Often GENERAL BEHAVIOR INVENTORY Self-Report Version Here are some questions about behaviors that occur in the general population. Think about how often they occur for you. Using the scale below, select the

More information

A-Z of Mental Health Problems

A-Z of Mental Health Problems Mental health problems can cover a broad range of disorders, but the common characteristic is that they all affect the affected person s personality, thought processes or social interactions. They can

More information

DEPRESSION. There are a couple of kinds, or forms. The most common are major depression and dysthymic disorder.

DEPRESSION. There are a couple of kinds, or forms. The most common are major depression and dysthymic disorder. DEPRESSION OBJECTIVES: At the end of this class, you will be able to: 1.list and describe several kinds of depression, 2.discuss the signs of depression, and 3.relate the treatment of depression. INTRODUCTION

More information

Depression Care. Patient Education Script

Depression Care. Patient Education Script Everybody has the blues from time to time, or reacts to stressful life events with feelings of anxiety, sadness, or anger. Normally these feelings go away with time but when they persist, and are present

More information

did you feel sad or depressed? did you feel sad or depressed for most of the day, nearly every day?

did you feel sad or depressed? did you feel sad or depressed for most of the day, nearly every day? Name: Age: Date: PDSQ This form asks you about emotions, moods, thoughts, and behaviors. For each question, circle YES in the column next to that question, if it describes how you have been acting, feeling,

More information

Depressive, Bipolar and Related Disorders

Depressive, Bipolar and Related Disorders Depressive, Bipolar and Related Disorders Robert Kelly, MD Assistant Professor of Psychiatry Weill Cornell Medical College White Plains, New York Lecture available at www.robertkelly.us Financial Conflicts

More information

COUPLE & FAMILY INSTITUTE OF TRI-CITIES AMEN ADULT GENERAL SYMPTOM CHECKLIST

COUPLE & FAMILY INSTITUTE OF TRI-CITIES AMEN ADULT GENERAL SYMPTOM CHECKLIST COUPLE & FAMILY INSTITUTE OF TRI-CITIES AMEN ADULT GENERAL SYMPTOM CHECKLIST Please rate yourself on each symptom listed below. Please use the following scale: 0--------------------------1---------------------------2--------------------------3--------------------------4

More information

Here are a few ideas to help you cope and get through this learning period:

Here are a few ideas to help you cope and get through this learning period: Coping with Diabetes When you have diabetes you may feel unwell and have to deal with the fact that you have a life long disease. You also have to learn about taking care of yourself. You play an active

More information

Problem Situation Form for Parents

Problem Situation Form for Parents Problem Situation Form for Parents Please complete a form for each situation you notice causes your child social anxiety. 1. WHAT WAS THE SITUATION? Please describe what happened. Provide enough information

More information

Mental/Emotional Health Problems. Mood Disorders and Anxiety Disorders

Mental/Emotional Health Problems. Mood Disorders and Anxiety Disorders Mental/Emotional Health Problems Mood Disorders and Anxiety Disorders Mood Disorders: When a person experiences extreme or prolonged moods. Mental Health Problems Anxiety Disorders: extreme worries about

More information

Handout 3: Mood Disorders

Handout 3: Mood Disorders Handout 3: Mood Disorders Mood disorders are called affective (emotional) disorders. There are two categories of mood disorders: Depressive Disorders Bipolar Affective Disorders Depressive Disorders Minor

More information

,2($".+;2".$;+'#04.23)+ %(+<=>+&"#2+

,2($.+;2.$;+'#04.23)+ %(+<=>+&#2+ 82$2&$%(9+"(:+3"("9%(9+&0330(+&;%.:+"(:+":-.$+,0:-.2+7+,2($".+;2".$;+'#04.23)+ %(++&"#2+,0:-.2+5+++?033-(%&"$%0(++ @A%..)+"(:++ B))2))32($+ M;0-9;$N++ '2#&2'$%0(N+"(:+ 3230#F+ '#04.23)+,0:-.2++O+++++++++

More information

Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum

Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum HRSA-UIC Assessment of Depression Perinatal during Pregnancy Project: and Postpartum Primary Care Tool for Assessment of Depression during Pregnancy and Postpartum te to health care provider: This tool

More information

The prominent symptoms of schizophrenia include three broad categories of symptoms:

The prominent symptoms of schizophrenia include three broad categories of symptoms: by Lynn Marcinko McFarr, Ph.D., Founding Fellow, ACT What is Schizophrenia? Schizophrenia can be a devastating illness. It affects approximately one percent of the population. People afflicted with schizophrenia

More information

Auditory System Case Histories

Auditory System Case Histories 574 Auditory System Case Histories CASE 1: A 14-year old girl is brought to the emergency room by her mother who tells you that she thinks her daughter poked something in her ear. The girl states that

More information

My Father Has a Mood. Disorder

My Father Has a Mood. Disorder My Father Has a Mood Disorder 1996 Bipolar Support Canterbury Inc. Reprinted 2004 Illustrations by Judy Lee Bipolar Support Canterbury would like to acknowledge the assistance of J R McKenzie Trust and

More information

Management of a HIV-infected patient with a psychiatric disorder

Management of a HIV-infected patient with a psychiatric disorder Management of a HIV-infected patient with a psychiatric disorder Maria Ferrara, Modena, Italia Guida Da Ponte, Lisboa, Portugal Jordi Blanch, Barcelona Main complaint Mr M is a 30-year-old HIV+ man In

More information

AP Psychology: Abnormal Quiz 1

AP Psychology: Abnormal Quiz 1 AP Psychology: Abnormal Quiz 1 1. Applying a medical model to identify and treat psychological disorders should be used: A) in every case. B) only in cases of suspected trauma. C) only in cases of suspected

More information

Bright Nights: Understanding Depression

Bright Nights: Understanding Depression Bright Nights: Understanding Depression KEVIN SETHI, MD MARCH 18 TH, 2019 Objectives Features of Depression Facts and Myths Treatment Options Medications Neuromodulation Cognitive Behavioral Therapy Mindfulness

More information

Mental Health Issues in Nursing Homes. I m glad you asked.

Mental Health Issues in Nursing Homes. I m glad you asked. Mental Health Issues in Nursing Homes I m glad you asked. I m glad you asked Susan Wehry, M.D. Associate Professor of Psychiatry, College of Medicine, University of Vermont Consultant, State of Vermont

More information

Handout 2: Understanding Psychotic Illness

Handout 2: Understanding Psychotic Illness Handout 2: Understanding Psychotic Illness A Psychosis refers to a state where a person loses contact with reality. The word is derived from the Latin words "psyche" meaning mind and "osis" meaning illness.

More information

Your Anxious Child: What Parents Need to Know. Caryl Oris, MD

Your Anxious Child: What Parents Need to Know. Caryl Oris, MD Your Anxious Child: What Parents Need to Know Caryl Oris, MD What s Normal? n Normal developmental fears: n Separation Anxiety n Fear of the dark n Separation Anxiety n Fear is a physiological reaction

More information

Schizophrenia and Other Psychotic Disorders

Schizophrenia and Other Psychotic Disorders Schizophrenia and Other Psychotic Disorders Chapter 14 This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display,

More information

Mood Disorders for Care Coordinators

Mood Disorders for Care Coordinators Mood Disorders for Care Coordinators David A Harrison, MD, PhD Assistant Professor, Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Introduction 1 of 3 Mood disorders

More information

Dealing with Traumatic Experiences

Dealing with Traumatic Experiences Dealing with Traumatic Experiences RECOGNIZING THE SIGNS POST INCIDENT STRESS AND HOW TO COPE WITH IT Some of the stress symptoms that individuals can experience after traumatic incidents are listed below.

More information

6800$5< /,)(7,0( ',$*126(6 &+(&./,67 'DWH RI &XUUHQW BBBB BBBB BBBBBB

6800$5< /,)(7,0( ',$*126(6 &+(&./,67 'DWH RI &XUUHQW BBBB BBBB BBBBBB Criteria for Probable Diagnosis: 1. Meets criteria for core symptoms of the disorder. 2. Meets all but one, or a minimum of 75% of the remaining criteria required for the diagnosis 3. Evidence of functional

More information

CASE 5 - Toy & Klamen CASE FILES: Psychiatry

CASE 5 - Toy & Klamen CASE FILES: Psychiatry CASE 5 - Toy & Klamen CASE FILES: Psychiatry A 14-year-old boy is brought to the emergency department after being found in the basement of his home by his parents during the middle of a school day. The

More information

Some Common Mental Disorders in Young People Module 3B

Some Common Mental Disorders in Young People Module 3B Some Common Mental Disorders in Young People Module 3B MENTAL ILLNESS AND TEENS About 70% of all mental illnesses can be diagnosed before 25 years of age When they start, most mental illnesses are mild

More information

A NEW MOTHER S. emotions. Your guide to understanding maternal mental health

A NEW MOTHER S. emotions. Your guide to understanding maternal mental health A NEW MOTHER S emotions Your guide to understanding maternal mental health It is not your fault It is treatable Understanding Maternal Mental Health Life with a new baby is not always easy and the adjustment

More information

Are All Older Adults Depressed? Common Mental Health Disorders in Older Adults

Are All Older Adults Depressed? Common Mental Health Disorders in Older Adults Are All Older Adults Depressed? Common Mental Health Disorders in Older Adults Cherie Simpson, PhD, APRN, CNS-BC Myth vs Fact All old people get depressed. Depression in late life is more enduring and

More information

Depression: what you should know

Depression: what you should know Depression: what you should know If you think you, or someone you know, might be suffering from depression, read on. What is depression? Depression is an illness characterized by persistent sadness and

More information

What is Schizophrenia?

What is Schizophrenia? What is Schizophrenia? What is schizophrenia? Schizophrenia is a mental illness which affects one person in every hundred. Schizophrenia interferes with the mental functioning of a person and, in the long

More information

Session 16: Manage Your Stress

Session 16: Manage Your Stress Session 16: Manage Your Stress Stress is part of life. However, you can learn better ways to take care of yourself when faced with stress. Stress is not always bad. Some stress can make life interesting

More information

Depression awareness. Bayside Academy Parent Workshop - October 2, 2017

Depression awareness. Bayside Academy Parent Workshop - October 2, 2017 Depression awareness Bayside Academy Parent Workshop - October 2, 2017 Lauren Alexander 6th Grade (Last Names Lo-Z) and 8th Grade Counselor LAAlexander@smfcsd.net John-Michael Gomez Mental Health Clinician

More information

Chapter 29. Caring for Persons With Mental Health Disorders

Chapter 29. Caring for Persons With Mental Health Disorders Chapter 29 Caring for Persons With Mental Health Disorders The Whole Person The whole person has physical, social, psychological, and spiritual parts. Mental relates to the mind. Mental health and mental

More information

Bipolar and Affective Disorders. Harleen Johal

Bipolar and Affective Disorders. Harleen Johal + Bipolar and Affective Disorders Harleen Johal hkj1g11@soton.ac.uk + Affective (mood) disorders n Depression n Bipolar disorder n Anxiety n Treatment + Depression: Definition n Pervasiveand persistent

More information

3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose

3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose A module within the 8 hour Responding to Crisis Course Our purpose 1 What is mental Illness Definition of Mental Illness A syndrome characterized by clinically significant disturbance in an individual

More information

Medical Interpretation in Psychotherapy. Francis Stevens, Ph.D.

Medical Interpretation in Psychotherapy. Francis Stevens, Ph.D. Medical Interpretation in Psychotherapy Francis Stevens, Ph.D. Welcome My background Introduction Break up into pairs Introduce yourself What interpretation services have you done? What do you think would

More information

Typical or Troubled? Teen Mental Health

Typical or Troubled? Teen Mental Health Typical or Troubled? Teen Mental Health Adolescence is a difficult time for many teens, but how does one know the difference between typical teen issues and behavior that might signal a more serious problem?

More information

Behavioral Issues in Dementia. March 27, 2014 Dylan Wint, M.D.

Behavioral Issues in Dementia. March 27, 2014 Dylan Wint, M.D. Behavioral Issues in Dementia March 27, 2014 Dylan Wint, M.D. OVERVIEW Key points Depression Definitions and detection Treatment Psychosis Definitions and detection Treatment Agitation SOME KEY POINTS

More information

Cours 6 : Mental Illness and Mental Health Care, Part II

Cours 6 : Mental Illness and Mental Health Care, Part II UE1-Anglais Pr. Bernier Le 14/12/2017 à 8H 30 Ronéotypeur : Roxane BIDAUD Cours 6 : Mental Illness and Mental Health Care, Part II 1 /8 Sommaire I) Chapter I: Mood Disorders, depression and Bipolar Disorder

More information

- copyright

- copyright Relaxation Exercises Let s start with breathing! Your breathing is often the first thing to be affected by stress. When we are anxious we tend to hunch up the shoulders and breathe in a more rapid and

More information

Elements of Communication

Elements of Communication Elements of Communication Elements of Communication 6 Elements of Communication 1. Verbal messages 2. Nonverbal messages 3. Perception 4. Channel 5. Feedback 6. Context Elements of Communication 1. Verbal

More information

CHILDHOOD C 3 HANGE CARE TOOL: PROVIDER REPORT

CHILDHOOD C 3 HANGE CARE TOOL: PROVIDER REPORT Date: / / Patient s Project ID# For use as-needed in clinic visits A SURVEY TO LEARN ABOUT A PATIENT S NEEDS AND ABILITIES: Health care providers of children and adolescents aged 5 to 2 How is this patient

More information

Delirium. Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning.

Delirium. Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning. Delirium Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning. DELIRIUM IS A MEDICAL EMERGENCY! Delirium: Hallmark Features Inattention-

More information

Clinical Education Initiative INTRODUCTION TO HIV PSYCHIATRY. Speaker: Hansel Arroyo, MD

Clinical Education Initiative INTRODUCTION TO HIV PSYCHIATRY. Speaker: Hansel Arroyo, MD Clinical Education Initiative Support@ceitraining.org INTRODUCTION TO HIV PSYCHIATRY Speaker: Hansel Arroyo, MD 3/1/2017 Introduction to HIV Psychiatry [video transcript] 00:00:07 - So we're gonna be talking

More information

Winter Night Shelters and Mental Healh Barney Wells, Enabling Assessment Service London.

Winter Night Shelters and Mental Healh Barney Wells, Enabling Assessment Service London. Winter Night Shelters and Mental Healh Barney Wells, Enabling Assessment Service London. Introduction goals of session - What is mental health - What is interaction between poor mental health and CWS -

More information

Jonathan Haverkampf BIPOLAR DISORDR BIPOLAR DISORDER. Dr. Jonathan Haverkampf, M.D.

Jonathan Haverkampf BIPOLAR DISORDR BIPOLAR DISORDER. Dr. Jonathan Haverkampf, M.D. BIPOLAR DISORDER Dr., M.D. Abstract - Bipolar disorder is a condition affecting an individual s affective states (mood). The different flavors of bipolar disorder have in common that there are alterations

More information

Understanding and Recognizing Childhood Depression

Understanding and Recognizing Childhood Depression Understanding and Recognizing Childhood Depression A PARENT S GUIDE Live Session Being Recorded This is a reminder that our live session is being recorded for future playback for those parents who could

More information

PRISM SECTION 15 - STRESSFUL EVENTS

PRISM SECTION 15 - STRESSFUL EVENTS START TIME : PRISM SECTION 15 - STRESSFUL EVENTS Statement I.1: These next questions are about difficult or stressful things that can happen to people. It may be hard to remember everything about these

More information

PTSD for PAG Clinicians: Empowering Young Women with PTSD

PTSD for PAG Clinicians: Empowering Young Women with PTSD PTSD for PAG Clinicians: Empowering Young Women with PTSD Paritosh Kaul, MD 1 Bethany D. Ashby, PsyD 2 Jennifer L. Woods, MD, MS 1 University of Colorado School of Medicine 1 Section of Adolescent Medicine,

More information

This initial discovery led to the creation of two classes of first generation antidepressants:

This initial discovery led to the creation of two classes of first generation antidepressants: Antidepressants - TCAs, MAOIs, SSRIs & SNRIs First generation antidepressants TCAs and MAOIs The discovery of antidepressants could be described as a lucky accident. During the 1950s, while carrying out

More information

The Stimulation Test. What, Why, and How. Date. Time. Place. Dr./Nurse. Phone _elhmtp_HG64712_stim_br_fa3.indd 3

The Stimulation Test. What, Why, and How. Date. Time. Place. Dr./Nurse. Phone _elhmtp_HG64712_stim_br_fa3.indd 3 The Stimulation Test Date Time Place Dr./Nurse Phone 45364_elhmtp_HG64712_stim_br_fa3.indd 3 7/28/10 1:46:55 PM What You Should Know About Your Child s Stimulation Test 2 Key Terms 3 Normal Growth 4 Evaluation

More information

Alzheimer Disease and Related Dementias

Alzheimer Disease and Related Dementias Alzheimer Disease and Related Dementias Defining Generic Key Terms and Concepts Mild cognitive impairment: (MCI) is a state of progressive memory loss after the age of 50 that is beyond what would be expected

More information

Psychological Sleep Services Sleep Assessment

Psychological Sleep Services Sleep Assessment Psychological Sleep Services Sleep Assessment Name Date **************************************************** Insomnia Severity Index For each question, please CIRCLE the number that best describes your

More information

INSOMNIA SEVERITY INDEX

INSOMNIA SEVERITY INDEX Name: Date: INSOMNIA SEVERITY INDEX For each of the items below, please circle the number that most closely corresponds to how you feel. 1. Please rate the CURRENT (i.e. last 2 weeks) severity of your

More information

Paranoid Schizophrenia. Prepared by : Noor Al-Hakami pharm-d candidate KSU

Paranoid Schizophrenia. Prepared by : Noor Al-Hakami pharm-d candidate KSU Paranoid Schizophrenia Prepared by : Noor Al-Hakami pharm-d candidate KSU Paranoid schizophrenia is one of several types of schizophrenia which affect around 40 % of people with schizophrenia It tends

More information

Determining Major Depressive Disorder in Youth.

Determining Major Depressive Disorder in Youth. Co-parenting chapter eight. Watching for Depression in Yourself and Your Child. by Yvonne Sinclair M.A. If you notice your child has been feeling sad most of the day and can t seem to shake that down feeling,

More information

PATIENT NAME: DATE OF DISCHARGE: DISCHARGE SURVEY

PATIENT NAME: DATE OF DISCHARGE: DISCHARGE SURVEY PATIENT NAME: DATE OF DISCHARGE: DISCHARGE SURVEY Please indicate whether you feel Living Hope Eating Disorder Treatment Center provided either Satisfactory or Unsatisfactory service for each number listed

More information

PATIENT SURVEY FOR ADMINISTRATIVE USE ONLY. TO BE COMPLETED BY STUDY COORDINATOR.

PATIENT SURVEY FOR ADMINISTRATIVE USE ONLY. TO BE COMPLETED BY STUDY COORDINATOR. PATIENT SURVEY FOR ADMINISTRATIVE USE ONLY. TO BE COMPLETED BY STUDY COORDINATOR. DATE OF VISIT: / / PATIENT ID: REGULAR PROVIDER: SITE OF VISIT: Cleveland Houston Manhattan Pittsburgh Thank you for agreeing

More information

Nightmares and night terrors

Nightmares and night terrors Nightmares and night terrors Q. My three-and-a-half-year-old has started waking every night around the same time, and screaming. I think he s in the middle of a nightmare. He s really frightened, and I

More information

The Psychiatric Liaison Team for Older Adults

The Psychiatric Liaison Team for Older Adults The Psychiatric Liaison Team for Older Adults A guide to delirium, depression and dementia for patients and carers South London and Maudsley NHS Foundation Trust Page The Liaison Team We are a mental health

More information

Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan

Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan Rationale: In the event a [resident] verbalizes suicidal thoughts or even a plan, the carer will know what steps to take for safety

More information

Post-traumatic Stress Disorder

Post-traumatic Stress Disorder Parkland College A with Honors Projects Honors Program 2012 Post-traumatic Stress Disorder Nicole Smith Parkland College Recommended Citation Smith, Nicole, "Post-traumatic Stress Disorder" (2012). A with

More information

The treatment of bipolar disorder in adults, children and adolescents

The treatment of bipolar disorder in adults, children and adolescents DRAFT FOR CONSULTATION The treatment of bipolar disorder in adults, children and adolescents The paragraphs in the draft are numbered for the purposes of consultation. The final version will not contain

More information

Psychotic disorders Dr. Sarah DeLeon, MD PGYIV, Psychiatry ConceptsInPsychiatry.com

Psychotic disorders Dr. Sarah DeLeon, MD PGYIV, Psychiatry ConceptsInPsychiatry.com Psychotic disorders Dr. Sarah DeLeon, MD PGYIV, Psychiatry ConceptsInPsychiatry.com Introduction Psychotic spectrum disorders include schizotypal personality disorder, delusional disorder, brief psychotic

More information

Prepared by: Elizabeth Vicens-Fernandez, LMHC, Ph.D.

Prepared by: Elizabeth Vicens-Fernandez, LMHC, Ph.D. Prepared by: Elizabeth Vicens-Fernandez, LMHC, Ph.D. Sources: National Institute of Mental Health (NIMH), the National Alliance on Mental Illness (NAMI), and from the American Psychological Association

More information

F r e q u e n t l y A s k e d Q u e s t i o n s

F r e q u e n t l y A s k e d Q u e s t i o n s Anorexia Nervosa Q: What is anorexia nervosa? A: A person with anorexia nervosa (an-uh- RECK-see-uh nur-voh-suh), often called anorexia, has an intense fear of gaining weight. Someone with anorexia thinks

More information

Aging and Mental Health Current Challenges in Long Term Care

Aging and Mental Health Current Challenges in Long Term Care Aging and Mental Health Current Challenges in Long Term Care Stephanie Saur & Christina Pacheco Acute Care Behavioural Consultants Alzheimer Society Peel What is Mental Health? Mental health includes our

More information

Early Warning Signs of Psychotic Disorders and the Importance of Early Intervention

Early Warning Signs of Psychotic Disorders and the Importance of Early Intervention Early Warning Signs of Psychotic Disorders and the Importance of Early Intervention Margaret Migliorati, MA, LPCC The University of New Mexico mmigliorati@salud.unm.edu Mental Health As a Public Health

More information

Depression and Bipolar Disorder

Depression and Bipolar Disorder The Canadian Mental Health Association (CMHA) is a nation-wide, charitable organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness.

More information

Schizophrenia. Introduction. Overview and Facts

Schizophrenia. Introduction. Overview and Facts Introduction is a chronic, severe and disabling brain disease that typically shows its first clear symptoms in late adolescence or early adulthood. It is one of several types of Psychotic Disorders. It

More information

Medicare Wellness Visit

Medicare Wellness Visit of Birth: Today s : Medicare Wellness Visit Dear Patient, Your Medicare benefits include an Annual Wellness Visit to assist in preventing illness or detect illness at an early stage. Your Annual Wellness

More information

Talking to Teens About Anxiety. A Supplement to the 2018 Children s Mental Health Report

Talking to Teens About Anxiety. A Supplement to the 2018 Children s Mental Health Report Talking to Teens About Anxiety A Supplement to the 2018 Children s Mental Health Report Everyone talks about how stressed they are, but getting teens to open up about serious anxiety isn t easy. Sometimes

More information

Creating and Maintaining a Safe and Comfortable Home

Creating and Maintaining a Safe and Comfortable Home Creating and Maintaining a Safe and Comfortable Home Crisis Prevention and Management Training for Limited Mental Health Assisted Living Facility Staff Program Manager and Trainer MARGO FLEISHER Acknowledgements

More information

Update on First Psychotic Episodes in Childhood and Adolescence. Cheryl Corcoran, MD Assistant Professor of Psychiatry Columbia University

Update on First Psychotic Episodes in Childhood and Adolescence. Cheryl Corcoran, MD Assistant Professor of Psychiatry Columbia University Update on First Psychotic Episodes in Childhood and Adolescence Cheryl Corcoran, MD Assistant Professor of Psychiatry Columbia University Childhood-Onset Psychosis 8% of psychiatrically referred youth

More information

Delirium Information for relatives, carers and patients

Delirium Information for relatives, carers and patients Delirium Information for relatives, carers and patients Contents Part A Introduction What is delirium? Quotes from relatives or carers showing what might happen to a patient suffering from delirium How

More information

Coping with Advanced Stage Heart Failure and LVAD/Transplant. Kristin Kuntz, Ph.D. Department of Psychiatry and Behavioral Health

Coping with Advanced Stage Heart Failure and LVAD/Transplant. Kristin Kuntz, Ph.D. Department of Psychiatry and Behavioral Health Coping with Advanced Stage Heart Failure and LVAD/Transplant Kristin Kuntz, Ph.D. Department of Psychiatry and Behavioral Health What is Health Psychology? Health psychology focuses on how biology, psychology,

More information

UW MEDICINE PATIENT EDUCATION. Baby Blues and More DRAFT. Knowing About This in Advance Can Help

UW MEDICINE PATIENT EDUCATION. Baby Blues and More DRAFT. Knowing About This in Advance Can Help UW MEDICINE PATIENT EDUCATION Baby Blues and More Recognizing and coping with postpartum mood disorders Some women have baby blues or more serious postpartum mood disorders. It helps to know about these

More information

TREANA 5mg and 10mg Film-coated Tablets

TREANA 5mg and 10mg Film-coated Tablets PACKAGE LEAFLET: INFORMATION FOR THE USER TREANA 5mg and 10mg Film-coated Tablets OLANZAPINE This leaflet is a copy of the Summary of Product Characteristics and Patient Information Leaflet for a medicine,

More information

PATIENT SLEEP QUESTIONNAIRE

PATIENT SLEEP QUESTIONNAIRE PATIENT SLEEP QUESTIONNAIRE Name: Date of Birth: Today s Date Primary Care Physician Telephone # Physician ordering test (Other than PCP): Physician s Tel. #: _ Age: Years Height: Feet Inches Weight: Lb

More information

Eating Disorders in Youth

Eating Disorders in Youth Eating Disorders in Youth Evaluating and Treating in the Medical Home February 27, 2017 Rebecca Marshall, MD, MPH Outline Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Avoidant Restrictive Food

More information

When you re told you have cancer. QUESTIONS TO ASK MY DOCTOR About My Cancer Adapted with permission from the American Cancer Society

When you re told you have cancer. QUESTIONS TO ASK MY DOCTOR About My Cancer Adapted with permission from the American Cancer Society QUESTIONS TO ASK MY DOCTOR About My Cancer Adapted with permission from the American Cancer Society If you or a loved one has been diagnosed with cancer, you probably have a lot of questions and concerns.

More information

USF Mood & Anxiety Disorders Program

USF Mood & Anxiety Disorders Program QUICK INVENTORY OF DEPRESSIVE SYMPTOMATOLOGY (SELF-REPORT)(QIDS-SR16) Please circle the one response to each item that best describes you for the past seven days. 1. Falling Asleep: 0 I never take longer

More information

Module 3 - How Pain Affects You

Module 3 - How Pain Affects You Module 3 - How Pain Affects You You have learned that pain is produced as a result of all of the incoming electrical or danger signals which reach your brain. Example: Mum Watching Her Son Play Footy Think

More information

Signs of Acute Stress Disorder Symptom Behavioral Signs Support Needed

Signs of Acute Stress Disorder Symptom Behavioral Signs Support Needed APPENDIX G: A GUIDE TO RECOGNIZING ACUTE STRESS DISORDER IN POSTPARTUM WOMEN IN THE HOSPITAL SETTING Michelle Flaum Hall, EdD, LPCC-S, Xavier University INTRODUCTION The Diagnostic and Statistical Manual

More information

Depression During and After Pregnancy

Depression During and After Pregnancy Depression During and After Pregnancy Q: What is depression? A: Depression is more than just feeling blue or down in the dumps for a few days. It s a serious illness that involves the brain. With depression,

More information

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,

More information

VCU CENTER FOR SLEEP MEDICINE NEW PATIENT QUESTIONNAIRE

VCU CENTER FOR SLEEP MEDICINE NEW PATIENT QUESTIONNAIRE VCU CENTER FOR SLEEP MEDICINE NEW PATIENT QUESTIONNAIRE Name:_ DOB: MR#: Date: Sex: Age: Height: Referring physician: Primary care physician: What is your primary sleep problem? Please explain any strange

More information

The cancer of mental illness

The cancer of mental illness The cancer of mental illness KWL Chart and Hearing Voices Simulations De-brief on activity What is schizophrenia? Recognition of Schizophrenia Symptoms Anderson Cooper Simulation Diagnosis and Treatment

More information

AUDITORY VOCAL HALLUCINATION RATING SCALE (AVHRS) 1,2 (Jenner and Van de Willige, 2002)

AUDITORY VOCAL HALLUCINATION RATING SCALE (AVHRS) 1,2 (Jenner and Van de Willige, 2002) AUDITORY VOCAL HALLUCINATION RATING SCALE (AVHRS) 1,2 (Jenner and Van de Willige, 2002) The AVHRS is a structured interview to obtain detailed information about a patient s auditory vocal hallucinations

More information

Schizophrenia. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available.

Schizophrenia. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available. What is schizophrenia? Schizophrenia is a severe mental health condition. However,

More information

AN OVERVIEW OF ANXIETY

AN OVERVIEW OF ANXIETY AN OVERVIEW OF ANXIETY Fear and anxiety are a normal part of life. Normal anxiety keeps us alert. Intervention is required when fear and anxiety becomes overwhelming intruding on a persons quality of life.

More information

Your Child & Epilepsy

Your Child & Epilepsy Your Child & Epilepsy 1 Alexander The Great 2 Napoleon 3 Jonty Rhodes 4 EPILEPTICS CANNOT ENJOY LIFE BECAUSE THEY ARE ALWAYS FEARFUL THAT ANY TIME AN ATTACK MAY BE PRECIPITATED 5 Epilepsy - Definition

More information

UPMC SAFE-T Training Adapted for Pediatric Primary Care. Sheri L. Goldstrohm, Ph.D.

UPMC SAFE-T Training Adapted for Pediatric Primary Care. Sheri L. Goldstrohm, Ph.D. UPMC SAFE-T Training Adapted for Pediatric Primary Care Sheri L. Goldstrohm, Ph.D. Prevalence of Suicide in the U.S. 10th most frequent cause of death for all ages 2nd leading cause of death for individuals

More information

Managing Psychotic Disorders in the Primary Care Setting

Managing Psychotic Disorders in the Primary Care Setting Managing Psychotic Disorders in the Primary Care Setting Anne Dohrenwend, Ph.D., ABPP McLaren Regional Medical Center Heather Kirkpatrick, Ph.D., ABPP Genesys Regional Medical Center Presentation Outline!

More information

MODULE III Challenging Behaviors

MODULE III Challenging Behaviors Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident MODULE III Challenging Behaviors S WEHRY 2004 Objectives: Part One Describe principles of communication Describe behavior as

More information

Antidepressants. Dr Malek Zihlif

Antidepressants. Dr Malek Zihlif Antidepressants The optimal use of antidepressant required a clear understanding of their mechanism of action, pharmacokinetics, potential drug interaction and the deferential diagnosis of psychiatric

More information

Brief Notes on the Mental Health of Children and Adolescents

Brief Notes on the Mental Health of Children and Adolescents Brief Notes on the Mental Health of Children and Adolescents The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems

More information

Changes in Therapeutic Concepts. De-mystifying psychiatric drugs. Models of drug action

Changes in Therapeutic Concepts. De-mystifying psychiatric drugs. Models of drug action De-mystifying psychiatric drugs Joanna Moncrieff, UCL, NELFT, CPN, September 2012 Models of drug action Disease centred model Drug centred model Drugs correct an abnormal brain state Drugs as disease treatments

More information