Suchergebnisse

This book offers a series of authoritative reviews on pain in psychiatric disorders written by leading experts. They discuss the complex interplay between pain and psychiatric disorders such as anxiety, depression and borderline personality disorder, as well as neurosteroids, epigenetic mechanisms and TRPV1, with a strong focus on neurobiological mechanisms and current and future therapeutic targets. Special attention is given to the importance of inflammation and the immune system as a common substrate in both pain and psychiatric disorders. The state-of-the-art reviews present both preclinical and clinical research, providing the reader with sound knowledge that provides a basis for further research and clinical practice. Pain in Psychiatric Disorders is of special interest to psychiatrists, neurologists, neuroscientists, pharmacologists and other healthcare professionals treating pain in psychiatric patients, as well as research students with an interest in this field

Cover -- Front Matter -- Contents -- Preface -- References -- Animal Models for the Study of Comorbid Pain and Psychiatric Disorders -- Abstract -- Animal Measurement of Pain-Like Behaviors and Models of Chronic Pain -- Comorbid Psychiatric Disorders in Chronic Pain -- Animal Models of Chronic Pain -- Concluding Remarks -- References -- Pain, Depression and Inflammation: Are Interconnected Causative Factors Involved? -- Abstract -- Stress, Inflammation and Depression -- The Link between Depression and Pain -- The Association of Neuroinflammation with Pain and Depression -- Can Drugs Which Decrease Inflammation Also Be Effective in the Treatment of Pain and Depression? -- Conclusion -- References -- Neuroinflammatory Mechanisms Linking Pain and Depression -- Abstract -- Introduction to Depression-Pain Co-Morbidity -- Peripheral Immune Alterations Observed in Depression-Pain Co-Morbidity -- Neuroinflammation Associated with Depression-Pain Co-Morbidity -- Preclinical Evidence Supporting a Role for Inflammation in Emotion and Pain Interactions -- Modulating (Neuro)Inflammation Reduces Depression-Like and Pain-Related Behaviour in Preclinical Models -- Conclusion and Future Directions -- Acknowledgements -- References -- Cytokines in Neuropathic Pain and Associated Depression -- Abstract -- Neuropathic Pain -- The Role of Individual Cytokines in Neuropathic Pain -- Conclusion -- References -- Biogenic Amines and the Amino Acids GABA and Glutamate: Relationships with Pain and Depression -- Abstract -- The Role of Monoamines in Depression and Chronic Pain -- GABA and Glutamate in Depression and Chronic Pain -- Antidepressants in the Treatment of Chronic Pain -- Conclusion -- Acknowledgements -- References -- Supraspinal Transient Receptor Potential Subfamily V Member 1 (TRPV1) in Pain and Psychiatric Disorders -- Abstract.

Aims: Psychiatric disorders are common among substance dependants. The objectives of this study were to assess the rate of neurotic disorders among opioid addicts, and reassess the rate of those neurotic disorders two weeks after complete detoxification of the patients. Measurements: Data were gathered from 500 (496 men and 4 women) opioid dependants, using DSM-IV criteria. The Middlesex Hospital Questionnaire (MHQ) was used to measure free-floating anxiety, depression, phobia, obsession, hysteria and somatization. Results: Four hundred and ninety-six (99.2%) of the subjects were men of whom the majority (65.2%) were married, 26.4% single and the others were divorced or separated. Three hundred and thirty-four (66.8%) were in age range of 20to 39 years. Of the subjects 154 (30.8) were self-employed, 116 (23.2%) were factory workers, 100 (20%) unemployed, 64 (12.8%) employees and 32 (6.4%) retailers. The majority, 322 (64.4%), reported elementary and high school as their level of education and only 20(4%) were illiterate. The means for neurotic disorders (using the MHQ) before and two weeks after detoxification were 10.12 and 9.98 for anxiety, 7.54 and 7.41 for phobia, 10.10 and 9.76 for depression, 11.11 and 11.05 for obsession, 8.47 and 8.49 for hysteria and 9.82 and 9.46 for somatization, respectively. The mean difference was significant only for depression. Conclusions: Present findings indicated that the rate of neurotic disorders in opioid dependants is high and (except for depression) was not significantly different before detoxification and two weeks after detoxification. Opium was found to be the most prevalent form of opioid used. Also it can be concluded that during the last years some demographic characteristics of Iranian opioid addicts in this sample have changed. Cultural attitudes toward substance use quite likely affect the pattern of substance use. These findings can be considered when planning preventive and therapeutic programs.

The issue of the severity of psychiatric disorders has great clinical importance. For example, severity influences decisions about level of care, and affects decisions to seek government assistance due to psychiatric disability. Controversy exists as to the efficacy of antidepressants across the spectrum of depression severity, and whether patients with severe depression should be preferentially treated with medication rather than psychotherapy. Measures of severity are used to evaluate outcome in treatment studies and may be used as meaningful endpoints in clinical practice. But, what does it mean to say that someone has a severe illness? Does severity refer to the number of symptoms a patient is experiencing? To the intensity of the symptoms? To symptom frequency or persistence? To the impact of symptoms on functioning or on quality of life? To the likelihood of the illness resulting in permanent disability or death? Putting aside the issue of how severity should be operationalized, another consideration is whether severity should be conceptualized similarly for all illnesses or be disorder specific. In this paper, we examine how severity is characterized in research and contemporary psychiatric diagnostic systems, with a special focus on depression and personality disorders. Our review shows that the DSM‐5 has defined the severity of various disorders in different ways, and that researchers have adopted a myriad of ways of defining severity for both depression and personality disorders, although the severity of the former was predominantly defined according to scores on symptom rating scales, whereas the severity of the latter was often linked with impairments in functioning. Because the functional impact of symptom‐defined disorders depends on factors extrinsic to those disorders, such as self‐efficacy, resilience, coping ability, social support, cultural and social expectations, as well as the responsibilities related to one's primary role function and the availability of others to assume those ...

Many clients have both alcoholism and mental health problems. Inexperienced clinicians may treat either the alcoholism or the psychiatric disorder, which results in fragmented or inadequate treatment. Uncoordinated service delivery systems may also undermine treatment.

Abstract Background Most previous research that has examined mental health among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combatants has relied on self-report measures to assess mental health outcomes; few studies have examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders among Marines who deployed to combat in Iraq and Afghanistan. Methods The study sample consisted of 1113 Marines who had deployed to Iraq or Afghanistan. Demographic and psychosocial predictor variables from a survey that all Marines in the sample had completed were studied in relation to subsequent psychiatric diagnoses. Univariate and multivariate logistic regression were used to determine the influence of the predictors on the occurrence of psychiatric disorders. Results In a sample of Marines with no previous psychiatric disorder diagnoses, 18% were diagnosed with a new-onset psychiatric disorder. Adjusting for other variables, the strongest predictors of overall psychiatric disorders were female gender, mild traumatic brain injury symptoms, and satisfaction with leadership. Service members who expressed greater satisfaction with leadership were about half as likely to develop a mental disorder as those who were not satisfied. Unique predictors of specific types of mental disorders were also identified. Conclusions Overall, the study's most relevant result was that two potentially modifiable factors, low satisfaction with leadership and low organizational commitment, predicted mental disorder diagnoses in a military sample. Additional research should aim to clarify the nature and impact of these factors on combatant mental health.

AbstractPsychiatric disorders in epileptic patients may complicate treatment because of the complex relationship between neurological and mental illness.

Background: The Mapuche are the largest indigenous group in Chile; yet almost all data on the mental health of indigenous populations are from North America. Aim: The study examines the differential DSM-III-R prevalence rates of psychiatric disorders and service utilization among indigenous and non-indigenous community residence. Methods: The Composite International Diagnostic Interview (CIDI) was administered to a stratified random sample of 75 Mapuche and 434 non-Mapuche residents of the province of Cautín. Lifetime prevalence and 12-month prevalence rates were estimated. Results: Approximately 28.4% of the Mapuche population had a lifetime, and 15.7% a 12-month, prevalent psychiatric disorder compared to 38.0% and 25.7%, respectively, of the non-Mapuche. Few significant differences were noted between the two groups; however, generalized anxiety disorder, simple phobia, and drug dependence were less prevalent among the Mapuche. Service utilization among the Mapuche with mental illness was low. Conclusions: This is a preliminary study based on a small sample size. Further research on the mental health of indigenous populations of South America is needed.