Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers

Background Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers. Objective Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS). Methods Sixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission. Results Eleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n=8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity

Quality of life in patients with chronic idiopathic urticaria: the impact of Axis I and Axis II psychiatric disorders

Objective: Chronic idiopathic urticaria (CIU) associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently present in patients with CIU. This study examined the impact of Axis I and Axis II psychiatric disorders oil the QoL of patients with CIU. Method: The study sample consisted of 100 subjects including CIU patients with only Axis I psychiatric diagnoses (n=25), CIU patients with only Axis II diagnoses (n=25), CIU patients with both Axis I and Axis II diagnoses (n=25), CIU patients without any Axis I and Axis II diagnosis (n=25), and healthy control subjects with respect to urticaria and psychiatric disorders (n=25). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-11) was used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief (WHOWOL-BREF). Results: There were significant differences among the groups with respect to all WHOQOL-BREF subscale scores. The QoL levels were similar among CIU patients with only Axis I psychiatric diagnoses, CIU patients with only Axis II diagnoses and CIU patients with both Axis I and Axis It diagnoses, and between CIU patients without any Axis I and Axis II diagnosis, and healthy control Subjects. When compared with those of CIU patients without any Axis I and Axis II diagnosis, CIU patients without concurrent psychiatric diagnoses had significantly lower scores in most domains of the QoL scale. Conclusions: Axis I and Axis II psychiatric disorders seem to be considerable factors influencing the QoL in CIU patients. (C) 2008 Elsevier Inc. Ail rights reserved

Postictal physichosis

Postiktal psikoz epileptik hastalarda görülen psikozların % 25'ini oluşturur. Tipik olarak tonik klonik veya kompleks parsiyel nöbet kümeleri sonrası ortaya çıkar. Bilateral bağımsız epileptik aktivite postiktal psikozlu hastalarda sıklıkla görülmektedir. Olguda postiktal psikoz gelişen ve risperidon ile tedavi edilen epileptik bir hasta sunulmuştur.Postictal psychosis represents 25% of the psychoses seen in epileptic patients. PIP typically appears after a cluster of tonicclonic seizures or complex partial seizures. Bilateral independent epileptiform activity has been observed in patients with postictal psychosis. We present the case of a patient who developed postictal psychosis and was treated with risperidon

Postiktal psikoz

epileptik hastalarda görülen psikozların % 25’ini oluşturur. Tipik olarak tonik klonik veya kompleks parsiyel nöbet kümeleri sonrası ortaya çıkar. Bilateral bağımsız epileptik aktivite postiktal psikozlu hastalarda sıklıkla görülmektedir. Olguda postiktal psikoz gelişen ve risperidon ile tedavi edilen epileptik bir hasta sunulmuştu

Benign Paroksismal Pozisyonel Vertigolu Hastalarda, Anksiyete, Duygudurum ve Kişilik Bozuklukları

WOS:000450095400009PubMed ID: 30042641Introduction: This study presents the current prevalence of anxiety,mood, and personality disorders as well as factors associated with theexistence of psychiatric disorders in patients with benign paroxysmalpositional vertigo (BPPV).Methods: The study sample comprised 46 patients with BPPV and 74control subjects. Anxiety and mood disorders were ascertained via theStructured Clinical Interview for the Diagnostic and Statistical Manual(DSM) of Mental Disorders, Fourth Edition/Clinical Version. Personalitydisorders were diagnosed via the Structured Clinical Interview for DSM,Revised Third Edition, Personality Disorders.Results: Of the 46 patients, 18 (39.1%) had at least one mood or anxietydisorder and 13 (28.3%) had at least one personality disorder. The mostcommon Axis I and Axis II disorders in the patient group were majordepression in 8 (17.4%) and obsessive–compulsive personality disorderin 10 (21.7%) patients, respectively. It was found that major depression(p0.021), generalized anxiety disorder (p0.026) and obsessive–compulsive personality disorder (p0.001) were more prevalent in theBPPV group compared with the control group.Conclusion: Results suggest that psychiatric disturbances should becarefully checked in patients with BPPV due to the relatively high rateof comorbidity.Amaç: Bu çalışma benign paroksismal pozisyonel vertigo (BPPV)hastalarında psikiyatrik bozuklukların varlığı ile ilişkili faktörlerin veanksiyete, duygudurum ve kişilik bozukluklarının mevcut yaygınlığınısunmaktadır.Yöntem: Araştırma örneklemi 46 BPPV hastası ve 74 kontrol olgusundanoluşmuştur. Anksiyete ve duygudurum bozuklukları Structured ClinicalInterview for the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition/Clinical Version yoluyla tespit edildi. Kişilik bozukluklarıtanısı Structured Clinical Interview for DSM, Revised Third EditionPersonality Disorders ile konuldu.Bulgular: Kırk altı hastanın 18’in (%39,1) de en az bir duygudurum yada anksiyete bozukluğu ve 13’ün (%28,3) de en az bir kişilik bozukluğuvardı. Eksen I ve Eksen II tanıları olarak en sık, sırasıyla 8 (%17,4)hastada majör depresyon ve 10 (%21,7) hastada obsesif kompulsifkişilik bozukluğu vardı. Major depresyon (p:0,021), yaygın anksiyetebozukluğu (p:0,026) ve obsesif kompulsif kişilik bozukluğu (p:0,001)yaygınlığının kontrol grubu ile karşılaştırıldığında BPPV grubunda dahasık görüldüğü bulunmuştur.Sonuç: Sonuçlar; BPPV tanılı hastaların, psikiyatrik bozuklukların yüksekoranlı komorbiditeleri nedeniyle dikkatle değerlendirilmeleri gerektiğiniortaya koymaktadır