VIOLENCE IS NOT ONLY WRONG,IT’S DISEASED-it’s always painful and too often fatal-as with Martin Luther King,no less.When emotions run high,doctors have difficulty making progress-calm,dispassionate review of the obv...VIOLENCE IS NOT ONLY WRONG,IT’S DISEASED-it’s always painful and too often fatal-as with Martin Luther King,no less.When emotions run high,doctors have difficulty making progress-calm,dispassionate review of the obvious evidence is vital,if you aim for less pain and fewer deaths.This paper is based on the self-evident precept that violated children unmistakeably predate violent adults.The remedy,highlighted here,is unusual in all psychiatry,in that it is backed by solid,irrefutable,objective,scientific evidence-from brainscans,no less-at least it is,for those willing to look.The paper has 6 parts:1.Introduction;2.Un-memorising Terror;3.Nutritious Emotions;4.Tyrannical Revenge;5.The Way to Cure Nucleargeddon Is Paved With Good Intentions;6.Conclusion.Parenting is a troubled skill,largely because mis-parenting perpetuates itself.As the poet Philip Larkin says of parents-“they fill you with the faults they had,and add some extra just for you”.Larkin moderates his criticism with“they may not mean to,but they do”.Sadly his“solution”-“don’t have any kids yourself”can extinguish the human race as reliably as ever revengeful Emotional Dwarfism will.展开更多
Schizophrenia and attention deficit hyperactivity disorder(ADHD) are two psychiatric disorders with a negative impact on quality of life of individuals affected. Although they are classified into distinct disorders ca...Schizophrenia and attention deficit hyperactivity disorder(ADHD) are two psychiatric disorders with a negative impact on quality of life of individuals affected. Although they are classified into distinct disorders categories, attentional dysfunction is considered as a core feature in both conditions, either at the clinical then pathophysiological level. Beyond the obvious clinical overlap between these disorders, the Research DomainCriteria approach might offer an interesting perspective for disentangling common circuits underpinning both disorders. Hence, we review evidences regarding the overlap between schizophrenia and ADHD, at the clinical level, and at the level of underlying brain mechanisms. The evidence regarding the influence of environmental risk factors in the emergence of both disorders, and their developmental trajectories is also reviewed. Among these, we will try to elucidate the complex relationship between stimulants use and psychotic symptoms, discussing the potential role of ADHD medication in inducing psychosis or in exacerbating it. We aim that, taken together, these findings may promote further investigation with important implications both for clinicians and research. In fact, considering the amounting evidence on the overlap between schizophrenia and ADHD, the delineation of their boundaries might help in the decision for diagnosis and treatment. Moreover, it may help to promote interventions focused on the prevention of both schizophrenia and ADHD, by the reduction of recognized environmental risk factors.展开更多
The new field of mitochondrial filamentation and its first potential applications are just getting underway (1-7), following a series of pilot experiments in our laboratory over the past few decades (8-14). I should l...The new field of mitochondrial filamentation and its first potential applications are just getting underway (1-7), following a series of pilot experiments in our laboratory over the past few decades (8-14). I should like to give a brief overview of the role that some new methods are playing in this emerging area of physiological bioenergetics, supported by a few references to our contributions as I scarcely have the faculties now to understand other specific contributions. This new field is brimming with promises for medicine, science and society, in general. I cannot and must not be concrete or comprehensive, because I honestly feel that it is now that matters are really beginning to take off, assisted by the most appropriate international capabilities.展开更多
In this study, the authors describe the profile of people seen in criminal psychiatric expertise in northern Benin and their results. It covered the 138 psychiatric assessments carried out as part of criminal proceedi...In this study, the authors describe the profile of people seen in criminal psychiatric expertise in northern Benin and their results. It covered the 138 psychiatric assessments carried out as part of criminal proceedings in the years 2017 and 2018. Expertises were on men in 94.9% of the cases. They were over 30 years old in 66.2% of cases. They were prosecuted for blood crimes in 89.5% of cases. The defendants were in detention at the time of the expert in 87.5% of cases. Psychiatric experts diagnosed a psychiatric disorder in 22.8% of cases. There was a relationship between the identified psychiatric disorder and the offense that motivated the charge in 25.8% of the mental disorder cases. It was exclusively cases of psychotic disorders. There was an abolition of discernment in 3.8% of the accused.展开更多
Objective: Intramuscular (IM) Benzodiazepines and/or Haloperidol alone or with benzodiazepines are frequently used to treat agitation. Based on emerging literature regarding Quetiapine used for the control of anxiety ...Objective: Intramuscular (IM) Benzodiazepines and/or Haloperidol alone or with benzodiazepines are frequently used to treat agitation. Based on emerging literature regarding Quetiapine used for the control of anxiety we examined Quetiapine as a possible alternative in selected cases. Methods: This study was a single-blind randomized study comparing Quetiapine PO (300 mg) with a combination of Haloperidol (5 mg), Benztropine mesylate (2 mg) and lorazepam (2 mg) administered IM to treat agitated patients seeking care in a busy psychiatric emergency setting. Male or female patients (18 - 60), deemed by the attending (admitting) psychiatrist to be indicative of agitated and/or aggressive behavior and had a Positive and Negative Syndrome Score-Excited Component (PANSS-EC), as evaluated by the Research Psychiatrist, and total score equal to or greater than 15. Patients deemed competent were randomized into one of the following treatment groups: Quetiapine 300 or Haloperidol 5 mg, benztropine mesylate, or lorazepam given by the IM route. Two scales, PANSS-EC and CGI-C were used to assess patients in the trial. The primary outcome measure PANSS-EC at 2 hours after administration of the medication. Results: Sixty-eight patients were included in the study. There were no significant treatment group differences in baseline condition. There was no significant difference between the two conditions. There was, however, a significant within-group decrease from baseline condition. Conclusion: Finding no significant differences suggests that in general the two treatments were equivalent. To sum up, Quetiapine 300 mg as a single dose appeared safe and effective in agitated patients treated in an ER. The results were similar to a comparison group receiving an intra-muscular combination of Haloperidol, Lorazepam and Benztropine. This study has significant limitations. The study was single blind and the use of a placebo would have strengthened the design but would be considered unethical. The sample size was relatively small and the group of patients who come to the ER may not be representative of the population of patients who visit across the country. And finally it was a select subgroup who made up the study population and who were probably less severely ill than other subjects who came to our ER.展开更多
文摘VIOLENCE IS NOT ONLY WRONG,IT’S DISEASED-it’s always painful and too often fatal-as with Martin Luther King,no less.When emotions run high,doctors have difficulty making progress-calm,dispassionate review of the obvious evidence is vital,if you aim for less pain and fewer deaths.This paper is based on the self-evident precept that violated children unmistakeably predate violent adults.The remedy,highlighted here,is unusual in all psychiatry,in that it is backed by solid,irrefutable,objective,scientific evidence-from brainscans,no less-at least it is,for those willing to look.The paper has 6 parts:1.Introduction;2.Un-memorising Terror;3.Nutritious Emotions;4.Tyrannical Revenge;5.The Way to Cure Nucleargeddon Is Paved With Good Intentions;6.Conclusion.Parenting is a troubled skill,largely because mis-parenting perpetuates itself.As the poet Philip Larkin says of parents-“they fill you with the faults they had,and add some extra just for you”.Larkin moderates his criticism with“they may not mean to,but they do”.Sadly his“solution”-“don’t have any kids yourself”can extinguish the human race as reliably as ever revengeful Emotional Dwarfism will.
文摘Schizophrenia and attention deficit hyperactivity disorder(ADHD) are two psychiatric disorders with a negative impact on quality of life of individuals affected. Although they are classified into distinct disorders categories, attentional dysfunction is considered as a core feature in both conditions, either at the clinical then pathophysiological level. Beyond the obvious clinical overlap between these disorders, the Research DomainCriteria approach might offer an interesting perspective for disentangling common circuits underpinning both disorders. Hence, we review evidences regarding the overlap between schizophrenia and ADHD, at the clinical level, and at the level of underlying brain mechanisms. The evidence regarding the influence of environmental risk factors in the emergence of both disorders, and their developmental trajectories is also reviewed. Among these, we will try to elucidate the complex relationship between stimulants use and psychotic symptoms, discussing the potential role of ADHD medication in inducing psychosis or in exacerbating it. We aim that, taken together, these findings may promote further investigation with important implications both for clinicians and research. In fact, considering the amounting evidence on the overlap between schizophrenia and ADHD, the delineation of their boundaries might help in the decision for diagnosis and treatment. Moreover, it may help to promote interventions focused on the prevention of both schizophrenia and ADHD, by the reduction of recognized environmental risk factors.
文摘The new field of mitochondrial filamentation and its first potential applications are just getting underway (1-7), following a series of pilot experiments in our laboratory over the past few decades (8-14). I should like to give a brief overview of the role that some new methods are playing in this emerging area of physiological bioenergetics, supported by a few references to our contributions as I scarcely have the faculties now to understand other specific contributions. This new field is brimming with promises for medicine, science and society, in general. I cannot and must not be concrete or comprehensive, because I honestly feel that it is now that matters are really beginning to take off, assisted by the most appropriate international capabilities.
文摘In this study, the authors describe the profile of people seen in criminal psychiatric expertise in northern Benin and their results. It covered the 138 psychiatric assessments carried out as part of criminal proceedings in the years 2017 and 2018. Expertises were on men in 94.9% of the cases. They were over 30 years old in 66.2% of cases. They were prosecuted for blood crimes in 89.5% of cases. The defendants were in detention at the time of the expert in 87.5% of cases. Psychiatric experts diagnosed a psychiatric disorder in 22.8% of cases. There was a relationship between the identified psychiatric disorder and the offense that motivated the charge in 25.8% of the mental disorder cases. It was exclusively cases of psychotic disorders. There was an abolition of discernment in 3.8% of the accused.
文摘Objective: Intramuscular (IM) Benzodiazepines and/or Haloperidol alone or with benzodiazepines are frequently used to treat agitation. Based on emerging literature regarding Quetiapine used for the control of anxiety we examined Quetiapine as a possible alternative in selected cases. Methods: This study was a single-blind randomized study comparing Quetiapine PO (300 mg) with a combination of Haloperidol (5 mg), Benztropine mesylate (2 mg) and lorazepam (2 mg) administered IM to treat agitated patients seeking care in a busy psychiatric emergency setting. Male or female patients (18 - 60), deemed by the attending (admitting) psychiatrist to be indicative of agitated and/or aggressive behavior and had a Positive and Negative Syndrome Score-Excited Component (PANSS-EC), as evaluated by the Research Psychiatrist, and total score equal to or greater than 15. Patients deemed competent were randomized into one of the following treatment groups: Quetiapine 300 or Haloperidol 5 mg, benztropine mesylate, or lorazepam given by the IM route. Two scales, PANSS-EC and CGI-C were used to assess patients in the trial. The primary outcome measure PANSS-EC at 2 hours after administration of the medication. Results: Sixty-eight patients were included in the study. There were no significant treatment group differences in baseline condition. There was no significant difference between the two conditions. There was, however, a significant within-group decrease from baseline condition. Conclusion: Finding no significant differences suggests that in general the two treatments were equivalent. To sum up, Quetiapine 300 mg as a single dose appeared safe and effective in agitated patients treated in an ER. The results were similar to a comparison group receiving an intra-muscular combination of Haloperidol, Lorazepam and Benztropine. This study has significant limitations. The study was single blind and the use of a placebo would have strengthened the design but would be considered unethical. The sample size was relatively small and the group of patients who come to the ER may not be representative of the population of patients who visit across the country. And finally it was a select subgroup who made up the study population and who were probably less severely ill than other subjects who came to our ER.
