Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at th...Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at the behavioral level in people with ID in institutionalized settings. The aim was to gain nuanced insight into appropriate understanding and classification in this specific context, and derive implications for research and practice. Methods: Individual cases of people with ID (n = 7) were studied to assess compulsive symptoms through two days of on-site observation of the person with ID within the institution, guided group discussions (n = 28), and semi-structured interviews with key informants and caregivers of the person with ID (n = 20). Caregiver ratings of the compulsive behavior checklist were compiled. Data were analyzed using qualitative content analysis. Results: All forms of OCD were present. Characteristics of compulsive behaviors in people with ID at the behavioral level included less complex and more obvious compulsive acts, immediate responses, signs of tension, motor restlessness, facial expression changes, repetition, need for predictability, time-consuming behaviors, and aggressive reactions when these acts were interrupted. Some of the compulsive behaviors corresponded to the ICD-11 OCD code 6B20, and others to compulsions as a psychological symptom (MB23.4). Conclusions: OCD may manifest atypically at the behavioral level in people with ID, posing significant challenges for accurate classification due to symptom ambiguity. Follow-up differential diagnostic studies are needed to more accurately identify and differentiate OCD symptoms in people with ID. Further, disorder-specific guidelines for recognizing OCD in people with ID are needed for institutionalized settings without psychiatric-psychotherapeutic expertise.展开更多
Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of...Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.展开更多
AIM: to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions(SCI-MOODS and MOODS-SR).METHODS: We conducted a review of studies published between 1997 and August 2014. The...AIM: to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions(SCI-MOODS and MOODS-SR).METHODS: We conducted a review of studies published between 1997 and August 2014. The search was performed using Pubmed and Psyc INFO databases. Analysis of the papers followed the inclusion and exclusion criteria recommended by the PRISMA Guidelines, namely:(1) articles that presented a combination of at least two terms, "SCI-MOODS" [all fields] or "MOODS-SR" [all fields] or "mood spectrum" [all fields];(2) manuscript in English;(3) original articles; and(4) prospective or retrospective original studies(analytical or descriptive), experimental or quasi-experimental studies. Exclusion criteria were:(1) other study designs(case reports, case series, and reviews);(2) non-original studies including editorials, book reviews and letters to the editor; and(3) studies not specifically designed and focused on SCI-MOODS or MOODS-SR.RESULTS: The search retrieved 43 papers, including 5 reviews of literature or methodological papers, and 1 case report. After analyzing their titles and abstracts, according to the eligibility criteria, 6 were excluded and 37 were chosen and included. The SCI-MOODS and the MOODS-SR have been tested in published studies involving 52 different samples across 4 countries(Italy, United States, Spain and Japan). The proposed mood spectrum approach has demonstrated its usefulness mainly in 3 different areas:(1) Patients with the socalled "pure" unipolar depression that might manifest hypomanic atypical and/or sub-threshold aspects systematically detectable with the mood questionnaire;(2) Spectrum features not detected by other instruments are clinically relevant, because they might manifest in waves during the lifespan, sometimes together, sometimes alone, sometimes reaching the severity for a full-blown disorder, sometimes interfering withother mental disorders or complicating the course of somatic diseases; and(3) Higher scores on the MOODSSR factors assessing "psychomotor disturbances","mixed instability" and "suicidality" delineate subtypes of patients characterized by the more severe forms of mood disorders, the higher risk for psychotic symptoms,and the lower quality of life after the remission of the full-blown-episode.CONCLUSION: The mood spectrum model help researchers and clinicians in the systematic assessment of those areas of psychopathology that are still neglected by the Diagnostic and Statistical Manual of Mental Disorders 5classification.展开更多
目的探究与分析伴与不伴抑郁情绪孤独症谱系障碍患儿静息态脑功能磁共振成像特征的差异性。方法选取福建省福州神经精神病防治院2019年4月—2022年2月收治的45例合并情绪障碍的首诊孤独症谱系障碍患儿作为观察组,选择同时期来福建省福...目的探究与分析伴与不伴抑郁情绪孤独症谱系障碍患儿静息态脑功能磁共振成像特征的差异性。方法选取福建省福州神经精神病防治院2019年4月—2022年2月收治的45例合并情绪障碍的首诊孤独症谱系障碍患儿作为观察组,选择同时期来福建省福州神经精神病防治院就诊的45例未合并情绪障碍的首诊孤独症谱系障碍患儿作为对照组,两组均接受了功能磁共振成像技术(functional magnetic resonance imaging,fMRI)检查,对比两组患儿功能连接异常脑区。结果观察组与对照组比较,患儿左侧楔前叶、扣带回、左侧中央前回、双侧中央后回、双侧舌回、右侧颞中回、右侧颞上极、左侧颞横回、双侧顶上小叶、左侧岛叶功能连接异常增强,差异有统计学意义(P<0.05)。观察组与对照组比较,患儿左侧额中回、左侧顶下小叶、双侧额上回、右侧眶下回功能接连异常减弱,差异有统计学意义(P<0.05)。结论fMRI在伴抑郁情绪孤独症谱系障碍患儿中的应用能够有效地区分多个脑区功能连接异常的变化及其相关症状与改变,尤其是感觉运动区域以及注意网络功能降低等异常改变,从而为疾病的诊断及治疗提供合理参考依据。展开更多
女性性功能障碍(female sexual dysfunction,FSD)根据精神障碍诊断下统计手册第4版(DSM-Ⅳ)标准主要分为:性欲障碍、性唤起障碍、性高潮障碍和性交疼痛。2013年5月DSM-Ⅴ正式发布,主要变化包括将性厌恶归为焦虑症,改变了女性性高潮障碍...女性性功能障碍(female sexual dysfunction,FSD)根据精神障碍诊断下统计手册第4版(DSM-Ⅳ)标准主要分为:性欲障碍、性唤起障碍、性高潮障碍和性交疼痛。2013年5月DSM-Ⅴ正式发布,主要变化包括将性厌恶归为焦虑症,改变了女性性高潮障碍的定义,合并性欲障碍和性唤起障碍为性兴趣/唤起障碍,合并性交疼痛和阴道痉挛为生殖器-盆腔疼痛/插入障碍。妇科医生应能够做出女性性功能障碍基本诊断,将重点放在发现器质性病变以及对阴道痉挛患者的治疗,而对性欲障碍、性唤起障碍和性高潮障碍患者仍建议转诊至心理科治疗。展开更多
文摘Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at the behavioral level in people with ID in institutionalized settings. The aim was to gain nuanced insight into appropriate understanding and classification in this specific context, and derive implications for research and practice. Methods: Individual cases of people with ID (n = 7) were studied to assess compulsive symptoms through two days of on-site observation of the person with ID within the institution, guided group discussions (n = 28), and semi-structured interviews with key informants and caregivers of the person with ID (n = 20). Caregiver ratings of the compulsive behavior checklist were compiled. Data were analyzed using qualitative content analysis. Results: All forms of OCD were present. Characteristics of compulsive behaviors in people with ID at the behavioral level included less complex and more obvious compulsive acts, immediate responses, signs of tension, motor restlessness, facial expression changes, repetition, need for predictability, time-consuming behaviors, and aggressive reactions when these acts were interrupted. Some of the compulsive behaviors corresponded to the ICD-11 OCD code 6B20, and others to compulsions as a psychological symptom (MB23.4). Conclusions: OCD may manifest atypically at the behavioral level in people with ID, posing significant challenges for accurate classification due to symptom ambiguity. Follow-up differential diagnostic studies are needed to more accurately identify and differentiate OCD symptoms in people with ID. Further, disorder-specific guidelines for recognizing OCD in people with ID are needed for institutionalized settings without psychiatric-psychotherapeutic expertise.
文摘Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.
文摘AIM: to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions(SCI-MOODS and MOODS-SR).METHODS: We conducted a review of studies published between 1997 and August 2014. The search was performed using Pubmed and Psyc INFO databases. Analysis of the papers followed the inclusion and exclusion criteria recommended by the PRISMA Guidelines, namely:(1) articles that presented a combination of at least two terms, "SCI-MOODS" [all fields] or "MOODS-SR" [all fields] or "mood spectrum" [all fields];(2) manuscript in English;(3) original articles; and(4) prospective or retrospective original studies(analytical or descriptive), experimental or quasi-experimental studies. Exclusion criteria were:(1) other study designs(case reports, case series, and reviews);(2) non-original studies including editorials, book reviews and letters to the editor; and(3) studies not specifically designed and focused on SCI-MOODS or MOODS-SR.RESULTS: The search retrieved 43 papers, including 5 reviews of literature or methodological papers, and 1 case report. After analyzing their titles and abstracts, according to the eligibility criteria, 6 were excluded and 37 were chosen and included. The SCI-MOODS and the MOODS-SR have been tested in published studies involving 52 different samples across 4 countries(Italy, United States, Spain and Japan). The proposed mood spectrum approach has demonstrated its usefulness mainly in 3 different areas:(1) Patients with the socalled "pure" unipolar depression that might manifest hypomanic atypical and/or sub-threshold aspects systematically detectable with the mood questionnaire;(2) Spectrum features not detected by other instruments are clinically relevant, because they might manifest in waves during the lifespan, sometimes together, sometimes alone, sometimes reaching the severity for a full-blown disorder, sometimes interfering withother mental disorders or complicating the course of somatic diseases; and(3) Higher scores on the MOODSSR factors assessing "psychomotor disturbances","mixed instability" and "suicidality" delineate subtypes of patients characterized by the more severe forms of mood disorders, the higher risk for psychotic symptoms,and the lower quality of life after the remission of the full-blown-episode.CONCLUSION: The mood spectrum model help researchers and clinicians in the systematic assessment of those areas of psychopathology that are still neglected by the Diagnostic and Statistical Manual of Mental Disorders 5classification.
文摘目的探究与分析伴与不伴抑郁情绪孤独症谱系障碍患儿静息态脑功能磁共振成像特征的差异性。方法选取福建省福州神经精神病防治院2019年4月—2022年2月收治的45例合并情绪障碍的首诊孤独症谱系障碍患儿作为观察组,选择同时期来福建省福州神经精神病防治院就诊的45例未合并情绪障碍的首诊孤独症谱系障碍患儿作为对照组,两组均接受了功能磁共振成像技术(functional magnetic resonance imaging,fMRI)检查,对比两组患儿功能连接异常脑区。结果观察组与对照组比较,患儿左侧楔前叶、扣带回、左侧中央前回、双侧中央后回、双侧舌回、右侧颞中回、右侧颞上极、左侧颞横回、双侧顶上小叶、左侧岛叶功能连接异常增强,差异有统计学意义(P<0.05)。观察组与对照组比较,患儿左侧额中回、左侧顶下小叶、双侧额上回、右侧眶下回功能接连异常减弱,差异有统计学意义(P<0.05)。结论fMRI在伴抑郁情绪孤独症谱系障碍患儿中的应用能够有效地区分多个脑区功能连接异常的变化及其相关症状与改变,尤其是感觉运动区域以及注意网络功能降低等异常改变,从而为疾病的诊断及治疗提供合理参考依据。
文摘女性性功能障碍(female sexual dysfunction,FSD)根据精神障碍诊断下统计手册第4版(DSM-Ⅳ)标准主要分为:性欲障碍、性唤起障碍、性高潮障碍和性交疼痛。2013年5月DSM-Ⅴ正式发布,主要变化包括将性厌恶归为焦虑症,改变了女性性高潮障碍的定义,合并性欲障碍和性唤起障碍为性兴趣/唤起障碍,合并性交疼痛和阴道痉挛为生殖器-盆腔疼痛/插入障碍。妇科医生应能够做出女性性功能障碍基本诊断,将重点放在发现器质性病变以及对阴道痉挛患者的治疗,而对性欲障碍、性唤起障碍和性高潮障碍患者仍建议转诊至心理科治疗。
