Karl Ludwig Kahlbaum(1828-1899)was the first to conceptualize and describe the main clinical features of a novel psychiatric illness,which he termed catatonia in his groundbreaking monograph published 150 years ago.Al...Karl Ludwig Kahlbaum(1828-1899)was the first to conceptualize and describe the main clinical features of a novel psychiatric illness,which he termed catatonia in his groundbreaking monograph published 150 years ago.Although Kahlbaum postulated catatonia as a separate disease entity characterized by psychomotor symptoms and a cyclical course,a close examination of his 26 cases reveals that most of them presented with motor symptom complexes or syndromes associated with various psychiatric and medical conditions.In his classification system,Kraepelin categorized catatonic motor symptoms that occur in combination with psychotic symptoms and typically have a poor prognosis within his dementia praecox(schizophrenia)disease entity.Because of the substantial influence of Kraepelin’s classification,catatonia was predominantly perceived as a component of schizophrenia for most of the 20th century.However,with the advent of the psychopharmacotherapy era starting from the early 1950s,interest in catatonia in both clinical practice and research subsided until the early 2000s.The past two decades have witnessed a resurgence of interest in catatonia.The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition,marked a paradigmatic shift by acknowledging that catatonia can occur secondary to various psychiatric and medical conditions.The introduction of an independent diagnostic category termed“Catatonia Not Otherwise Specified”significantly stimulated research in this field.The authors briefly review the history and findings of recent catatonia research and highlight promising directions for future exploration.展开更多
Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises...Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior.Predicting aggression in psychiatric wards is crucial,because aggressive behavior not only endangers the safety of both patients and staff,but it also extends the hospitalization times.Predictions of aggressive behavior also need careful attention to ensure effective treatment planning.This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes(dementia,psychoactive substance use,acute psychotic disorder,schizophrenia,bipolar affective disorder,major depressive disorder,obsessivecompulsive disorder,personality disorders and intellectual disability).The prevalence of aggressive behavior and its underlying risk factors,such as sex,age,comorbid psychiatric disorders,socioeconomic status,and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior.Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed.Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.展开更多
Electroconvulsive therapy(ECT),which is among the oldest and most controversial treatments in the field of psychiatry,has its 80th birthday this year.In this brief historical overview,the discovery of the therapeutic ...Electroconvulsive therapy(ECT),which is among the oldest and most controversial treatments in the field of psychiatry,has its 80th birthday this year.In this brief historical overview,the discovery of the therapeutic effects of convulsive therapy by LaszlóMeduna,and the circumstances that motivated Ugo Cerletti and Lucio Bini to use electricity as a means of seizure induction are described.Meduna’s original theory about the antagonism between epilepsy and schizophrenia has been replaced by hypotheses on the mechanism of action of ECT.The position of ECT in modern psychiatry is also discussed with special attention to its most important clinical indications,including catatonia,and preand postpartum affective and psychotic states that are responsive to ECT and in which ECT may even be lifesaving.Adverse effects and comparison of ECT with recently developed brain stimulation methods are also reviewed.The negative media portrayal of ECT and its earlier misuse may have contributed to its negative professional and public perceptions indicated repeatedly in attitude surveys.This negative attitude has played an important role in the decreasing use of ECT in the developed world and a reduction in access to ECT,which constitutes a violation of psychiatric patients’right to an effective treatment.展开更多
Hematopoietic stem cell transplantation(HSCT)has become a conventional and potentially curative treatment for various hematological diseases.As more sophisticated procedures have been developed and mortality rates hav...Hematopoietic stem cell transplantation(HSCT)has become a conventional and potentially curative treatment for various hematological diseases.As more sophisticated procedures have been developed and mortality rates have decreased,attention has shifted to the psychosocial challenges associated with transplantation.The psychosocial difficulties accompanying transplantation are addressed in the context of both quality of life(QOL)and psychopathological research.Among the psychiatric comorbidities of HSCT,anxiety,depression,sleep and sexual disorders,delirium and post-traumatic stress disorder are the most studied conditions.Recently,more attention has been focused on the psychosocial burden of caregivers.Devising recommendations for the management of psychiatric symptoms and psychosocial interventions in HSCT sufferers and close relatives is a major concern to consultation–liaison psychiatrists and transplant teams.This review synthesizes and critically evaluates the current literature on the psychosocial aspects of HSCT and appraises the clinical significance of these outcomes.Issues of QOL assessment;psychosocial functioning and QOL in the course of HSCT;impact of graft-versus-host disease and other predictors of QOL and psychosocial functioning;comorbid psychiatric disorders;and interventions to maintain or improve QOL and reduce psychopathology and psychosocial burden on family members are presented.展开更多
文摘Karl Ludwig Kahlbaum(1828-1899)was the first to conceptualize and describe the main clinical features of a novel psychiatric illness,which he termed catatonia in his groundbreaking monograph published 150 years ago.Although Kahlbaum postulated catatonia as a separate disease entity characterized by psychomotor symptoms and a cyclical course,a close examination of his 26 cases reveals that most of them presented with motor symptom complexes or syndromes associated with various psychiatric and medical conditions.In his classification system,Kraepelin categorized catatonic motor symptoms that occur in combination with psychotic symptoms and typically have a poor prognosis within his dementia praecox(schizophrenia)disease entity.Because of the substantial influence of Kraepelin’s classification,catatonia was predominantly perceived as a component of schizophrenia for most of the 20th century.However,with the advent of the psychopharmacotherapy era starting from the early 1950s,interest in catatonia in both clinical practice and research subsided until the early 2000s.The past two decades have witnessed a resurgence of interest in catatonia.The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition,marked a paradigmatic shift by acknowledging that catatonia can occur secondary to various psychiatric and medical conditions.The introduction of an independent diagnostic category termed“Catatonia Not Otherwise Specified”significantly stimulated research in this field.The authors briefly review the history and findings of recent catatonia research and highlight promising directions for future exploration.
文摘Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior.Predicting aggression in psychiatric wards is crucial,because aggressive behavior not only endangers the safety of both patients and staff,but it also extends the hospitalization times.Predictions of aggressive behavior also need careful attention to ensure effective treatment planning.This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes(dementia,psychoactive substance use,acute psychotic disorder,schizophrenia,bipolar affective disorder,major depressive disorder,obsessivecompulsive disorder,personality disorders and intellectual disability).The prevalence of aggressive behavior and its underlying risk factors,such as sex,age,comorbid psychiatric disorders,socioeconomic status,and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior.Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed.Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.
文摘Electroconvulsive therapy(ECT),which is among the oldest and most controversial treatments in the field of psychiatry,has its 80th birthday this year.In this brief historical overview,the discovery of the therapeutic effects of convulsive therapy by LaszlóMeduna,and the circumstances that motivated Ugo Cerletti and Lucio Bini to use electricity as a means of seizure induction are described.Meduna’s original theory about the antagonism between epilepsy and schizophrenia has been replaced by hypotheses on the mechanism of action of ECT.The position of ECT in modern psychiatry is also discussed with special attention to its most important clinical indications,including catatonia,and preand postpartum affective and psychotic states that are responsive to ECT and in which ECT may even be lifesaving.Adverse effects and comparison of ECT with recently developed brain stimulation methods are also reviewed.The negative media portrayal of ECT and its earlier misuse may have contributed to its negative professional and public perceptions indicated repeatedly in attitude surveys.This negative attitude has played an important role in the decreasing use of ECT in the developed world and a reduction in access to ECT,which constitutes a violation of psychiatric patients’right to an effective treatment.
文摘Hematopoietic stem cell transplantation(HSCT)has become a conventional and potentially curative treatment for various hematological diseases.As more sophisticated procedures have been developed and mortality rates have decreased,attention has shifted to the psychosocial challenges associated with transplantation.The psychosocial difficulties accompanying transplantation are addressed in the context of both quality of life(QOL)and psychopathological research.Among the psychiatric comorbidities of HSCT,anxiety,depression,sleep and sexual disorders,delirium and post-traumatic stress disorder are the most studied conditions.Recently,more attention has been focused on the psychosocial burden of caregivers.Devising recommendations for the management of psychiatric symptoms and psychosocial interventions in HSCT sufferers and close relatives is a major concern to consultation–liaison psychiatrists and transplant teams.This review synthesizes and critically evaluates the current literature on the psychosocial aspects of HSCT and appraises the clinical significance of these outcomes.Issues of QOL assessment;psychosocial functioning and QOL in the course of HSCT;impact of graft-versus-host disease and other predictors of QOL and psychosocial functioning;comorbid psychiatric disorders;and interventions to maintain or improve QOL and reduce psychopathology and psychosocial burden on family members are presented.
