Abstract:
OBJECTIVE:To examine clinical characteristics and treatment responses of patients presenting with delirium and mania to a psychiatric inpatient unit. METHOD:Chart review of 16 cases admitted to McLean Hospital with delirium and mania was conducted. We examined the demographics, psychiatric symptoms, clinical course, and response to treatment with medications and electroconvulsive therapy (ECT). RESULTS:Patients with delirium and mania had negative medical and neurological work-ups and were more likely to be younger, female and with a prior diagnosis of bipolar disorder. Sudden onset of symptoms, incontinence/inappropriate toiletting, and denudativeness are distinctive features of the syndrome. Consistent and significant benefit was seen with ECT. In many cases, high dose benzodiazepines were helpful. In a small number of cases, clozapine was also beneficial but this effect took an average of four weeks to be seen, while atypical antipsychotics, lithium and valproate produced variable results and took an average of three and a half weeks to work, if at all. Typical antipsychotics and anticholinergic drugs led to clinical worsening. LIMITATIONS:Most patients were on more than one medication and hence treatment responses cannot be definitively ascribed to a specific intervention. Studies of larger groups of such patients in different clinical settings need to be done to confirm our observations. CONCLUSIONS:Delirious mania is a severe psychiatric syndrome which can be accurately recognized and effectively treated. The definitive treatment for this condition is ECT. In cases where ECT is not available, high dose benzodiazepines should be used. Clozapine, quetiapine, lithium and valproate cannot be considered first-line treatments and these medications take an unacceptably long time to work even when helpful; typical antipsychotics and anticholinergic drugs should be avoided.
journal_name
J Affect Disordjournal_title
Journal of affective disordersauthors
Karmacharya R,England ML,Ongür Ddoi
10.1016/j.jad.2007.12.001subject
Has Abstractpub_date
2008-08-01 00:00:00pages
312-6issue
3eissn
0165-0327issn
1573-2517pii
S0165-0327(07)00420-Xjournal_volume
109pub_type
杂志文章abstract:BACKGROUND:Identifying the bipolar (BP) spectrum, including the classic Bipolar I subtype (BP-I), Bipolar II (BP-II) and subthreshold bipolar disorders not meeting DSM-IV diagnostic criteria has raised growing interest, as these softer expressions of bipolar spectrum have been underdiagnosed in spite of clinical conseq...
journal_title:Journal of affective disorders
pub_type: 杂志文章
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更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Although recent studies have shown high rates of current and lifetime depression in HIV-infected patients, there is little systematic data on the occurrence of bipolarity in these patients. METHOD:We compared 46 HIV patients with index major depressive episode (MDE) to an equal number of age- and sex-matche...
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abstract:BACKGROUND:Sudden sensorineural hearing loss (SSNHL) occurs as an unexplained, rapid loss of hearing that can cause significant stress in the affected individual. This study aims to assess the risk of depressive disorders in SSNHL patients. METHODS:From the National Health Insurance Research Database (NHIRD) in Taiwan...
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abstract:BACKGROUND:The results of multivariate analyses to identify potential predictors of response to fluoxetine or placebo separately in 96 child and adolescent outpatients with major depressive disorder from a recent controlled trial are presented. METHODS:A variety of clinical, demographic and laboratory factors were exa...
journal_title:Journal of affective disorders
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-08-01 00:00:00
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更新日期:2020-04-15 00:00:00
abstract:BACKGROUND:Valproic acid (VPA) is widely used for treating patients with bipolar disorder; however, it has adverse effects on cognitive function. This study investigated the effect of VPA on the risk of dementia in patients with bipolar disorder. METHODS:We analyzed data from Taiwan's Longitudinal Health Insurance Dat...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2016.05.010
更新日期:2016-09-01 00:00:00
abstract::Twenty affective disorder patients (16 bipolar and 4 unipolar) and 24 normal controls received scans with positron emission tomography (PET) using [18F]2-deoxyglucose (FDG) as a tracer. Subjects received a series of brief electrical stimuli to their right arms during FDG uptake. Patients with bipolar affective illness...
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更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Rates of relapse and predictive relapse factors were studied over more than 4 years in a sample of Spanish outpatients with DSM-III-R criteria for unipolar major depressive episode. METHODS:A final sample of 139 outpatient was followed monthly in a naturalistic study. The Structured Clinical Interview for D...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2003.11.008
更新日期:2004-10-15 00:00:00
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journal_title:Journal of affective disorders
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更新日期:1998-01-01 00:00:00
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更新日期:1995-04-04 00:00:00
abstract:BACKGROUND:Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to dat...
journal_title:Journal of affective disorders
pub_type: 杂志文章,随机对照试验
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更新日期:2015-09-15 00:00:00
abstract:BACKGROUND:To determine any positive aspects of living with a clinical mood disorder, and indirectly address the question--"If you could live your life again, would you press the 'magic button' to experience life without a mood disorder?" METHOD:Patients referred to a tertiary mood disorder facility were asked to comp...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2011.11.008
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Previous work indicates that emotive processing, such as of facial expressions, may be altered in major depressive disorder (MDD). Individuals with MDD tend to exhibit a mood-congruent processing bias, though MDD may also be characterized by blunted emotive processing in general. Females tend to exhibit enha...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2011.10.047
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Recent studies have demonstrated the relevance of subjective time perceptions with regard to depressive symptoms among aging and older adults. Moreover, loneliness was found to bear a strong connection to such symptoms. However, little is known about the connection between the three constructs. Accordingly, ...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2018.08.019
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The influence of seasons on mood disorders is controversial. OBJECTIVE:To examine monthly variations in admissions for mania and depressions including variations with sex and age and correlations with frequencies of suicides. METHODS:All admissions for mania or depression (N=4341) in a population of 1,800,...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/s0165-0327(00)00373-6
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Asthma is associated with multiple psychiatric comorbidities. However, the relationship between asthma and suicidality has not be well established. METHODS:According to the PRISMA guidelines, protocol of the study was registered in the PROSPERO database (CRD42019123150). A systematic search of the PubMed, E...
journal_title:Journal of affective disorders
pub_type: 杂志文章,meta分析
doi:10.1016/j.jad.2019.06.031
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Because of the relationship between childhood behavior disorders and adult substance abuse, we hypothesized that substance abusing adult bipolars were more likely to have had behavior disorders as children than nonabusing bipolar adults. METHODS:Conduct disorder (CD) symptoms in 132 bipolar adults were compa...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/s0165-0327(97)00176-6
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To assemble expert clinical experience and judgement in the treatment of anxiety and related disorders in a systematic, quantitative manner. METHODS:A panel of internationally recognized Experts in treating anxiety and depression was constituted by multistage peer nomination. 90% completed a questionnaire. T...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/0165-0327(95)00064-x
更新日期:1995-12-18 00:00:00
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journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2005.10.011
更新日期:2006-02-01 00:00:00
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journal_title:Journal of affective disorders
pub_type: 杂志文章
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更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Accumulating evidence has converged to suggest that childhood trauma may contribute to bipolar disorder (BD). This study aimed to investigate the patterns of childhood trauma among patients with bipolar I (BD-I) and bipolar II (BD-II) disorders, according to DSM-IV and in contrast with healthy volunteers. We...
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journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2005.08.011
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Cognitive abilities tend to decline in advanced age. A novel protective factor of cognitive decline in advanced age is purpose-in-life (PiL), a trait-like tendency to derive life meanings and purpose. However, whether PiL protects against cognitive decline in late-middle-age is unclear. Hence, we examined th...
journal_title:Journal of affective disorders
pub_type: 杂志文章
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更新日期:2020-02-15 00:00:00
abstract:BACKGROUND:A correct timely diagnosis of bipolar depression remains a big challenge for clinicians. This study aimed to develop a clinical characteristic based model to predict the diagnosis of bipolar disorder among patients with current major depressive episodes. METHODS:A prospective study was carried out on 344 pa...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2011.05.054
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:In most settings, generalized anxiety disorder (GAD) is highly comorbid with major depressive disorder (MDD). This raises uncertainty about the clinical relevance of GAD as a distinct diagnostic entity. The demonstration of functional impairment attached to GAD, independent of that attributable to MDD, would...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/S0165-0327(02)00457-3
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Many studies report high prevalence rates for co-morbid alcohol problems in bipolar disorder (BP). Some hypothesize that individuals use alcohol to self-medicate, but few studies examine the range of possible reasons and none explicitly explores the role of mood state. We examined drinking motives in BP depre...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2011.09.005
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare adolescents diagnosed with major depressive disorder (MDD) and healthy adolescents with regard to cyberbullying, cyber victimization, internet addiction, and digital game addiction. MATERIALS AND METHODS:This cross-sectional study was performed in Selçuk University Hospital. The s...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.03.046
更新日期:2020-06-01 00:00:00
abstract::This study examined the primary-secondary distinction with respect to DSM-IV alcohol use disorders and major depression in a large representative sample of the USA. Primary, secondary and concurrent depressives (i.e. the comorbid groups), respondents classified with major depression only and respondents classified wit...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/0165-0327(96)00002-x
更新日期:1996-06-05 00:00:00
abstract:BACKGROUND:Depression treatment by General Practitioners (GPs) and patient outcomes improved significantly after a comprehensive 20-h training program of GPs. This study examines whether the effects on patient outcomes are caused by the improvements in the process of care. METHODS:Seventeen GPs participated in the tra...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/S0165-0327(03)00074-0
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Ketamine induces rapid and robust antidepressant effects, and many patients also describe dissociation, which is associated with antidepressant response. This follow-up study investigated whether antidepressant efficacy is uniquely related to dissociative symptom clusters. METHODS:Treatment-resistant patien...
journal_title:Journal of affective disorders
pub_type: 临床试验,杂志文章
doi:10.1016/j.jad.2018.02.049
更新日期:2018-05-01 00:00:00