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The COVID-19 pandemic has fundamentally changed all aspects of American life, including, for many, how we vote. We explore the question of who supports unrestricted absentee ballots during a pandemic. We argue that women are more likely to support absentee ballots because they allow for greater flexibility and minimize the potential for exposure. We test this theory using the National Panel Study of COVID-19 (n = 1,892), which asked respondents about their preferences for absentee ballots, their worry about the coronavirus, and their household composition. Using multinomial logistic regressions, we find that women are more likely to support allowing absentee ballots compared with more restrictive voting options and are more likely to say they support absentee ballots for all if they know someone who has contracted COVID-19. The policy implications for these findings are discussed along with other sociodemographic indicators in our analysis.
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Despite the high prevalence of obsessive-compulsive symptoms located around 2-3% of the population, there continue to be cases where the characteristics of the patient or the circumstances of their environment, they fall short queries mental health or when they do not for the disorder itself, but for another reason obsessional symptoms worsen.
Expose using clinical case, the existence of patients with obsessive pathology whose characteristics do not seek mental health consultation, until this is associated with a new disease that interferes significantly in vital organization.
We report the case of a man of 88 years old, married at 60, was admitted to the psychiatric consultation at the request of his wife 29 years his junior, for behavioral disorders several years of evolution and history of obsessive symptoms compulsive, which did not interfere with their daily lives by the lack of insight and poor social environment
OCD is included in anxiety disorders.
It is characterized by the presence of obsessions and compulsions that interfere with personal, work and / or patient's social.
There are cases that own personality traits of the patient, this disorder is not diagnosed early and choose to go only when associated with worsening cognitive impairment rituals and interfere with family life.
Cannabis use has demonstrated an association with earlier onset of psychosis. Investigation of sociodemographic and clinical characteristics in association with cannabis use in adults with first-episode psychosis (FEP) has resulted in inconsistent findings. The clinical profile of cannabis users amongst adolescents with FEP remain widely understudied.
To investigate the frequency of cannabis use, and its association with sociodemographic and clinical characteristics in adolescent-versus adult-onset FEP.
Naturalistic cross-sectional study of 1363 FEP cases aged 14-35 (136 with adolescent-onset psychosis) referred to Early Intervention Services for psychosis in London (UK) (2003-2009). Sociodemographic and clinical data (age of psychosis onset, symptom domains, substance misuse, insight, violence, global functioning, and duration of untreated psychosis [DUP]) were collected at entry to EIS.
Cannabis users were more likely to be male (78.2%), White (43.0%) and unemployed (72.0%). No significant difference was found in cannabis abuse/dependence frequencies between adolescents (28.4%) and adults (24.7%). Cannabis abuse/dependence was associated with an earlier onset of psychosis by 2 years (p<0.001), greater manic and positive symptoms (p<0.001), increased violence (p=0.011), and poorer functioning (p=0.013) and insight (p=0.003). For adolescents, cannabis abuse/dependence was associated with greater positive symptoms, poorer functioning and longer DUP.
Cannabis use shapes the clinical presentation of FEP individuals. Similar frequencies of cannabis use between age groups suggest that substance misuse services should be provided to all, aiming to reducing consumption. Greater vigilance amongst clinicians would enable earlier detection of psychosis in substance misusing adolescents, to reduce DUP and minimise associated poor outcomes.
In this exhibition we aim to describe a clinical case and the different consequences that may present additional problems with eating disorders, focusing with emphasis on development and clinical picture. This disorder usually occurs in non-obese adolescents accused, showing symptoms significantly related to interpersonal functioning of these adolescents, who tend to be isolated or seek company of younger guys. They are characteristic of obsessive-compulsive disorders related or unrelated to the food. Dietary restriction involves biological and physical changes, highlighting the alteration of hypothalamic and endocrine system, leading to signs and symptoms such as amenorrhea, cold intolerance, hypotension … Neurochemical changes have also been attributed to malnutrition.
The present case is a 31 year old woman. Initiates contact with Mental Health at age 15 by anorexia nervosa. Patient requests for worsening nutritional status, family relationships, and alcohol consumption, being the turning point and main motivation, the birth of his daughter. 8 months ago gave birth, being an unexpected delivery at home. Unaware that pregnancy, justifying as secondary amenorrhea eating disorder and abdominal inflammation malnutrition. Daughter born seven months income requires low weight and withdrawal symptoms during pregnancy as continuous with anxiolytic and antidepressant treatment.
It has a favorable, always maintaining therapeutic commitment announced at the beginning of tratamiento. Currently still in out patient reviews with Psychiatry, Clinical Psychology, Nursing and Nutrition.
Immigration in Spain is from the early ‘90s phenomenon of demographic and economic importance, according to INE, in January 2011 first residing in the country nearly 6.7 million people born outside our borders. In recent years, many immigrants are living in especially difficult circumstances.
Show that these people undergo a series of very specific stressors and duels: precarious and harsh working conditions, poor diet, loneliness and lack of social support… This would enhance the appearance of psychiatric symptoms in various areas, closely related to lifestyles that maintain and in some cases precipitate substance use in this group, primarily those that have a sedative profile.
We will present the clinical case of a 34 year old Nigerian male. No somatic or psychiatric history of interest. Cannabis smoker since adolescence. A year after his arrival in Spain admitted to our inpatient unit due to clinical psychotic. Was a challenge from the point of view of psychopharmacological have many side effects with low doses of typical antipsychotics
Disappearance of psychotic and affective symptoms to approach the case from a pharmacological perspective, social and cultural.
Addressing the relationship between life stressors and cannabis as a trigger or catalyst for psychotic episodes in individuals predisposed. Pathological elaborations of cultural integration of an immigrant (whether by denial of the original culture or over-identification with the host culture) facilitates the use of toxic either for blending with Western consumer culture or cultural consumption radicalization toxic in some East African countries.
Currently the Eating Behavior Disorders have become a social and health problem of the first kind that requires a specialized and interdisciplinary approach to these disorders. These clinical conditions are characterized by their complexity and diversity symptomatology, which implies a significant interference in their functioning in different areas of life and clinically significant distress.
Given the high burden of care in the USMC that difficult to monitor these patients at appropriate intervals, as well as the seriousness of the clinical and physical complications that can result, ultimately, in death, it seems necessary to implement group interventions to ensure greater continuity of care.
In all forms of group therapy underlying common advantages which advocate their implementation. Recent studies show that group therapy for eating disorders is equally effective as individual treatment. So in the USMC - Huelva conducted a psychotherapeutic group aimed at people with these clinical pictures. The present work is to analyze the impact of the intervention group in the eating disorder symptoms, anxiety and depression, comparing the results obtained in the tests applied before and after treatment.
Psychometric tests used were:
- Beck Depression Inventory (BDI)
- Inventory of State-Trait Anxiety Inventory (STAI)
- Inventory of Eating disorders (EDI)
The results reflect a clinically relevant improvement in both psychometric testing quality indicators (no hospitalizations, no emergency service attendance, adherence, etc.)
We should consider that group psychotherapy has unique properties that offer individual psychotherapy.
Given the high prevalence, severity and difficulty recognizing psychiatric disorders in patients with TBI, it is necessary to conduct a detailed history, gathering information on the location of the lesion and its relationship with the table in the psychopathological examination.
Illustrated by a clinical case, the close relationship between the injury of specific brain areas and the emergence of psychopathology that allows us to deepen the understanding of the biological substrate of mental disorders.
Exposure of a clinical picture and brief literature review of the existing literature.
We report the case of a man of 49 years old, no personal or family history was admitted to the hospital after a traffic accident with severe TBI. Computed tomography (CT) scan shows intraparenquematoso right temporal hematoma, subarachnoid hemorrhage, subdural hematoma right, pneumocephalus front right, front left fracture of both orbits and right maxillary sinus.
The interest in the study and the relationship of psychiatric symptoms with the location of the lesions, we can provide improved understanding of the biological basis of mental disorders.
The aim of this essay is to point out the relevance of psychosocial rehabilitation treatment in the course of a person's life. In order to get this purpose, we shall present and analyse the progress and development in treatment lived by a patient diagnosed with severe mental disorder during her early teens. Several mental health devices have been involved in her treatment.
The patient is a 25 years old woman, her treatment started at the age of fourteen when she was diagnosed with Hebephrenic Schizophrenia by the medical team of the child and adolescence Outpatient Surgery Centre of Huelva. It was developed a multidisciplinary work with the patient, setting out the following objectives to reach:
Social and family integration.
Social abilities acquisition.
Self-awareness of the mental disorder
social and working reintegration
The treatment was carried out in the Outpatient Surgery Centre till she was eighteen years old. At this age, she was derived to the USMC to go on with her rehabilitation. Thanks to the treatment the patient got the clinical stabilization (no more medical admissions were required), and she was able not just to take up again her studies, but also to reach a good family integration though she lived the dead of her mother along the treatment.
Currently, the patient is under treatment in the USMC. She gets over the difficulties associated with her mental disorder, living a normalized social, family and working life.
This study focuses on the rehabilitation treatment in a Day Hospital of Children and Adolescents. This Hospital consists of a psychiatrist, three nurses, five nursing assistants, an occupational therapist, a schoolteacher, a part-time endocrine, a social worker and an administrative assistant, who are responsible for carrying out the therapeutic process whose notable aspects consist of psychosocial treatment aimed at the reintegration of child-adolescent to the social and/or labour normalized circuit through discussion groups and workshops.
As a working example, we are talking about a patient who starts treatment at the age of 15. He was referred to this unit to assess the benefit of a psychopharmacological treatment, from his USMC of reference, where he had been going two years. It's in the Day Hospital where he was diagnosed as bipolar affective disorder, requiring adequate control of his psychopharmacological treatment and a socio-familiar situation as stable as possible. This is due to the family dysfunction detected which may influence the evolution of the underlying pathology. After two years of monitoring, manic disorder appears requiring hospitalization, which when stabilized returns to be referred to the Day Hospital to continue rehabilitation process. This unit has tried to integrate him in his area and to get awareness of illness and treatment adherence, proposed objectives of the individual treatment plan.
Today is euthymic, following the treatment properly, has regained his school activities and has adapted best to the family dynamics. All this was possible thanks to the multidisciplinary approach undertaken in the Day Hospital.
Suicide is a public health problem of the first magnitude for both its costs and its implications for the population. The attention to suicide attempts is itself one of the first reasons for psychiatric consultation, if not the first, in hospitals. Among the risk factors for suicide is the presence of mental disorders on Axis I and II, and the existence of previous attempts.
Studying the behavior of some of the risk factors for suicide known (psychiatric history and previous attempts) in a sample from service Emergency Hospital Juan Ramón Jiménez
Performed a retrospective analysis (for a period of 6 months of 2013) of the risk factors associated with suicidal behavior of patients seen in the emergency department of our hospital for attempted suicide.
In an interim analysis found that up to 50% of patients treated for attempted suicide had made ??previous attempts. Most of them had any axis I disorder (> 75%) and were or had been in outpatient psychiatric follow. Extensive treatment with psychotropic drugs performed most (> 80%)
The high number of cases with previous attempts provides a clear example of the problem of suicidal behavior relapse. The importance of this is increased when you consider that most were receiving or had received psychiatric treatment, reflecting the limitations in our daily clinical practice we have to control this pubic health problem.
Addressing the psychosocial rehabilitation of mental health patients, can be approached in various ways. In this case illustrates how a multidisciplinary approach so early impact on rehabilitation os psychiatric illness.
Patient is a woman of 45 years, starting in mental health in 1989 and with five entries in the inpatient psychiatric unit between 2006–2011, with a diagnosis of bipolar disorder. During this period has come to irregularly shaped mental health unit, with poor adherence therapeutics and instability in their symtoms, without being able to normalize their mood. Has presented several manic episodes with psychotic symptoms and depressive episodes.
Treatment begins with a comprehensive approach: psychiatry, psychology, social work, and assistant nursing.
Treatment objectives were: raise awareness of disease, adherence and development and expansion of social skills in order to reduce the number of admissions and achieve clinical stabilization.
Included in the treatment psychoeducational group therapy, activities and social skills workshops and home visits. Therefore, we emphasize the importance of integrative treatment in the rehabilitation of this patient and the approach of this type of intervention to detect these cases.
Suicidal behavior is a serious public health problem, being one of the leading causes of death in our country. Therefore, the identification of factors that increase or decrease the level of suicidal risk is of great importance for the close link with the conduct. There are several risk factors, including family and contextual, among which are the loss of significant others, including those that have been produced by suicide.
In this paper, we analyze these factors in a group of patients performing a Group Therapy.
Several studies point to the existence of a moderate correlation between the BDI item 9 (‘suicidal impulse’) with a higher score on the SSI. Another goal is to check whether this relationship is between the members of our group.
To this end, two scales were administered prior to the start of Therapy: Beck Depression Inventory, a self-report scale, and the Scale of Suicide Ideation Beck (hetero).
Our study confirms the existence of a moderate correlation between BDI item 9 (‘suicidal impulse’) and SSI. Therefore, item 9 of the BDI predicts a moderate way the result of the SSI that is related to suicidality. Similarly there is a significant correlation between total BDI SSI. We conclude that the intensity of the symptoms of depression is related to suicidality.
Consider necessary after evaluation and detection of these high-risk individuals, conducting therapeutic work aimed at the prevention of suicidal behavior within the individual treatment plan for these patients.
The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present.
Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions.
Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?
Delusional ideas disorder is characterized by the appearance of a single delusional theme or a group of related ideas together, which normally are very persistent.
This, plus the fact that the definition of the disorder have been changing and that these patients rarely seek psychiatric help, makes it difficult to accurately assess their epidemiology, but it is estimated that delirious take between 1 and 4% of psychiatric entries and its prevalence in the general population is 0.03%.
Analyze the variables that influence the clinical evolution.
- Risk factors
- Protective Factors
Rate the treatments tested in Mental Health since the patient is diagnosed.
Analysis of the clinical history of the patient's mental health. Results-Case report
Male, 36, who was diagnosed with delusional disorder at the age of 21, after starring an episode of hetero-aggressiveness to objects.
From the beginning is characterized by delusional interpretations of referential character, gradually reaching a systematic structure delusional. Secondarily, this causes episodes of behaviour disorders with occasional psychomotor agitation, important social isolation and withdrawal, seriously affecting their daily functioning.
During a year, he required four hospitalizations for exacerbation of clinical psychotic delusional self-referential and prejudice delusional ideation, with intense feelings of hopelessness and suicidal ideation.
Since the possibilities of treatment of this disorder are limited by little or no disease awareness and that his delusions are usually highly structured, we find it important continue investigating the keys to achieving higher therapeutic adherence and successful social adaptation despite continue with chronic delusional ideation.
Concerns about the body and food are present in much of the population. Furthermore, alteration in eating behavior as a symptom may be part of the symptomatology of various clinical profiles. And, of course, is the main symptom of eating disorders.
One of the features offered by these tables is the high comorbidity posing with axis I disorders and Axis II. According to the literature, about half of women with ED experience anxiety disorders. Regarding affective disorders, between 20 and 80% developed at least one major depressive episode during their lifetime. Personality disorders are highly prevalent in this population, mainly the cluster B and C, linking the first and second BN with AN.
The overall goal of this work is to analyze the comorbidity of these diagnosis.
Our research is a descriptive analysis of a sample of 30 patients from the USMC-Huelva with different diagnoses of eating disorders.
The variables studied are:
- Main diagnosis
- No. of entries at Unit Mental Health Hospitalization
- Consultations in the Emergency Department
The results show that the majority of patients have been diagnosed with anorexia nervosa purging type. These patients, mostly, have another disorder, highlighting dependence disorders and / or substance abuse, anxiety disorders and personality disorders. In the sample studied, three of the subjects required hospitalization in Mental Health, and of these, only one was due solely to own principal diagnosis criteria (malnutrition).
The importance of a comprehensive approach that includes history of each patient and associated disorders.
In a situation of imminent discharge with a serious problem such as no adherence, vague and imprecise concept of the concept of psychosis, poor support and family support, poor social relationships and social skills, little emotional resonance and leave the residence, what do we do?
In this case we opted for patient referral to a rehabilitation unit as the TC. This is where targets are raised to make an Individual treatment plan: improving disease awareness and treatment adherence, family information about the disease, extend relationships and use of leisure time, reduction of negative symptoms and residential support.
The patient is 32 years old, daughter of separated parents, diagnosed schizophrenic psychosis with 7 hospital admissions in the last 9 years. The disease is associated with the consumption of toxic. There are changes in the character, family relationship problems, clinical delusional and hallucinatory behavior disorders with numerous leaks of the home and making marginal life. Prior to the TC is trying two leads to Area Rehabilitation Unit with treatment failure after cessation of medication. After two years of follow up in TC have achieved most of the objectives proposed at the beginning, normalizing, as far as possible, the life of the patient.
We study the contact line dynamics of a viscous droplet deposited at the centre of a substrate subject to an axial thermal gradient. The temperature of the substrate decreases with distance from the centre, so the Marangoni stress induced at the liquid–air interface displaces the liquid radially outward. The flow experiences two stages. In the first stage, the droplet evolves towards an axially symmetric ring whose radius increases with time as
. Using the lubrication approximation, we perform numerical simulations that confirm this law for the motion of the front and show that the maximum thickness of the profile decreases as
. We explain the evolution law of the contact line by balancing Marangoni and viscous stresses. In the second stage, the contact line becomes unstable and develops smooth corrugations whose amplitude increases with time and that eventually become long fingers. The temporal evolution of the Fourier spectra of the contour shows a shift of the most unstable mode from smaller to larger azimuthal wavenumbers.
Although most unipolar depression clinical guidelines advise against evaluating the efficacy of antidepressant pharmacological treatment until it has been administered in therapeutic doses for a minimum of 4–6 weeks, there is an increasing tendency to make therapeutic decisions after only 2 weeks of treatment. We present a study which aim is to determine whether the clinical course, following 2 weeks of antidepressant treatment, allows therapeutic decisions to be made for patients affected by a moderate/severe depressive episode. The study has an 8-week, prospective, observational design in which all consecutive in- and outpatients with moderate/severe unipolar major depression aged over 17 years received antidepressant treatment based on a standardized treatment protocol. Clinical status was assessed at baseline and at 2-, 4-, and 8-weeks. The final sample consisted of a total of 114 subjects. In our sample, the rate of remitters versus non-remitters was similar between the 2-week improvers and the 2-week non-improvers. It should also be emphasized that it was not possible to explain, based on the epidemiological and clinical characteristics assessed, which 2-week non-improvers would tend towards remission and which would show a partial or full response. Based on these results, for patients affected by a moderate/severe unipolar depressive episode, it would not be appropriate to make new therapeutic decisions following 2 weeks of anti-depressive pharmacological treatment depending on whether the patient has shown clinical improvement or not.
Disclosure of interest
The authors have not supplied their declaration of competing interest.