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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative delirium is a common syndrome that is often mistaken for other psychiatric conditions, particularly depression. Numerous investigators have found a clear convincing association between delirium and increased morbidity and mortality. For this reason, greater attention should be focused on accurate clinical diagnosis. In this article, pre- and postoperative risk factors are reviewed. Lastly, areas demanding immediate further investigation are identified. In particular, outcome studies with particular emphasis on the role of age and prior drug exposure are urgently needed.
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PMID:Postoperative delirium. 181 84

The realization that many intensive care patients develop psychoreactive problems ranging from confusion to depression to frank mutism led us to include Dehydrobenzperidol (DHB) in our analgesia and sedation scheme. The early prophylactic administration of this drug was found to be particularly effective in the prevention of delirium following an alcohol and/or drug overdose.
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PMID:[Psychopharmacologic aspects in intensive care medicine]. 181 35

All incident cases of clinically diagnosed Alzheimer's disease were identified through the unique record linkage system of the Mayo Clinic. Thirty-nine (32%) of the sample of 122 had a psychiatric history that preceded the onset of CDAD by at least 3 years. Twenty-five percent of the study population had had an episode of delirium within 2 years of the onset of CDAD. Eighty-four percent of the cases had psychiatric symptoms in the course of CDAD that were documented in their medical records. Specific symptom patterns included agitation, combativeness, confusion and disorientation, depression, psychosis, and wandering. These symptoms occurred more frequently in clusters than singularly.
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PMID:Psychiatric symptoms in cases of clinically diagnosed Alzheimer's disease. 185 24

46 subjects infected with human immunodeficiency virus (HIV) were followed up to determine psychiatric morbidity, both prior to and after information regarding their HIV status was revealed to them. Among these patients, 4 had AIDS syndrome while 42 individuals were HIV carriers. The preinformation morbidity in the AIDS group included 2 individuals who presented with delirium and 1 with an adjustment disorder. The psychiatric diagnosis among the HIV carriers revealed 1 patient with major depression, 4 with adjustment disorders, and 4 with alcohol dependence syndrome. The additional morbidity after the diagnosis was revealed and included major depression and adjustment disorders which could be managed by psychological intervention and counseling in most instance. The individual who later developed major depression committed suicide. The study, though preliminary in nature, suggests that it may be beneficial to include psychiatric management as past of the general care of individuals with HIV infection.
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PMID:Psychiatric morbidity in HIV infected individuals. 185 20

The physiological imbalances associated with organ insufficiency and the complexity of organ transplant surgery and postoperative care puts patients at risk for psychiatric disorders. The brain is susceptible to a variety of insults as a result of these complex processes, including those secondary to medications and infections. We review literature relevant to organ transplant patients and also include empirical knowledge based on clinical practice. We first describe the physiologic and psychiatric issues for each major organ that is commonly transplanted, including liver, kidney, heart, bone marrow, and pancreas, as well as multiple organ transplantation. We then discuss the pharmacologic treatment and neuropsychiatric side effects of rejection with various immunosuppressants, including cyclosporine, azathioprine, OKT3, FK506, and corticosteroids. Certain bacterial, fungal, viral, and protozoal infections occur more frequently in the transplant population; their relationship to neuropsychiatric dysfunction is discussed. We then present details of psychopharmacotherapy of delirium, other organic mental disorders, depression, mania, anxiety, and insomnia, with attention to drug interactions and differential diagnosis. Particularly cautious monitoring of medication doses and serum levels is recommended in these patients.
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PMID:Psychopharmacology and neuropsychiatric syndromes in organ transplantation. 187 24

The recognition, management, and treatment of fatigue and depression in the patient in the intensive care unit has been presented in a framework to allow consideration of intrapsychic, interpersonal, environmental, and disease factors that can be altered by various means. It is rare that fatigue so seriously complicates the primary illness as to be life threatening itself. Depression and delirium are associated with increased morbidity and mortality on their own; therefore, prompt attention to major depressive disorders and organic effective disorders is necessary. Through it all, attention to the person who has the disease with fatigue, depression, or both is essential.
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PMID:Fatigue and depression in the patient in the intensive care unit. 187 19

Primary care physicians seeing a growing number of elderly demented patients must consider a number of problem areas when treating such patients. This article offers the mnemonic FICS'M (Family, Intellectual status, Continence, Sleep, and Mobility) to help physicians address treatable problems associated with dementing illnesses. Strategies are offered to minimize morbidity from the particular problem and from the treatment, such as trying "low toxicity" therapies and medications with few side effects. Other medical, ethical, and legal issues are discussed, including handling dangerous behaviors and abuse, nursing home placement and autopsy, and specific treatment of both the dementia itself and associated disorders--agitation, depression, and delirium.
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PMID:A checklist for managing the dementia patient. 190 22

It is evident that human immunodeficiency virus (HIV) infection is one of the most serious public health issues in decades. HIV infection compromises cell-mediated immunity which ultimately may result in the acquired immunodeficiency syndrome (AIDS). AIDS, to date, remains an incurable and progressively fatal disorder. HIV infection is spreading beyond the originally identified high-prevalence groups of gay/bisexual males, intravenous drug abusers, and recipients of infected blood or blood products. Today, more and more heterosexual males, women, adolescents, and children have been infected with this lethal virus. This report addresses some of the psychiatric complications associated with HIV infection and discusses the diagnostic and clinical management challenges that clinicians must face as they deal with the increasing population of HIV-infected patients. Depression, anxiety, psychosis, delirium, and dementia are commonly encountered disorders associated with HIV spectrum disorders which must be accurately identified and can be effectively managed with psychopharmacological interventions.
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PMID:Psychopharmacotherapy of psychiatric syndromes in asymptomatic and symptomatic HIV infection. 192 28

In the study of dementia four distinct categories of instruments can be distinguished: instruments to examine cognitive dysfunction, to measure the severity of dementia, to assess disturbances in daily behaviour, and instruments to make a differential diagnosis of dementia. The Cambridge Examination for Mental Disorders of the Elderly (CAMDEX), published in 1988, incorporates these four categories in a single comprehensive interview schedule. Items related to the diagnosis of clouded/delirious state, depression and other psychiatric symptoms are also included. The Dutch version (CAMDEX-N) and accompanying software for data analysis and for scientific research were developed. Items were added to the section on physical and neurological examination, and to the section on ancillary investigations. The software can be adapted to future developments in dementia research.
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PMID:[CAMDEX-N: the Dutch version of the Cambridge Examination for Mental Disorders of the Elderly with automatic data processing]. 192 99

This report has discussed the normal psychological responses associated with diagnosis and treatment of leukemia, specific psychological disorders that are encountered in the context of treatment, and psychological issues that develop after definitive treatment as patients become survivors from leukemia. Psychopharmacologic and psychotherapeutic strategies to treat the specific disorders of anxiety, depression, and delirium have been outlined. Similarly, survival issues have been considered as an ever-growing number of patients are cured of leukemia.
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PMID:Psychiatric aspects of adult leukemia. 196 84


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