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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The conception of a specific association between maturity-onset diabetes and manic-depressive psychosis, on a common basis with diencephalic functional obesity, has been recently taken again in consideration by the psychiatric literature. Investigations on this problem from diabetological point of view have been so far completely lacking, and are proposed with the present study. Symptomatic depressive conditions in diabetes are frequent and should be primarily separated from depressive endogenous psychosis. The pathogenesis of the association between diabetes of the adult-obese type and psychosis might be discussed according to a transactional theoretical model, assuming a positive feed-back mechanism of the two relationships: diabetes-psychosis and psychosis-diabetes. With these criteria, 4 observations of the clinical association were collected out of 274 admissions for diabetes, during 1976. Diabetes is intended as overt diabetes; obesity presented with the stenic picture; psychosis had a monopolar melancholic course. Similar clinical features were characteristic in all cases. The relationship diabetes-psychosis showed no evidence, unless importance should be given to a potential diabetes in 3 cases. On the contrary, the relationship psychosis-diabetes could be demonstrated in the four cases. A psychosomatic scheme connecting the neuro-hormonal correlations to a genetically conditioned exhaustion of the beta-function, is postulated. During melancholic recurrences, diabetes proved to be insulin-dependent and even insulin-resistent in 2 cases. Tricyclic antidepressant theraphy did not modify the metabolic situation.
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PMID:[Association of adult obese-type diabetes and depressive psychosis (clinical cases)]. 61

The distribution of some risk factors on different psychiatric diseases in 1726 hospitalized patients were investigated within a prevalence study. To all tested factors there was a contrary behaviour of oligophrenic patients opposite to the group with a schizophrenia, organic and affective psychotics. Hypertension only was found more frequently in non psychotic psychopathia and oligophrenia than in psychosis. Therefore the prevalence of hypertriglyceridemia, hypercholesterinemia, diabetes, specific Ecg-changes, smoking of cigarettes and severe physical inactivity in oligophrenics was less except in all other group of diseases, also in consideration of the different frequency of psychopharmacal treatment. Electrocardiographical signs for coronary heart diseases also show a similar distribution of frequency. Likewise in psychiatric patients seems to be an agreement with the coronary morbidity and the somatic risk factors.
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PMID:[The risk of heart disease in various psychiatric diseases]. 101 3

Magnesium is an essential cofactor for many enzymatic reactions, especially those involved in energy metabolism. Deficits of magnesium are prevalent due to inadequate intake or malabsorption and due to the renal loss of magnesium that occurs in certain disease states (alcoholism, diabetes) and with drug therapy (diuretics, aminoglycosides, cisplatin, digoxin, cyclosporin, amphotericin B). Protracted deficits of magnesium in humans and animals result in neurological disturbances, including hyperexcitability, convulsions and various psychiatric symptoms ranging from apathy to psychosis, some of which can be reversed with magnesium supplementation, others requiring correction of the dysregulation mechanism. Although the role of magnesium in neuronal function is not completely understood, a lowering of CSF or brain magnesium can induce epileptiform activity and there is an association between decreased CSF magnesium and the development of seizures. CSF concentrations of magnesium are normally higher than magnesium plasma ultrafiltrate (diffusible) concentrations due to the active transport of magnesium across the blood-brain barrier. Under conditions of magnesium deficiency, CSF concentrations decline, although this decline lags behind and is less pronounced than the changes observed in plasma magnesium concentrations. Decreases in CSF magnesium concentrations correlate with the alterations observed in extracellular brain magnesium concentrations in animals following the dietary deprivation of magnesium. CSF magnesium concentrations can readily be repleted following magnesium supplementation, although high dose magnesium therapy, such as that used in the treatment of convulsions in eclampsia, will only increase CSF magnesium concentrations to a very limited degree (approximately 11-18 per cent) above physiological concentrations. Greater increases in CSF magnesium may occur in neonates since neonatal swine, following treatment with magnesium, have CSF magnesium concentrations that are similar to their plasma concentrations. There has been a recent resurgence of interest in magnesium deficiency and its neurological consequences due to the finding that magnesium, at physiological concentrations, blocks N-methyl-D-aspartate (NMDA) receptors in neurones. NMDA receptors are normally activated by glutamate and/or aspartate which represent the principal neurotransmitters for excitatory synaptic transmission in vertebrate CNS. Magnesium deficiency produces epileptiform activity in the CNS which can be blocked by NMDA receptor antagonists. Other mechanisms, including alterations in Na+/K(+)-ATPase activity, cAMP/cGMP concentrations and calcium currents in pre- and postsynaptic membranes, may also be at least partially responsible for the neuronal effects associated with low brain magnesium. Further studies are necessary to increase our understanding of the neurological implications of magnesium deficit in the central nervous system.
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PMID:Brain and CSF magnesium concentrations during magnesium deficit in animals and humans: neurological symptoms. 129 67

Two studies examine the prevalence of tardive dyskinesia (TD) in neuroleptic-treated diabetic patients. Study 1 compared 38 diabetic patients with 38 nondiabetic patients treated for psychotic disorders with low to moderate doses of neuroleptics (mean chlorpromazine equivalents = 300 mg/day) for an average of 18 years. Study 2 compared 24 diabetic and 27 nondiabetic patients treated for an average of 2.6 years with a mean 31 mg/day of metoclopramide for gastrointestinal disease. Patients were examined for TD using standardized scales by raters blind to all treatment and illness variables. In both studies, there were no differences between the diabetic and nondiabetic groups in age, sex, type of psychiatric illness, and dose and duration of neuroleptic treatment or severity of parkinsonism. In both studies, the diabetic patients had significantly greater prevalence and severity of TD. No measures of diabetes severity were associated with TD in either study. Possible pathophysiologic mechanisms for the increased prevalence of TD in neuroleptic-treated patients with diabetes will be discussed.
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PMID:Tardive dyskinesia and diabetes mellitus. 136 76

This study measured the prevalence of chronic medical conditions in 4,549 middle aged persons attending three large general practices in Dublin over the course of a calender year. The prevalence of the following conditions were measured: coronary heart disease, hypertension, stroke, diabetes, asthma, chronic bronchitis, rheumatic disorders, dyspepsia, depression, anxiety disorders, psychoses, and cancer. In order to obtain a valid denominator for the study a second community based study was carried out in the same areas to determine what proportion of persons visit their general practitioner over the course of a year. Overall 40.5% of males and 44% of females suffered from a least one of the twelve conditions, with rheumatic disorders having the highest prevalence (14.5%) and psychotic disorders the lowest (0.75%).
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PMID:General practice estimates of the prevalence of common chronic conditions. 147 57

Six cases of acute renal failure (ARF) due to rhabdomyolysis were experienced between 1984 and 1989. Patients' ages ranged from 33 to 92 years old (average ages 61) and all were male. The causes of rhabdomyolysis were as follows: one crush syndrome, one acute arterial occlusion, one diabetic hyperosmolar nonketotic coma and three cases of malignant syndrome due to neuroleptica (mainly haloperidol). Underlying diseases included, one case of abdominal aneurysm, two cases of diabetes mellitus, two cases of schizophrenia and one case of reactive psychosis. Dehydration was considered as an important factor in the onset of rhabdomyolysis and ARF, because it was observed in 4 of the cases in this study. In all cases, the serum levels of potassium, phosphorus and uric acid as well as myoglobin and myogenic enzymes increased markedly. In patients with myoglobinuric ARF, severe metabolic acidosis and hypocalcemia in the oliguric phase and hypercalcemia in the diuretic phase were prominent. Muscle biopsy showed myolytic degeneration in 2 of 4 cases. Five cases were treated with hemodialysis and one case was managed conservatively. All 6 cases had relatively good prognosis. However, 3 cases with malignant syndrome showed outcomes more severe than in the other 3 cases without such syndrome.
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PMID:[Acute renal failure due to rhabdomyolysis--clinical investigation on our 6 cases]. 163 34

We present a clinical case of a 43-year-old female with progressive systemic sclerosis, Basedow's disease, atrial fibrillation and diabetes mellitus. She twice developed exacerbations of a psychotic state. She showed a depressive state followed by a paranoic hallucinatory state and stupor. Electroencephalograms revealed slow abnormal records both in psychotic and remitting periods and 123I IMP SPECT of the brain showed a low blood flow in the psychotic stage. A case of progressive diffuse sclerosis with a paranoic hallucinatory state is rarely reported. As her Basedow's disease had been well controlled, the psychotic symptoms of the present case are regarded as organic hallucinosis and organic delusional disorder due to progressive diffuse sclerosis.
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PMID:Progressive systemic sclerosis with mental disorder. 181 80

Diabetes mellitus and bilateral optic atrophy are the defining characteristics of the autosomal recessive Wolfram syndrome. Diabetes insipidus, neurogenic bladder, deafness, and other neurological manifestations are frequent. A review was made of the medical records of 68 Wolfram syndrome patients, aged between 8 and 43 years, identified by casefinding throughout the USA. 41 of the patients (60%) had episodes of severe depression, psychosis, or organic brain syndrome, as well as impulsive verbal and physical aggression. These symptoms were very severe in 17 patients (25%), of whom 12 required admission to a psychiatric hospital and 11 attempted suicide. We conclude that the Wolfram syndrome gene predisposes homozygotes to psychiatric illness.
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PMID:Psychiatric findings in Wolfram syndrome homozygotes. 197 60

The article deals with the results of investigation of psychic disturbances in 7 patients with diabetes mellitus. Psychic dysfunctions which are important for forensic psychiatric practice (depressions, transitory psychotic episodes at the background of hyperglycemia and pathologic states with consciousness disturbance, psychomotor excitement and incorrect behaviour in hypoglycemic states) were analysed. Characteristics were noted which contributed to diagnosing in patients with diabetes mellitus, the states of temporary morbid mental disorder and choosing correct expert conclusion in relation to persons who committed indictable actions.
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PMID:[The forensic psychiatric evaluation of mental disorders in diabetic patients]. 208 54

Percutaneous endoscopic gastrostomy (PEG) has become the preferred method of nutritional support in virtually every patient in whom this procedure is technically feasible because of its apparent technical facility, cost containment, and bedside insertion. PEG can, however, be associated with serious complications and death. This is a report of three patients who developed life-threatening abdominal wall abscesses and four patients who died after PEG insertion. The patients ranged in age from 30 to 80 years, four female and three male. Complicating medical conditions included cirrhosis, diabetes, heart-lung transplantation, neurological dysfunction, and psychosis. The four patients who died were all noted to have had unsatisfactory adhesion between the gastric serosa and the anterior abdominal wall, resulting in large gastric defects where the PEG had been placed and intraperitoneal contamination with gastric contents and feedings. Three additional patients developed abdominal wall abscesses requiring operative debridement. The patient considered to be high risk for surgical gastrostomy may be a higher risk for PEG. Alternatives to PEG should be considered in patients with poor nutritional status or debilitating medical conditions, or in patients undergoing immunosuppressive therapy and steroid use. Psychosis and dementia should be considered relative contraindications to PEG because these patients may dislodge the gastrostomy tube, resulting in severe wound infection and, possibly, death.
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PMID:Fatal and disastrous complications following percutaneous endoscopic gastrostomy. 249 84


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