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Query: UMLS:C0028754 (obesity)
 124,988 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

Antipsychotic drugs have long been noted to cause pronounced weight gain, and drug-induced obesity can assume major clinical importance in long-term medication in the management of chronic schizophrenia. Obesity is associated with increased morbidity and may reduce compliance, leading to a return of psychotic symptoms. In a survey of 226 patients attending depot neuroleptic clinics in one inner London borough, it was found that the prevalence of clinically relevant obesity was four times that in the general population.
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PMID:Prevalence of obesity in patients receiving depot antipsychotics. 290 36

In Japan, the age-adjusted death rate from ischemic heart disease has decreased for both male and female since 1970, although the rate appears to be slightly affected by mortality from senility without mention of psychosis, "cardiac insufficiency", and sudden death in elderly persons. On the other hand, consultation rate has shown an increase, suggesting an increase in the number of recovered patients and a lengthening in the duration of ischemic heart disease from onset to termination by CCU treatment. A 7.5-year prospective study of ischemic heart disease (myocardial infarction + angina pectoris on effort + sudden death) among residents 40 years and older was conducted at a rural community, Akadani-Ijimino district in Niigata Prefecture. Statistically significant risk factors appeared to be age, hypertension, ECG abnormalities and fuduscopic changes. Even in 1977-1984 when Japanese dietary habits were westernized, neither hyperlipidemia nor obesity was related to the development of ischemic heart disease in this agricultural district. Statistically significant risk ratios were not observed for any nutrient or food, although the ratio for animal fat, calcium, salted vegetables and caloric percent of animal protein was more than one respectively.
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PMID:Trends in death and consultation rates of ischemic heart disease in Japan and the risk factors in a rural community. 359 72

The present study comprises all deaths in Norwegian psychiatric hospitals in 1950-74 with the diagnosis of non-organic (functional) psychosis: 5106 deaths. Mortality declined in both sexes as did excess mortality which is now 1.7 times the general population in the male, and 2.3 times in the female sex. However, a significant rise in unnatural deaths (suicides and accidents) took place in both sexes during 1963-74, as mortality increased 2-3 times in comparison with 1950-62. This rise in unnatural deaths is probably directly related to the introduction of drug therapy, which created an increased need for protection of the hospital population. A challenge which the accompanying changes in the hospital environment have failed to meet. Cardio-vascular mortality increased considerably during 1963-74 in both sexes. The rise is most likely the combined result of an adverse effect of drug therapy in individual patients (obesity, physical inactivity, increased smoking habits), the reduced stress-relieving effect of hospitalisation through shorter stays in hospital and the liberalization policy. We may not yet have experienced the total adverse effect on mortality of the increase in behavioural risk factors in psychiatric patients. It is suggested that future mortality studies include psychiatric out-patients.
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PMID:Recent rise in supposedly stress dependent causes of death in psychiatric hospitals in Norway indicating increased "stress" in hospitals? 400 6

A 37-year-old woman presented with acute psychosis and cognitive impairment. Skull x-ray showed an enlarged sella turcica with erosion of the floor. Endocrinologic workup suggested the diagnosis of Cushing's disease and hyperprolactinemia. She had no cushingoid feature, and the only physical sign was mild generalized obesity. She showed a paradoxic response to dexamethasone suppression, and underwent trans-sphenoidal resection of a pituitary macroadenoma. Electron microscopy showed the tumor to be a Crooke's cell adenoma. Results of immunohistochemical staining were positive only for ACTH and beta-endorphin. The neuropsychiatric manifestations resolved after surgery.
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PMID:Occult Cushing's disease presenting with acute psychosis. 671 82

The Symptom Checklist 90-Revised (Derogatis, 1975) was administered to 37 obese adults in outpatient treatment for obesity. Individuals who had become obese during childhood showed greater interpersonal sensitivity and exhibited more psychotic symptoms than those who had become obese later in life. The findings support the belief that morbid obesity is characteristically associated with elevated levels of internal psychological conflict.
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PMID:A note on interpersonal sensitivity and psychotic symptomatology in obese adult outpatients with a history of childhood obesity. 765 Jun 31

Clozapine (CLZ) and metabolites norclozapine and clozapine-N-oxide were assayed with a new, sensitive (2 pmol), and selective method in 68 serum samples from 44 psychotic subjects, 20 to 54 years old, ill 16 years, and treated with CLZ for 2.2 years (currently at 294 mg, 3.4 mg/kg daily). CLZ levels averaged 239 ng/ml (0.73 microM; 92 ng/ml per mg/kg dose) or 48% of total analytes (norclozapine = 41% [91% of CLZ] and clozapine-N-oxide = 11%); metabolite and CLZ levels were highly correlated (rs = 0.9), and CLZ levels varied with daily dose (rs = 0.7). Sampling twice yielded similar within-subject analyte levels (r = 0.8 to 0.9; difference = 24% to 33%). Range and variance narrowed when levels were expressed per weight-corrected dose (ng/ml per mg/kg). Levels per dose were 40% higher in nonsmoking women than men, despite a 60% lower milligram per kilogram dose in women, and did not vary by diagnosis or age in this limited sample. Fluoxetine increased serum CLZ analytes by 60%; valproate had less effect. Patients rated treatment very positively; observer-assessed benefits typically were more moderate. Common late side effects were sialorrhea (80%), excess sedation (58%), obesity (55% > 200 lb), mild tachycardia (51%), constipation (32%), and enuresis (27%); there were no seizures or leukopenia. There was little evident relationship of drug dose or serum level to current clinical measures or side effect risks.
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PMID:Clozapine and metabolites: concentrations in serum and clinical findings during treatment of chronically psychotic patients. 819 52

The purpose of this case study is to document hepatic adverse effects associated with long-term risperidone use in pediatric populations. Charts of all patients admitted to the National Institute of Mental Health (NIMH) from December 1993 to April 1996 who had been treated with risperidone were screened for hepatotoxicity and weight gain. From the medical records of 13 psychotic children admitted to the NIMH and treated with risperidone, 2 children (both male) who presented with obesity, liver enzyme abnormalities, and confirmatory evidence of fatty liver were identified. In each case liver damage was reversed after discontinuation of risperidone and/or associated weight loss. The observations suggest that long-term risperidone therapy is possibly associated with hepatotoxicity in male pediatric patients. It is recommended that pediatric patients treated with risperidone have baseline liver function tests, careful monitoring of weight, and periodic monitoring of liver function tests during the maintenance phase of therapy.
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PMID:Case study: risperidone-induced hepatotoxicity in pediatric patients. 978 8

Obesity as psychosomatic disease is a mass phenomenon. The number of obese males (BMI > 30) became doubled in the last ten years. In the etiology of obesity play an important role the reactive obesity. In the background of "yo-yo syndrome" often could be found depression, or other psychotic disorder. The low self-esteem, body dissatisfaction, tension, anxiety disorders is well-known in a slimming diet. Obese subjects (n = 29) who were admitted on their request with a view to losing weight were examined (Hamilton Depressive Scala, Hamilton Anxietas Scala, Eating Attitude Test) Physical Conditioning and internal Medicine Department of National Sports Medicine Institute, Budapest. Among obesities with mild and severe depression as treatment of somatic complications was used fluoxetine, in severe cases and depression with severe anxiety was associated with supportive or cognitive-behavioral treatment. The prevalence of binge eating disorders were at 57% and bulimia nervosa was at 3% in using population (n = 29). Decreasing of anxiety and grade of depression significantly correlated with body mass index (p < 0.023, F = 1.997, p < 0.034, F = 3.131). The treatment of fluoxetine significantly correlated with body mass index (T1: p < 0.023, T2: p < 0.03, T3: p < 0.004). The patients indicated their well being as fluoxetine reduced eating, satiety and lower binges.
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PMID:[The combined effect of psychotherapy and fluoxetine on obesity]. 1054 Aug 96

Determining the cause of death when a restrained person suddenly dies is a problem for death investigators. Twenty-one cases of death during prone restraint are reported as examples of the common elements and range of variation in these apparently asphyxial events. A reasonable diagnosis of restraint asphyxia can usually be made after ruling out other causes and collecting supportive participant and witness statements in a timely fashion. Common elements in this syndrome include prone restraint with pressure on the upper torso; handcuffing, leg restraint, or hogtying; acute psychosis and agitation, often stimulant drug induced; physical exertion and struggle; and obesity. Establishing a temporal association between the restraint and the sudden loss of consciousness/death is critical to making a correct determination of cause of death.
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PMID:Asphyxial death during prone restraint revisited: a report of 21 cases. 2675 13


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