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Query: UMLS:C0036341 (schizophrenia)
60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies of clients with severe mental illness (SMI) typically focus on individuals in larger urban areas. Less is known about clients in rural and smaller urban areas. Here we compare the psychiatric status, home and community activities of daily living, and social and vocational functioning of 1600 adult clients with SMI from 18 small-city and rural Wisconsin counties. Rural clients are less likely to have a diagnosis of schizophrenia or organic brain syndrome; have higher levels of general pathology, including more belligerent, bizarre, nervous, and depressive behaviors; and engage in fewer vocational activities than urban clients.
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PMID:Rural-urban differences in psychiatric status and functioning among clients with severe mental illness. 925 Apr 28

Obsessive love and delusional jealousy as persistent mental disorders, are well-known but rare psychiatric conditions, the prevalence of which is estimated to be less than 0.1%. Delusional jealousy should not be confused with exaggerated "pathological" jealousy, which is characterized by excessive suspicion and possessiveness on the part of individuals who, as a rule, suffer from considerably disordered self-esteem. As a paranoid development, delusional jealousy occurs in particular among male chronic alcoholics. As in all delusional disorders, trivial events are evaluated with unshakeable certainty as proof of the correctness of the delusive notion. Obsessive love is seen predominantly in women. In the differential diagnosis, other mental disorders such as schizophrenia, manic or organic brain syndrome must be excluded.
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PMID:[Delusional jealousy and obsessive love--causes and forms]. 1575 23

Violence is an important social problem. Violence in the community has important social relevance for the political, criminal justice, and health care systems. Studies of homicide offenders have suggested a high prevalence of neurologic dysfunction due to organic brain damage such as traumatic brain injury, epilepsy and dementia have been observed to exhibit excessive violence. Moreover, violence in the mentally ill can be viewed as an important medical and mental health problem with significant implications for forensic psychiatry and the community. Although numerous previous studies showed that rate of violent behavior in the community is not much higher in patients with serious mental disorders (schizophrenia) than in healthy controls, that rate is substantially higher in patients with psychiatric comorbidity and substance abuse. A high proportion of patients in forensic psychiatric facilities are diagnosed with comorbidity, most often with schizophrenia, paranoid psychosis, organic brain syndrome, various personality disorders and comorbid substance abuse. These patients represent a high risk group for violence within forensic psychiatric facilities, and repetitive violent behavior in the community. Understanding the neurobiological basis of aggressive behavior clearly has important social and clinical implications. By introduction of neuroimaging studies (MRI, fMRI, PET, SPECT) as a useful tool in forensic psychiatry, the neurobiological aspect of violence is better understood. Previous studies have shown that individuals with frontotemporal brain dysfunction are frequently displaying antisocial behavior (disinhibition, impulsivity, lack of empathy) that justify the diagnosis of "acquired sociopathy/psychopathy". A correlation between the potential for impulsive aggression mediated by limbic brain structures, and the control of the aggression by frontotemporal brain regions has been shown. The individuals with such brain dysfunction have an increased risk of violent behavior and scored high on the Webster's and Hare's violence risk assessment scale. This article reviews the relationship between psychiatric comorbidity, violence risk assessment and neuroimaging in forensic psychiatry and showing the useful directions for future research, screening and prevention of violent behavior among mentally ill criminal offenders.
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PMID:Relationship between comorbidity and violence risk assessment in forensic psychiatry - the implication of neuroimaging studies. 2056 56

Because it stems from a variety of causes and interacting factors, organic brain syndrome is a difficult condition to diagnose. Several factors make it distinguishable from functional disorders, schizophrenia or hysteria. The syndrome cannot be considered in isolation from the patient's personality, however, since this will affect his coping with the disorder.
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PMID:The diagnosis of organic brain syndrome. 2130 79

The psychological aspects of hypothyroidism are reviewed with reference to the available literature. A case history of hypothyroidism along with its psychological manifestations is discussed and a conclusion is drawn that usually four characteristic types of psychological pictures co-exist with hypothyroidism viz. organic brain syndrome, schizophrenia form psychoses, affective psychosis, especially the depression and mixed variety. Suggestion for therapy are also outlined.
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PMID:Psychological aspects of hypothyroidism (review and case study). 2196 22

Psychiatric diagnosis is not considered a risk factor for offending following discharge. However, treatment interventions and aftercare are strongly influenced by clinical primary diagnosis. We compared differential risks of reoffending of patients falling into six primary diagnostic categories following discharge from Medium Secure Units in the UK: schizophrenia/schizoaffective disorder; delusional disorder; mania/hypomania; depressive disorder; organic brain syndrome; personality disorder. We followed up 1344 patients, on average 6.2 years (SD=2.1) at risk, discharged from 7 of 14 Regional Medium Secure services in England and Wales. Outcomes were period prevalence, incidence, and cumulative probability of criminal conviction. Established demographic and criminal history predictors of reoffending were observed across different diagnostic categories. Risks of all offending were increased for personality disorder, violence/acquisitive offending for delusional disorder, sexual offending for mania/hypomania and violence/acquisitive offending for organic brain syndrome. Patterns of risk over time differed markedly between categories of mental disorder. Most patients with personality disorder who offended violently did so within 4 years of discharge. A subgroup with delusional disorder demonstrated increased risk of violent offending 5 years after discharge. Differential risks of reoffending are observed between different diagnostic groups. Clinical diagnosis should be included together with established risk measures in risk management following discharge. Close supervision of patients with personality disorder should begin immediately after discharge when risks of reoffending are greatest. For delusional disorder further investigation is needed into the marked increase in risk of violence after 5 years.
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PMID:Psychiatric diagnosis and differential risks of offending following discharge. 2566 Mar 50

We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile. The progression of these events casts doubts on our admitting diagnosis as the primary cause of the patient's symptoms. The patient's clinical condition improved only when his endocrinopathy was treated with hormone replacement, fluids, and electrolyte correction in addition to antipsychotics. An inability to verify the patient's psychiatric history and a remote history of pituitary resection several decades earlier, unknown to the treating team, added to the diagnostic conundrum. We revised the diagnosis to neuropsychiatric manifestations secondary to an organic brain syndrome due to a partial pituitary resection. The patient was discharged with no symptoms of psychosis, good insight, judgment, and good reality testing.
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PMID:Neuropsychiatric Manifestations in a Patient with Panhypopituitarism. 2856 21

Human being is not spared from a broad-ranged emotional state, including being jealous. Jealousy has both affective-cognitive and behavioural-evaluative dimension where the person perceives, or experiences a real threat on a valued relationship. As this complex emotion becomes irrational and not amenable to reason, it later transforms into a dangerously 'green-eyed monster'. This perilous situation which is viewed as pathological jealousy is a form of delusion, which is maintained by a fixed and false reasoning in an originally entrusted intimate relationship. Pathological jealousy is equally prevailing among both gender, and with a greater ubiquity among the geriatric population. The role of dopamine hyperactivity in the fronto-parietal-temporal region was implicated, with the anatomical mapping of the ventromedial prefrontal cortex (vmPFC), cingulate gyrus (CG), and amygdala involvement in the context of the disease's neurobiology. The etiology of pathological jealousy includes major psychiatric disorders, i.e. delusional disorder, schizophrenia, mood disorder, organic brain syndrome, and among others, the drug-induced psychosis. The role of relationship issues and psychodynamic perspective, i.e. psychological conflicts with dependence on a romantic partner, and low self-esteem are involved. Pathological jealousy inherits high-risk forensic psychiatry entanglement, which may warrant intensive intervention, including hospital admission and antipsychotic treatment. Treatment options include an early recognition, managing underlying neuropsychiatric disorders, psycho education, cognitive psychotherapy, and choosing an effective psychopharmacological agent. The management strategy may also resort to a geographical intervention, i.e. separation between both persons to complement the biological treatment.
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PMID:Subduing the Green-eyed Monster: Bridging the Psychopharmacological and Psychosocial Treatment Perspective in Understanding Pathological Jealousy. 2867 99


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