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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of the 2,256 admissions to a general hospital psychiatry unit between April 1982 and December 1987 showed that 129 (6%) had been treated with electro-convulsive therapy (ECT); 91% of these had a diagnosis of mood disorder. Most patients were taking concurrent psychotropic medication and received an average of 9 treatments per course of ECT. Men and patients taking benzodiazepines had shorter convulsions. However, there were no differences in seizure length and number of treatments between younger and older patients and between those taking and not taking tricyclic antidepressants.
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PMID:A survey of ECT in a general hospital psychiatry unit. 197 64

Recent research on the various biological indices of bipolar mood disorder reveals a complex framework for the understanding of this psychobiological disorder. Four major constructs emerge from the professional literature to form the basis of the current understanding of and approaches to bipolar disorder. The first construct is that of biological rhythms and mood disorders. From this perspective, time is considered as a biological dimension evidenced by biological rhythms. Disruption of certain internal circadian rhythms yields behavioral change and symptoms of psychobiological disequilibrium. Concepts inherent in this particular construct include sleep, effect of light on mood pattern, and possible biochemical indices of mood modulation such as melatonin or phenylethylamine. The second construct attempts to explore the linkage between biochemical brain function and aberrant mood behavior. This information bifurcates into two major categories: (1) effects of psychopharmacological substances on neurotransmitter synthesis and release; and (2) implications of dietary influences on neurotransmitter activity and the psychobiological ramifications of such activity on the clinical understanding of the behavioral disorder. An eclectic set of concepts form the third construct in the framework presented here. These concepts address other possible etiological or mitigating biological influences on bipolar mood states. Such influences include, but are not limited to, limbic seizure activity, neuroendocrine dysfunction, and organic substrates of bipolar states such as various malignancies. The final construct explores the role of genetics in either the predisposition to or the emergence of bipolar mood disordered states. This report will focus on a review of the aforementioned constructs, pointing to significant research and narrative professional publications. In addition, the presentation will address the application of the nursing process to psychobiological aspects of bipolar mood disorder, specifically circadian rhythmicity disturbance and dietary influences on neurotransmission.
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PMID:Psychobiological indices of bipolar mood disorder: future trends in nursing care. 231 96

Three male chronically psychotic patients (mean age 33.0 +/- S.D. 7.2 years), two with schizoaffective disorder and one with organic affective disorder, received carbamazepine (CBZ) because of affective symptoms (and, in one case, partial complex seizures) refractory to management with antipsychotic drugs. Coincident with CBZ administration (and clinical improvement), hyponatremia developed thought to be due to the antidiuretic effect of this drug. Lithium was added to counteract the antidiuretic effect of CBZ. Further clinical improvement ensured, serum sodium levels became normal, and there was an increase in the white blood cell count in each patient. The clinical implications of our findings are discussed.
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PMID:Increase in white blood cell count and serum sodium level following the addition of lithium to carbamazepine treatment among three chronically psychotic male patients with disturbed affective states. 362 4

The prevalence and severity of psychopathology in 15 epileptic patients treated with phenobarbital and 24 patients treated with carbamazepine were compared. The groups were similar across a wide range of demographic, seizure-related, and family-environmental variables. Patients treated with phenobarbital, when compared with those treated with carbamazepine, showed a much higher prevalence of major depressive disorder (40% v 4%, P = .02), and suicidal ideation (47% v 4%, P = .005) as determined by semistructured psychiatric interviews. The differential prevalence of depression between medication groups was only noted in those with a family history of a major affective disorder among first-degree relatives. Family discord and number of stressful life events were also associated with depression in this cohort. Patients treated with phenobarbital should be closely monitored for depression, and alternative treatments should probably be sought for patients with newly diagnoses epilepsy and a personal or family history of an affective disorder. The clinical and research implications of these findings are discussed.
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PMID:Phenobarbital treatment and major depressive disorder in children with epilepsy. 368 4

This is a report on six psychiatric patients who indulged in excessive ingestion of water and subsequently developed tonic-clonic seizures in the course of the underlying mental disorders. On the basis of the DSM-III criteria, they were diagnosed as follows: schizophrenic disorder, 4; schizo-affective disorder, 1; borderline personality disorder, 1. The levels of serum electrolytes were estimated during five episodes of seizures in three patients. Hyponatremia was a consistent finding (serum sodium: mean = 120.6 mEq/liter). Plasma osmolality and plasma levels of arginine vasopressin (AVP) were determined during two episodes in two patients. The inappropriately high circulating levels of AVP relative to plasma hypoosmolality were documented. However, the response to the overnight fluid deprivation and acute water load during the period of no seizures in two patients revealed no evidence of the persistent SIADH, suggesting the temporal association of hyponatremic encephalopathy with inappropriate AVP secretion. It is not conclusive whether the transient SIADH is the cause or the consequence of hyponatremic encephalopathy, although a delusion or an auditory hallucination could play a critical role in drinking water excessively in three patients.
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PMID:The syndrome of self-induced water intoxication in psychiatric patients. 406 56

In a double-blind study the authors compared severity of psychopathology and personality organization in three groups of patients: those with organic (neurogenic) seizures alone (N = 11), those who exhibited both neurogenic and psychogenic ("hysterical") seizures (N = 13), and those with pure psychogenic ("hysterical") seizures (N = 13). Patients with neurogenic seizures were found to have alcoholism, anxiety disorder, and minor affective disorder. Patients with mixed and psychogenic seizures had more severe psychopathology, including major affective disorders and major character pathology. Patients with mixed and psychogenic seizures also had a markedly higher incidence of suicide attempts and past history of psychiatric treatment.
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PMID:Are hysterical seizures more than hysteria? A research diagnostic criteria, DMS-III, and psychometric analysis. 709 12

Elevations of urinary N-acetyl-beta-glucosaminidase (NAG) were found in previous studies of epileptic patients using carbamazepine. Since NAG can be a sensitive indicator of urinary tract problems, it was postulated that carbamazepine could be causing urinary tract damage. To explore this issue further, 27 mood disorder patients who were taking carbamazepine were compared to 171 mood disorder patients who were not using carbamazepine. There were no significant differences in NAG levels between the two groups. A hypothesis is presented which states that the elevated NAG levels found in some seizure patients could be associated with abnormalities of serotonin metabolism.
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PMID:Is carbamazepine associated with NAG elevations suggestive of renal disease? 757 67

Forty-six female patients with pseudoseizures were compared with 50 female patients referred to a psychiatric outpatient clinic. Patients with convulsive pseudoseizures were more likely to be single and childless. An abnormal EEG was more frequently reported in patients with convulsive pseudoseizures, contributing to their earlier diagnosis of epilepsy. The defence mechanisms of patients with convulsive pseudoseizures using the Defense Mechanisms Inventory (DMI) were particularly characterized by higher scores on the 'reversal' scale and lower scores on the 'turning against self' scale. Mood disorders were more common in general psychiatric patients, while one-third of convulsive pseudoseizure patients did not complain of psychiatric symptoms.
Seizure 1995 Sep
PMID:Psychiatric morbidity and psychodynamics of patients with convulsive pseudoseizures. 758 54

Learned helplessness is the perception that one's behaviour cannot produce a desired outcome. Individuals with intractable epilepsy who have learned that the occurrence of a seizure is beyond their control can develop such a helpless attitude with cognitive, affective and behavioral components which may generalize to many aspects of life. Post-operative testing was done on 42 patients, aged 17-60 years with I.Q. > 80 who had temporal lobectomies (25 R, 17 L) with follow-up 1-14 years (mean 5 years). In addition to seizure outcome, psychosocial adjustment was measured using the Washington Psychosocial Inventory (WPSI) and a structured interview. Three variables of learned helplessness were also assessed: internal or external locus of control, resourcefulness, and depression. Seizure outcome was: completely seizure free, 36%; > 90% improvement, 38% < 90% improvement, 26%. Overall post-operative psychosocial adjustment was good, marked improvement in lifestyle was noted by 85%, personality change for the better by 65% and improved mood by 47%. A transient mood disorder was noted by 38% in the first six months following surgery. Psychosocial adjustment was better in patients who were seizure free or had > 90% reduction in seizures compared to those with < 90% improvement. Two measures of learned helplessness, depression and lack of resourcefulness correlated with poor postoperative psychosocial adjustment. Other variables beside seizure control must be considered in determining the ultimate outcome of epilepsy surgery.
Seizure 1994 Sep
PMID:Psychosocial function following temporal lobectomy: influence of seizure control and learned helplessness. 800 Jul 10

We investigated a possible relation between aura phenomena and psychopathology in patients with seizure disorders. Twenty-one patients with a variety of seizure types (90% with generalized seizures, 72% with complex partial seizures, CPS) were studied. Aura phenomena were evaluated with the Silberman-Post Psychosensory Phenomena Scale; psychopathology was assessed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L), the Minnesota Multiple Personality Inventory (MMPI), and the Washington Psychosocial Seizure Inventory (WPSI). Psychosensory symptoms occurring in the absence of frank seizures, but not those occurring with seizures, were related to increased psychopathology (primarily mood and anxiety related) and greater time in psychiatric treatment. Psychosensory symptoms may reflect ongoing neurophysiologic dysfunction related to epilepsy and may therefore be a useful subject for further study.
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PMID:Aura phenomena and psychopathology: a pilot investigation. 808 22


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