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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Delirium or acute confusional status (ACS) is a common mental disorder found in hospitalized patients. A total of 278 patients were evaluated. Of these, 30 (10.8%) developed ACS. The patients who developed ACS were 70 years of age or older, had history of stroke or dementia, as well as impairment in activities of daily living, and required enteral feeding more frequently. The infections and hip fracture were the most frequent reasons for hospitalization. The mortality in patients with ACS was significantly higher than in patients without ACS.
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PMID:[Acute confusional state in hospitalized patients]. 1556 May 37

There have been no data on the performance of the Initiation-Perseveration subtest of the Mattis Dementia Rating Scale (MDRS-IP) in screening poststroke dementia (PSDE). Three months after the index stroke, a research assistant administered the MDRS-IP and Mini-Mental State Examination (MMSE) to 83 Chinese stroke patients with lacunar infarcts who were consecutively admitted to the stroke unit of a general hospital. A psychiatrist, who was blind to the MDRS-IP and MMSE scores, interviewed all 83 patients and made a Diagnostic and Statistical Manual of Mental Disorders (4th edition) diagnosis of dementia, which served as the benchmark for judging the performance of MDRSIP. The optimal cutoff point of MDRS-IP was 22/23. The sensitivity, specificity, and positive and negative predictive values of MDRS-IP, and the area under the receiver operating characteristic curve were 82%, 90%, 0.41, 0.98, and 0.91, respectively. The overall performance of the MDRS-IP was comparable to the MMSE.
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PMID:Screening of dementia in stroke patients with lacunar infarcts: comparison of the mattis dementia rating scale and the mini-mental state examination. 1568 21

Although classical psychopathological studies have shown the presence of an independent diagnostic category, 'atypical psychosis', most psychotic patients are currently classified into two major diagnostic categories, schizophrenia and bipolar disorder, by the Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria. 'Atypical psychosis' is characterized by acute confusion without systematic delusion, emotional instability, and psychomotor excitement or stupor. Such clinical features resemble those seen in organic mental syndrome, and differential diagnosis is often difficult. Because patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) sometimes show organic mental disorder, 'atypical psychosis' may be caused by mutations of mitochondrial DNA (mtDNA) in some patients. In the present study whole mtDNA was sequenced for seven patients with various psychotic disorders, who could be categorized as 'atypical psychosis'. None of them had known mtDNA mutations pathogenic for mitochondrial encephalopathy. Two of seven patients belonged to a subhaplogroup F1b1a with low frequency. These results did not support the hypothesis that clinical presentation of some patients with 'atypical psychosis' is a reflection of subclinical mitochondrial encephalopathy. However, the subhaplogroup F1b1a may be a good target for association study of 'atypical psychosis'.
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PMID:Mitochondrial DNA sequence analysis of patients with 'atypical psychosis'. 1604 57

The diagnosis of dementia of the Alzheimer's type is defined by criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the National Institute of Neurologic, Communicative Disorders and Stroke-AD and Related Disorders Association. The latter divides diagnosis into definite, probable, and possible Alzheimer's disease (AD), with definitive diagnosis requiring pathologic confirmation. Both criteria require that other causes of dementia are excluded. A diagnosis of AD can be made with reasonably high accuracy using a combination of clinical criteria, neuropsychologic testing, and conventional CT and MR imaging. There is increasing emphasis on early recognition. Although current therapies produce a mild improvement in symptoms, there are several disease-modifying therapies on the horizon. This article reviews current standards in clinical diagnosis and management.
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PMID:Clinical diagnosis and management of Alzheimer's disease. 1644 89

Delirium on the day of admission to general internal medicine wards was studied in 400 consecutive patients aged 70 years and above regarding occurrence, associated factors, clinical profile, length of hospital stay, and mortality. The patients were assessed using the Organic Brain Syndrome Scale and the Mini-Mental State Examination, and delirium was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (4th ed) criteria. Delirium on the day of admission occurred in 31.3% of the patients and was independently associated with old age, fever on the day of admission (> or = 38 degrees C), treatment with neuroleptics, impaired vision, male sex, and previous stroke. Delirious patients had longer hospital stay (15.4 vs 9.5 days, P < .001), a higher mortality rate during hospitalization (11/125 vs 5/275, P < .001), and a higher 1-year mortality rate (45/125 vs 55/275, P = .001). Delirium is a common complication with often easily identified causes, and it has a serious impact on outcome for older medical patients.
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PMID:Delirium in older patients admitted to general internal medicine. 1669 Sep 93

Post-stroke depression (PSD) has an important impact on the quality of life of patients with stroke. We studied 100 stroke patients (mean age+/-SD: 64.6+/-11.6, range: 32-85 years) in the subacute phase (2-5 weeks after onset) and investigated the prevalence and clinical correlates of PSD in the subacute phase. The prevalences of PSD and major depression in the subacute phase evaluated by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were 20.0 and 5.0%, respectively. These values were lower than those reported in Caucasian studies. The Zung Self-Rating Depression Scale (SDS) did not underestimate the presence of PSD and was thus considered valuable for the initial screening of PSD. However, SDS may overestimate PSD especially in patients with anxiety disorders or somatoform disorders and vice versa. Apathy was observed in 40.2% of patients; however, it was widely distributed and observed even in patients without serious depression.
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PMID:Characteristics of post-stroke depression in Japanese patients. 1670 13

The 59 year-old, high-qualified male patient had been treated for psychiatric illness due to depressive symptoms, "pathological crying", amplified somatic style and severe insomnia. Earlier he had one depressive episode. There was no psychotrauma detected to cause these symptoms and no neurological symptoms, either. The clinical appearance was psychotic depression, so combined antidepressant, anxiolytic, hypnotic, and antipsychotic therapy was started. The MAWI examination showed mild intellectual deficit, so cerebral MRI was done, also. This examination helped to verify the correct diagnosis: post-stroke depression.
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PMID:[Depressive symptoms as differential-diagnostic problem]. 1684 64

Depression can occur in association with virtually all the other psychiatric and physical diagnoses. Physical illness increases the risk of developing severe depressive illness. There are two broadly different mechanisms. The most obvious has a psychological or cognitive mechanism. Thus, the illness may provide the life event or chronic difficulty that triggers a depressive episode in a vulnerable individual. Secondly, more specific associations appear to exist between depression and particular physical disorders. These may turn out to be of particular etiological interest. The best examples are probably stroke and cardiovascular disease. Finally, major depression, but especially minor depression, dysthymia, and depressive symptoms merge with other manifestations of human distress with which patients present to their doctors. Such somatic presentations test the conventional distinction between physical and mental disorder and are a perennial source of controversy.
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PMID:Depression and associated physical diseases and symptoms. 1688 10

Aim of this study is to investigate the QoL older people making regular use of BDZ. All subjects aged 65-84 years attending their General Practitioners were invited to fill in a questionnaire about their consumption of BDZ and all the subjects consuming BDZ to fill in the Medical Outcome Measures Short Form-36 (MOS SF-36) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaires. A total of 2,246 subjects used BDZ and 1,109 (49.4%) of them filled in the MOS SF-36 questionnaire. 1,005 of these participants also completed the PRIME-MD questionnaire (90.6%). The presence of sleep disorders and the characteristics of the BDZ used were not associated with any score in the MOS SF-36 questionnaire, whereas the Prime diagnosis was the most important predictor, since subjects with depression and/or anxiety had a lower mean score on each scale than subjects without disorders. Among a sample of Italian seniors taking BDZ, QoL was associated with the presence of anxiety and/or depression. Age, gender, education and the presence of cardiovascular diseases or stroke were associated with specific aspects of QoL, when anxiety and depression were controlled for.
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PMID:Health-related quality of life in older people using benzodiazepines: a cross-sectional study. 1706 30

Conversion disorder is caused by previous severe stress, emotional conflict, or an associated psychiatric disorder, and usually presents with one or more neurologic symptoms. Clinically, it is challenging to diagnose diseases such as transient ischemia attack, stroke, brain tumor, spinal cord injury, and neuropathy. In this case report, we present a male stroke patient who had a typical conversion disorder.
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PMID:Conversion disorder in stroke: a case report. 1711 Mar 49


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