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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The spectrum ranges from fearful concerns about illness to clinical anxiety disorders, such as phobias, panic attacks, generalized anxiety, post-traumatic stress disorder and adjustment disorder. Anxiety and fear are often associated with hospitalization, heart disease, insomnia, and somatopsychic syndromes. Determining the cause of the anxiety may help the physician plan the treatment approach. In selected cases, benzodiazepines are useful adjuncts to therapy.
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PMID:The spectrum of anxiety disorders in family practice. 368 77

Psychogenic dizziness is defined as recurring or persistent symptoms of balance dysfunction, inconsistent with organic vestibular disease as determined by history, clinical examination and pertinent investigations, and consistent with emotional origin. Of 1,335 patients seen in our dizziness clinic between January 1988 and August 1991, psychogenic dizziness was diagnosed in 180 (13.5%) patients. There were 67 men and 113 women aged from 12 to 77 years (mean age 40.2 years). The characteristics of psychogenic dizziness are: (1) continuous dizziness for long periods of time; (2) younger patients; (3) predominant female; (4) associated symptoms of panic attack, such as headache, breathlessness, nausea, sleep disturbance, paresthesias, anxiety and palpitation; (5) symptoms of aggravation due to stressful life events; (6) normal neurotological bedside examination; (7) hyperventilation reproduced accurately. The electronystagmographic results of 74 patients show normal bithermal caloric responses in 47 patients (63.5%), caloric hyperactivity in 21 patients (28.4%), canal paresis in four patients (5.4%), canal paresis with directional preponderance in two patients (2.7%), large random voluntary eye swings or severe blinking in 35 patients (47.3%), and spontaneous nystagmus (slow phase velocity < 6.5 degrees/s) in four patients (5.4%). There were 31 patients who consulted psychiatrists with diagnoses of anxiety (51.6%), depression (16.1%), insomnia (12.9%), psychosomatic disorder and adjustment disorder. Treatment of patients with psychogenic dizziness must be directed at the underlying anxiety. Psychiatric consultation is necessary.
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PMID:[Psychogenic dizziness]. 848 48

Implantation of a permanent pacemaker requires a psychological effort on the patient's part for adaptation in the acute term, and chronically, it restricts activities of the patient and may cause some psychiatric disturbances. To investigate psychiatric morbidity and depressive symptomatology of the patients with permanent pacemakers, 84 pacemaker patients were diagnosed using the DSM-III-R criteria and depressive symptoms were determined by modified Hamilton Depression Rating Scale (mHDRS). Sixteen (19.1%) patients had been given a psychiatric diagnosis. The most frequent diagnoses were adjustment disorder (5.9%) and major depressive episode (4.7%). Nine patients (10.7%) were diagnosed as having clinical depression (mHDRS > or = 17). The mean score of mHDRS was 7.57 +/- 7.46, and the severity of depression was significantly higher in females. The most frequent symptoms are difficulties in work and activities (53.6%), psychic anxiety (48.8%), loss of energy (42.9%), and hypochondriasis and insomnia (39.3%). Depressed mood, psychic anxiety, loss of energy, loss of interest, insomnia, and hypochondriasis were significantly more frequent in females. Uneducated patients had a more significant loss of energy than educated patients. Depressed mood, psychic anxiety, and somatic concerns and symptoms were more frequent in patients with permanent pacemakers than in the general population. These symptoms, resembling mixed anxiety-depression disorder, were related to fears of having a permanent pacemaker, since our series were composed of uneducated patients who did not have enough knowledge about the device.
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PMID:Psychiatric morbidity and depressive symptomatology in patients with permanent pacemakers. 922 59

We report a 55 years old married woman without history of drug dependence. Due to a severe marital conflict she developed a chronic adjustment disorder with depressed mood. Zopiclone, 7.5 mg at night was prescribed for her insomnia and she rapidly became tolerant and dependent to the hypnotic. She was admitted to a psychiatric clinic, slowly detoxified and treated with pharmacotherapy and psychotherapy. Six months later, she has resumed her housekeeping and professional activities and is maintained with a benzodiazepine at night for insomnia.
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PMID:[Zopiclone dependence. Report of one case]. 946 Feb 72

Sixty percent of 536 new referrals to a psychiatric clinic at a general hospital complained of insomnia. Prevalence was high in all psychiatric categories, especially in physiologic disorders, somatoform disorders and mood disorders, followed by epilepsy. Complaints of difficulty in falling asleep were high in the physiologic and somatoform disorder groups. Complaints of nocturnal awakening were high in the anxiety and physiologic disorder groups, while complaints of early morning awakening were high in the organic and mood disorder groups. Prescription rates of hypnotics was most prevalent in the mood and adjustment disorder groups, whereas a non-pharmacological approach, including psychological education and behavioral therapy, was applied mainly to the physiologic disorder group.
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PMID:Prevalence of insomnia in various psychiatric diagnostic categories. 1204 75

Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, although the concept was recognized for many years before that. In DSM-IV, six subtypes are described based on the predominant symptoms, but no further diagnostic criteria are offered to assist the clinician. These are common conditions, especially in primary care and in consultation liaison psychiatry, where the prevalence ranges from 11% to 18% and from 10% to 35%, respectively. Yet they are under-researched, possibly due to the failure of some of the common diagnostic tools to allow for the diagnosis of adjustment disorder. Among the tools that incorporate adjustment disorder, the concordance between the clinical and interview diagnosis is very poor, with the diagnosis being made more commonly in clinical practice than the diagnostic tools allow for. Adjustment disorder is found in all cultures and in all age groups. The presence of a causal stressor is essential before a diagnosis of adjustment disorder can be made, while the symptoms vary and include those that are found in other common psychiatric disorders. It is also important to distinguish adjustment disorder from normal reactions to stressful events. Adjustment disorders are difficult to distinguish from normal responses to life's stressors, while the distinction from major depression also poses a classificatory conundrum since both are conceptually different. Adjustment disorder is a diagnosis based on the longitudinal course of symptoms in the context of a stressor, while a diagnosis of major depression is a cross-sectional one based on symptom numbers. Treatments consist mainly of brief interventions, while pharmacotherapy is limited to the symptomatic management of anxiety or insomnia. There are no robust studies demonstrating benefits from antidepressants. However, the number of studies of either type of intervention is very limited.
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PMID:Adjustment disorder: epidemiology, diagnosis and treatment. 1984 14

The objective of this study was to investigate preexisting psychiatric disorders in self-immolation patients. In a case-control study, 30 consecutive cases of deliberate self-inflicted burns, admitted to the regional burn center, were compared with 30 controls. Mental disorders were assessed via detailed clinical interview. Descriptive data revealed that 67% of self-immolation patients had adjustment disorder (all female), 10% drug and alcohol abuse/dependence (all male), 7% dysthymia, 3% major depression, 3% anorexia nervosa, 3% primary insomnia, 7% borderline personality disorder (50% male), 7% depressive personality disorder (100% female), and 3% antisocial personality disorder. In bivariate comparisons, adjustment disorders emerged as related to risk of self-immolation (odds ratio = 13.00). This study suggests that adjustment disorder is a risk factor for self-immolation. As a result, it has been suggested that increasing education about problem-solving approaches, and coping skills for females and at-risk groups are appropriate prevention programs and strategies in Iranian communities.
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PMID:Psychiatric disorders (Axis I and Axis II) and self-immolation: a case-control study from Iran. 2007 Apr 65

With the expected increase in the number of international students coming to Japan as part of the Ministry of Education, Culture, Sports, Science & Technology's "300,000 Foreign Student (Global 30) Plan", the demands on university mental health facilities will also increase. However, the rate of mental disorders of recent international students has not been fully evaluated. As part of an initiative to establish effective treatment measures for the mental health of international students, we investigated the present status and recent trends of these students who visited the Mental Health Service (MHS) in the Tsukuba University Health Center. The demographic characteristics, pathway, stress, and diagnosis of international students who visited the MHS from 2005 to 2010 were investigated retrospectively based on medical records. The subjects were 59 international students (15 male, 44 female; mean age: 28.4). The consultation rate of international students was significantly lower than that of Japanese students each year. Although the rate is almost stable in Japanese students (2.1-2.5%), it has increased significantly in international students, from 0.5% in 2005 to 1.4% in 2010. A larger percentage of the subjects were from Asia (66%), compared to the former Soviet Union (10%) and Europe (7%). A greater proportion of the subjects were graduate students (67%). The diagnoses were as follows: depression (34%), adjustment disorder (32%), insomnia (15%), and schizophrenia (9%). The percentage requiring emergency consultation was 24%, including the most severe cases that had to return to their home country. Sixty-nine percent of the subjects stayed in Japan for more than 1 year. Half of the subjects decided to visit the MHS themselves. The results of the present study show that the consultation rate of international students was lower than that of Japanese students in spite of the "culture shock" experienced by international students. This result is in agreement with previous reports. Among international students, however, there is a trend indicating an increase of visits to the MHS in recent years, approaching the rate for Japanese students. Preparations for emergency consultation are still important.
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PMID:[An analysis of mental disorders of international students visiting the Mental Health Service at Tsukuba University Health Center]. 2242 Jan 47

Mefloquine was widely prescribed to U.S. military service members until 2009 when use was limited to personnel with contraindications to doxycycline and no contraindications to mefloquine. The need to estimate the occurrence of neuropsychiatric outcomes (NPOs) in service members prescribed mefloquine warranted a comprehensive evaluation of this issue. Active component service members filling a prescription for mefloquine, doxycycline, or atovaquone/proguanil (A/P) between January 1, 2008 and June 30, 2013, were included in the analysis. The risk of developing incident NPOs and the risk of subsequent NPOs among subjects with a history of the condition were assessed. A total of 367,840 individuals were evaluated (36,538 received mefloquine, 318,421 received doxycycline, and 12,881 received A/P). Among deployed individuals prescribed mefloquine, an increased risk of incident anxiety was seen when compared with doxycycline recipients (incidence rate ratio [IRR] = 1.12 [1.01-1.24]). Among nondeployed mefloquine recipients, an increased risk of posttraumatic stress disorder (PTSD) was seen when compared with A/P recipients (IRR = 1.83 [1.07-3.14]). An increased risk of tinnitus was seen for both deployed and nondeployed mefloquine recipients compared with A/P recipients (IRR = 1.81 [1.18-2.79]), 1.51 (1.13-2.03), respectively). Six percent of the mefloquine cohort had an NPO in the year before receiving mefloquine. When comparing individuals with a prior neuropsychiatric history to those without, the ratio of relative risks for adjustment disorder, anxiety, insomnia, and PTSD were higher (not statistically significant) for mefloquine compared with doxycycline. These findings emphasize the continued need for physicians prescribing mefloquine to conduct contraindication screening.
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PMID:Neuropsychiatric Outcomes After Mefloquine Exposure Among U.S. Military Service Members. 2871 4

The authors examined the prevalence, characteristics, and correlates of depressive disorder among medical inpatients age 60 or over at a private teaching hospital. Seventy-six of 129 patients admitted to the general medicine and cardiology services at Duke University Hospital were screened for depressive disorder using DSM-III-R criteria. Depressive disorders were diagnosed in 34.2% of patients: major depression in 13.2%, adjustment disorder in 11.8%, depression not otherwise specified in 5.3%, organic mood disorder in 1.3%, and uncomplicated bereavement in 2.6%. Of patients with major depression, all had symptoms of mild-to-moderate severity. The most common presenting symptoms were insomnia, psychomotor agitation, difficulty concentrating, and loss of energy. Depression was more prevalent among women, general medicine patients, staff (vs. private) patients, and those who were functionally disabled or had multiple serious medical conditions. When other patient characteristics were controlled, however, only health factors were independently associated with depression.
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PMID:Depressive Disorder in Older Medical Inpatients on General Medicine and Cardiology Services at a University Teaching Hospital. 2853 Sep 20


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