scholarly journals New-Onset Panic, Depression with Suicidal Thoughts, and Somatic Symptoms in a Patient with a History of Lyme Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Amir Garakani ◽  
Andrew G. Mitton
Keyword(s):  
Depressive Symptoms ◽  
Lyme Disease ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Depression And Anxiety ◽  
Chronic Lyme Disease ◽  
History Of

Lyme Disease, or Lyme Borreliosis, caused byBorrelia burgdorferiand spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years after being successfully treated for a positive Lyme test after receiving a tick bite. During inpatient psychiatric hospitalization his psychiatric and physical symptoms did not improve with antidepressant and anxiolytic treatments. The patient’s panic attacks resolved after he was discharged and then, months later, treated with long-term antibiotics for suspected “chronic Lyme Disease” (CLD) despite having negative Lyme titers. He however continued to have subsyndromal depressive symptoms and chronic physical symptoms such as fatigue, myalgias, and neuropathy. We discuss the controversy surrounding the diagnosis of CLD and concerns and considerations in the treatment of suspected CLD patients with comorbid psychiatric diagnoses.

scholarly journals Peripherally Inserted Central Catheter-Associated Nocardia nova Endocarditis in a Patient Receiving Intravenous Antibiotics for Chronic Lyme Disease

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Aji B Njie ◽  
Michael Mitchell ◽  
Read Pukkila-Worley
Keyword(s):  
Lyme Disease ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Persistent Symptoms ◽  
Chronic Lyme Disease ◽  
Intravenous Antibiotics ◽  
History Of

Abstract Long-term antibiotics are not effective for the therapy of patients with persistent symptoms and a history of Lyme disease. However, some clinicians still prescribe these therapies. We present a case of peripherally inserted central catheter-associated Nocardia nova endocarditis in a patient who had been receiving intravenous antibiotics for the management of chronic Lyme disease. This case highlights an important risk associated with the unscientific use of indwelling peripheral catheters and intravenous antibiotics for the management of such patients.

Psychological Morbidity Among Post-COVID-19 Patients: A Cross-sectional Study from Chennai, South India

2021 ◽  
Vol 4 (01) ◽  
pp. 10-17
Author(s):  
D. Devi ◽  
V. Monica ◽  
Ravi Santhosh ◽  
Vijaya Raghavan ◽  
P. Poornachandrika
Keyword(s):  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Psychological Morbidity ◽  
Care Hospital ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Results

Background: The COVID-19 pandemic is a global health threat and is by far the largest outbreak of atypical pneumonia, since the SARS outbreak in 2003. A range of psychiatric morbidities such as persistent depression, anxiety, panic attacks, delirium and suicidality were observed in the post infectious state across the world. Hence, the aim of the study was to understand the psychological status of the patients affected by COVID during their post-COVID follow-up period and to examine the socio-demographic and clinical factors associated with high psychological morbidity. Materials and Methods: A cross sectional study conducted in the post-COVID follow up clinic, at a tertiary care hospital between the months of August - November 2020, using a semi structured proforma and rating scales such as Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) for depression, anxiety and insomnia, respectively. Results: The study results indicate that the prevalence of depression and anxiety among post-COVID-19 patients was 21.9% and 11.9%, respectively. Insomnia was observed among 21.7%Among various sociodemographic and clinical variables examined, it was observed that female gender, patients with ongoing stressors and patients with post-COVID-19 persistent physical symptoms were found to be associated with greater depression and anxiety among the study population. Conclusions: Persistent physical symptoms and ongoing life stressors are found to be associated with depression and anxiety among post-COVID-19 patients. Hence, periodic screening for individuals with persisting physical symptoms and care for the vulnerable population such as those with ongoing stressors will provide a significant advantage in the follow up of the mental health of the patients affected with COVID-19.

Stability of Psychiatric Symptoms among Mentally Ill Chemical Abusers in Long-Term Residential Treatment Programs

1997 ◽  
Vol 27 (4) ◽  
pp. 795-806
Author(s):  
Larry Nuttbrock ◽  
Michael Rahav ◽  
James Rivera ◽  
Daisy Ng-Mak ◽  
Bert Pepper
Keyword(s):  
Depressive Symptoms ◽  
Residential Treatment ◽  
Mentally Ill ◽  
Psychiatric Symptoms ◽  
Treatment Programs ◽  
Mean Values ◽  
Changing Patterns ◽  
Chemical Abusers ◽  
Anxiety Depression

We examined patterns of changes in psychiatric symptoms among mentally ill chemical abusers (MICAs) in long-term residential treatment. Clients were evaluated with various measures of psychopathology, referred to a therapeutic community (TC) or community residence, and reassessed after 2, 6, and 12 months of treatment with regard to anxiety, depressive symptoms, and psychotic ideation. Reductions in mean values of psychopathology were found only for anxiety and depressive symptoms at the TC during the first 2 months of treatment. However, an examination of changing patterns of symptoms revealed a more complex set of findings. At both programs, a significant number of MICAs showed reductions in psychopathology during treatment, a significant minority exhibited no improvements in psychiatric symptoms, and a few reported new symptoms of anxiety, depression, and psychotic ideation. We conclude that the symptoms of the vast majority of MICAs are highly labile during treatment.

Graves’ Hyperthyroidism-Induced Psychosis Treated With Aripiprazole—A Case Report

2012 ◽  
Vol 26 (1) ◽  
pp. 59-61 ◽  
Author(s):  
Livia R. Macedo ◽  
Jehan Marino ◽  
Brady Bradshaw ◽  
Joseph Henry
Keyword(s):  
Atrial Fibrillation ◽  
Psychiatric Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Long Term Effects ◽  
Free T4 ◽  
History Of ◽  
Antithyroid Peroxidase Antibody ◽  
First Time

Graves’ disease is an autoimmune syndrome with symptoms such as tachycardia, atrial fibrillation, and psychiatric symptoms. Limited evidence exists for the treatment of Graves’ hyperthyroidism-induced psychosis with atypical antipsychotics. A 47-year-old female with a psychiatric history of bipolar disorder presented for the first time to the psychiatric hospital. She was agitated and grossly psychotic with delusions. Electrocardiogram showed atrial fibrillation and tachycardia. Drug screen urinalysis was negative. Endocrine workup resulted in a diagnosis of Graves’ disease (thyroid-stimulating hormone [TSH]: 0.005 μIU/mL, triiodothyronine [T3]: 537 ng/dL, thyroxine [T4]: 24 mcg/dL, free T4: 4.5 ng/dL, positive antithyroid peroxidase antibody, and antinuclear antibody). Aripiprazole 10 mg daily was initiated and titrated to 15 mg daily on day 4. On day 16, her suspicious behavior, judgment, and insight improved. Other medications given included aspirin 325 mg daily, metoprolol 25 mg twice daily, titrated to 12.5 mg twice daily, and methimazole 30 mg daily, titrated to 20 mg twice daily, and discontinued on day 29. The patient received radioiodine I-131 treatment 1 week later. We report the first known case on the use of aripriprazole to treat Graves’ hyperthyroidism-induced psychosis. Further studies examining the long-term effects and appropriate dose and duration of aripiprazole in this patient population are needed.

scholarly journals Treatment of Anxiety and Depression in a Patient with Brugada Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Jasper J. Chen ◽  
Rajbir S. Sangha
Keyword(s):  
Brugada Syndrome ◽  
Psychiatric Symptoms ◽  
Medication Management ◽  
Clinical Manifestations ◽  
Physical Symptoms ◽  
Clinical Findings ◽  
Panic Attacks ◽  
Anxiety And Depression ◽  
Presenting Symptoms ◽  
Channel Blocking

Background. Brugada syndrome is rare and has been a clinically diagnosable entity since 1992. Its clinical manifestations are highly variable, and while some patients remain asymptomatic, others endure sudden cardiac death. Initial presenting symptoms may include palpitations, seizures, syncope, and nocturnal agonal respiration. The diagnosis of Brugada syndrome relies on both clinical findings and characteristic ECG patterns that occur spontaneously or are induced by usage of sodium-channel blocking agents.Aims of Case Report. Many psychiatrists may be unaware of the possibility of medical cocontributing etiologies to physical symptoms of anxiety and depression. We present a case of a patient who was treated psychiatrically for anxiety and panic attacks and who was subsequently diagnosed with Brugada syndrome and treated medically with an implantable cardioverter defibrillator (ICD), the only treatment option demonstrated to be effective. Her psychiatric symptoms predated her diagnosis of Brugada syndrome by at least fifteen years.Conclusion. The patient's eventual diagnosis of Brugada syndrome altered the course of her psychopharmacologic medication management and illustrates the utility of a psychosomatic approach to psychiatric symptom management.

scholarly journals Psychological Morbidity Among Post-COVID-19 Patients: A Cross-sectional Study from Chennai, South India

2021 ◽  
Vol 4 (01) ◽  
pp. 10-17
Author(s):  
D. Devi ◽  
V. Monica ◽  
Ravi Santhosh ◽  
Vijaya Raghavan ◽  
P. Poornachandrika
Keyword(s):  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Panic Attacks ◽  
Psychological Morbidity ◽  
Care Hospital ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Results

Background: The COVID-19 pandemic is a global health threat and is by far the largest outbreak of atypical pneumonia, since the SARS outbreak in 2003. A range of psychiatric morbidities such as persistent depression, anxiety, panic attacks, delirium and suicidality were observed in the post infectious state across the world. Hence, the aim of the study was to understand the psychological status of the patients affected by COVID during their post-COVID follow-up period and to examine the socio-demographic and clinical factors associated with high psychological morbidity. Materials and Methods: A cross sectional study conducted in the post-COVID follow up clinic, at a tertiary care hospital between the months of August - November 2020, using a semi structured proforma and rating scales such as Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) for depression, anxiety and insomnia, respectively. Results: The study results indicate that the prevalence of depression and anxiety among post-COVID-19 patients was 21.9% and 11.9%, respectively. Insomnia was observed among 21.7%Among various sociodemographic and clinical variables examined, it was observed that female gender, patients with ongoing stressors and patients with post-COVID-19 persistent physical symptoms were found to be associated with greater depression and anxiety among the study population. Conclusions: Persistent physical symptoms and ongoing life stressors are found to be associated with depression and anxiety among post-COVID-19 patients. Hence, periodic screening for individuals with persisting physical symptoms and care for the vulnerable population such as those with ongoing stressors will provide a significant advantage in the follow up of the mental health of the patients affected with COVID-19.

The Protean Neuropsychiatric and Vestibuloauditory Manifestations of Neurosarcoidosis

2017 ◽  
Vol 22 (4-5) ◽  
pp. 205-217 ◽  
Author(s):  
Jacqueline J. Greene ◽  
Ilka C. Naumann ◽  
Janet M. Poulik ◽  
Kevin T. Nella ◽  
Lindsay Weberling ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implantation ◽  
Psychiatric Symptoms ◽  
Altered Mental Status ◽  
Rapid Onset ◽  
Normal Serum ◽  
High Dose ◽  
Leptomeningeal Enhancement ◽  
History Of

Background: A rare subset of sarcoidosis, neurosarcoidosis, is reported to occur in 5-7% of sarcoid patients and can manifest in a variety of ways. The most common are facial paralysis and optic neuritis, less commonly causing cochleovestibulopathy, blindness, anosmia, and other cranial nerve (CN) palsies. The sensory deficit may be severe and psychiatric symptoms may result from the effects of the disease or steroid treatment. Although MRI-compatible cochlear implants are now available, concerns about the feasibility of recoverable hearing with cochlear implantation in these patients as well as the practical difficulty of disease monitoring due to implant artifact must be considered. Results: We present 3 recent cases from different institutions. The first is a 39-year-old man with a history of progressively worsening hearing loss, followed by visual loss, delusions, agitation, ataxia, and musical auditory hallucinations, diffuse leptomeningeal enhancement on MRI with a normal serum angiotensin-converting enzyme (ACE) level but elevated cerebrospinal fluid (CSF) ACE levels, suggesting neurosarcoidosis, was treated with corticosteroids, and underwent successful cochlear implantation. The second is a 36-year-old woman with rapid-onset horizontal diplopia, left mixed severe sensorineural hearing loss (SNHL) and tinnitus, diffuse leptomeningeal enhancement on MRI, and progressive palsy of the left CNs IV, VI, VII, IX, X and XI, with altered mental status requiring admission following high-dose intravenous corticosteroids. The third is a 15-year-old boy who presented with sudden, bilateral, profound SNHL, recurrent headaches, and left facial weakness refractory to antivirals, ultimately diagnosed with neurosarcoidosis following an aborted cochlear implantation where diffuse inflammation was found, and histopathology revealed Schaumann bodies; he was treated with methotrexate and later underwent successful cochlear implantation. Conclusions: Neurosarcoidosis is an elusive diagnosis and can cause hearing loss and psychiatric symptoms. Cochlear implantation for patients with severe hearing loss should be considered once the diagnosis is confirmed, as it is possible to achieve a successful level of hearing. Psychiatric symptoms can manifest with the onset of neurosarcoidosis, result from CN deficits, or develop as a side effect from long-term, high-dose corticosteroids, and should be monitored carefully in patients with neurosarcoidosis.

Do suicide victims who leave notes differ from those who do not? A study in Greece

2011 ◽  
Vol 26 (S2) ◽  
pp. 1632-1632
Author(s):  
A. Paraschakis ◽  
I. Michopoulos ◽  
A. Douzenis ◽  
C. Christodoulou ◽  
F. Koutsaftis ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Mental Illness Stigma ◽  
Psychological Autopsy ◽  
Suicide Notes ◽  
Mental Problems ◽  
Suicide Note ◽  
History Of ◽  
First Time

IntroductionSuicide notes are considered very sensitive markers of suicide attempt severity providing a lot of information about the mental state of the victim. An interesting question is whether note writers differ from suicide victims who don’t leave suicide notes.Objective and MethodTo present and discuss the differences between these two subgroups. We collected psychological autopsy data from one year's suicide deaths (November 2007 -October 2008), at the Athens’ Department of Forensic Medicine (covering 35% of the total Greek population).ResultsNote writers represented 21.7% of our sample (30 out of 138), had no history of psychiatric disorders (p = 0.003) or recent (psychiatric) hospitalization (p = 0.026), were mostly men (p = 0.001), and died by hanging or shooting (p = 0.04). We believe that the powerful stigma associated with psychiatric disorders in our Country could provide a possible explanation for our results. A lot of people suffer in silence. For many of the deceased's relatives the suicide note provided, for the first time, an insight into their loved one's mental problems. It is also believed that psychiatric symptoms are indicating character weakness, incompatible with the sense of power that, particularly men, should display. Finally, it is well-known that men commit suicide more often than women, choosing more violent methods (hanging or shooting) compared to them.ConclusionsMore efforts against mental illness stigma and towards improving detection of psychiatric disorders are needed in our Country. Unfortunately, suicide notes seem to represent the first and only means of communication of mental suffering for a lot of people.

scholarly journals Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Marc Praetner ◽  
Timo Schiele ◽  
Lukas Werle ◽  
Janina Kuffer ◽  
Sandra Nischwitz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Depressive Symptoms ◽  
Antidepressant Treatment ◽  
Treatment Options ◽  
Panic Attacks ◽  
Case Presentation ◽  
History Of ◽  
Serotonin Toxicity

Background. The pharmacological treatment options of Parkinson’s disease (PD) have considerably evolved during the last decades. However, therapeutic regimes are complicated due to individual differences in disease progression as well as the occurrence of complex nonmotor impairments such as mood and anxiety disorders. Antidepressants in particular are commonly prescribed for the treatment of depressive symptoms and anxiety in PD. Case Presentation. In this case report, we describe a case of a 62-year-old female patient with PD and history of depressive symptoms for which she had been treated with moclobemide concurrent with anti-Parkinson medications pramipexole, rasagiline, and L-DOPA+benserazide retard. An increase in the dosage of moclobemide 12 months prior to admission progressively led to serotonergic overstimulation and psychovegetative exacerbations mimicking the clinical picture of an anxiety spectrum disorder. After moclobemide and rasagiline were discontinued based on the hypothesis of serotonergic overstimulation, the patient’s psychovegetative symptoms subsided. Conclusions. The specific pharmacological regime in this case probably caused drug-drug interactions resulting in a plethora of psychovegetative symptoms. Likely due to the delayed onset of adverse effects, physicians had difficulties in determining the pharmacologically induced serotonin toxicity. This case report emphasizes the complexity of pharmacological treatments and the importance of drug-drug interaction awareness in the treatment of PD patients with complicating nonmotor dysfunctions such as depression.

scholarly journals Lyme Disease: In the “Lime Light” for Over 25 Years

2019 ◽  
Vol 1 (3) ◽  
pp. 1-9
Author(s):  
Kenisha J Evans ◽  
Eric Ayers ◽  
Cassandra E. Stinson ◽  
Arren E Simpson ◽  
Delisa Quayson
Keyword(s):  
Lyme Disease ◽  
Persistent Symptoms ◽  
Chronic Lyme Disease ◽  
The Future ◽  
The Difference ◽  
Made In

Lyme disease has been a topic of debate practically since its discovery in the 1970’s. The hot topic is whether or not long-term antibiotics should be used for Lyme disease patients with persistent symptoms. The source of such a long-running debate stems from the difference in opinions over the cause of long-term, persistent symptoms after treatment in some patients. Toward its end, Medicine has finally begun to embrace the existence of Chronic Lyme Disease, but changes still need to be made in the future.

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