Association of sleep duration with mental health: results from a Spanish general population survey

Sleep and Breathing - The purpose of the present study was to evaluate the association of sleep duration and mental health among the general population. A cross-sectional study was carried out with...     

Slipped Capital Femoral Epiphysis: Early Intervention and Referral

Slipped capital femoral epiphysis is the most common hip pathology in children aged 8–15 years old. Research has shown that when a nonorthopedic provider evaluates this patient population, there can be a significant delay in the appropriate treatment, which may have serious consequences for the prognosis of the patient. The delays are often caused by the practitioner's inability to put the clinical picture into focus with regard to how these patients typically present.. This article presents the demographics, clinical presentation, differential diagnosis, radiological and physical examination techniques, and prevention strategies to recognize this condition and provide early intervention.     

Pregabalin in acute treatment of anxious depression: A case series

Symptoms of anxiety are common in patients with depression. In this retrospective case series we investigated the effect of Pregabalin as an add-on medication in unipolar depressed patients with high levels of anxiety. The therapeutic effect of Pregabalin showed a fast onset and was comparable to the anxiolytic effect of benzodiazepines.     

A circadian signal of change of season in patients with seasonal affective disorder.

BACKGROUND: In animals, the circadian pacemaker regulates seasonal changes in behavior by transmitting a signal of day length to other sites in the organism. The signal is expressed reciprocally in the duration of nocturnal melatonin secretion, which is longer in winter than in summer. We investigated whether such a signal could mediate the effects of change of season on patients with seasonal affective disorder. METHODS: The duration of melatonin secretion in constant dim light was measured in winter and in summer in 55 patients and 55 matched healthy volunteers. Levels of melatonin were measured in plasma samples that were obtained every 30 minutes for 24 hours in each season. RESULTS: Patients and volunteers responded differently to change of season. In patients, the duration of the nocturnal period of active melatonin secretion was longer in winter than in summer (9.0 +/- 1.3 vs 8.4 +/- 1.3 hours; P=.001) but in healthy volunteers there was no change (9.0 +/- 1.6 vs 8.9 +/- 1.2 hours; P=.5). CONCLUSIONS: The results show that patients with seasonal affective disorder generate a biological signal of change of season that is absent in healthy volunteers and that is similar to the signal that mammals use to regulate seasonal changes in their behavior. While not proving causality, this finding is consistent with the hypothesis that neural circuits that mediate the effects of seasonal changes in day length on mammalian behavior mediate effects of season and light treatment on seasonal affective disorder.     

Repeated Neural Tube Defects and Valproate Monotherapy Suggest a Pharmacogenetic Abnormality

Valproate (VPA) is an effective, widely used antiepileptic drug. Unfortunately its use in pregnant women is associated with neural tube defects in the offspring. Although the etiology of neural tube defects is multifactorial, there is evidence that underlying genetic susceptibility plays a part. We describe two women taking moderate doses of VPA who repeatedly bore children with neural tube defects, despite folate supplementation. This suggests a pharmacogenetic susceptibility to the teratogenic effects of VPA.     

Living his writings: The example of neurologist G. Gilles de la tourette

Gilles de la Tourette is known for the disease which now bears his name. As one of the closest followers of Jean‐Martin Charcot, he always remained faithful to his mentor's views and was one of the most vehement defenders of La Salpêtrière. His activities in the management of hysterics and in hypnotism helped build his reputation during his lifetime, but are now largely forgotten. Gilles de la Tourette had an unusual personality, with hypomanic and histrionic traits. We present some ignored aspects of his life based on the discovery of personal letters which illuminate the hidden side of this famous neurologist. © 2010 Movement Disorder Society     

Patient-Centered Care in Affective,Non-Affective,and Schizoaffective Groups: Patients’ Opinions and Attitudes

An outcome evaluation was conducted to obtain psychiatric inpatients’ perspectives on acute care mental health treatment and services. The applicability of diagnostic categories based on affective, non-affective, and schizoaffective disorder were considered in the predictability of responses to treatment regimens and the related services provided in an inpatient psychiatric unit. A multidimensional approach was used to survey patients, which included the DAI-30, the BMQ, the SERVQUAL, and the CSQ-8. Overall, findings indicate that inpatient satisfaction could be improved with tailoring treatment to suit their respective symptoms. Furthermore, this exploratory study demonstrates some preliminary support for the inclusion of patients with a diagnosis of schizoaffective disorder as a separate group toward improving acute mental health care while hospitalized.     

The Impact of Stigma of Mental Illness in a Canadian Community: A Survey of Patients Experiences

We examined stigma experiences and its impact among patients (n = 41) hospitalized for mental illness. We studied their characteristics contributing to the expectation, intensity, and frequency of stigma they could experience. Opinions were compared on the Experiences with the Stigma of Mental Illness scale measuring stigma experiences and impact. There were differences on perceived stigma in: being 19 years or younger at first symptom or treatment, having had one previous psychiatric hospitalizations and having attended one or more outpatient sessions. Those having attended outpatient sessions, being previously hospitalized or younger suffered more impact.     

Selecting patients for epilepsy surgery: Synthesis of data

The consideration of epilepsy surgery for those with medically refractory seizure disorders requires a well-functioning multidisciplinary team and a systematic approach to investigations, with the aim of advising patients of their chances of being seizure free following surgery, and the risks of any procedure. Investigatory pathways may be outlined that cover most clinical situations, and the indications for invasive EEG studies. It is crucial that patients and their families are given realistic expectations of what may, and may not, be achieved with surgical treatment, and that long-term follow-up is maintained post-operatively.