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Cipriani G.,Neurology Unit | Vedovello M.,Neurology Unit | Ulivi M.,Neurology Unit | Lucetti C.,Neurology Unit | And 2 more authors.
American Journal of Alzheimer's Disease and other Dementias | Year: 2013

The delusional misidentification syndromes (DMSs) are psychopathologic phenomena in which a patient consistently misidentifies persons, places, objects, or events. Although often described in relation to psychotic states including schzofrenia, it is, nevertheless, widely considered that these syndromes have an anatomical basis because of their frequent association with organic brain disease; studies have pointed to the presence of identifiable lesions, especially in the right frontal lobe and adjacent regions, in a considerable proportion of patients. The purpose of this article is to examine the phenomenon in people with dementia. We searched the electronic databases for original research and review articles on DMS in patients with dementia using the search terms "Delusional Misidentification Syndrome, Capgras syndrome, Fregoli syndrome, reduplicative paramnesia, and dementia." The DMSs are a frequent problem in dementia. The violence and dangerousness in patients with dementia having these syndromes are well documented, and forensic aspects are highlighted. Pathogenetic viewpoint and management are considered. © The Author(s) 2013.

Salawu F.K.,Neurology Unit | Umar J.T.,Psychiatry Unit | Olokoba A.B.,University Of Ilorin
Annals of African Medicine | Year: 2011

Alzheimers disease (AD) is the most common type of dementia in aging adults, and a substantial burden to patients, caregivers, and the healthcare system. It is an increasingly significant public health issue; with the number of people living with AD projected to increase dramatically over the next few decades, making the search for treatments and tools to measure disease progression increasingly urgent. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. The subject headings and keywords used were Alzheimers disease, dementia, primary neuronal degeneration and senile plagues. Only the articles written in English were included. The diagnosis is still primarily made based on history and physical and neurologic examinations. Approved treatments are few and of limited efficacy, serving mostly to slow or delay progression and not to cure the disease, despite significant research by pharmaceutical industries. Cholinesterase inhibitors offer some help in treating cognitive and global functioning, as well as behavioral abnormalities in patients with mild-, moderate-, or severe-stage disease. The N-methyl-d-aspartate (NMDA) antagonist, memantine, is similarly effective alone or in combination with cholinesterase inhibitors in moderate to severe stages of the disease. Recent insights into the pathophysiology of AD have led to promising investigational therapies, including the development of γ- and β-secretase inhibitors as well as active and passive immunization against the amyloid β-protein.

Centorrino F.,Harvard University | Masters G.A.,McLean Hospital | Talamo A.,Harvard University | Talamo A.,University of Rome La Sapienza | And 3 more authors.
Human Psychopharmacology | Year: 2012

Objective We evaluated prevalence and risk factors for metabolic syndrome in inpatients treated with antipsychotics, with or without other psychotropic drugs. Although the literature on metabolic syndrome in psychiatry has expanded in recent years, we seek to elucidate some of the remaining gaps by examining a severely and chronically ill population heavily treated with pharmacological agents. Methods With data from medical records of 589 adults hospitalized at McLean Hospital in 2010 and 2011, we used standard statistical analyses to characterize risks and covariates of metabolic syndrome. Results With prior antipsychotic treatment, prevalence of metabolic syndrome was 29.5%. The syndrome was strongly associated with being overweight (≥25 kg/m2 in 60.1% of subjects), older age, longer treatment-exposure, schizoaffective diagnosis (39.8%), more illness-episodes or hospitalizations, polytherapy, and higher total daily chlorpromazine-equivalent doses, but not sex. Notably, metabolic syndrome risk was greater among young, antipsychotic treated patients (15.5-fold at age ≤25 years). Conclusions The findings extend information on the association of metabolic syndrome with antipsychotic treatment. Metabolic syndrome was found in 30% of antipsychotic-exposed inpatients. Risk was surprisingly high in young persons and after brief treatment-exposure, and psychotropic polytherapy increased risk. © Copyright © 2012 John Wiley & Sons, Ltd.

Uyanik V.,Psychiatry Unit | Tuglu C.,Trakya University | Gorgulu Y.,Trakya University | Kunduracilar H.,Trakya University | Uyanik M.,Trakya University
Psychiatry Research | Year: 2015

We aimed to assess the relationship between cytokine levels and the severity of the manic period in medication free patients. 30 Medication free patients and 28 healthy subjects (HS) were recruited. Plasma levels of pro-inflammatory, anti-inflammatory, inflammatory cytokines, and hs-CRP levels were investigated upon hospital admission, after six weeks follow up in bipolar disease manic episode and the results were compared to HS. The severity of the manic episodes was assessed according to the Young mania rating scale. TNF-α, INF-γ, IL-6 and hs-CRP levels were significantly higher in patients with manic episode of bipolar I disorder before treatment than HS. After treatment the levels of TNF-α, INF-γ, IL-6 and hs-CRP were observed to be significantly decreased. There was no difference between the levels of anti-inflammatory cytokines in patients before or after treatment of bipolar disorder and HS. hs-CRP was observed to be the only parameter correlated with clinical response. The most significant outcome of this study is the correlation between clinical outcome and hs-CRP levels in treatment naive manic episode bipolar type I patients. hs-CRP is the most consistent indicator according to pro-inflammatory, inflammatory and anti-inflammatory cytokines, in predicting treatment outcomes. © 2015 Elsevier Ireland Ltd.

Srivastava C.,Psychiatry Unit | Dhingra V.,Mln Medical College | Bhardwaj A.,North Essex Partnership Foundation Trust | Srivastava A.,Vatsalya Hospital
Indian Journal of Psychiatry | Year: 2013

Morality (from the Latin word moralitas that means "manner, character, proper behavior") is the differentiation of intentions, decisions, and actions between those that are good (or right) and those that are bad (or wrong). It is determined by how one′s genetic makeup interacts with the environment. The development of morality has been a subject of investigation for a number of decades, and our understanding of neuro-biological and psychological mechanisms has increased manifolds in the last few decades. Development of morality has been of particular significance to psychiatric literature because of its significant contribution to the development of one′s personality and it′s aberration in various disorders. Cultures that have been just, equal and moral have been widely accepted and appreciated. In this review, we shall summarize the modern theories of moral development and then look into a part of our past and cultural heritage and review the traditional Hindu concepts of morality and their contribution to development of one′s personality and their relevance in the current times.

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