IntroductionSensory deficits such as blindness and deafness are very common forms of disability, affecting over 300 million people worldwide according to World Health Organization estimates. These conditions can lead to misinterpretations of the environment, which may contribute to the development of a delusional disorder in predisposed people.ObjectivesThe objective of this study is to establish the prevalence of blindness and hearing loss across delusional disorder.AimsThe aim is to provide useful information regarding this frequent, often disregarded, comorbidity.MethodsOur results proceed from the Andalusian delusional disorder case-register (DelirAnda). We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis following DSM-V criteria, we recollected data on the prevalence of blindness and hearing loss, which were defined based on clinical diagnosis.ResultsOne thousand four hundred and fifty-two patients matched DSM-5 delusional disorder criteria. Among them, 49.8% of our sample were women. The overall prevalence of sensory deficits was 7.4%, 3.5% of the patients with delusional disorder were blind, while 3.9% of them suffered from hearing loss.ConclusionsOur results are consistent with previous studies, such as the Deliremp study, which found a 5.7% prevalence of sensory deficit among delusional disorder patients. These results show a higher prevalence of sensory deficit among delusional disorder patients compared with the general population. However, causality could not be established. Further study should be undertaken regarding the relationship between these two conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe clinical case has been submitted because it presents a number of difficulties in diagnosis. After seven psychiatric hospitalizations, it does not present a definitive diagnosis, poor prognosis and multiple relapses.ObjectivesBoth analyze clinical, psychopathological and epidemiological characteristics of behavioral disorders in relation to a clinical case and review causes, incidence, prevalence, diagnostic, therapeutic tools and the importance of an appropriate differential diagnosis to reach a correct therapeutic approach.MethodsReview of the impact literature for the last five years concerning behavioral disorders: prevalence, incidence, pathogenesis and its relationship with psychiatric disorders encoded in DSM-V.ResultsIt is evident that the patient has behavioral disorders and psychotic symptoms in the context of cocaine intoxication. Although sometimes the dose of cocaine has been very small and probably not justifies in all cases a toxic psychosis, it is true that withdrawal periods have been short; therefore difficult to assess. Also mania-like symptoms have been discussed because the patient has an increased activity, dysphoric mood, anxiety and decreased need for sleep.ConclusionsResponse to treatment and hyperactivity, impulsivity and inattention characteristics make us consider the diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD). ADHD in adults and adolescents have significant comorbidity with substance abuse, particularly cocaine, amphetamines and psychostimulants, also alcohol, tobacco and cannabis, and with other psychiatric disorders: oppositional defiant, personality (especially cluster B: antisocial, etc), anxiety (generalized anxiety, phobias, panic..), affective or eating disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionDuration of untreated illness (DUI) has been considered as a relevant variable used to measure the degree of disabilities that are associated with psychotic disorders. In this paper we describe a cluster of patients with a DUI superior to 1 year according to their symptoms and sociofamiliar functioning.MethodsWe compare a group with a DUI superior to 1 year (n = 7) against a group with a DUI inferior to 1 year (n = 17).ResultsThe group with a DUI superior to 1 year showed an average age of 4 years younger (21) as the duration of untreated psychosis (DUP) of 1 to 3 months in the 80% of cases and higher percentage of unemployed or without occupation. The 60% were derived from primary care, compared to the 17% of the other group. Although the consumption of toxic substances was similar in both groups, no toxic psychosis were found in comparison with the 35% present in the group with a DUI inferior to 1 year. PANSS’ profile scored more positive and less negative symptoms. Both have similar general psychopathology. There were group differences in the Social Functioning Scale (SFS) with lower scores in the superior to 1 year DUI, in the following scales: Prosocial, Autonomy, Execution and Employment. The Global Assessment of Functioning (GAF) gives an average of almost 8 points higher.DiscussionWhile the SFS shows significant differences in several areas of social functioning, both PANSS’ profile and the family questionnaire do not support greater deterioration, as evidenced in the GAF's average score.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe existence of independent services and facilities for mental health and for addictions in Andalusia stand in the way of addressing dual pathology. The strong comorbidity between substance use and early psychosis has been deeply studied in recent literature. The aim of this paper is to analyse a group of consumers in the First Episode Psychosis Program (FEP) to address the lack of the actual interventions performed.MethodsDescriptive statistical analysis of demographic and clinical variables of a group with drug consumption (n = 17) is compared to a non-consumer group (n = 7).ResultsOur sample of patients included, consumers who represent 71% of the sample. All consumers were users of cannabis or derivatives and 35% of consumers were diagnosed at some point of Toxic psychosis. Only 23% received care in drug addiction centers. They have less education. The duration of untreated psychosis (DUP) is greater than in non-users and only 35% of the cases were detected in Primary Care. PANSS with higher scores. Greater differences in general psychopathology. The Social Functioning Scale (SFS) were worse in the Isolation scale. The Family Questionnaire (FQ) showed more difficulties in the family setting. Finally the Global Assessment of Functioning (GAF) gives an average of 8 points lower (severe symptoms).DiscussionWe would like to point out the low percentage of users who receive specialized care for their addiction. Better collaboration with Primary Care is required to improve the capacity of detection to reduce the time slot of untreated symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionMental disorders are often comorbid with chronic physical conditions. This relationship has been looked into in some mental disorders, such as depression or schizophrenia. However, very few studies have explored this comorbidity in the delusional disorder.ObjectivesThe objective of this study is to establish the prevalence of common chronic medical conditions across delusional disorder.AimsThe aim is to provide useful information regarding this frequent, often disregarded, comorbidity.MethodsOur results proceed from the Andalusian delusional disorder case-register (DelirAnda). We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis following DSM-5 criteria, we recollected data on the prevalence of 10 different medical conditions, which were defined based on clinical diagnosis.ResultsOne thousand four hundred and fifty-two patients matched DSM-5 delusional disorder criteria. Among them, 49.8% of our sample were women. The overall prevalence of medical conditions was 66%. Thirty-one percent of the patients with delusional disorder had only one comorbid physical condition, 20% of them suffered from two conditions, and 15% of them had three or more chronic conditions. The most prevalent physical condition among delusional disorder patients was diabetes, affecting 16% of these patients.ConclusionsChronic physical conditions are highly prevalent among patients with delusional disorder. Comorbid physical conditions may have an important impact on the course of delusional disorder. A correct diagnosis and treatment of this comorbidity should be made to help improve the prognosis and life quality of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionDual pathology is a term applied to those subjects suffering simultaneously from addiction and other mental disorder. Group psychotherapy can be used in people who have both diagnoses with good results in improvement of addiction and disease stabilization.ObjectivesThe purpose of this study is to analyse to efficacy of a group of psychotherapy for patients with alcohol addiction and other mental disorder, and analyse the presence of personality disorder in this group and how it affects its evolution.MethodsThe study was conducted on a sample of 16 patients diagnosed with alcohol abuse or dependence with psychiatric co-morbidity who attended a therapy group for 6 months from January16 to June16. The study was conducted in ambulatory care (outpatient), being an open and heterogeneous group.ResultsMain diagnosis was unspecified personality disorder and mood disorder (25%) followed by borderline personality disorder and mood disorder (18.75%), attention deficit disorder and hyperactivity (18.75%), mood disorder (12.5%), substance use disorder without other psychiatric co-morbidity (12.5%), narcissistic personality disorder (6.25%) and impulse control disorder (6.25%). Regarding progress in the stages of change, results were as follows: 31.5% of patients progressed to the stage of preparation for action, 25% alternating periods of abstinence from alcohol with brief relapse, 25% advanced to the stage of action, 18.5% managed to stay alcohol withdrawn.ConclusionsIn our sample, we can conclude that a therapeutic group including patients at different stages of change and diagnoses is positive. At the end, improvement in mood and anxiety was observed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
IntroductionConcurrent with the recent global economic crisis there is a rising concern about the effect of recession on suicide mortality rates.AimTo record patients treated urgently in community mental health unit of Motril, Granada (Spain) by attempted suicide.MethodsDescriptive study recording patients treated urgently in Motril community mental health unit who have done any suicide gesture from February 2015 until December of that year.ResultsIn total, 39 urgent assessments were recorded during the observational period.The month of highest incidence was November, with 6 visits followed by August and October (5).The most common method was voluntary drug intake.Origin:– 59% were remitted from the general hospital emergency department;– critical care and emergency ambulatory devices: 1;– primary care: 10;– another specialist: 2;– own initiative: 2.Discharge diagnosis:– 35.8% individuals did not meet criteria for any mental disorder, although some of them were classified with V or Z diagnosis according to ICD-10 for making a reactive gesture to a emotional crisis, couple breakups or economic problems;– 11 of them meet criteria for various anxiety disorders, obsessive compulsive and adaptative crisis.DiscussionKnowing some peculiar characteristics in suicidal populations as well as the most prevalent pathologies, it could be adapted both the profile of nurse attendance and the type of resources needed to ensure effective patient care.ConclusionProfile of patients attended for suicide attempt in an outpatient setting in a semi-rural coastal area is variated. It is worth to mention that one-third of this population did not meet criteria for any mental disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionDelusional disorder has reached an entity of growing interest with a prevalence in developed countries between 1 and 4% of the psychiatric consultations.ObjectiveTo describe various socio-demographic and clinical variables that characterize patients diagnosed with delusional disorder in Andalucía according to DSM-5 criteria.MethodsReviewing common medical history digital records. First, it has been proved whether it complies DSM-5 criteria for the diagnosis of delusional disorder. Then, there have been different epidemiological variables collected: age, sex, family psychiatric history, and marital status, and employment status, age of onset of illness, number of years of follow-up by specialized care, the number of visits to your computer, and number of hospitalizations in a psychiatric inpatient unit among others.of the 1927 patients studied, 1452 met the criteria for diagnosis of delusional disorder. These patients live in Andalusia and come to different mental health care units, with an average follow-up period of 9 years and 1 month.ResultsAbout half of the sample were women and half men (49% versus 51%).Forty-seven percent of the sample are married or have a couple, and 19% are in active employment.Thirty-two percent have a family history of psychiatric mental disorder written in his digital clinical record.Seventy-five percent of the sample meets criteria F22, while 25% are diagnosed as other psychoses.ConclusionThis is the largest record of cases registered with delusional disorder to date, in which we describe the biopsychosocial characteristics of this group of patients in the largest Spanish region.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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