Pseudobulbar affect (PBA) is a neurological condition that is associated with short periods of involuntary, sudden, and inappropriate emotions such as crying or laughing, which are mood incongruent. An accurate estimate of the prevalence of PBA is hard to obtain due to varying diagnostic criteria and variable patient populations. The cause of PBA is not known, but current evidence suggests dual etiology. A neural circuit dysfunction and an abnormality of neurotransmitters that regulate motor expression of emotions. PBA can easily be mistaken for a depressive disorder due to the overlap of symptoms. Moreover, patients with PBA may have a major depressive disorder (MDD) or other depressive disorders. Therefore, it is essential to recognize and treat PBA as well as possible psychiatric comorbidities. We present a case report of a 59-yearold man with no past psychiatric history who presents with paroxysms of episodes of crying for the past one year. He endorsed feelings of hopelessness and poor concentration. MRI of the brain revealed bilateral basal ganglia and a thalamic infarct. The patient was treated with citalopram. This case describes a unique presentation of pseudobulbar affect mimicking depression.
Focal impaired awareness seizures (FIAS), previously known as complex partial seizures, refer to focal seizures that start in one hemisphere of the brain and are associated with an impairment in consciousness. FIAS of temporal lobe origin most often present with psychopathology, such as behavioral and affective symptoms. It has a bimodal age distribution peaking at the extremes of life. Geriatric presentations can often be subtle and go unnoticed asides from a few symptoms, such as confusion and memory lapses. Here, we present a unique case of a geriatric patient with FIAS presenting as transient psychosis.
INTRODUCTIONLegislative policies aimed at curbing early exposure to smoking among youth are a crucial public health strategy. Yet little is known about US adults' public opinion on restricting exposure of children to movies depicting smoking. This study sought to characterize US adults' levels of support to restrict the exposure of children to smoking in movies and explore associations with sociodemographic characteristics. METHODS We used cross-sectional data from the 2020 Health Information National Trends Survey (HINTS, n=3750) of adults in the United States to estimate the prevalence of opinions toward restricting the exposure of children to smoking in movies and examine correlates of support using weighted logistic regression. RESULTS In all, 48.2% of adults endorsed a supportive opinion. In multivariable logistic regression analysis, the odds of endorsing a supportive opinion were higher among Black/African American adults (OR=1.61; 95% CI: 1.04-2.49, p=0.033), and Hispanics (OR=1.78; 95% CI: 1.17-2.72, p=0.008) when compared to Whites. Similarly, compared to those aged 18-34 years, the odds of endorsing a supportive opinion were also greater among those aged 50-64 years (OR=2.15; 95% CI: 1.43-3.24, p<0.001) or aged ≥65 years (OR=3.83; 95% CI: 2.31-6.36, p<0.001). Higher odds for support were observed among those exposed to federal court-ordered anti-smoking tobacco messages (OR=1.37; 95% CI 1.06-1.78, p=0.018) and among those who reported using social media to share health information (OR=1.51; 95% CI: 1.02-2.23, p=0.041). CONCLUSIONS Only 48% of US adults endorsed support for restricting the exposure of children to smoking in movies. This study has identified subgroups of US adults for whom tailored communication interventions may increase support for policies that protect children from early initiation of smoking.
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