Pharmacogenetic testing for the guidance of psychiatric treatment of a schizoaffective patient with haltlose personality disorder

Marques, João Gama

doi:10.1017/s1092852917000669

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…A recent case report (Gama Marques, 2019b) in a homeless patient with schizoaffective disorder used the power of pharmacogenetics. The patient had already experienced 85 admissions in 25 years, taken a combination of benzodiazepines, antidepressants, mood stabilizers and antipsychotics, and undergone electroconvulsive therapy.…”

Section: Resultsmentioning

confidence: 99%

Schizoaffective disorder in homeless patients: A systematic review

Forte

Bento²,

Marques

2022

Int J Soc Psychiatry

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Background: Schizoaffective psychosis is a severe and chronic psychiatric disorder defined by the presence of mood symptoms, like mania and/or depression and schizophrenia, such as hallucinations and/or delusions. Aims: We aim to find out whether there is a correlation between schizoaffective psychosis and being homeless. Method: To do so, a literature search was carried out in the PubMed platform in April 2022, using the keywords ‘schizoaffective’ and ‘homeless’. Results: In this review, 28 articles from this search were included. Intrinsic characteristics, rates of psychiatric readmission, prediction of homelessness, medication noncompliance, and substance use were explored, as they were the main themes of the results. Conclusions: The homeless population suffers from great diagnostic variability and the diagnosis schizoaffective psychosis is still evolving contributing to such diagnostic and treatment difficulties. Their frequent visits to the healthcare services, especially emergency room leads to consequent interaction with multiple healthcare professionals, resulting in a myriad of diagnoses, with clinical remission and therapeutic goals not being attained. More studies are necessary for a better evaluation of this super difficult population.

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Section: Resultsmentioning

confidence: 99%

Schizoaffective disorder in homeless patients: A systematic review

Forte

Bento²,

Marques

2022

Int J Soc Psychiatry

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“…30,38,39 A good example of the complex problems psychiatrists have to deal with on a daily basis was published as a case report, by one of the authors, describing one particular super difficult patient, living as homeless, with 85 hospital admissions in a 25-year span. 40 Healthcare usage by homeless people remains a challenge worldwide, a truly composite problem that led to the proposition, by some authors, that homeless people with mental illness should become the object of Marontology, a new medical specialty, named after the Greek word marontos, which means unwanted. 41 The study of the national homeless population is fundamental to the understanding of a phenomenon conditioned by the social picture of each country, providing the national social and health services a better source for policy implementation, allowing a more evidence-based approach targeting the well-being of the homeless.…”

Section: Introductionmentioning

confidence: 99%

“…The multiple problems that the people living homeless recurrently present and the categorization of them as off-limits or distracting makes their treatment perceived as demotivating among the health workers, the so-called “difficult patients” or even “super difficult patients.” 30 , 38 , 39 A good example of the complex problems psychiatrists have to deal with on a daily basis was published as a case report, by one of the authors, describing one particular super difficult patient, living as homeless, with 85 hospital admissions in a 25-year span 40 …”

Section: Introductionmentioning

confidence: 99%

Mental illness among 500 people living homeless and referred for psychiatric evaluation in Lisbon, Portugal

Fernandes

Marques

Bento³

et al. 2021

CNS Spectr.

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Background Our goal was to identify the demographic profile of the people living homeless with mental illness in Lisboa, Portugal, and their relationship with the national healthcare system. We also tried to understand which factors contribute to the number and duration of psychiatric admissions among these homeless people. Methods We used a cross-sectional design, collecting data for 4 years among homeless people, in Lisboa, Portugal, that were referred as possible psychiatric patients to Centro Hospitalar Psiquiátrico de Lisboa (CHPL). In total, we collected data from 500 homeless people, then crosschecked these people in our CHPL hospital electronic database and obtained 467 patient matches. Results The most common psychiatric diagnosis in our sample was drug abuse (34%), followed by alcohol abuse (33%), personality disorder (24%), and acute stress reaction (23%). Sixty-two percent of our patients had multiple diagnoses, a subgroup with longer follow-ups, more psychiatric hospitalizations, and longer psychiatric hospitalizations. The prevalence of psychotic disorders was high: organic psychosis (17%), schizophrenia (15%), psychosis not otherwise specified (14%), and schizoaffective disorder (11%), that combined altogether were present in more than half (57%) of our homeless patients. Conclusion The people living homeless with multiple diagnoses have higher mental health needs and worse determinants of general health. An ongoing effort is needed to identify and address this subgroup of homeless people with mental illness to improve their treatment and outcomes.

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“…Finally, the diagnosis of emotionally unstable PD appeared to be associated with homelessness referrals to an acute young adult psychiatric unit ( 34 ). Still, a single case report of a schizoaffective homeless man with a previous diagnosis of haltlöse PD highlights the need for more studies examining PD Not Otherwise Specified (NOS) ( 35 ).…”

Section: Resultsmentioning

confidence: 99%

Homeless people: a review of personality disorders

Henriques-Calado,

Gama Marques

2024

Front. Psychiatry

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Personality disorders in homeless people pose a challenge to the medical community and society, requiring specialized approaches for these super-difficult patients. The prevalence of personality disorders is higher in homeless populations than in the general population. However, there is a knowledge gap regarding personality disorders among people experiencing homelessness, and the implications of this lack of recognition are substantial. This paper provides a brief narrative review of personality disorders among homeless individuals. The primary importance and specificity of these disorders in this population remain unexplored. We searched PubMed and Web of Science databases in February and November 2023 using the keywords ‘homeless’ and ‘personality disorder’, and selected fifty-eight studies to be included in this literature review. The main themes of the results were personality disorders in homeless individuals and comorbid psychiatric disorders; risk factors and other psychological and behavioral data; clinical and intervention outcomes; and challenges linked to assessment, treatment, and intervention. The homeless population experiences significant diagnostic variability and the diagnosis of personality disorders is still evolving, contributing to difficulties in diagnosis, assessment, and treatment. A future challenge is to raise clinical awareness and optimize research knowledge, assessment, and intervention in personality disorders among homeless individuals with comorbid psychiatric disorders.

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Pharmacogenetic testing for the guidance of psychiatric treatment of a schizoaffective patient with haltlose personality disorder

Cited by 6 publications

References 5 publications

Schizoaffective disorder in homeless patients: A systematic review

Schizoaffective disorder in homeless patients: A systematic review

Mental illness among 500 people living homeless and referred for psychiatric evaluation in Lisbon, Portugal

Homeless people: a review of personality disorders

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