6 results
CANNABIDIOL- PROVOKES OR TREATS ANXIETY DISORDERS?
- H. Arshad, A. Arshad, M. Khalid, A. R. Khan, F. Arain, S. Khatri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S685
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Introduction
After the introduction of proposal regarding cannabidiol for the treatment of some psychiatric disorders including anxiety, there is confusion if cannabidiol use is associated with the provocation of anxiety symptoms or it can be safely used for the treatment. In nonmedical terms, (Cannabidiol) Cannabis is referred to as Marijuana and has been considered a potential substance of abuse for ages, that raises few questions for its use as a treating agent. It is an interesting area to be explored.
ObjectivesOur aim is to find out the implications of Cannabidiol use. We look forward to knowing the mechanism behind cannabidiol being a potential treatment strategy for anxiety.
MethodsA literature search was conducted using the search terms [anxiety] OR [cannabis] OR[ Marijuana] OR [cannabidiol] OR [tetrahydrocannabinol] OR [phytocannabinoids] OR [panic] OR [generalized anxiety] OR [social anxiety] OR [psycholgic distress] OR[psychosis] OR [depression]. The overall search produced 230 results. We included 30 studies relevant to the subject in this review.
ResultsResults revealed that anxiety is highly prevalent in individuals with a history of cannabidiol use in comparison to non-users. Symptoms of stress are more pronounced with more frequent cannabidiol use. Chronic users present with more severe symptoms like palpitations and the constant restlessness that are difficult to be managed. The potential role of Cannabinoids in reducing the conditioning of fear can be considered one of the reasons for investigations being done on it. Cannabidiol (Cb1) receptor plays a potential role in producing anxiolytic effects. The side effects of first-line drugs like distorted body shape due to weight gain, sexual health concerns and resistance along with frequent relapses, available for managing anxiety disorders are one of the reasons to consider alternative substances. Though, human testings are still underway, animal models are used currently for experimentation purposes and show positive anxiolytic effects of cannabidiol.
ConclusionsThere is increased need to investigate necessary chemical and physiologic changes that are produced within the body in response to cannabidiol use. More investigations should be done on human subjects along with animal studies. Proper guidelines should be shared with practicing physicians so that new and pretested ways are open for the treatment of resistant cases with proper implications of knowledge in clinical settings so that there is minimal chance of abuse of potentially addictive chemicals.
Keywords: Cannabis, Cannabidiol, anxiety, treatment, provocation.
Disclosure of InterestNone Declared
WHAT IS MORE DANGEROUS- SUICIDALITY IN EPILEPSY OR EPILEPSY AS A DISEASE? _A REVIEW
- H. Arshad, K. Hussain, M. Khalid, F. Arain, A. R. Khan, A. Arshad
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S918
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Introduction
Epilepsy is a neurologic condition characterized by spontaneous jerky body movements. It is a chronic morbid condition mostly diagnosed during childhood. Patients are maintained on long-term medications to prevent recurrent seizures that can damage the brain. Medications used for the management of epilepsy have several side effects and require proper monitoring. Patients with epilepsy are at increased risk of psychiatric comorbidities.
ObjectivesOur aim is to find factors responsible for causing suicidality in patients with epilepsy.
MethodsA review was conducted using Pubmed database with the search terms [epilepsy] OR [neurological conditions] OR [suicide] OR [suidical attempt] OR [suicidal ideation] OR [depression] OR [psychiatric diseases] OR [mood disorders] OR [anxiety] OR [sleeplessness] which yielded around 800 articles. The number was later reduced to be centered around the main area of interest and produced around 40 articles.
ResultsResults show that many contributing factors play an unavoidable role in promoting suicidal ideation that can lead to suicidal attempts in epilepsy. The stigma associated with epilepsy leads to social isolation, lack of opportunities, financial constraints, and impact on close relationships which can be the reasons for depression. According to the review, the foremost contributing factor is the underlying social, emotional, and economic condition of epilepsy patients. Depression and anxiety are the most prevalent psychiatric comorbidities in epileptic patients. Epileptic patients who develop psychiatric ailments show decreased adherence to medications that further worsen the problem.
ConclusionsThough, this area in neurology has started getting attention for further research and guidelines. But efforts are still inadequate for this to be put into clinical practice. More desperate actions needed to be taken for proper diagnosis and management of suicidal ideations by proper use of assessment tools so that timely actions are planned. This is a highly demanding area due to the impact of depressive symptoms on the prognosis of the chronic neurologic condition.
Keywords: Suicidality; Epilepsy; neurology.
Disclosure of InterestNone Declared
Psychiatric Manifestations of Iron Deficiency Anemia-A Literature Review
- H. Arshad, A. Arshad, M. Y. Hafiz, G. Muhammad, S. Khatri, F. Arain
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S243-S244
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Introduction
Anemia due to iron deficiency is a highly prevalent medical condition in women and children. Iron deficiency presents with fatigue, low mood, anxiety, restlessness, palpitations, and headache. Poor nutritional intake can be the reason of iron deficiency in underprivileged populations. It can lead to behavioral symptoms that can manifest as chronic psychiatric ailments.
ObjectivesOur objective is to consolidate manifestations of iron deficiency anemia concerning psychiatric ailments. We will figure out if it impacts the severity of psychiatric symptoms. We aim to find out if there are any underlying factors that impact the correlation of iron deficiency with psychiatric disorders like depression, anxiety, sleep disorders, and restless leg syndrome.
MethodsDetailed literature review conducted using PUBMED, OVID, GOOGLE SCHOLAR with the search terminologies [iron] OR [sleep disorders] OR [depression] OR[deficiency] OR [anxiety] OR [ADHD] OR [VITAMINS] OR[PICA] OR [CHILDREN] OR [women] OR [antidepressants] OR [sleep medicine] OR [antipsychotics] that yielded 150 results that were narrowed down to be focused on our research area. Inclusion criteria included studies with participants with iron deficiency anemia regardless of age group, gender, economic and social background. Exclusion criteria included patients with normal hemoglobin levels.
ResultsResults yielded a positive impact of treating iron deficiency anemia in patients with psychiatric ailments. The symptoms of low mood, fatigue, anxiety, anhedonia, and sleeplessness get better as iron deficiency improves. According to the search, some physicians misdiagnose iron deficiency as depression. Antidepressants were found to be working better when added with iron supplements. Restlessness and palpitations can also be the manifestations of iron deficiency. Patients with underlying iron deficiency are more predisposed to developing psychiatric disorders. According to published data, restless leg syndrome was found to be associated with iron deficiency. Some psychiatric drugs can lead to iron deficiency and can provoke underlying iron deficiency even more. Iron deficiency impacts memory areas of the brain like the hippocampus and prefrontal cortex.
ConclusionsIt is much needed more than ever before that proper consideration to the diagnosis of iron deficiency anemia must be given with the assistance of predesigned guidelines. Misdiagnosis of iron deficiency anemia as a psychiatric disorder can be misleading toward the insidious usage of psychiatric medications. Proper attention must be provided to this neglected area so that management of iron deficiency is tailored in the right direction and it is diagnosed at less severe stages. It will be helpful for general physicians and practicing psychiatrists in the field.
Keywords: Iron deficiency, Psychiatric Disorders, Anxiety, depression.
Disclosure of InterestNone Declared
Stimulant induced Dermatological and Vascular Complications in patients with ADHD: A literature review
- F. Arain, M. Jawad, A. Azeem, H. Arain, A. Williams, M. Zeshan
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S420
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Introduction
Methylphenidate and amphetamine are the two most widely used stimulants in managing Attention Deficit Hyperactivity Disorder (ADHD)1. Reynaud’s phenomenon (RP) is a reversible distal vasoconstriction presenting with various dermatological symptoms. RP can secondarily develop after certain medications as well2.
ObjectivesThe review was undertaken to synthesize the incidence of RP within ADHD population treated with stimulants, and any causal relation of RP and stimulant-use.
MethodsPubMed, Psych-Info and Google Scholar were searched using these keywords: skin change, Raynaud, stimulants and methylphenidate. All relevant study types were included. Results were synthesized narratively.
ResultsInitial search yielded 240 articles with 5 articles fulfilling our inclusion criteria. One was retrospective case-controlled study while remaining 4 were case reports. Six cases were identified with an age of 12-19 years, who presented with RP after being treated with methylphenidate-or-dextroamphetamine. In one case, multiple clinical signs of RP were seen with cold distal fingers, transient color changes and even frank ulceration3–6. In two cases, it was seen that RP was dose-dependent with stimulant use and got resolved after decreasing the dosage respectively. In case-control study, 32 cases with RP and 32 controls were enrolled. The results showed a statistically significant association (χ2 =5, p=0.01) between RP and past-or-current stimulant usage.7
ConclusionsThe literature review suggests weak evidence of the association between RP and stimulant use but no evidence of any causal link. Further studies are needed to identify characters that can predict this adverse effect in vulnerable ADHD individuals.
DisclosureNo significant relationships.
The enduring effects of adverse childhood experiences (ACES) on mood dysregulation in children: A literature review
- F. Arain, N. Chavannes, C.C. Corona, A. Tohid, H. Arain, M. Jennings, A. Sanchez-Lacay
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S211
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Introduction
Behavioral dysregulation is a common presentation of children in the Emergency-Room (ER)1. A 10-year-old African-American boy with attention-deficit/hyperactivity disorder, oppositional defiant disorder with poor treatment adherence, two previous psychiatric hospitalizations and multiple ER visits, presented with dysregulation and aggressive behavior. He had inconsistent parenting and poor attachment with present involvement of child protective services. We did a systematic review to interpret associations between adverse childhood experiences (ACEs) and the development of behavioral dysregulation in later life.
ObjectivesTo see associations between ACEs and the development of behavioral dysregulation in later life.
MethodsWe searched PsycINFO, APA PsycNet, PubMed, and Medline. Among 35 articles, five were included: 1) a meta-analysis of health consequences and ACEs1; 2) a data analysis of 64,329 youth from the Florida Department of Juvenile Justice that focused on suicide attempts and ACEs2; 3) a systematic review of 42 articles related to ACEs 3; 4) data from 22,575 youth for childhood abuse, trauma and neglect 4 and 5) a multimodal logistic regression study on 64,000 juvenile offenders focused on ACE scores and latent trajectory.5
ResultsThere is increased risk of substance use, mental and physical health problems, and violence associated with ACEs1, 2. The relationship between childhood difficulties and suicide is interceded by adolescent’s maladaptive behaviors3. By age 35, ACEs increase the risk of becoming a serious juvenile offender4. Increased exposure to ACEs differentiates early-onset and sustained criminality from other forms of criminality5.
ConclusionsACEs can affect the development of a child in multiple ways including suicidal behavior, aggression, impulsivity, criminality, academic difficulties and substance abuse
Role of digital health in improving physical and mental well-being during COVID-19 pandemic
- F. Arain, A. Tohid, H. Arain, S. Afzal, M.S. Tauheed, M. Tauheed, M. Zeshan, W. Azeem
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S276
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Introduction
Due to the COVID-19 pandemic, there is a steep rise in the acceptance of telemedicine and digital health, including increased interest in pursuing mental health treatment through telepsychiatry. Digital health helps following social distancing measures and increases the health outcomes.
ObjectivesTo see the role of digital health in improving physical and mental well-being during COVID-19 Pandemic
MethodsThis study is a part of a large global project where 240 people inquired advice on phone app during COVID-19-Pandemic. Later on, a short study was conducted on the same population through survey to evaluate the effectiveness of digital health/tele-mental health. We also searched PubMed, Google Scholar, PsychInfo, and Medline for words “Digital Health, Tele-mental health, COVID-19-Pandemic”. Reviewed 40 articles and included 3 in this review1,4,5.
ResultsWe received a total of 98 responses. 65.6% people reported that online health resources are helpful in relieving pandemic-induced anxiety/stress, 66.2% reported to continue online health services after pandemic, 37.7% noted that digital health saves times in waiting areas, 46% reported lack of physical interaction with doctor as a disadvantage of digital health, and 40.3% reported comfort in using tele-mental health. Our literature review has shown barriers like privacy concerns and technological issues1. Provision of tele-psychiatry is safe and effective in continuity of mental health care.4,5
ConclusionsThere has been an increased inclination towards digital health during any disaster. During COVID-19-Pandemic, digital health has increased access to mental health care and reduced risk of infection. The drawbacks include poor patient-doctor relationship, reimbursement concerns, and lack of confidentiality.