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Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
P-40 - Lack of Association Between the Val158met Catechol-o-methyltransferase Gene Polymorphism and Methamphetamine Dependence
- L. Hosak, O. Sery, M. Beranek, M. Alda
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- Journal:
- European Psychiatry / Volume 27 / Issue S1 / 2012
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
About 25 000 serious methamphetamine abusers live in the Czech Republic among the total population of 10 million. Dependence on methamphetamine is markedly related to the brain neurotransmitter dopamine, metabolised by catechol-O-methyltransferase enzyme.
ObjectivesThe objective of our study was to deepen our knowledge on the genetic background of methamphetamine dependence.
AimsThe main aim of the study was to ascertain whether the Val158Met catechol-O-methyltransferase gene polymorphism is associated with methamphetamine dependence in the Czech Republic.
MethodsOne hundred and twenty-three subjects dependent on methamphetamine (women N = 44), parents of sixty-seven dependent individuals, and four hundred healthy controls (women N = 250) were involved into the study. We performed a population-based as well as family-based genetic association studies.
ResultsWe did not find any significant association between the Val158Met catechol-O-methyltransferase gene polymorphism and methamphetamine dependence using the population-based or family-based design (P = 0.41-0.66; Chi-Square Test or UNPHASED program, Version 3.1.4, respectively). We found a trend toward a statistically significant difference between the Val allele carriers and Met/Met homozygotes in the frequence of psychotic symptoms induced by methamphetamine (more frequent in Val carriers; P = 0.062; Chi-Square Test).
ConclusionsFurther research involving haplotype analysis and other dopamine-related genetic polymorphisms in large populations is needed. More attention should also be paid to possible role of the Val158Met catechol-O-methyltransferase gene polymorphism in individual clinical subtypes of dependence on methamphetamine involving e.g. psychotic features or violence.
Abnormal reward valuation and event-related connectivity in unmedicated major depressive disorder
- S. Rupprechter, A. Stankevicius, Q. J. M. Huys, P. Series, J. D. Steele
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- Journal:
- Psychological Medicine / Volume 51 / Issue 5 / April 2021
- Published online by Cambridge University Press:
- 07 January 2020, pp. 795-803
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Background
Experience of emotion is closely linked to valuation. Mood can be viewed as a bias to experience positive or negative emotions and abnormally biased subjective reward valuation and cognitions are core characteristics of major depression.
MethodsThirty-four unmedicated subjects with major depressive disorder and controls estimated the probability that fractal stimuli were associated with reward, based on passive observations, so they could subsequently choose the higher of either their estimated fractal value or an explicitly presented reward probability. Using model-based functional magnetic resonance imaging, we estimated each subject's internal value estimation, with psychophysiological interaction analysis used to examine event-related connectivity, testing hypotheses of abnormal reward valuation and cingulate connectivity in depression.
ResultsReward value encoding in the hippocampus and rostral anterior cingulate was abnormal in depression. In addition, abnormal decision-making in depression was associated with increased anterior mid-cingulate activity and a signal in this region encoded the difference between the values of the two options. This localised decision-making and its impairment to the anterior mid-cingulate cortex (aMCC) consistent with theories of cognitive control. Notably, subjects with depression had significantly decreased event-related connectivity between the aMCC and rostral cingulate regions during decision-making, implying impaired communication between the neural substrates of expected value estimation and decision-making in depression.
ConclusionsOur findings support the theory that abnormal neural reward valuation plays a central role in major depressive disorder (MDD). To the extent that emotion reflects valuation, abnormal valuation could explain abnormal emotional experience in MDD, reflect a core pathophysiological process and be a target of treatment.
Chapter 1 - Black Student Mothers: A Culturally Relevant Exploratory Study
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- By Sureshi M. Jayawardene, San Diego State University, Serie McDougal III, professor of Africana studies in the College of Ethnic Studies
- Edited by Marquita Gammage, Antwanisha Alameen-Shavers
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- Book:
- Challenging Misrepresentations of Black Womanhood
- Published by:
- Anthem Press
- Published online:
- 29 May 2019
- Print publication:
- 22 March 2019, pp 9-26
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Summary
Introduction
The Status of Black Women in the United States reported in 2017 that Black women are disproportionately likely to be mothers while pursuing a college education (DuMonthier et al. 2017). A briefing paper issued by the Institute for Women's Policy Research (IWPR) indicates that two in five (i.e. 37 percent) of all Black women undergraduate students are raising dependent children (2017). Contrary to common perceptions, according to a Journal of Blacks in Higher Education publication from 2005, many Black single mothers are educated beyond high school, and others are seeking education toward better conditions for themselves and their families. Nevertheless, one of the most prevalent racial stereotypes about Black single mothers is that of inadequacy, particularly that they are uneducated. Single mothers in college are challenged with balancing a range of responsibilities including school, parenthood and often also employment. For Black single mothers, the added burden of racial stereotypes and myths presents further challenges to succeeding as both students and parents.
To date, little scholarly attention has been paid to Black mothers, in general, who are pursuing higher education while raising children. Based on data collected using a questionnaire about Black student mothers currently or formerly enrolled at US colleges and universities, we assess self-perceptions and mechanisms of self-determination. A more comprehensive view of the experiences of Black student mothers can help highlight strategies that are effective in challenging existing distortions about Black womanhood and motherhood as well as debunking negative racial stereotypes associated with Black mothers. We posit that a look at the agency and lived experiences of Black women student parents can help in designing university and college programs and services better suited to support these students’ overall success in higher education.
The present exploratory study aims to identify patterns, ideas or hypotheses to gain insights into the topic of Black student mothers’ college/university experience that has, thus far, been understudied. This essay is organized as follows. First, a literature review provides a view of the major discursive positions regarding issues Black women experience at the intersection of motherhood and college attendance. Next, the methodology section outlines the conceptual framework, data collection and sample.
22 - Consent, capacity and the law
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- By Jonathan Waite, Nottinghamshire Healthcare NHS Trust, Richard Barnes, Mossley Hill Hospital, Liverpool, Daniel M. Bennett, University of Aberdeen, Donald Lyons, Mental Welfare Commission for Scotland, Declan M. McLoughlin, St Patrick's University Hospital, Dublin, Ireland, Hugh Series, Oxford Health NHS Foundation Trust
- Edited by Jonathan Waite, Andrew Easton
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- Book:
- The ECT Handbook
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 204-223
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Summary
All medical procedures, be they therapeutic or investigative, touch on the issue of consent – that is a measure of willingness on the part of the patient to undertake the procedure proposed. In this, ECT is no different to other therapeutic interventions. However, ECT has a particular status both within psychiatry and within the law that makes specific discussion of issues with regard to consent necessary.
General issues regarding consent
Electroconvulsive therapy is unusual in that consent obtained is for a course of treatments rather than for an individual procedure. It is also customary that the person seeking the consent will not be the person giving the treatment. The fact that the person receiving treatment has a psychiatric disorder sufficiently severe for ECT to be considered raises questions about their capacity; this makes it particularly important that consent is properly obtained and valid. It is unlawful and unethical to treat a patient who is capable of understanding the nature of any procedure, its purpose and implications, the anticipated benefits and any reasonably foreseeable adverse effects without first explaining it. The patient must then agree. Even if patients choose not to be informed of the full details of their diagnosis and treatment, they must be given the option of receiving this information. Guidance on good practice in consent can be found in publications from the Department of Health in England and Wales (2009), the Department of Health, Social Services and Public Safety in Northern Ireland (2003) and the Scottish Executive (2006), as well as from the General Medical Council (2008).
Obtaining valid consent should be considered a process rather than an event and it is necessary for patients to be given an adequate length of time to consider the benefits and drawbacks of the proposed treatment before making an informed decision. Patients should be informed of the risks and unwanted effects of ECT (Chapters 7–9) and they need to realise that a general anaesthetic is involved. If there are specific anaesthetic risks, the anaesthetist should explain these and obtain the necessary consent.
It is helpful for patients and carers to be provided with information obtained from different sources. Written information sheets may be useful (e.g. Appendix V); these need to be accompanied by the opportunity to discuss issues with members of the therapeutic team, family members, carers, advocates, etc.
Monitoring of Multilayered Bacterial Biofilm Morphology by Cryo-SEM for Raman Spectroscopy Measurements
- K. Hrubanova, S. Bernatova, O. Samek, M. Sery, P. Zemanek, J. Nebesarova, F. Ruzicka, V. Krzyzanek
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- Journal:
- Microscopy and Microanalysis / Volume 21 / Issue S3 / August 2015
- Published online by Cambridge University Press:
- 23 September 2015, pp. 187-188
- Print publication:
- August 2015
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Contributors
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- By Tom Abbott, Gareth L. Ackland, Hollman D. Aya, Berthold Bein, Karim Bendjelid, Matthieu Biais, Elizabeth J. Bridges, Maxime Cannesson, Cédric Carrié, Alice Carter, Maurizio Cecconi, Daniel Chappell, Jason H. Chua, Gary Colins, Diego Orbegozo Cortes, Lester A. H. Critchley, Daniel De Backer, Katia Donadello, Eric Edison, Byron D. Fergerson, Tong J. Gan, Michael T. Ganter, Leslie M. Garson, Christoph K. Hofer, Christoph Ilies, James M. Isbell, Matthias Jacob, Mazyar Javidroozi, Zeev N. Kain, Elisa Kam, Gautam Kumar, Yannick Le Manach, Sheldon Magder, Aman Mahajan, Gerard R. Manecke, Paul E. Marik, Joseph Meltzer, Debra R. Metter, Timothy E. Miller, Xavier Monnet, Michael Mythen, Rudolph Nguyen, Rupert Pearse, Michael R. Pinsky, Davinder Ramsingh, Steffen Rex, Andrew Rhodes, Joseph Rinehart, Mathieu Sèrié, Aryeh Shander, Nils Siegenthaler, Ann B. Singleton, Faraz Syed, Jean-Louis Teboul, Robert H. Thiele, Shermeen B. Vakharia, Trung Vu, Nathan H. Waldron, David Walker, William Wilson
- Edited by Maxime Cannesson, University of California, Irvine, Rupert Pearse
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- Book:
- Perioperative Hemodynamic Monitoring and Goal Directed Therapy
- Published online:
- 05 September 2014
- Print publication:
- 04 September 2014, pp vii-x
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22 - Consent, capacity and the law
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- By Jonathan Waite, Consultant Psychiatrist, Nottinghamshire Healthcare NHS Trust, Richard Barnes, Consultant in Old Age Psychiatry, Mossley Hill Hospital, Liverpool, Daniel M. Bennett, Consultant Forensic Psychiatrist, NHS Tayside, and Honorary Senior Lecturer in Psychiatry, University of Aberdeen, Donald Lyons, Mental Welfare Commission for Scotland, Declan M. McLoughlin, Research Professor of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, and St Patrick's University Hospital, Dublin, Ireland, Hugh Series, Consultant Psychiatrist, Oxford Health NHS Foundation Trust
- Edited by Jonathan Waite, Andrew Easton
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- Book:
- The ECT Handbook
- Published online:
- 02 January 2018
- Print publication:
- 01 May 2013, pp 204-223
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Summary
All medical procedures, be they therapeutic or investigative, touch on the issue of consent – that is a measure of willingness on the part of the patient to undertake the procedure proposed. In this, ECT is no different to other therapeutic interventions. However, ECT has a particular status both within psychiatry and within the law that makes specific discussion of issues with regard to consent necessary.
General issues regarding consent
Electroconvulsive therapy is unusual in that consent obtained is for a course of treatments rather than for an individual procedure. It is also customary that the person seeking the consent will not be the person giving the treatment. The fact that the person receiving treatment has a psychiatric disorder sufficiently severe for ECT to be considered raises questions about their capacity; this makes it particularly important that consent is properly obtained and valid. It is unlawful and unethical to treat a patient who is capable of understanding the nature of any procedure, its purpose and implications, the anticipated benefits and any reasonably foreseeable adverse effects without first explaining it. The patient must then agree. Even if patients choose not to be informed of the full details of their diagnosis and treatment, they must be given the option of receiving this information. Guidance on good practice in consent can be found in publications from the Department of Health in England and Wales (2009), the Department of Health, Social Services and Public Safety in Northern Ireland (2003) and the Scottish Executive (2006), as well as from the General Medical Council (2008).
Obtaining valid consent should be considered a process rather than an event and it is necessary for patients to be given an adequate length of time to consider the benefits and drawbacks of the proposed treatment before making an informed decision. Patients should be informed of the risks and unwanted effects of ECT (Chapters 7–9) and they need to realise that a general anaesthetic is involved. If there are specific anaesthetic risks, the anaesthetist should explain these and obtain the necessary consent.
Contributors
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- By Nozomi Akanuma, Gonzalo Alarcón, R. Arunachalam, Sarah H. Bernard, Frank M. C. Besag, Istvan Bodi, Stephen Brown, Franz Brunnhuber, Antonella Cerquiglini, J. Helen Cross, R. Shane Delamont, Archana Desurkar, Lee Drummond, Rona Eade, Robert D. C. Elwes, Bidi Evans, Peter Fenwick, Colin D. Ferrie, Paul L. Furlong, Laura H. Goldstein, Sally Gomersall, Sushma Goyal, Jane Hanna, Yvonne Hart, Dominic C. Heaney, Graham E. Holder, Mrinalini Honavar, Elaine Hughes, Jozef M. Jarosz, John G. R. Jefferys, Jane Juler, Mathias Koepp, Michalis Koutroumanidis, Maureen Lahiff, Louis Lemieux, David McCormick, Brian Meldrum, John D. C. Mellers, Nicholas Moran, John Moriarty, Robin G. Morris, Nandini Mullatti, Lina Nashef, Jennifer Nightingale, T. J. von Oertzen, Corina O'Neill, Philip N. Patsalos, Stella Pearson, Charles E. Polkey, Ronit Pressler, Edward H. Reynolds, Mark P. Richardson, Leone Ridsdale, Robert Robinson, Greg Rogers, Euan M. Ross, Richard P. Selway, Stefano Seri, Simeran Sharma, Graeme J. Sills, Andrew Simmons, Shiri Spector, Mark Stevenson, Jade N. Thai, Brian Toone, Antonio Valentín, Nuria T. Villagra, Matthew Walker, William Whitehouse
- Edited by Gonzalo Alarcón, King's College London, Antonio Valentín, King's College London
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- Book:
- Introduction to Epilepsy
- Published online:
- 05 July 2012
- Print publication:
- 26 April 2012, pp xii-xv
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Melatonin as a sedation substitute for diagnostic procedures: MRI and EEG
- E Wassmer, M Fogarty, A Page, K Johnson, E Quin, S Seri, W Whitehouse
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- Journal:
- Developmental Medicine and Child Neurology / Volume 43 / Issue 2 / February 2001
- Published online by Cambridge University Press:
- 14 February 2001, p. 136
- Print publication:
- February 2001
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