4.Psychiatric morbidities after stroke in Asia: A systematic review
Meliza Angelica J. De Leon ; Alejandro C. Baroque II
Journal of Medicine University of Santo Tomas 2023;7(2):1222-1228
Background:
Stroke is currently the second leading cause of death worldwide and is one of the leading causes of long-term disability . Mood disorders are prevalent after a stroke and may hinder physical, functional, and cognitive recovery; hence, it is undeniably necessary to recognize them early. Stroke mortality is generally higher in Asia as most of the countries therein are in economic transition . Socioeconomic status is a major contributor to stroke burden as greater odds of disability are found in patients with lower educational status and income.
Objectives:
The primary objective of this study is to identify the psychiatric morbidities commonly seen after a stroke in Asia.
Search Methods:
The following databases were utilized for extensive literature search: PubMed (January 2002 to June 2022), Cochrane Library (January 2002 to June 2022), and EBSCO (January 2002 to June 2022). The search made use of keyword combinations, Boolean operators "AND" and "OR," truncations, and field tags last October 2022.
Selection Criteria:
Articles on the prevalence and cross-sectional studies were included if they involved stroke survivors who developed post-stroke psychiatric morbidities in Asia. Additional inclusion criteria consisted of studies that have to be written in the English language and having free full texts available.
Data Collection and Analysis:
This systematic review made use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and guidelines. The JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data was used in the assessment for the quality of articles to be included in this systematic review.
Results and Conclusion
Affective disorders and generalized anxiety disorder were the common psychiatric morbidities identified post-stroke. The Hospital Anxiety and Depression Scale (HADS) may be used to diagnose post-stroke depression and anxiety. Males in their middle to late adulthood with higher National Institutes of Health Stroke Scale (NIHSS) scores and poor stroke outcomes (higher scores in the Modified Rankin Scale) were associated with a higher likelihood of developing the aforementioned psychiatric morbidities.
Depression
;
Anxiety
;
Mania
;
Psychotic Disorders
;
Asia
7.Application Prospect of Integrative Omics in Forensic Identification of Methamphetamine-Associated Psychosis.
Long-Rui ZHAO ; Jian-Bo ZHANG ; Wei HAN ; Li ZHU ; Teng CHEN ; Fang-Lin GUAN
Journal of Forensic Medicine 2022;38(5):650-656
The clinical symptoms and signs of methamphetamine-associated psychosis (MAP) and schizophrenia are highly similar, but the situation is completely different when MAP and schizophrenia patients need to be assessed for criminal responsibility after they comitted a harmful behavior. Therefore, the distinction between the two psychoses is very important in forensic psychiatry. At present, the identification of these two psychoses is mainly dependent on the corresponding criteria such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese Classification of Mental Disorders Version 3 (CCMD-3). It's challenging to diagnose and distinguish between the two in practical cases due to their similar clinical symptoms and the lack of effective objective indexes. Different from the limitations of single omics, integrative omics intergrates data from multiple dimensions and has been extensively studied in the field of schizophrenia and has achieved some preliminary results. In view of the correlation between MAP and schizophrenia and the potential application value of integrative omics, this paper proposes an integrative omics strategy for MAP pathogenesis and forensic identification, aiming to improve the further understanding of the relationship between the two psychoses and the corresponding pathogenesis. It also provides references for the future exploration of integrative omics in forensic precise identification and effective monitoring and early warning methods.
Humans
;
Methamphetamine/adverse effects*
;
Psychoses, Substance-Induced/etiology*
;
Psychotic Disorders/genetics*
;
Schizophrenia/genetics*
;
Diagnosis, Differential
8.A trauma perspective on a case of Mayer-Rokitansky-Kuster-Hauser Syndrome presenting with major depression with psychosis
Maria Theresa Sarah C. Rivera ; Jhun Robbie U. Galicia ; Rodelen C. Paccial
The Philippine Journal of Psychiatry 2022;3(1-2):60-66
The psychological impact of the diagnosis of congenital anomalies is an area with limited
research; and more limited still when such congenital anomalies are not very obvious. MayerRokitansky-Kuster-Hauser (MRKH) syndrome can be one of those less apparent congenital
anomalies. Owing to their inability to bear children, women confronted with the diagnosis of
MRKH can be left stressed, or worse, traumatized by the fact that they can no longer function
in their traditional gender roles. This may leave any individual wanting to deny the diagnosis or
even withhold such information. And the experience is a fertile ground for the development of
any mental illness. MRKH occurs in every 1 out of 4000-5000 females. Although the
psychological impact of stress is a well –established fact, there are fewer literature on the
possible genetic link of MRKH and mental illness, the psychodynamic underpinnings and the
similarities to trauma of the diagnosis of MRKH, in particular.
We present here a case of MRKH syndrome with an initial presentation of major depression
and psychosis; with the diagnosis of MRKH initially withheld from the resident psychiatrist. We
would also want to highlight a trauma perspective of the case presented as well as to
emphasize the need for more research congenital anomalies are accompanied by co-morbid
psychiatric illnesses.
Depression
;
Psychotic Disorders
;
Psychological Distress
9.Sheehan’s Syndrome presenting as postpartum psychosis
Harold Henrison C. Chiu ; Ella Mae I. Masamayor ; Ma. Belen B. Pilit-Hizon ; Angelique Bea C. Uy ; Ma. Cecille S. Añ ; onuevo-Cruz ; Gabriel V. Jasul Jr
Acta Medica Philippina 2022;56(12):65-69
Sheehan’s syndrome is characterized by hypopituitarism following ischemic necrosis of the pituitary gland caused by postpartum hemorrhage and impaired blood supply to the enlarged pituitary gland during pregnancy. The worldwide prevalence has since decreased due to improvements in obstetric care. Behavioral change is a rare presentation and is often misdiagnosed and managed as psychosis. We report a 42-year-old woman presenting with behavioral changes associated with postpartum failure of lactation and amenorrhea. Hormonal work-up revealed panhypopituitarism; serum cortisol, 98.93 (NV: 138–690 nmol/L); free T4, less than 5.15 (NV: 11.5–23.00 pmol/L); free T3, less than 2.30 (NV: 2.89–4.88 pmol/L); FSH, 3.63 (NV: 30–135 mIU/mL); LH, 3.88 (NV: 13–80 mIU/mL); serum estradiol, 3.89 (NV: 10.41–35.0 pg/mL); IGF-1, 13.13 (NV: 56–194 ng/mL); and serum prolactin, 1.8 (NV: 2.6–24.8 ng/mL). Cranial MRI with contrast revealed an atrophic pituitary gland consistent with Sheehan's syndrome. The symptoms improved substantially upon replacement with steroids and thyroid hormones and she was able to resume her routine activities. The psychiatric features of hypopituitarism can be attributed to a combination of hypothyroidism, hypoglycemia, and hypocortisolism and have been shown to reverse with adequate hormone replacement.
Hypopituitarism
;
Psychotic Disorders
;
Hypopituitarism
10.Covid-19, not your normal flu: A case report on Covid-19 psychosis and mania in a Malaysian hospital
Rebecca Pei Ying Wong ; Philip George
Malaysian Family Physician 2022;17(3):144-148
Evidence suggests that acute severe coronavirus disease 2019 (COVID-19) may be associated with neuropsychiatric symptoms. This is a case report of a patient who had recently been infected with COVID-19 and had no history of psychiatric disorders presenting a few days after inpatient discharge from COVID-19 treatment with acute onset of psychosis and manic symptoms. This case illustrates the psychiatric presentation, possible causes, and management of post-COVID-19 psychosis.
COVID-19
;
Psychotic Disorders
;
Mania


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