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SCHIZOPHRENIA and OTHER PSYCHOTIC DISORDERS of EARLY ONSET Jean Starling & Isabelle Feijo
IACAPAP Textbook of Child and Adolescent Mental Health Chapter OTHER DISORDERS H.5 SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS OF EARLY ONSET Jean Starling & Isabelle Feijo Jean Starling FRANZCP, MPH Child and adolescent psychiatrist, Director, Walker Unit, Concord Centre for Mental Health, Sydney, and senior clinical lecturer, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia Conflict of interest: none declared Isabelle Feijo FRANZCP Psychiatrist, Walker Unit, Concord Centre for Mental Health, Sydney, Australia and specialist in child and adolescent psychiatry and psychotherapy, Swiss Medical Association Conflict of interest: none declared Jackson Acknowledgement: thanks to Pollock; Polly Kwan who vetted the untitled. Cantonese websites This publication is intended for professionals training or practising in mental health and not for the general public. The opinions expressed are those of the authors and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader. -
N-Acetylcysteine in the Treatment of Excoriation Disorder: a Randomized Clinical Trial
This supplement contains the following items: 1. Original protocol, final protocol, summary of changes 2. Original statistical analysis plan, final statistical analysis plan, summary of changes Downloaded From: https://jamanetwork.com/ on 09/28/2021 ORIGINAL PROTOCOL A Double-Blind, Placebo-Controlled Study of N-Acetyl Cysteine in Pathologic Skin Picking Jon E. Grant, M.D., J.D, M.P.H. University of Minnesota School of Medicine Minneapolis, MN IRB Code #1002M77897 Protocol Version 25 January 2010 TASCS# 100028 assigned to this protocol !1 Downloaded From: https://jamanetwork.com/ on 09/28/2021 A Double-Blind, Placebo-Controlled Study of N-Acetyl Cysteine in Pathologic Skin Picking This project will take place at the University of Minnesota, Department of Psychiatry. Dr. Jon E. Grant, MD, JD, MPH is the Principal Investigator and can be phoned at 612-273-9736, email at [email protected] or by mail at 2450 Riverside Avenue, Minneapolis, MN 55454. This clinical trial will be conducted in the spirit of Good Clinical Practice (GCP) and in accordance with this IRB approved protocol. No deviation from the protocol will be implemented without the prior review and approval of the IRB except where it may be necessary to eliminate an immediate hazard to a research subject. In such a case, the deviation will be reported to the IRB as soon as possible. Investigational Agent N-acetyl cysteine (NAC) – 600mg by mouth twice a day for three weeks; 1200mg by mouth twice a day for three weeks; 1200mg by mouth each morning and 1800mg by mouth every afternoon for three weeks. -
Increased Tactile Sensitivity and Deficient Feed-Forward Inhibition in Pathological Hair Pulling and Skin Picking
Behaviour Research and Therapy 120 (2019) 103433 Contents lists available at ScienceDirect Behaviour Research and Therapy journal homepage: www.elsevier.com/locate/brat Increased tactile sensitivity and deficient feed-forward inhibition in pathological hair pulling and skin picking T ∗ David C. Houghtona,b, , Mark Tommerdahlc, Douglas W. Woodsb,d a Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA b Psychological & Brain Sciences Department, Texas A&M University, College Station, TX, 77843, USA c Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, 27599, USA d Department of Psychology, Marquette University, Milwaukee, WI, 53233, USA ARTICLE INFO ABSTRACT Keywords: An increasing body of evidence has linked pathological body-focused repetitive behaviors (BFRBs) to excessive Trichotillomania sensory sensitivity and difficulty modulating sensory inputs. Likewise, neurobiological evidence points to deficits Excoriation disorder in feed-forward inhibition and sensory habituation in conditions with similar symptomatology. There is cur- Psychophysics rently little evidence regarding potential physiological sensory abnormalities in BFRBs. The current study Sensation compared 46 adults with pathological hair pulling and/or skin picking to 46 age-matched healthy control participants on a series of self-report measures and objective psychophysical tests of neurophysiological sensory functions. Persons in the BFRB group reported increased scores on the Sensory Gating Inventory (U=320.50, p < .001) and all of its subscales (all p-values < .001), reflecting abnormal sensory experiences. The BFRB 2 group also showed decreased tactile thresholds (increased sensitivity) (F[1, 76] = 10.65, p = .002, ηp = .12) 2 and deficient feed-forward inhibition (F[1, 76] = 5.18, p = .026, ηp = .064), but no abnormalities in quickly- adapting sensory habituation were detected on an amplitude discrimination task. -
Skin Picking
child & youth Mental Health Series Today’s topic: Speaker: Dr. Erin Kelly November 15, 2018 If you are connected by videoconference: Please mute your system while the speaker is presenting. Complete today’s evaluation & apply for professional credits Please feel free to ask questions! Complete today’s evaluation & apply for professional credits By You will have had an opportunity to registering apply for professional credits or a certificate of attendance for today’s event… You will receive an email with a link to today’s online evaluation Visit our website to download slides You may and view archived events also want to… Sign-up to our distribution list to receive our event notifications Questions? [email protected] Speaker has nothing to disclose with regard to commercial support. Declaration Speaker does not plan to of conflict discuss unlabeled/ investigational uses of commercial product. Goals • What is Excoriation Disorder? • How does it typically present? • Differential diagnoses? • Clinical Correlates? • Management? Excoriation (Skin Picking) Disorder • Repetitive picking, rubbing, scratching, digging, or squeezing of skin, with or without instrumentation, resulting in visible tissue damage and impairment in functioning • Part of a group of disorders characterized by “self-grooming behaviour” in which hair, skin, nails are manipulated. “Body Focused Repetitive Behaviours” or BFRBs Excoriation (Skin Picking) Disorder • Occasional picking at cuticles, acne, scabs, callouses, and other skin abnormalities is a very common -
“What About Bob?” an Analysis of Gendered Mental Illness in a Mainstream Film Comedy
“What About Bob?” An Analysis of Gendered Mental Illness in a Mainstream Film Comedy A Thesis Presented in partial fulfillment of the requirements for the degree of Master of Arts in the College of Graduate Studies of Northeast Ohio Medical University. Anna Plummer M.D. Medical Ethics and Humanities 2020 Thesis Committee: Dr. Julie Aultman (Advisor) Dr. Rachel Bracken Brian Harrell Copyright Anna Plummer 2020 ABSTRACT Mental illness has been a subject of fictional film since the early 20th century and continues to be a popular trope in mainstream movies. Portrayals of affected individuals in movies tend to be inaccurate and largely stigmatizing, negatively influencing public perception of mental illness. Recent research suggests that gender stereotypes and mental illness intersect, such that some mental illnesses are perceived as “masculine” and others as “feminine.” This notion may further stigmatize such disorders in individuals, as well as falsely inflate observed gender disparities in certain mental illnesses. Since gendered mental illness is a newly identified concept, little research has been performed exploring the way stereotypical gendered mental illness is depicted in mainstream film. This paper analyzes the movie What About Bob? to show that comedic film perpetuates stigma surrounding feminine mental illness in men and identifies the need for further study of gendered mental illness in movies to ascertain the effect such depictions have on the observed gender disparities in prevalence of certain mental disorders, as well as offers a proposal for coursework for film and medical students. i ACKNOWLEDGMENTS This paper would not have been possible without Dr. Aultman, whose teaching inspired me to pursue further education in Medical Ethics and Humanities, and whose guidance has been invaluable not only for this project, but also for addressing ethical issues in the clinic. -
White Matter Abnormalities in Adults with Bipolar Disorder Type-II
www.nature.com/scientificreports OPEN White matter abnormalities in adults with bipolar disorder type‑II and unipolar depression Anna Manelis1*, Adriane Soehner1, Yaroslav O. Halchenko2, Skye Satz1, Rachel Ragozzino1, Mora Lucero1, Holly A. Swartz1, Mary L. Phillips1 & Amelia Versace1 Discerning distinct neurobiological characteristics of related mood disorders such as bipolar disorder type‑II (BD‑II) and unipolar depression (UD) is challenging due to overlapping symptoms and patterns of disruption in brain regions. More than 60% of individuals with UD experience subthreshold hypomanic symptoms such as elevated mood, irritability, and increased activity. Previous studies linked bipolar disorder to widespread white matter abnormalities. However, no published work has compared white matter microstructure in individuals with BD‑II vs. UD vs. healthy controls (HC), or examined the relationship between spectrum (dimensional) measures of hypomania and white matter microstructure across those individuals. This study aimed to examine fractional anisotropy (FA), radial difusivity (RD), axial difusivity (AD), and mean difusivity (MD) across BD‑II, UD, and HC groups in the white matter tracts identifed by the XTRACT tool in FSL. Individuals with BD‑II (n = 18), UD (n = 23), and HC (n = 24) underwent Difusion Weighted Imaging. The categorical approach revealed decreased FA and increased RD in BD‑II and UD vs. HC across multiple tracts. While BD‑II had signifcantly lower FA and higher RD values than UD in the anterior part of the left arcuate fasciculus, UD had signifcantly lower FA and higher RD values than BD‑II in the area of intersections between the right arcuate, inferior fronto‑occipital and uncinate fasciculi and forceps minor. -
Nerve-16-17-Final.Pdf
2 the nerve • 2016-17 CONTENTS R EARCH IN BRIEF 4 - The Diffusive Memristor Gabrielle Abad 9 - Zika Virus & Its Neurological Impacts Srijesa Khasnabish A icles 11 - Excoriation Disorder Emily Yao 14 - Infrared Vision in Snakes Can Yumuk 16 - Conquer Your Mind Mehul Khetrapal 18 - Neuroeconomics Tiantian Li 22 - The Next Generation of Captain America Akane Ichiki 24 - Architecture & Cognition in the Sydney Crotts Monolingual & Bilingual Brain S UDENT R EARCH 26 - Restoring Hearing Loss Andrea Zhang O INION 27 - The Suffering Artist Amanda Fortin 32 - Neuroethics of Identity Erin Ferguson the nerve • 2016-17 3 STAFF Olivia Nguyen Erin Ferguson Colin Stuart Gabrielle Abad Janelle Maxwell Ian Anderson Ben Rabin Sydney Crotts Priyanka Shah Camila de Freitas Josh Strauss Erin Ferguson Colin Stuart Amanda Fortin Emma Wheeler Mehul Khetrapal Ryan Wong Srijesna Khasnabish Emily Yao Katherine Kolin Can Yumuk Tiantian Li Andrea Zhang Haodong Liu Sydney Crotts Martinelli Valcin Radhika Dhanak Valentina Wicki Nic Larstanna Emily Yao Natalya Shelchkova 4 the nerve • 2016-17 LETTER FROM THEE TOR Dear reader, The word ‘neuroscience’ is often intimidating to those who do not pursue the study Janelle Maxwell of the human brain in an academic setting. Yet, with neuroscience research being Ben Rabin one of the largest growing fields to date, it is paramount to make all knowledge ac- cessible without all the scientific jargon in order to propel the general understand- Priyanka Shah ing of our society forward. Having served as editor-in-chief for the Nerve Magazine Josh Strauss for two and a half years, I am continuously humbled and inspired by the passion in Colin Stuart our community to make neuroscience, psychology, biomedical, and other scientific fields more available to the public. -
Obsessive-Compulsive and Related Disorders: a Critical Review of the New Diagnostic Class
CP11CH07-Abramowitz ARI 3 March 2015 12:56 Obsessive-Compulsive and Related Disorders: A Critical Review of the New Diagnostic Class Jonathan S. Abramowitz and Ryan J. Jacoby Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; email: [email protected] Annu. Rev. Clin. Psychol. 2015. 11:165–86 Keywords First published online as a Review in Advance on obsessive-compulsive disorder, obsessive-compulsive and related disorders, January 2, 2015 trichotillomania, excoriation, hair pulling, hoarding, body dysmorphic The Annual Review of Clinical Psychology is online at disorder clinpsy.annualreviews.org Annu. Rev. Clin. Psychol. 2015.11:165-186. Downloaded from www.annualreviews.org This article’s doi: Abstract 10.1146/annurev-clinpsy-032813-153713 The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders Access provided by University of North Carolina - Chapel Hill on 02/17/16. For personal use only. Copyright c 2015 by Annual Reviews. includes a new class of obsessive-compulsive and related disorders (OCRDs) All rights reserved that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, its empirical va- lidity and practical utility are questionable. This article reviews the phe- nomenology of OCD and then presents a critical analysis of the arguments underlying the new OCRD class. This analysis leads to a rejection of the OCRD classification on both scientific and logical grounds. The article closes with a discussion of the treatment implications of the OCRDs approach. 165 CP11CH07-Abramowitz ARI 3 March 2015 12:56 Contents INTRODUCTION.............................................................. -
Common Pitfalls in ERP for OCD
Common Pitfalls in ERP for OCD ©Justin K. Hughes, MA, LPC & Molly Martinez, PhD Thank you for being here sufferers, support, family, professionals. 2 Common Pitfalls in ERP for OCD ©Justin K. Hughes, MA, LPC & Molly Martinez, PhD HELLO! Justin Hughes, MA, LPC Molly Martinez, PhD Owner, Dallas Counseling, PLLC Clinical Psychologist Clinician, Writer, Speaker Specialists in OCD & Anxiety Recovery (SOAR) www.justinkhughes.com www.soartogether.net Dallas, TX Richardson, TX ©Justin K. Hughes, MA, LPC & Molly Martinez, PhD 4 Learning Objectives 1) Overview OCD and ERP 2) Identify roadblocks to effective ERP 3) Identify solutions to address these common pitfalls 5 Want these slides right now??? www.justinkhughes.com/ocd 6 PART ONE: Review The Basics You Probably Know... ● What OCD is ● What ERP is ● That ERP is the PART ONE: gold-standard of Review the evidence-based treatment Basics for OCD 8 For a PRIZE... What is the average amount of symptom reduction after a trial of ERP for OCD? 9 60-70%!! (Abramowitz & Jacoby, 2015; Foa et al., 2010) 10 You Might Know... ● Compulsions function by reducing distress via: ○ Reassurance PART ONE: ○ Avoidance Review the ● ERP is hard Basics ● ERP requires planning ● ERP requires adjustment ● ERP doesn’t always work as expected 11 PART TWO: ERP Pitfalls & Solutions ● Fear-Related Issues ○ Therapists’ Fears ○ Not Addressing the Core Fear ○ Clients’ Fear of Distress ● Covert Compulsive Behaviors ○ Reassurance ○ Mental Compulsions PART TWO: ○ Distraction ● Treatment Plan(ning) Problems ERP Pitfalls & ○ Treatment Compliance Solutions ○ Not Going Far Enough ○ Not Working with Family ○ Wrong Form of Exposure ○ Unrealistic Expectations (Extinction Burst)Medication Myths/Misconceptions ○ Detours & Comorbidities ○ Therapy “Dosing” ○ No Relapse Prevention Plan 13 Fear-Related Pitfalls & Solutions For a PRIZE.. -
Anxiety Disorders
Anxiety Disorders Anxiety Disorders Overview n What is anxiety? n Categories of anxiety disorders n Generalized Anxiety Disorder n Panic Disorder n Specific Phobia/Social Phobia n Obsessive Compulsive Disorder n DSM-IV diagnoses n Treatments Anxiety n Probably experienced some of this during the exam n What does it feel like? n When is it a “disorder?” n What is the difference between fear and anxiety? n Anxiety defined as n uneasiness stemming from the anticipation of danger n Fear defined as n a reaction to a specific threat from the real, physical world 1 Anxiety n Anxiety is an evolutionary useful feeling n part of the flight or fight response n useful to have a response of energizing to get out of a situation n sometimes this gets in our way n feels not so adaptive Anxiety n Diagnosing n For a person to be diagnosed as having anxiety, the anxiety must be out of proportion to the perceived threat n The anxiety is recognized by the individual seeking treatment to be excessive or unreasonable Anxiety Disorders n Several types/different diagnoses n Based on formal (topographical) features n Should be distinct n Will see much overlap within a category (e.g. within Anxiety) n Also see overlap between other categories (e.g., OCD and eating disorders) 2 Anxiety Disorders n Six disorders: n Generalized anxiety disorder (GAD) n Obsessive-compulsive disorder (OCD) n Phobias n Panic disorder ________________________________ n Acute stress disorder n Post-traumatic stress disorder (PTSD) Generalized Anxiety Disorder (GAD) GAD n One of the most -
''The Mind Is Its Own Place'': Amelioration of Claustrophobia in Semantic Dementia
Hindawi Publishing Corporation Behavioural Neurology Volume 2014, Article ID 584893, 5 pages http://dx.doi.org/10.1155/2014/584893 Case Report ‘‘The Mind Is Its Own Place’’: Amelioration of Claustrophobia in Semantic Dementia Camilla N. Clark,1 Laura E. Downey,1 Hannah L. Golden,1 Phillip D. Fletcher,1 Rajith de Silva,2 Alberto Cifelli,2 and Jason D. Warren1 1 Dementia Research Centre, UCL Institute of Neurology, University College London, 8-11 Queen Square, London WC1N 3BG, UK 2 Essex Neurosciences Centre, Queen’s Hospital, Rom Valley Way, Romford RM7 0AG, UK Correspondence should be addressed to Jason D. Warren; [email protected] Received 1 March 2013; Accepted 17 June 2013; Published 6 March 2014 Academic Editor: Argye E. Hillis Copyright © 2014 Camilla N. Clark et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Phobias are among the few intensely fearful experiences we regularly have in our everyday lives, yet the brain basis of phobic responses remains incompletely understood. Here we describe the case of a 71-year-old patient with a typical clinicoanatomical syndrome of semantic dementia led by selective (predominantly right-sided) temporal lobe atrophy, who showed striking amelioration of previously disabling claustrophobia following onset of her cognitive syndrome. We interpret our patient’s newfound fearlessness as an interaction of damaged limbic and autonomic responsivity with loss of the cognitive meaning of previously threatening situations. This case has implications for our understanding of brain network disintegration in semantic dementia and the neurocognitive basis of phobias more generally. -
Obsessive–Compulsive Or Addiction? Categorical Diagnostic Analysis Of
Psychiatry Research 281 (2019) 112518 Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Obsessive–compulsive or addiction? Categorical diagnostic analysis of excoriation disorder compared to obsessive-compulsive disorder and T gambling disorder ⁎ Elen Cristina Batista Oliveirraa, , Chelsea L. Fitzpatrickb, Hyoun S. Kimb, Daniel Carr Ribeiro Gulassaa, Roberta Souza Amarala, Nicoli de Mattos Cristianaa, Ana Yaemi Hayashiuchia, Daniel S. McGrathb, Hermano Tavaresa a Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil b Department of Psychology, University of Calgary, Calgary, Alberta, Canada ARTICLE INFO ABSTRACT Keywords: Excoriation disorder (ED) is currently classified in the 5th edition of the Diagnostic and Statistical Manual of Excoriation disorder Mental Disorders’ Obsessive–compulsive and Related Disorders section (OCRD). However, there remain debates Skin picking disorder regarding whether ED is related to obsessive–compulsive disorder (OCD) or whether it is better conceptualized – Obsessive compulsive as a behavioral addiction. The present research compared the diagnostic overlap and psychiatric comorbidities Impulse control disorders of 121 individuals seeking treatment for ED (n = 40), OCD (n = 41) and gambling disorder (GD) (n = 40). ED Gambling disorder was more likely to overlap with OCD (n = 14) than GD (n = 3). Compared to OCD, ED had similar frequencies of Comorbidity – DSM-5 other body focused repetitive behaviors (BFRBs), but higher frequency of addictive behaviors (Odds Ratio OR = 11.82). In comparison to GD, ED had similar frequencies of addictive behaviors, but higher frequency of BFRBs (OR=19.67).