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[PMID]:29441972
[Au] Autor:Sakurada H; Yasuhara K; Kato K; Asano S; Yoshida M; Yamamura M; Tachi T; Teramachi H
[Ti] Título:An investigation of visual hallucinations associated with voriconazole administration to patients with hematological malignancies.
[So] Source:Pharmazie;71(11):660-664, 2016 Nov 02.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Voriconazole (VRCZ) is commonly administered to treat fungal infections in patients with hematological malignancies. Some of these patients experience VRCZ-associated visual hallucinations. We conducted a retrospective survey to investigate the characteristic features of this side effect. Patients with hematological malignancies who were treated with VRCZ for a fungal infection after hospitalization at Ichinomiya municipal hospital between 1 October 2005 and 31 December 2015 were included in this study (n = 103). Fifteen of these (14.6%) reported visual hallucinations that started on day 1-7. Seven of these 15 patients developed this symptom rapidly (day 1 or 2). Three patients had transient symptoms (lasting 2-12 days), 6 patients experienced hallucinations throughout the treatment, and the duration was unknown in 6 patients. Eleven patients experienced visual hallucinations when their eyes were closed (73 %) and these disappeared when they opened their eyes. One patient had visual hallucinations with open eyes, while the state of the eyes was unknown in 3 patients. The patients saw a range of images including people, animals, landscapes, and foods; several reported seeing images like those found in movies. In addition, 9 of 15 patients (60%) with visual hallucinations had visual disturbances. This was a higher proportion than that observed in patients who did not develop hallucinations (17 of 88; 19.3 %; P < 0.05). However, we found no significant difference between the blood VCRZ concentrations of patients who developed or did not develop visual hallucinations. This study indicated that most of these patients had visual hallucinations that manifested on eye closure, and they did not progress to serious mental illness. Our findings emphasized the importance of fully explaining the features of this symptom to each patient prior to starting VRCZ administration in order to reduce anxiety. In addition, since VRCZ discontinuation will compromise patient management, therapeutic drug monitoring should be used to increase the likelihood of successful therapy.
[Mh] Termos MeSH primário: Antifúngicos/efeitos adversos
Alucinações/induzido quimicamente
Neoplasias Hematológicas/complicações
Neoplasias Hematológicas/psicologia
Voriconazol/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antifúngicos/sangue
Antifúngicos/uso terapêutico
Feminino
Alucinações/epidemiologia
Alucinações/psicologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Micoses/complicações
Micoses/prevenção & controle
Estudos Retrospectivos
Transtornos da Visão/induzido quimicamente
Transtornos da Visão/epidemiologia
Voriconazol/sangue
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6725


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[PMID]:29384611
[Au] Autor:Hiromitsu K; Midorikawa A
[Ti] Título:Downward and Parallel Perspectives in an Experimental Study of Out-of-Body Experiences.
[So] Source:Multisens Res;29(4-5):439-51, 2016.
[Is] ISSN:2213-4794
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Out-of-body experiences (OBEs) have been reported in patients with neurological or psychiatric disorders. According to these reports, the patients looked down on their body from overhead. Based on this phenomenon, we adopted a downward perspective in an experimentally induced OBE paradigm and compared responses to an OBE questionnaire (sensations of OBE) with self-location mapping (feelings of body drift). The results revealed a correlation between the sensation of an OBE and self-location under the downward-perspective condition but not under the parallel-perspective condition; however, no significant difference was observed between the two conditions. Thus, the effect of perspective on OBE illusion that has been reported in clinical research of OBE did not affect the results obtained in previous studies inducing OBE.
[Mh] Termos MeSH primário: Imagem Corporal/psicologia
Despersonalização/psicologia
Autoimagem
Percepção Visual/fisiologia
[Mh] Termos MeSH secundário: Feminino
Alucinações/psicologia
Seres Humanos
Imaginação
Masculino
Sensação
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE


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[PMID]:29191033
[Au] Autor:Schildkrout B
[Ad] Endereço:From the Department of Psychiatry, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston.
[Ti] Título:Joan of Arc-Hearing Voices.
[So] Source:Am J Psychiatry;174(12):1153-1154, 2017 Dec 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Pessoas Famosas
Alucinações/psicologia
Medicina nas Artes
Pinturas
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.17080948


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[PMID]:28792579
[Au] Autor:Laval C
[Ad] Endereço:Sociologue, chercheur associé Lyon2 et Rennes2.
[Ti] Título:[A New Challenge of Working Together: Psychiatry and Heraing Voices].
[Ti] Título:Des professionnels de santé mentale engagés auprès d'un réseau d'entendeurs de voix dans un programme de chez soi d'abord..
[So] Source:Sante Ment Que;42(1):391-409, 2017.
[Is] ISSN:0383-6320
[Cp] País de publicação:Canada
[La] Idioma:fre
[Ab] Resumo:Recovery model, as the hearing voices movement, promotes the users discourse among the health workers. This interference of users in the expertise considering the meaning of their voices is faced with the vision of advocating health workers, particularly the psychiatrists supporting the psychiatric users movement. On the field, this association seems challenging. On the experimental site in Marseille, professionals through various tensions and practical difficulties tend to reconsider their power / knowledge. This new challenge of working together leads them to adopt both a more humble position towards their clinical expertise and a more ambitious position regarding their participation in the construction of public controversies highlighted by the speaking experience of the hearing voices movement.
[Mh] Termos MeSH primário: Comportamento Cooperativo
Alucinações
Relações Interprofissionais
Serviços de Saúde Mental
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE


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[PMID]:29050393
[Au] Autor:Alderson-Day B; Lima CF; Evans S; Krishnan S; Shanmugalingam P; Fernyhough C; Scott SK
[Ad] Endereço:Department of Psychology, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, UK.
[Ti] Título:Distinct processing of ambiguous speech in people with non-clinical auditory verbal hallucinations.
[So] Source:Brain;140(9):2475-2489, 2017 Sep 01.
[Is] ISSN:1460-2156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Auditory verbal hallucinations (hearing voices) are typically associated with psychosis, but a minority of the general population also experience them frequently and without distress. Such 'non-clinical' experiences offer a rare and unique opportunity to study hallucinations apart from confounding clinical factors, thus allowing for the identification of symptom-specific mechanisms. Recent theories propose that hallucinations result from an imbalance of prior expectation and sensory information, but whether such an imbalance also influences auditory-perceptual processes remains unknown. We examine for the first time the cortical processing of ambiguous speech in people without psychosis who regularly hear voices. Twelve non-clinical voice-hearers and 17 matched controls completed a functional magnetic resonance imaging scan while passively listening to degraded speech ('sine-wave' speech), that was either potentially intelligible or unintelligible. Voice-hearers reported recognizing the presence of speech in the stimuli before controls, and before being explicitly informed of its intelligibility. Across both groups, intelligible sine-wave speech engaged a typical left-lateralized speech processing network. Notably, however, voice-hearers showed stronger intelligibility responses than controls in the dorsal anterior cingulate cortex and in the superior frontal gyrus. This suggests an enhanced involvement of attention and sensorimotor processes, selectively when speech was potentially intelligible. Altogether, these behavioural and neural findings indicate that people with hallucinatory experiences show distinct responses to meaningful auditory stimuli. A greater weighting towards prior knowledge and expectation might cause non-veridical auditory sensations in these individuals, but it might also spontaneously facilitate perceptual processing where such knowledge is required. This has implications for the understanding of hallucinations in clinical and non-clinical populations, and is consistent with current 'predictive processing' theories of psychosis.
[Mh] Termos MeSH primário: Giro do Cíngulo/fisiologia
Alucinações/fisiopatologia
Córtex Pré-Frontal/fisiologia
[Mh] Termos MeSH secundário: Estimulação Acústica
Adulto
Percepção Auditiva/fisiologia
Estudos de Casos e Controles
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Incerteza
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE
[do] DOI:10.1093/brain/awx206


  6 / 9198 MEDLINE  
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[PMID]:28829845
[Au] Autor:Leandro JE; Beato J; Pedrosa AC; Pinheiro-Costa J; Falcão M; Falcão-Reis F; Carneiro ÂM
[Ad] Endereço:Department of Ophthalmology, São João Hospital, Porto, Portugal.
[Ti] Título:The Charles Bonnet Syndrome in Patients With Neovascular Age-Related Macular Degeneration: Association With Proton Pump Inhibitors.
[So] Source:Invest Ophthalmol Vis Sci;58(10):4138-4142, 2017 Aug 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: We investigate the prevalence of the Charles Bonnet syndrome (CBS) in patients with neovascular age-related macular degeneration (AMD) and analyze the role of oral proton pump inhibitors (PPIs) and other potential risk factors. Methods: A total of 510 consecutive patients with neovascular-AMD followed at a single tertiary center in Portugal were screened for CBS. Using a structured questionnaire, psychiatrically healthy individuals were interviewed systematically and divided into a CBS group and a non-CBS group. Demographic data, current medication, and ocular risk factors were collected and compared between the two groups. Results: A total of 500 patients met the inclusion criteria and 471 with complete data were included in the final analysis. The prevalence of CBS was 9.0% (45/500). Using a binary logistic regression model, correlations were found between older age (P = 0.002), PPI intake (P = 0.022), poor visual acuity (P = 0.004), and development of CBS. PPIs doubled the risk of CBS from 7% (20/304) to 15% (25/167), with an odds ratio of 2.154. The increased risk for visual hallucinations caused by PPIs was independent of age (P = 0.598) and visual acuity (P = 0.739). Conclusions: The prevalence of CBS in neovascular-AMD patients is high and mainly affects older individuals with poor visual acuity. PPIs seem to increase the risk of development of hallucinations independently of the degree of visual loss.
[Mh] Termos MeSH primário: Alucinações/epidemiologia
Inibidores da Bomba de Prótons/efeitos adversos
Degeneração Macular Exsudativa/complicações
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Alucinações/induzido quimicamente
Alucinações/etiologia
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Portugal/epidemiologia
Prevalência
Fatores de Risco
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.16-21270


  7 / 9198 MEDLINE  
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[PMID]:28817967
[Au] Autor:Kianirad Y; Simuni T
[Ad] Endereço:a Department of Neurology , Northwestern University, Feinberg School of Medicine , Chicago , IL , USA.
[Ti] Título:Pimavanserin, a novel antipsychotic for management of Parkinson's disease psychosis.
[So] Source:Expert Rev Clin Pharmacol;10(11):1161-1168, 2017 Nov.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Parkinson's disease psychosis (PDP) may develop in up to 60% of Parkinson's patients and is associated with increased morbidity and mortality. It also correlates with depression and dementia, and can contribute to caregiver stress and burnout. Pimavanserin is the first FDA approved drug for the treatment of hallucinations and delusions associated with PDP. Areas covered: For this review, a MEDLINE literature search (via PubMed) and information provided by ACADIA Pharmaceuticals were used. This review will discuss the pathophysiology and current management of PDP. In addition, this review will focus on the rationales behind the development of pimavanserin, mechanism of action, pharmacokinetics, pharmacodynamics, and the clinical trials evaluating the efficacy and safety of pimavanserin. Last, the review will address the drug's package insert warning. Expert commentary: Pimavanserin, a 5HT2A receptor inverse agonist, is the first FDA approved drug for the treatment of PDP which has been shown to reduce psychosis in PD through its unique mechanism of action. Pimavanserin, does not worsen PD motor symptoms and has an acceptable safety profile. The development of pimavanserin as an antipsychotic opened a new therapeutic avenue in the treatment of PDP as well as targeting psychosis in other disorders such as Alzheimer's disease.
[Mh] Termos MeSH primário: Doença de Parkinson/tratamento farmacológico
Piperidinas/uso terapêutico
Transtornos Psicóticos/tratamento farmacológico
Ureia/análogos & derivados
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Antipsicóticos/farmacologia
Antipsicóticos/uso terapêutico
Delusões/tratamento farmacológico
Delusões/etiologia
Agonismo Inverso de Drogas
Alucinações/tratamento farmacológico
Alucinações/etiologia
Seres Humanos
Doença de Parkinson/fisiopatologia
Doença de Parkinson/psicologia
Piperidinas/efeitos adversos
Piperidinas/farmacologia
Transtornos Psicóticos/etiologia
Transtornos Psicóticos/fisiopatologia
Agonistas de Receptores 5-HT2 de Serotonina/efeitos adversos
Agonistas de Receptores 5-HT2 de Serotonina/farmacologia
Agonistas de Receptores 5-HT2 de Serotonina/uso terapêutico
Ureia/efeitos adversos
Ureia/farmacologia
Ureia/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Piperidines); 0 (Serotonin 5-HT2 Receptor Agonists); 8W8T17847W (Urea); JZ963P0DIK (pimavanserin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2017.1369405


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[PMID]:28671925
[Au] Autor:Nanda T; Rasool N; Callahan AB; Stamper RL; Odel JG
[Ad] Endereço:*Columbia University College of Physicians and Surgeons †Harkness Eye Institute, Columbia University Medical Center, New York, NY ‡Department of Ophthalmology, University of California at San Francisco, San Francisco, CA.
[Ti] Título:Ophthalmic Timolol Hallucinations: A Case Series and Review of the Literature.
[So] Source:J Glaucoma;26(9):e214-e216, 2017 Sep.
[Is] ISSN:1536-481X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Systemic absorption and central nervous system (CNS) penetration of timolol drops are a well-studied phenomenon, resulting in common side effects such as bradycardia, bronchospasm, fatigue, and confusion. More serious CNS side effects, such as psychosis and depression, however, are rarely attributed to eye drops. We report a case series in which patients developed visual hallucinations secondary to topical ocular timolol use. METHODS: This study is a case series and review of the literature. RESULTS: Four patients with glaucoma developed visual hallucinations while using topical timolol. The patients were all elderly, caucasian females with associated CNS pathology. All patients had resolution of symptoms upon discontinuation and a positive retrial test to confirm the association. CONCLUSIONS: The rarity of this side effect and its anecdotal predilection for elderly, caucasian females with underlying neurological dysfunction, may involve a yet unknown predisposition or hypersensitivity to beta blocker action, such as blood brain barrier disruption leading to increased susceptibility to the medication. This case series highlights an important, although rare, side effect of this medication which clinicians should be aware of especially when using it in elderly patients who may have coexisting CNS pathology. It is important that this side effect be recognized and appropriately managed to prevent otherwise unnecessary investigations and treatment.
[Mh] Termos MeSH primário: Glaucoma/tratamento farmacológico
Alucinações/induzido quimicamente
Pressão Intraocular
Timolol/efeitos adversos
[Mh] Termos MeSH secundário: Administração Tópica
Idoso
Idoso de 80 Anos ou mais
Anti-Hipertensivos/efeitos adversos
Anti-Hipertensivos/uso terapêutico
Feminino
Seres Humanos
Soluções Oftálmicas/efeitos adversos
Timolol/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Ophthalmic Solutions); 817W3C6175 (Timolol)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1097/IJG.0000000000000712


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[PMID]:28657160
[Au] Autor:Bell RF; Eccleston C; Kalso EA
[Ad] Endereço:Regional Centre of Excellence in Palliative Care, Haukeland University Hospital, Bergen, Norway.
[Ti] Título:Ketamine as an adjuvant to opioids for cancer pain.
[So] Source:Cochrane Database Syst Rev;6:CD003351, 2017 06 28.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This is an update of a review first published in 2003 and updated in 2012.Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of refractory cancer pain, when opioids alone or in combination with appropriate adjuvant analgesics prove to be ineffective. Ketamine is known to have psychomimetic (including hallucinogenic), urological, and hepatic adverse effects. OBJECTIVES: To determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults. SEARCH METHODS: For this update, we searched MEDLINE (OVID) to December 2016. We searched CENTRAL (CRSO), Embase (OVID) and two clinical trial registries to January 2017. SELECTION CRITERIA: The intervention considered by this review was the addition of ketamine, given by any route of administration, in any dose, to pre-existing opioid treatment given by any route and in any dose, compared with placebo or active control. We included studies with a group size of at least 10 participants who completed the trial. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the search results and performed 'Risk of bias' assessments. We aimed to extract data on patient-reported pain intensity, total opioid consumption over the study period; use of rescue medication; adverse events; measures of patient satisfaction/preference; function; and distress. We also assessed participant withdrawal (dropout) from trial. We assessed the quality of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS: One new study (185 participants) was identified by the updated search and included in the review. We included a total of three studies in this update.Two small studies, both with cross-over design, with 20 and 10 participants respectively, were eligible for inclusion in the original review. One study with 20 participants examined the addition of intrathecal ketamine to intrathecal morphine, compared with intrathecal morphine alone. The second study with 10 participants examined the addition of intravenous ketamine bolus in two different doses to ongoing morphine therapy, compared with placebo. Both of these studies reported reduction in pain intensity and reduction in morphine requirements when ketamine was added to opioid for refractory cancer pain. The new study identified by the updated search had a parallel group design and 185 participants. This placebo-controlled study examined rapid titration of subcutaneous ketamine to high dose (500 mg) in participants who were using different opioids. There were no differences between groups for patient-reported pain intensity.Pooling of the data from the three included trials was not appropriate because of clinical heterogeneity.The study examining intrathecal drug administration reported no adverse events related to ketamine. In the study using intravenous bolus administration, ketamine caused hallucinations in four of 10 participants. In the rapid dose escalation/high-dose subcutaneous ketamine study, there was almost twice the incidence of adverse events in the ketamine group, compared to the placebo group, with the most common adverse events being needle site irritation and cognitive disturbance. Two serious adverse events (bradyarrhythmia and cardiac arrest) thought to be related to ketamine were also reported in this trial.For all three studies there was an unclear risk of bias overall. Using GRADE, we judged the quality of the evidence to be very low due to study limitations and imprecision due to the small number of participants in all comparisons. AUTHORS' CONCLUSIONS: Current evidence is insufficient to assess the benefits and harms of ketamine as an adjuvant to opioids for the relief of refractory cancer pain. The evidence was of very low quality, meaning that it does not provide a reliable indication of the likely effect, and the likelihood that the effect will be substantially different is high. Rapid dose escalation of ketamine to high dose (500 mg) does not appear to have clinical benefit and may be associated with serious adverse events. More randomised controlled trials (RCTs) examining specific low-dose ketamine clinical regimens in current use are needed.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Analgésicos/uso terapêutico
Dor do Câncer/tratamento farmacológico
Ketamina/uso terapêutico
Morfina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgésicos/efeitos adversos
Quimioterapia Adjuvante
Feminino
Alucinações/induzido quimicamente
Seres Humanos
Ketamina/efeitos adversos
Masculino
Meia-Idade
Morfina/efeitos adversos
Cuidados Paliativos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Opioid); 690G0D6V8H (Ketamine); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD003351.pub3


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[PMID]:28622335
[Au] Autor:Soares WB; Dos Santos EB; Bottino CMC; Elkis H
[Ad] Endereço:Old Age Research Group, Department and Institute of Psychiatry, University of São Paulo Medical School (Proter-Ipq-FMUSP), São Paulo, Brazil.
[Ti] Título:Psychotic symptoms in older people without dementia from a Brazilian community-based sample: A seven years' follow-up.
[So] Source:PLoS One;12(6):e0178471, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies of the incidence of psychotic symptoms in elderly people at risk of dementia are scarce. This is a seven year follow up study aiming to determine the incidence of psychotic symptoms and their correlation with other clinical aspects, in particular the rate of development of cognitive impairment. METHODS: Cohort study of a community-based sample of elderly subjects. At study entry in 2004, the sample was composed of 1,125 individuals aged 60 years and older. Of this total, 547 subjects were re-evaluated in 2011 and submitted to the original study protocol. Of these, 199 showed no psychotic symptoms at phase I, while 64 already had psychotic symptoms in 2004. RESULTS: The incidence of at least one psychotic symptom in the 7 year period was 8.0% (Visual/tactile hallucinations: 4.5%; Persecutory delusions: 3.0%; Auditory hallucinations: 2.5%). Development of psychotic symptoms was associated with epilepsy (OR: 7.75 and 15.83), lower MMSE (OR: 0.72) and reported depression (OR: 6.48). A total of 57.8% of individuals with psychotic symptoms developed cognitive impairment after 7 years. Visual/tactile hallucinations were the only psychotic symptom predictive of this impairment, which was related to lower MMSE and greater functional impairment. CONCLUSIONS: The incidence of psychotic symptoms and the conversion rate to cognitive impairment was in the upper range when compared with previous reports. Visual/tactile hallucinations were the most frequent symptoms and were predictive of cognitive impairment over the 7 year period. A significant relationship was found between the incidence of psychotic symptoms and low MMSE scores, as well as clinical comorbities such as epilepsy, reported depression, diabetes and syphilis.
[Mh] Termos MeSH primário: Transtornos Psicóticos/epidemiologia
Transtornos Psicóticos/psicologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Brasil/epidemiologia
Disfunção Cognitiva/epidemiologia
Disfunção Cognitiva/psicologia
Demência/epidemiologia
Demência/psicologia
Depressão/epidemiologia
Depressão/psicologia
Feminino
Seguimentos
Alucinações/epidemiologia
Alucinações/psicologia
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178471



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