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Dauriac-Le Masson V, Bornes C, Hadjedj L, Montariol P, Nguyen-Machet S, Hallouche N. Constipation in hospitalized psychiatric patients: An underestimated common phenomenon. Retrospective epidemiological study in an adult psychiatric hospital setting. Encephale 2024:S0013-7006(23)00213-0. [PMID: 38311484 DOI: 10.1016/j.encep.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/02/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE Constipation is more common in patients with mental disorders than in the general population. However, its frequency in hospitalized patients, its association with drugs and how teams become aware of it and take care of it are not fully identified. METHOD The retrospective study included 141 male and 127 female new patients admitted for routine treatment at France's largest psychiatric hospital between November 15 and December 11, 2017. A physician reviewed electronic medical records to diagnose constipation and record variables of interest: socio-demographic factors, diagnosis, drugs prescribed and taken. We calculated an anticholinergic impregnation score (AIS) for each patient by using a validated French scale. Patients were then classified into two groups by state of constipation defined by the physician. Univariate and multivariate analyses were used to study the frequency of constipation, factors associated with it and its management. RESULTS The prevalence of constipation was 38% (95% CI 32-44). Associated factors were taking antipsychotics and the burden of anticholinergic treatment. On multiple regression analysis, the only remaining factor was anticholinergic treatment: AIS≥5 was associated with constipation (odds ratio 1.80 [95% CI 1.07-3.14], P=0.027). Only 44.0% of patients were prescribed a preventive laxative, systematically in half of the cases. Above all, only 11.2% were administered this laxative (i.e., 25% of that prescribed). Digestive transit was poorly recorded in the table of constants (34.7%). We found one case of sub-occlusion as a severe case. CONCLUSION Constipation is common in psychiatric inpatients. The more the patient is prescribed drugs with a pronounced anticholinergic effect, the greater the risk. Alongside the preventive measures common to all psychiatric patients which must be promoted (concerning diet, physical activity, etc.), polymedication with this type of anticholinergic must be better monitored to prevent complications: prescription and administration of a preventive laxative, monitoring transit in the table of constants. Thus, a better knowledge of the subject and specific training are essential.
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Affiliation(s)
- Valerie Dauriac-Le Masson
- Medical Information Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France.
| | - Cedric Bornes
- Physical Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Lisa Hadjedj
- Physical Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Philippe Montariol
- Physical Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Sylvie Nguyen-Machet
- Physical Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Nabil Hallouche
- Physical Departement, GHU-Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
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Hu W, Cheng B, Su L, Lv J, Zhu J. Uric acid is negatively associated with cognition in the first- episode of schizophrenia. Encephale 2024; 50:54-58. [PMID: 36907671 DOI: 10.1016/j.encep.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND We explored the relationship between levels of serum uric acid (UA) and cognitive impairment in people with schizophrenia to order to better protect and improve cognitive function in such patients. METHODS A uricase method evaluated serum UA levels in 82 individuals with first-episode schizophrenia and in 39 healthy controls. The Brief Psychiatric Rating Scale (BPRS) and the event-related potential P300 were used to assess the patient's psychiatric symptoms and cognitive functioning. The link between serum UA levels, BPRS scores, and P300 was investigated. RESULTS Prior to treatment, serum UA levels and latency N3 in the study group were significantly higher than in the control group, whereas the amplitude P3 was considerably lower. After therapy, the study group's BPRS scores, serum UA levels, latency N3, and amplitude P3 were lower than before treatment. According to correlation analysis, serum UA levels in the pre-treatment study group significantly positively correlated with BPRS score and latency N3 but not amplitude P3. After therapy, serum UA levels were no longer substantially related to the BPRS score or amplitude P3 but strongly and positively correlated with latency N3. CONCLUSIONS First-episode schizophrenia patients have higher serum UA levels than the general population which partly reflects poor cognitive performance. Improving patients' cognitive function may be facilitated by lowering serum UA levels.
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Affiliation(s)
- W Hu
- Department of Psychiatry, The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; Key Laboratory of Brain Diseases Bioinformation (Xuzhou Medical University), Xuzhou, Jiangsu, China; The Key Lab of Psychiatry, Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - B Cheng
- Department of Psychiatry, The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; Key Laboratory of Brain Diseases Bioinformation (Xuzhou Medical University), Xuzhou, Jiangsu, China; The Key Lab of Psychiatry, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - L Su
- Yangzhou Sida Health Consulting Co., LTD, Yangzhou, Jiangsu, China
| | - J Lv
- Department of Psychiatry, The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - J Zhu
- Department of Psychiatry, The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; Key Laboratory of Brain Diseases Bioinformation (Xuzhou Medical University), Xuzhou, Jiangsu, China; The Key Lab of Psychiatry, Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Ait Idar A, Madani M, Berghalout M, Adali I, Manoudi F. [Stigma in psychiatry]. Encephale 2021; 48:288-293. [PMID: 34148648 DOI: 10.1016/j.encep.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
Mental illness affects 48.9 % of the Moroccan population. Despite this significant figure, mental illness remains unrecognized. The patients suffering from mental disorders are therefore subject to stigma and social rejection. A descriptive study was conducted at the consultation service of the psychiatric Ibn Nafiss hospital of the CHU of Marrakech. We chose as a sample 100 stabilized patients, followed on an outpatient basis. The study included the three mental disorders: depressive disorder, bipolar disorder, and schizophrenia. The number of patients in each group had been fixed beforehand; and we tried to get a fairly even distribution between the two genders. The questionnaire had three main axes: (1) Sociodemographic data of the patient. (2) Knowledge of the disease. (3) Evaluation of the experience of stigma. The results of our sample were as follows: For both sexes the age extremes were 19 to 68 years with an average of 38.5 with a clear predominance of women. For the entire population, most patients were single with a percentage of 60 %. Two thirds of the patients, i.e. 59 %, did not exceed primary school. For personal medical history, endocrine pathologies were the most prevalent, at 18 % of cases, while depression was the most common family psychiatric history in our study. We noticed that our population suffered more discrimination and disclosure from those around them regardless of family, social and professional with less appreciation of the positive aspects.
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Affiliation(s)
- A Ait Idar
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc.
| | - M Madani
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - M Berghalout
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - I Adali
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - F Manoudi
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
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Fond G, Pauly V, Orleans V, Antonini F, Fabre C, Sanz M, Klay S, Jimeno MT, Leone M, Lancon C, Auquier P, Boyer L. Increased in-hospital mortality from COVID-19 in patients with schizophrenia. Encephale 2020; 47:89-95. [PMID: 32933762 PMCID: PMC7392112 DOI: 10.1016/j.encep.2020.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/25/2020] [Indexed: 12/23/2022]
Abstract
Background There is limited information describing the presenting characteristics and outcomes of patients with schizophrenia (SCZ) requiring hospitalization for coronavirus disease 2019 (COVID-19). Aims We aimed to compare the clinical characteristics and outcomes of COVID-19 SCZ patients with those of non-SCZ patients. Method This was a case-control study of COVID-19 patients admitted to 4 AP–HM/AMU acute care hospitals in Marseille, southern France. COVID-19 infection was confirmed by a positive result on polymerase chain reaction testing of a nasopharyngeal sample and/or on chest computed scan among patients requiring hospital admission. The primary outcome was in-hospital mortality. The secondary outcome was intensive care unit (ICU) admission. Results A total of 1092 patients were included. The overall in-hospital mortality rate was 9.0%. The SCZ patients had an increased mortality compared to the non-SCZ patients (26.7% vs. 8.7%, P = 0.039), which was confirmed by the multivariable analysis after adjustment for age, sex, smoking status, obesity and comorbidity (adjusted odds ratio 4.36 [95% CI: 1.09–17.44]; P = 0.038). In contrast, the SCZ patients were not more frequently admitted to the ICU than the non-SCZ patients. Importantly, the SCZ patients were mostly institutionalized (63.6%, 100% of those who died), and they were more likely to have cancers and respiratory comorbidities. Conclusions This study suggests that SCZ is not overrepresented among COVID-19 hospitalized patients, but SCZ is associated with excess COVID-19 mortality, confirming the existence of health disparities described in other somatic diseases.
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Affiliation(s)
- G Fond
- Aix-Marseille Université, Health Service Research and Quality of Life Center (CEReSS), 27, boulevard Jean-Moulin, 13005 Marseille, France; Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France.
| | - V Pauly
- Aix-Marseille Université, Health Service Research and Quality of Life Center (CEReSS), 27, boulevard Jean-Moulin, 13005 Marseille, France; Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - V Orleans
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - F Antonini
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France; Aix-Marseille Université, Assistance publique-Hôpitaux Universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, Marseille, France
| | - C Fabre
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - M Sanz
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - S Klay
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - M-T Jimeno
- Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - M Leone
- Aix-Marseille Université, Assistance publique-Hôpitaux Universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, Marseille, France
| | - C Lancon
- Aix-Marseille Université, Health Service Research and Quality of Life Center (CEReSS), 27, boulevard Jean-Moulin, 13005 Marseille, France; Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - P Auquier
- Aix-Marseille Université, Health Service Research and Quality of Life Center (CEReSS), 27, boulevard Jean-Moulin, 13005 Marseille, France; Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - L Boyer
- Aix-Marseille Université, Health Service Research and Quality of Life Center (CEReSS), 27, boulevard Jean-Moulin, 13005 Marseille, France; Department of Medical Information, Assistance publique-Hôpitaux de Marseille, Marseille, France
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