Background And Objectives: Limited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice.
Design, Setting, Participants, & Measurements: We examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models.
Results: In the first ESKD year, 72% of elderly adults, 66% of adults and 64% of children had at least one hospitalization. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis. The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and organic disorders/dementias in elderly adults. Prevalence of hospitalizations with psychiatric diagnoses increased over time across groups, primarily from secondary diagnoses. 19% of elderly adults, 25% of adults and 15% of children were hospitalized with a secondary psychiatric diagnosis. Hazards ratios of all-cause death were higher in all dialysis adults hospitalized with either primary (1.29; 1.26 to 1.32) or secondary (1.11; 1.10 to 1.12) psychiatric diagnoses than in those hospitalized without psychiatric diagnoses.
Conclusions: Hospitalizations with psychiatric diagnoses are common in pediatric and adult ESKD patients, and are associated with subsequent higher mortality, compared with hospitalizations without psychiatric diagnoses. The prevalence of hospitalizations with psychiatric diagnoses likely underestimates the burden of mental illness in the population.
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http://dx.doi.org/10.2215/CJN.14191218 | DOI Listing |
Otol Neurotol
February 2025
Department of Radiology, Yale School of Medicine, New Haven, CT.
Background: Vestibular schwannoma (VS) is a common intracranial tumor that affects patients' quality of life. Reliable imaging techniques for tumor volume assessment are essential for guiding management decisions. The study aimed to compare the ABC/2 method to the gold standard planimetry method for volumetric assessment of VS.
View Article and Find Full Text PDFJ ECT
December 2024
From the Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
Autoimmune encephalitis (AE) tends to manifest as a mixture of neuropsychiatric and somatic symptoms, either of which may predominate, and often shows a progressive clinical course sometimes leading to life-threatening conditions. Catatonic and psychotic syndromes, regardless of whether associated with dysautonomia, are common manifestations of AE, especially concerning the anti-NMDAR subtype. Several autoantibodies targeting different neuronal epitopes have been linked to specific clinical manifestations and their detection is embedded in some of the diagnostic criteria for AE.
View Article and Find Full Text PDFJ Addict Med
November 2024
From the, Kaiser Permanente Washington Health Research Institute, Seattle, WA (GTL); Department of Health Systems and Population Health, University of Washington, Seattle, WA (GTL); Division of Research, Kaiser Permanente Northern California, Oakland, CA (FWC, KCY-W, MBD, CIC); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA (KCY-W, CIC); and Regional Offices, Kaiser Permanente Northern California, Oakland CA (DA, CC, AHA, AE).
Objectives: Assessment and counseling are recommended for individuals with prenatal cannabis use. We examined characteristics that predict prenatal substance use assessment and counseling among individuals who screened positive for prenatal cannabis use in prenatal settings.
Methods: Electronic health record data from Kaiser Permanente Northern California's Early Start perinatal substance use screening, assessment, and counseling program was used to identify individuals with ≥1 pregnancies positive for prenatal cannabis use.
Crit Care Med
December 2024
Department of Psychiatry and Human Behavior, Brown University, Alpert Medical School, Providence, RI.
Objectives: Neurocritically ill patients are at high risk for developing delirium, which can worsen the long-term outcomes of this vulnerable population. However, existing delirium assessment tools do not account for neurologic deficits that often interfere with conventional testing and are therefore unreliable in neurocritically ill patients. We aimed to determine the accuracy and predictive validity of the Fluctuating Mental Status Evaluation (FMSE), a novel delirium screening tool developed specifically for neurocritically ill patients.
View Article and Find Full Text PDFAm J Ther
January 2025
Faculty of Medicine, "Transilvania" University, Brasov, Romania; and.
Background: Dementia leads to cognitive decline affecting memory, thinking, and behavior. Current pharmaceutical treatments are symptomatic, with limited efficacy and significant drawbacks. Ginkgo biloba extract (EGb761) is being explored as an adjuvant therapy for dementia because of its potential neuroprotective effects.
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