Open Access Case Study

Potential of Stimulants to Augment Rehabilitation in the Acute Stroke Setting: Preliminary Support

Jenny M. Ngo, Michael Korsmo, Karen C. Albright, Mansi M. Jhaveri, Ramy E. l. Khoury, Sheryl Martin-Schild

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2016/20621

Aims: The objective of these case studies is to explore the possibility of using neurostimulants during the acute stage of stroke to facilitate effective rehabilitation of patients with severe strokes.

Presentation of Cases: In Case 1, methylphenidate was administered to a 63 year old woman with a left anterior cerebral artery infarct who was discharged to inpatient rehabilitation, rather than original recommendation of skilled nursing facility, prior to returning home. In Case 2, modafinil was administered to a 56 year old man with a left middle cerebral artery infarct who was discharged to inpatient rehabilitation prior to returning home. In Case 3, modafinil was administered to a 66 year old man with a left middle cerebral arery infarct who was discharged to inpatient rehabilitation. In Case 4, modafinil and methylphenidate were co-administered to a patient with a hypertensive intracerebral hemorrhage who experienced an adverse event possibly related to neurostimulants resulting in discontinuation. She was discharged to inpatient rehabilitation and subsequently to a skilled nursing facility.

Discussion: All cases initially presented to therapists with barriers to inpatient rehabilitation. Following neurostimulant administration, therapies recommended discharge to inpatient rehabilitation facility due to improvement in initial barriers. Three out of the four cases tolerated the neurostimulant well, while one case required discontinuation due to an adverse event.

Conclusion: Patients with severe strokes are less likely to meet criteria for inpatient rehabilitation. Depressed consciousness and limited attention are major barriers for which neurostimulants may be of benefit in the acute post-stroke setting. Administration of neurostimulants may improve participation in therapy, thus increasing qualification for inpatient rehabilitation, and ultimately accelerate recovery.  Safety data in this population during the acute stage of stroke are lacking.

 

Open Access Short Research Article

Transmission of the Parent-adolescent Attachment Bond to the Next Generation: A Case-control Study

Michela Gatta, Marta Sisti, Lorenza Svanellini, Laura Sudati, Martina Chioccarello, Ilaria Comis, Andrea Spoto

International Neuropsychiatric Disease Journal, Page 1-7
DOI: 10.9734/INDJ/2016/18058

Background and Goals: Many studies have examined how types of parent-child attachment bond are transmitted from one generation to the next, and how this may be associated with the occurrence of psychological disorders and dysfunctional relationships. In this study, we proposed to investigate the relationship, if any, between dysfunctional attachment bond and psychopathology, and to see whether dysfunctional parent-adolescent attachment bonds are handed down to the next generation.

Methods: The clinical group (cases) consisted of 44 adolescents with psychological disorders (21 males and 23 females) with a mean age of 15.3 years ± SD 1.549, attending our Service for Children, Adolescents and Families, ULSS 16 (Padua); the control group consisted of 44 adolescents, matched pairwise for age and gender, recruited at secondary schools in Vicenza. We used the Parental Bonding Instrument (PBI) to measure the adolescents’ perception of how their parents behaved towards them.

Results: A statistically significant difference was found between the two groups of adolescents regarding their attachment bond with their fathers and mothers: the clinical group had a higher percentage of dysfunctional attachment bonds with both their fathers (37% vs 10%) and their mothers (45% vs 13%). As for the transmission of dysfunctional attachment bonds to the next generation, we found that adolescents with dysfunctional relationships with their mothers had mothers whose attachment bond with their own parents had been dysfunctional too. The opposite was true in the control group, who showed 'positive' changes in relation to both the grandparent-father-adolescent triad, and the grandparent-mother-adolescent triad.

 

Open Access Original Research Article

Social Support after Stroke: Influence of Source of Support on Stroke Survivors’ Health-Related Quality of Life

Grace O. Vincent-Onabajo, Maryam M. Muhammad, Muhammad Usman Ali, Mamman Ali Masta, Habib Nasiru Aliyu

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2016/20240

Introduction: Social support has often been identified as a key determinant of important stroke outcomes such as health-related quality of life (HRQoL). Information on the influence of the specific sources of social support on poststroke HRQoL is however scarce. This study examined the influence of social support received from family, friends and significant others on stroke survivors’ HRQoL.

Methods: One hundred consenting stroke survivors were purposively recruited from two tertiary hospitals in Northern Nigeria into this cross-sectional study. Data on the stroke survivors’ socio-demographic and stroke-related attributes were obtained. Perceived support from friends, family and significant others was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS) while HRQoL was assessed using the Stroke-Specific Quality of Life-12 (SS-QoL-12) measure. Hierarchical regression analysis was used to identify the independent influence of the different sources of social support on HRQoL.

Results: Mean age of the stroke survivors was 51.39±13.52 years. None of the specific sources of social support had significant independent influence on overall and domain-specific HRQoL. Rather, overall social support, which represents the aggregate of support from each social support source, namely friends, family and significant others, had significant and independent positive influence on psychosocial (β = 0.74, P = 0.02) and overall (β = 0.56, P = 0.04) HRQoL.   

Conclusion: The outcome of this study suggests that social support from a combination of sources (overall social support), rather than support from any particular source, significantly and positively influenced the HRQoL of stroke survivors.

 

Open Access Original Research Article

Socio-demographic and Clinical Predictors of Co-morbid Psychiatric Disorders in Patients with Epilepsy

Mohammad Abu-Hegazy, Ibrahim Elmenshawi, Hanan Elsayed, Eman Elsheshtawy, Ramadan Abd Albr Hussein

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2016/20542

Background: Association between epilepsy and psychiatry has a long history that required a comprehensive care of patients with epilepsy. This would include special attention to the psychological and social consequences besides the control of seizures.

Aim: This study aimed at identifying the frequency of psychiatric disorders and its effects on the quality of life in patients with epilepsy as well as studying different variables crucial in the development of concomitant psychopathology.  

Materials and Methods: This cross-sectional study was carried on 140 patients with epilepsy, 100 healthy controls. All subjects were subjected to assessment using SCID1, SCID11, Quality Of Life in Epilepsy, EEG monitoring.

Results: 72 patients (51.4%) had psychiatric illness, significantly lower quality of life (t= 2.087, p 0.041). predictors for psychiatric disturbances were young age of epilepsy onset (Beta=.741 for depression, .368 for anxiety disorders), long duration of epilepsy (Beta=.263, Beta=.400 for anxiety, personality disorders), frequency, severity of epilepsy (Beta=1.076, .410, .975 for depressive, anxiety, personality disorders respectively). Temporal lobe epilepsy predicted personality disorders (Beta= -.471) while extra temporal epilepsy was associated with depression and anxiety disorders (Beta= .827, Beta=.900 respectively).

Conclusions: This work raises the importance of proper history taking and mental state examination along with identification of high-risk groups who are more prone to psychiatric comorbidity. 

Open Access Original Research Article

Brain-Derived Neurotrophic Factor, Copper, Zinc and High Density Lipoprotein (HDL) in Patients with Dementia

Petr Melnikov, Kleber F. Meneghel Vargas, Ana R. Coimbra, Lourdes Zélia Zanoni, Valter A. Nascimento

International Neuropsychiatric Disease Journal, Page 1-5
DOI: 10.9734/INDJ/2016/20121

The levels of BDNF, copper, zinc and common blood tests of two different groups of patients were considered: those with dementia syndrome and healthy older people. It would be premature to conclude that these indicators, with the exception of high density lipoprotein (HDL), are directly associated with clinical manifestations of this disorder. The HDL levels were significantly lower in dementia patients, compared to healthy control group, so it is possible to suggest that HDL can perform a protective function.