Open Access Case Study

Bilateral Pedal Oedema Associated with Intramuscular Haloperidol – A Rare Observation

Okwudili Obayi, Ndidi Tagbo

International Neuropsychiatric Disease Journal, Page 1-5
DOI: 10.9734/INDJ/2018/41874

Background: Cases of peripheral oedema associated with antipsychotic medication have been reported, especially with the atypical types of antipsychotics. The exact cause is not known.

Aim: Our purpose is to bring to the medical world that though peripheral oedema is more reported with atypical antipsychotics than the typical counterparts, rarely it occurs following typical antipsychotic medication such as haloperidol.

Presentation of Case: We report a case of pedal oedema following intramuscular injection of haloperidol to a 35-year old female doctor diagnosed with delusional disorder. Withdrawal of the drug led to immediate resolution of oedema but subsequent re-administration of the drug provoked a re-occurrence of oedema which again resolved quickly on the suspension of the haloperidol.

Discussion: Every antipsychotic, especially the second-generation antipsychotics, has the potential to cause peripheral oedema. The cause of the oedema is not very certain but its occurrence can cause embarrassment to patients and family leading to fear, unnecessary investigations, and poor medication adherence.

Conclusion: Clinicians are reminded that while peripheral oedema is known to be associated more with second-generation antipsychotics than the first generation antipsychotics like haloperidol, the latter occasionally cause a similar side-effect. Hence, routine enquiries of the side effect should be in all patients not only on those taking atypical antipsychotics.

Open Access Original Research Article

Subjective Quality of Life and Psychiatric Morbidity among School Teachers in Abeokuta, South-West Nigeria

Ighoroje Maroh, Amosu Sunday Mauton, Ogunwale Adegboyega, Abayomi Olukayode

International Neuropsychiatric Disease Journal, Page 1-12
DOI: 10.9734/INDJ/2018/41477

Aims: To measure subjective Quality of Life and its relationship to psychiatric morbidity and socio-demographic variables in secondary school teachers in Abeokuta, Ogun state, Nigeria.

Study Design: Cross-sectional.

Place and Duration of Study: 10 selected public secondary schools in Abeokuta between November 2014 and March 2015.

Methodology: The study was carried out among 341 school teachers in two stages. The 1st stage involved the administration of the World Health Organization Quality of Life (WHOQOL-BREF) and the 12-item General Health Questionnaire (GHQ-12), to all teachers to measure their subjective Quality of Life and to screen for a probable psychiatric disorder. In the second stage, subjects who were GHQ-positive and a proportion of those who were GHQ-negative were assessed using the Mini International Neuropsychiatric Interview to diagnose a depressive disorder, generalized anxiety disorder, somatization disorder and pain disorder.

Results: The mean scores of the domains of Quality of Life were; physical (70.7±12.9), environment (61.7±13.4), social (72.0±12.9) and psychological (72.2±11.2). The estimated true prevalence of psychiatric morbidity was 21.9%. The prevalence rates for depressive disorder, somatization disorder, generalized anxiety disorder and pain disorder were 11.1%, 5.6%, 5.9% and 12.9% respectively. The prevalence of having more than 1 of the 4 definitive disorders was 10.0%. The univariate analysis showed that age (F = 4.15, p = .007), length of years of service (F = 3.69, p = .006) and salary grade level (F = 3.62, p = .03) had significant association with the environment domain of QOL. Marital status (F = 3.79, p = .02) showed significant association with the social domain of QOL. While the teacher’s school category (F = 3.31, p = .03) was significantly associated with the psychological domain of QOL. The multivariate linear regression analysis, found that subjects who had spent the longest number of years in the teaching service had the best QOL on the environment domain (ß = 11.177, t = 2.365, p = .019), the married teachers had the best QOL on the social domain (ß = 10.555, t = 2.494, p = .013) while teachers in junior secondary schools had the best QOL in the psychological domain (ß = 4.205, t = 2.143, p =.033).  The study found significant associations between probable psychiatric morbidity and all the domains of Subjective Quality of Life.

Conclusions: The study showed that the subjective QOL among the sample of school teachers was strongly influenced by their length of years of service, marital status and teacher’s school categories. It also showed that there was a high prevalence of probable and definitive psychiatric morbidity among secondary school teachers and this correlated negatively to Subjective QOL. There is a need to focus on policies and practices that will improve the QOL of school teachers, and in the development of preventive strategies against mental illness and in providing treatment for persons with psychiatric disorders in the workplace.


Open Access Original Research Article

Effect of Clinical Traineeship on the Emotional Dimensions (Valence and Arousal) among Nurses Student

Lahcen Bandadi, Nadia Chamkal, Ahmed O. T. Ahami

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2018/41406

Aim: This study examines the effect of clinical traineeship on the emotional dimensions (valence and arousal) among nurses student.

Methods: Two groups were recruited. The first group consisting of the students who did not start the clinical traineeship. The second group composed of the students who finished their clinical traineeship. The images of the set 3 and the 11, which were taken from the International Affective Picture System (IAPS) constitute the emotional stimuli. The measurement of the emotional dimensions was carried out by the Self-Assessment Manikin (SAM). 

Results: The study shows the negative correlation between valence and arousal among the two groups. Concerning neutral images and positive images, no significant difference was observed between the two groups in terms of the valence. The negative images were evaluated unpleasant by both groups with a valence significant difference.

Conclusion: The present study has a significant implication in nursing education. Indeed, the results showed that despite the clinical traineeship period, all negative images were assessed unpleasant. Hence, the need to reflect on innovative approaches to reduce the unpleasing responses. In this perspective, programming academic training sessions to familiarize students with negative situations and help them to manage their emotions could influence emotional responses in a clinical setting.


Open Access Review Article

Overview of Occupational Diseases Caused by Mental Stress Most Frequently Observed in Brazilian Teachers: A Review

Karen Oliveira Gomes, Vitor Hugo Auzier Lima, Daniele Salgado de Sousa, Rebeson Moraes da Silva, Ysadora Maria Rodrigues Pinto, Dhiego Lima Costa, Eveli Freire de Vasconcelos

International Neuropsychiatric Disease Journal, Page 1-11
DOI: 10.9734/INDJ/2018/42056

The magisterium has always been considered by law as a painful activity, which causes physical or psychological wear and tear on the organism, due to the repetition of psychological movements, pressures and tensions that affect the worker emotionally. Decree 53.831 / 64 framed the role of teacher as painful. This article aims to discuss the main occupational diseases verified in teachers in Brazil and as specific objectives to describe how the workload of teachers can contribute to the development of occupational diseases and to verify in the literature, prevention and safety measures that have been used and published. The results show that occupational diseases in teachers are common in the teaching environment, where the mental and emotional ones are among the majority for this class, later the diseases of the locomotive apparatus, which demonstrate that working long hours without valorization or adequate remuneration can generate health damages.


Open Access Review Article

Psychotropic Medication-induced Weight Gain or Loss Looked through the Lens of Age and Psychiatric Diagnoses: A Narrative Review

Naseem Akhtar Qureshi, Dalal Salem Al-Dossari, Sara Osama Salem, Osama A. Alkhamees, Saud M. Alsanad

International Neuropsychiatric Disease Journal, Page 1-30
DOI: 10.9734/INDJ/2018/42585

Background: There is a myriad of risk factors associated with overweight and obesity in the psychiatric population.

Objective: The review aimed at looking at the psychotropic medications induced weight gain or loss through the lens of age categories and psychiatric diagnoses.

Methods: Electronic searches of three databases (from 2000 to 2018) using Boolean operators and keywords retrieved thousands of peer-reviewed articles published in scientific journals, and based on exclusion and inclusion criteria 155 pertinent articles were retained for this review.

Results: No age is immune to weight gain provided patients are treated either with standalone antipsychotic medications, antidepressants, mood stabilizers or their combinations. These medications are mostly used in adult patients with schizophrenia, mood disorders, other related psychoses and anxiety disorders resulting in more significant weight gain. Children and adolescents with similar mental disorders are also prone to develop weight gain when exposed to similar psychotropic drugs on a longterm basis. Unlike those two age categories, elderly patients with dementia or carry-on psychoses (residual psychosis) treated with psychotropic similar medicines tend to have minimal weight gain. Children and adult patients with attention deficit hyperactivity disorder exposed to psychostimulants, by and large, develop a significant reduction in weight. Similarly, elderly patients with dementias managed with acetylcholinesterase inhibitors develop a decrease in weight.

Conclusion: Although results of several studies concerning psychotropic drugs use in special age categories and several diagnoses are inconsistent across the board, more studies with rigorous methodologies are needed to further clarify the contributions by age and psychiatric diagnoses to weight gain in a psychiatric population exposed to psychotropic medications.