Notes

Distinct Scoring Methods of FDG PET/CT throughout Huge Mobile or portable Arteritis: Requirement of Standardization.
Clozapine, an antipsychotic medication used to treat treatment-refractory schizophrenia, has been associated with various dangerous side effects, including myocarditis. However, there have been few published cases reporting on patients with clozapine-induced myocarditis confirmed by cardiac magnetic resonance imaging or the management, treatment, and follow-up of these patients.

This report describes 2 cases of patients with treatment-refractory schizophrenia evidencing transient clozapine-induced myocarditis. Detailed information including laboratory values, imaging results, and clinical notes were gathered.

The 2 cases demonstrated differing manifestations of clozapine-induced myocarditis. Both cases showed that such myocarditis can be transient and can be treated clinically with close observation without discontinuation of clozapine.

These cases show that clozapine-induced myocarditis is transient at times and can self-resolve without discontinuation of clozapine. These observations may suggest a change in clinical practice so that, with close observation, we can avoid risking psychiatric decompensation in select patients with a history of treatment-resistant schizophrenia.
These cases show that clozapine-induced myocarditis is transient at times and can self-resolve without discontinuation of clozapine. These observations may suggest a change in clinical practice so that, with close observation, we can avoid risking psychiatric decompensation in select patients with a history of treatment-resistant schizophrenia.Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe cutaneous drug hypersensitivity reaction. Delays in making a diagnosis of DRESS syndrome and lack of timely treatment may result in morbidity and mortality. However, the presentation can be misinterpreted as other pathologies because of a broad spectrum of clinical presentations, delayed reactions, and prolonged course. Despite the discontinuation of the medication that is the culprit, relapses of drug reactions frequently occur weeks to months later. Several drugs that are associated with DRESS syndrome are prescribed as psychotropic medications. This report describes the case of a patient with DRESS syndrome who was evaluated with the RegiSCAR scoring system as a "definite case," which was possibly induced by carbamazepine prescribed to treat bipolar I disorder. The young female patient was successfully treated with steroid medication after carbamazepine was discontinued. She was prescribed aripiprazole for mood stabilization without a subsequent recurrence of DRESS syndrome. We recommend that, in cases such as described here, clinicians take DRESS syndrome into consideration and provide proper timely management, particularly for patients receiving psychotropic drugs. A brief review of the literature concerning DRESS syndrome associated with psychotropic drugs and its pathogenesis are outlined and discussed.Sleep problems affect the majority of patients with mental disorders and are very clinically relevant. However, they are often not assessed and treated appropriately and, to date, there is no established screening routine for sleep disturbances in this specific patient group. For patients with Parkinson disease, the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-Sleep) questionnaire is widely used. This questionnaire has excellent psychometric properties. It consists of 2 scales for assessing nighttime sleep problems (NS) and daytime sleepiness (DS). As the items in the scales are not disease-specific, the goal of this study was to validate the SCOPA-Sleep for use in patients with mental disorders. A total of 370 German patients with mental disorders completed the SCOPA-Sleep as well as a multitude of other instruments for assessment of validity [eg, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS)]. For validity estimation, 627 healthy subjects were also included in this study. Internal consistency was good with coefficients of 0.806 and 0.772 for the SCOPA-NS and the SCOPA-DS. Factor analysis revealed 2 factors which could each be assigned to one of the subscales. Convergent validity was high with correlations of 0.672 between the SCOPA-NS and the PSQI and 0.644 between the SCOPA-DS and the ESS. The German version of the SCOPA-Sleep showed good diagnostic accuracy, resulting in an area under the receiver operating curve of 0.959 for the SCOPA-NS and 0.728 for the SCOPA-DS. BIRB796 For patients with mental disorders, the SCOPA-Sleep proved to be an economical, reliable, and valid instrument for assessing NS and DS which is well accepted by patients. It can be recommended for routine assessment of both NS and DS.
Schizophrenia is a prevalent and serious disorder. Video games have shown potential as an aid in health care for people who suffer from schizophrenia. Although video games may contribute benefit in the treatment of schizophrenia, reviews on this topic are scarce. In this article, we systematically review the evidence concerning video game-based therapeutic interventions for people diagnosed with schizophrenia.

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in the PROSPERO database. We searched 4 databases-PubMed, Web of Science, EMBASE, and clinicaltrials.gov-to identify original studies exploring video game-based therapeutic interventions for people with schizophrenia.

After initial screening, full-text review, and study selection, 11 articles were included in the review. Most studies used video consoles as the platform, with a minority using a personal computer. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas.

Cognitive training could be one of the main mechanisms underlying the usefulness and effectiveness of video game-based therapeutic interventions. Software optimization and greater collaboration between developers and health care professionals are some of the priorities for future research in this area.
Cognitive training could be one of the main mechanisms underlying the usefulness and effectiveness of video game-based therapeutic interventions. Software optimization and greater collaboration between developers and health care professionals are some of the priorities for future research in this area.This column explores mindfulness as one part of Buddhist teaching and practice that has attracted attention in the treatment of mental and substance use disorders. Cognitive neuroscientific correlates of mindfulness are presented. Mindfulness is offered as a potentially valuable technique that can not only help patients in individual psychotherapies endure the painful emotions that are part of psychotherapy sessions and of managing life between sessions but also help patients and clinicians across modalities move beyond adherence to particular techniques that focus primarily on symptom reduction, to better meet patient needs and improve treatment outcomes. This column explores elements of a mindfulness coping skills group used in a residential treatment setting that emphasizes intensive individual psychotherapy in a psychodynamic system of care.This column presents a real-life case of a patient who developed severe and prolonged Parkinsonism secondary to the loading dose strategy recommended in the prescribing information (package insert) for paliperidone palmitate (Invega Sustenna). This column presents 2 major points. First, the case illustrates what the practitioner must do before following the general guidelines for a loading dose approach to the administration of paliperidone palmitate as outlined in the package insert to decrease the likelihood of a serious and potentially fatal consequence. Second, the case illustrates how therapeutic drug monitoring can be useful in assessing and managing patients who develop an untoward reaction. In this case, therapeutic drug monitoring was done using serum prolactin levels because the available laboratory could not measure the level of the drug itself in plasma, and the case highlights some limitations to keep in mind when using plasma prolactin levels to do such monitoring. To put this case in context, a review of the literature was conducted which identified 3 related cases. The author also refers readers to previous articles on therapeutic drug monitoring and pharmacokinetic considerations that arise when using depot (long-acting injectable) antipsychotics.The coronavirus disease 2019 (COVID-19) pandemic has highlighted links among economic stability, health outcomes, and migration. The facets of financial worry and their associated psychological burden have been understudied among the immigrant population. The goal of this study was to determine the specific facets of financial worry and associated psychological burden in immigrants. This cross-sectional study, which used data from the 2013 to 2018 National Health Interview Survey (NHIS), examined patient-reported measures of worry regarding financial strain. The NHIS is a household survey of noninstitutionalized, nonmilitary adults in the United States. Multivariable ordinal logistic regressions were used to define adjusted odds ratios (AORs) for financial worry and psychological distress, adjusting for various sociodemographic variables. Among 131,669 US-born and 26,155 non-US-born participants who responded to all 6 questions on the 6-item Kessler Psychological Distress Scale (K6), the overall prevalence ofith increased financial worry relative to US-born individuals with a similar level of psychological distress. Further research is needed to evaluate the role physicians can play in mitigating psychological distress in patients with increased financial worry.
Antipsychotics are frequently used for managing both acute and chronic neuropsychiatric disorders. While antipsychotics are known to be associated with increased mortality due to cardiac arrhythmia, there is a lack of consensus on the timing and frequency of electrocardiogram (ECG) monitoring.  The goal of this study was to examine current ECG monitoring practices for adults receiving antipsychotics, specifically during hospital admission.

The study involved a multisite retrospective chart review of adults admitted across 8 hospitals between January 2010 and December 2015 who received antipsychotics during hospitalization. The primary outcome was the presence of an ECG after receiving an antipsychotic.

During the study period, there were 26,353 hospitalizations during which adults received antipsychotic medication; the average age of the patients was 61.4 years, 50.1% were female, and 64.8% were white. The average comorbidity score was 1.4 with a median length of stay of 8.3 days. Of the 26,353 patients, ECG monitoring is not routinely practiced for hospitalized patients receiving antipsychotics. Further studies are needed to identify patients who would most benefit from ECG monitoring in the acute care setting.
This study demonstrated that, in a large health system, ECG monitoring is not routinely practiced for hospitalized patients receiving antipsychotics. Further studies are needed to identify patients who would most benefit from ECG monitoring in the acute care setting.
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