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Item does not contain fulltext BACKGROUND: Since the end of 2019, COVID-19 and its consequences are present everywhere. Dutch professionals are concerned about the mental consequences, and in particular that during and after hospitalization little attention is paid to psychological problems. AIM: To monitor the short-term course and severity of (neuro)psychiatric symptoms after hospitalization for COVID-19. To make a recommendation regarding whether or not to follow-up these patients psychiatrically to optimize care. METHOD: In an observational cohort-study screening questions and additional questionnaires were used during two follow-up contacts to monitor cognition (MoCA), affective symptoms (HADS and IES) and overall functioning. RESULTS: More than half of the 29 included patients showed (neuro)psychiatric problems at both follow-up moments. Two weeks after discharge, we mainly saw symptoms related to anxiety and depression. Except for complaints related to the traumatic experience of the COVID-19, these seemed to have a favorable natural course. A negative time effect was seen for complaints consistent with post-traumatic stress disorder. Two months after discharge limitations in cognition and overall functioning appeared to be the main complaints after COVID-19. CONCLUSION: (Neuro)psychiatric symptoms after a COVID-19 are common. The natural course for affective complaints is more favorable than for cognitive functions. Specialist follow-up of patients with post-COVID psychological problems is recommended.

Item does not contain fulltext BACKGROUND: Although anxiety disorders are more prevalent during the perinatal period, little attention has been given so far to the influence that pregnancy and the post-partum period can have on anxiety disorders. AIM: To review the literature concerning the prevalence, presentation and treatment of anxiety disorders during pregnancy and the post-partum period and to identify the risk factors involved. METHOD: We reviewed the literature in order to find articles concerning the influence of the post-partum period on various types of anxiety disorders. RESULTS: Having selected the most relevant articles, we discuss the findings in relation to specific types of anxiety disorder. CONCLUSION: Women are more vulnerable to anxiety disorders during the perinatal period. Because anxiety disorders can have a significant impact on the mother and her foetus/infant it is important that anxiety disorders are identified and treated at the earliest opportunity. 9 p.

Contains fulltext : 119310.pdf (Publisher’s version ) (Open Access) BACKGROUND: Atrial fibrillation (AF) is associated with increased mortality and morbidity, including risk for cerebral macro- and microinfarctions and cognitive decline, even in the presence of adequate oral anticoagulation. AF is strongly related to increased inflammatory activity whereby anti-inflammatory agents can reduce the risk of new or recurrent AF. However, it is not known whether anti-inflammatory therapy can also modify the deterioration of neurocognitive function in older patients with AF. In the present study, older patients with AF were treated with intensive lipid-lowering therapy with atorvastatin 40 mg and ezetimibe 10 mg, or placebo. We examined the relationship between neurocognitive functions and inflammatory burden. FINDINGS: Analysis of inflammatory markers revealed significant reductions in high sensitivity C-reactive protein (hs-CRP), fibroblast growth factor (FGF), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-1 receptor antagonist (IL-1RA), interleukin (IL)-9, IL-13 and IL-17, and interferon-gamma (IFNgamma) in the treatment group compared to placebo. Reduction in plasma concentration of IL-1RA, IL-2, IL-9 and IL-12, and macrophage inflammatory protein-1beta (MIP-1beta) correlated significantly with improvement in the neurocognitive functions memory and speed. Loss of volume in amygdala and hippocampus, as determined by magnetic resonance imaging (MRI), was reduced in the treatment arm, statistically significant for left amygdala. CONCLUSIONS: Anti-inflammatory therapy through intensive lipid-lowering treatment with atorvastatin 40 mg and ezetimibe 10 mg can modify the deterioration of neurocognitive function, and the loss of volume in certain cerebral areas in older patients with AF. TRIAL REGISTRATION CLINICAL TRIALSGOV: NCT00449410.

Contains fulltext : 79730.pdf (Publisher’s version ) (Closed access) Although a clear definition of pseudologia fantastica cannot be found in the literature, there is consensus that this condition differs quantitatively and qualitatively from 'normal lying'. We discuss recognition of pseudologia fantastica based on 2 patients who presented with suicidal ideations at the casualty department following a traumatic event. Early recognition is important in order to break the pattern of lying, to restrict the use of medical resources and, finally, to act in accordance with the general principle of 'primum-non-nocere'. Although a psychiatric diagnostic workup might be worthwhile, it remains difficult to engage these patients for psychiatric treatment.

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Contains fulltext : 209730.pdf (Publisher’s version ) (Open Access) Radboud University, 22 november 2019 Promotor : Prins, J.B. Co-promotores : Roeleveld, N., Gelder, M.M.H.J. van, Pop-Purceleanu, M.