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Sample records for neuroleptic medicated mentally

  1. The role of the community mental health nurse in the administration of depot neuroleptic medication: 'not just the needle nurse!'.

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    Muir-Cochrane, E C

    1998-12-01

    An ethnographic study explored the nature of community mental health nurses' involvement with clients during appointments for the administration of depot neuroleptic medication. Little has been written about this aspect of community mental health nursing practice. Findings illustrate how community mental health nurses attempt to engage clients in meaningful interactions when they attend appointments for their injections. Promoting an atmosphere of normalcy and minimising the distress of having neuroleptic medication by injection were key elements in approaches employed by nurses in this study. Results support current discussions in nursing literature concerned with the need for community mental health nurses to have well-developed interpersonal skills to enable them to capitalise therapeutically from the depot injection encounter.

  2. [Dysphagia or dysphagias during neuroleptic medication?].

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    Chaumartin, N; Monville, M; Lachaux, B

    2012-09-01

    upper sphincter of the oesophagus; (d) Polyphagia or "binge eating", is frequent in psychotic patients; (e) Finally, there are risk factors for dysphagia: xerostomia, poor dental status, advanced age, neurological diseases, polypharmacy, sedative drugs, CNS depression, etc., which worsen the symptom. Mr J., aged 28, with no psychiatric history, is admitted to the Unit for Difficult Patients in Villejuif for behavioural disorder with homicide on the street. The patient was restrained by passers-by and suffers a head injury and a fracture of the transverse process of L1 vertebra. A cranial CT scan is performed in the emergency room, it is normal. The patient is not known to psychiatric services, and has never taken neuroleptics. Mr J. is homeless, known in his neighbourhood for "his noisy delirium on the street and repeated alcohol abuse." After being arrested by the police in this context, a first psychiatric examination is conducted. The medical certificate states that his condition is not compatible with custody. Mr J. remains mute; he has stereotyped gestures and strange attitudes. No delusion is verbalized. He receives vials of loxapine 50mg causing sedation. At his arrival in the department, Mr J. has the same clinical picture, with a rigid and inexpressive face, reluctance, major unconformity, poor speech. The search for drugs in urine is positive for cannabis. The diagnosis of schizophrenia is rapidly raised, motivating further prescription of loxapine 300 mg daily in combination with clonazepam 6 mg daily. From the earliest days, dysphagia to solids with choking and regurgitation is noted, aggravated by the increase of loxapine treatment of 450 mg / day to 700 mg / day, 7 days after admission. A physical examination is performed before the worsening of dysphagia, it is normal, and in particular, reveals no extrapyramidal syndrome. An anti-cholinergic corrector is introduced, without clinical improvement. A new physical examination is performed; it is normal

  3. The subjective experiences of people who regularly receive depot neuroleptic medication in the community.

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    Phillips, L; McCann, E

    2007-09-01

    Little has been written on the subjective experiences of people who receive depot injections in the community. The authors of this paper have identified distinct gaps in the literature in terms of the views of service users regarding this particular intervention. Existing studies tend to focus upon the side effects of depot neuroleptic medication and the attitudes of Community Mental Health Nurses (CMHNs) towards administering depot medication and issues of compliance and non-compliance. Mental health nurses are frequently perceived as adhering solely to a biomedical approach to patient care in their practice and the therapeutic aspects of their role is frequently unacknowledged. This paper explores how, within the process of giving a depot injection, CMHNs are able to carry out an assessment of their client's needs as well as being someone who is consistent, reliable and supportive. This means that the process of giving a depot injection may be considered as a therapeutic intervention. Qualitative data were obtained through the administration of a semi-structured interview schedule that was constructed and consisted of a range of questions that elicited service users views and opinions related to their experiences of receiving depot neuroleptic medication in the community. The relationship between patient and nurse, as this study reveals, was one that was not only therapeutic, but also provided a forum where psychosocial and clinical issues could be discussed and explored. Crucially, the service users felt they did have a role and an influence in the delivery of their care.

  4. Nursing diagnosis in Severe Mental Illness (SMI with a parenteral neuroleptic treatment

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    Isabel Mateo Alejo

    2009-09-01

    Full Text Available The term Severe Mental Illness, refers to those mental disorders with a prolonged duration which involve a variable degree of disability and social dysfunction.Some necessities arise out of these disabilities that must be covered methodologically.The required instrument is the Nursing Process (NP, and, as a part of it, the Diagnosis.Objective: To identify the main Nursing Diagnoses in the SMI with a parenteral neuroleptic treatment.Methodology: -Study scope: Patients hospitalized in the Prolonged Psychiatric Care Unit of the “Instituto Psiquiátrico Servicios de Salud Mental José Germain”.Sixteen patients of both sexes were studied (all of the patients from this unit with a parenteral neuroleptic treatment.50% of them with typical neuroleptics, and the other 50% with the atypical kind. -Design: Descriptive transverse study. A revision of Clinical Records was conducted in the referenced unit, in a one-year time period.We assessed the most important diagnoses, excluding those in which it was not possible to specify the start date of the problem.Results and conclusions: The group of patients treated with typical neuroleptics face more alterations in the following Functional Patterns by M.Gordon: Pattern 1: Health Perception and Health ManagementPattern 4: Activity and ExercisePattern 6: Cognitive-Perceptual Pattern 8: Role-RelationshipsIn the second Pattern: Nutritional-Metabolic, significant differences have not been determined, one alteration appearing in each of the groups under study, and one of the diagnoses with the same results.

  5. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients

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    Dieter Naber

    2009-10-01

    Full Text Available Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis. Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

  6. A systematic review of service-user reasons for adherence and nonadherence to neuroleptic medication in psychosis.

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    Wade, Miriam; Tai, Sara; Awenat, Yvonne; Haddock, Gillian

    2017-02-01

    People diagnosed with psychosis, such as those with schizophrenia-related disorders, are routinely prescribed neuroleptic medication as a primary treatment. Despite reported benefits of neuroleptic treatment for symptom remission and relapse prevention, discontinuation rates are high. Research examining factors associated with neuroleptic non-adherence report inconsistent findings. Reasons for adherence to neuroleptic medication are under-researched. The current review aimed to synthesise evidence exploring service-user self-reported reasons for adherence and non-adherence to neuroleptic medication. A systematic literature search of databases and reference list searching identified 21 studies investigating service-user accounts of reasons for adherence and/or non-adherence to neuroleptic medication. Qualitative, quantitative and mixed-method studies were included in the review. Several themes of reasons were identified. Reasons for both adherence and non-adherence were largely similar; medication efficacy, compatibility with personal medication or religious beliefs, side-effects and the influence of relationships with other people. Experiences of stigma and economic difficulties were generally identified as reasons for non-adherence only while experiences of fear and coercion were identified as reasons for adherence only. The review identified crucial factors which may aid service providers in bettering treatment for people with psychosis and will provide evidence which could contribute to future prescribing guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. SEXUAL BEHAVIOUR IN SCHIZOPHRENIC PATIENTS ON NEUROLEPTIC MEDICATION

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    T.murali; John, C. J.; Ramakrishnan, N.; Gopinath, P.S.

    1984-01-01

    SUMMARY Sexual behaviour in forty mile schizophrenics on maintenance medication were studied. Authors observed that thirteen patients reported decrease in frequency of sexual thoughts, fifteen in frequency of intercourse. Eight patients reported decline in enjoyment of intercourse and six avoided sex.

  8. Neuroleptic malignant syndrome

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    Bino Rajamani

    2016-01-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a life-threatening emergency that is often seen as a complication of antipsychotic agents. It is characterized by a tetrad of motor, behavioral, autonomic, and laboratory abnormalities. We report a case of a 34-year-old man with a history of newly diagnosed Type 2 diabetes mellitus, mental retardation, and behavioral abnormalities who developed NMS after starting on antipsychotic agents. He presented with high temperature, muscle rigidity, tachycardia, and elevated blood pressure. After a week of hospital treatment in the general ward of a secondary care unit, he was discharged in a hemodynamically and mentally stable state.

  9. Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

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    Ueda S

    2016-02-01

    Full Text Available Satoshi Ueda,1 Takeshi Sakayori,1 Ataru Omori,2 Hajime Fukuta,3 Takashi Kobayashi,3 Kousuke Ishizaka,1 Tomoyuki Saijo,4 Yoshiro Okubo1 1Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan; 2Tamachuo Hospital, Tokyo, Japan; 3Kurumegaoka Hospital, Tokyo, Japan; 4Saijo Clinic, Tokyo, Japan Abstract: Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS, which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist’s failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry. Keywords: neuroleptic-induced deficit syndrome (NIDS, bipolar disorder, psychosis, atypical antipsychotics, electroconvulsive therapy

  10. Neuroleptic-induced catatonia or a mild form of neuroleptic malignant syndrome?

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    Kontaxakis, V P; Vaidakis, N M; Christodoulou, G N; Valergaki, H C

    1990-01-01

    Neuroleptic-induced catatonia (NIC) and milder neuroleptic malignant syndrome (NMS) share parkinsonian features, catatonic symptoms, mild fever, and have been described in patients receiving antipsychotic agents. We report the case of a patient with a schizophreniform disorder and a mild mental retardation who developed a condition which can be diagnosed either as NIC or as a mild form of NMS and has been treated successfully with a combination of amantadine (600 mg/day) and diazepam (30 mg/day). The overlapping between NIC and mild NMS cases might lead to an overestimation of the incidence of current NMS and reinforces the view of the existence of a 'neuroleptic toxicity spectrum'.

  11. The effect of neuroleptics on prolactinoma growth in a Jordanian schizophrenic girl.

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    Daradkeh, T K; Ajlouni, K M

    1988-02-01

    We describe a case of a schizophrenic girl who developed prolactinoma while being treated with neuroleptics. The clinical history and special investigations of the pituitary tumor suggest that neuroleptic medications may have enhanced the growth of the tumor in our patient. The author suggests that the relationship between the occurrence of prolactinoma and neuroleptic medications ought to be investigated in a large controlled study.

  12. Mental Health Medications

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    ... the period when she is most vulnerable to postpartum depression. After the baby is born, women and their doctors should watch for postpartum depression, especially if a mother stopped taking her medication ...

  13. Mental and Medical sciences today

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    David L. Rowland

    2014-10-01

    Full Text Available Journal of Mind and Medical Sciences is designed as a free online, open access, interdisciplinary and peer-reviewed journal. The JMMS mission is to address ideas and issues related to mind and medicine, publishing scientific review and empirical papers regarding mental and medical health and disease. Our goal is to stimulate constructive debates among scholars, researchers, physicians, scientists and health professionals with respect to the latest discoveries and trends in the field. The journal pays special attention to interdisciplinary and integrative perspectives, focusing primarily on papers approaching mind and body as a unitary domain of study. Our supposition is that the study of the human body and mind needs to be better integrated—in fact should not be studied in isolation from one another, a position that originates fact from the collaborative efforts of the two main editors, namely a psychologist and a physician. As an example, the mind body problem—an age-old question—is still a much debated topic. Despite enormous progress in neuroimaging, it remains unclear how abstract ideas come to “control” the physical brain and body to generate actions, responses, and behaviors. Thus, abstract ideas of the mind (e.g., the desire to seek a promotion, to become famous, or to help those surrounding you can drive decision making and life choices more strongly than the concrete/ biological needs of the body (food, warmth, shelter, etc.. From a pathological perspective, heavy psychological and physical burden can “overload” the mind, creating a mental condition of stress which may then negatively impact bodily function through symptoms such as gastric ulcer, hypertension, and so on. From the opposite perspective, the body and brain can interfere with and direct the functioning of mind. The need for sleep, for example, is due to fluctuation of neuromodulators within the brain. When such neuromodulators are pharmacologically manipulated

  14. A rare case of neuroleptic malignant syndrome presenting with serious hyperthermia treated with a non-invasive cooling device: a case report

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    Storm Christian

    2009-02-01

    Full Text Available Abstract Introduction A rare side effect of antipsychotic medication is neuroleptic malignant syndrome, mainly characterized by hyperthermia, altered mental state, haemodynamic dysregulation, elevated serum creatine kinase and rigor. There may be multi-organ dysfunction including renal and hepatic failure as well as serious rhabdomyolysis, acute respiratory distress syndrome and disseminated intravascular coagulation. The prevalence of neuroleptic malignant syndrome is between 0.02% and 2.44% for patients taking neuroleptics and it is not necessary to fulfil all cardinal features characterizing the syndrome to be diagnosed with neuroleptic malignant syndrome. Because of other different life-threatening diseases matching the various clinical findings, the correct diagnosis can sometimes be hard to make. A special problem of intensive care treatment is the management of severe hyperthermia. Lowering of body temperature, however, may be a major clinical problem because hyperthermia in neuroleptic malignant syndrome is typically unresponsive to antipyretic agents while manual cooling proves difficult due to peripheral vasoconstriction. Case presentation A 22-year-old Caucasian man was admitted unconscious with a body temperature of 42°C, elevated serum creatine phosphokinase, tachycardia and hypotonic blood pressure. In addition to intensive care standard therapy for coma and shock, a non-invasive cooling device (Arctic Sun 2000®, Medivance Inc., USA, originally designed to induce mild therapeutic hypothermia in patients after cardiopulmonary resuscitation, was used to lower body temperature. After successful treatment it became possible to obtain information from the patient about his recent ambulant treatment with Olanzapin (Zyprexa® for schizophrenia. Conclusion Numerous case reports have been published about patients who developed neuroleptic malignant syndrome due to Olanzapin (Zyprexa® medication. Frequently hyperthermia has been observed

  15. Neuroleptic malignant syndrome and methylphenidate.

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    Ehara, H; Maegaki, Y; Takeshita, K

    1998-10-01

    A 1-year-old female presented with neuroleptic malignant syndrome probably caused by methylphenidate. She had defects in the supratentorial brain including the basal ganglia and the striatum (multicystic encephalomalacia) due to severe perinatal hypoxic-ischemic encephalopathy, which was considered to be a possible predisposing factor causing neuroleptic malignant syndrome. A dopaminergic blockade mechanism generally is accepted as the pathogenesis of this syndrome. However, methylphenidate is a dopamine agonist via the inhibition of uptake of dopamine, and therefore dopaminergic systems in the brainstem (mainly the midbrain) and the spinal cord were unlikely to participate in the onset of this syndrome. A relative gamma-aminobutyric acid-ergic deficiency might occur because diazepam, a gamma-aminobutyric acid-mimetic agent, was strikingly effective. This is the first reported patient with neuroleptic malignant syndrome probably caused by methylphenidate.

  16. Atypical Neuroleptic Malignant Syndrome Associated with Use of Clozapine

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    Quevedo-Florez Leonardo

    2017-01-01

    Full Text Available The Neuroleptic Malignant Syndrome (NMS is a medical emergency of infrequent presentation in the emergency department, which is associated with the use of psychiatric drugs, such as typical and atypical antipsychotics. Our case addresses a 55-year-old patient diagnosed with undifferentiated schizophrenia for 10 years, who had been receiving clozapine and clonazepam as part of their treatment. This patient presents the symptoms of Neuroleptic Malignant Syndrome without fever, which improves with treatment especially with the withdrawal of clozapine. In the absence of fever and clinical improvement, the patient is considered to have an atypical presentation of this disease.

  17. Medical Student Mental Health Services: Psychiatrists Treating Medical Students

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    Gentile, Julie P.; Roman, Brenda

    2009-01-01

    Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs. Since this stressful lifestyle often continues through residency training and life as a physician, this is a critical period in which...

  18. Stress and mental health among medical students

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    Backović Dušan V.

    2013-01-01

    Full Text Available Introduction. Medical studies bring many stressful activities to students. Prolonged stress can make adverse effects to mental health and lead to further professional burnout. Objective. The aim of this study was to assess the association of stress impact and adverse effects of medical studies with psychological distress among medical students. Methods. The cross sectional study was conducted on 367 fourth­year medical students of the Faculty of Medicine in Belgrade, by means of the anonymous questionnaire, containing: socio­demographic data, self­reported health status and stressful influences of studying activities. Mental health status was estimated by General Health Questionnaire (GHQ­12. Results. More than 50% of students perceive frequent feeling of psychic tension, and one third has problems with insomnia. Nearly one­half of students assessed their general stress level as moderate or high. Exams were estimated as high stressor in 63.1% of all students. Stressful effects of communication with teaching staff were reported by one quarter of the examinees. The scores of GHQ­12 were above the threshold in 55.6 % of all students. Mental health problems among students were most significantly associated with stressful experience during exams and contacts with teaching staff. Conclusion. Academic stress makes great influence on mental health of medical students. Reduction of stress effects should be directed to optimization of the examination process and improvement of communication skills. [Projekat Ministarstva nauke Republike Srbije, br. OI 175078

  19. [Stress and mental health among medical students].

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    Backović, Dusan V; Maksimović, Milos; Davidović, Dragana; Zivojinović, Jelena Ilić; Stevanović, Dejan

    2013-01-01

    Medical studies bring many stressful activities to students. Prolonged stress can make adverse effects to mental health and lead to further professional burnout. The aim of this study was to assess the association of stress impact and adverse effects of medical studies with psychological distress among medical students. The cross sectional study was conducted on 367 fourth-year medical students of the Faculty of Medicine in Belgrade, by means of the anonymous questionnaire, containing: socio-demographic data, self-reported health status and stressful influences of studying activities. Mental health status was estimated by General Health Questionnaire (GHQ-12). More than 50% of students perceive frequent feeling of psychic tension, and one third has problems with insomnia. Nearly one-half of students assessed their general stress level as moderate or high. Exams were estimated as high stressor in 63.1% of all students. Stressful effects of communication with teaching staff were reported by one quarter of the examinees. The scores of GHQ-12 were above the threshold in 55.6% of all students. Mental health problems among students were most significantly associated with stressful experience during exams and contacts with teaching staff. Academic stress makes great influence on mental health of medical students. Reduction of stress effects should be directed to optimization of the examination process and improvement of communication skills.

  20. Catatonia versus neuroleptic malignant syndrome: the diagnostic dilemma and treatment

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    Manoj Kumar Sahoo

    2014-01-01

    Full Text Available Catatonia is a syndrome, comprised of symptoms such as motor immobility, excessive motor activity, extreme negativism, and stereotyped movements. Neuroleptic is able to induce catatonia like symptoms, that is, the neuroleptic malignant syndrome (NMS. In NMS, patients typically show symptoms such as an altered mental state, muscle rigidity, tremor, tachycardia, hyperpyrexia, leukocytosis, and elevated serum creatine phosphorous kinase. Several researchers have reported studies on catatonia and the association between catatonia and NMS, but none were from this part of the eastern India. In our case, we observed overlapping symptoms of catatonia and NMS; we wish to present a case of this diagnostic dilemma in a patient with catatonia, where a detailed history, investigation, and symptom management added as a great contribution to the patient′s rapid improvement.

  1. Mental health of dubai medical college students.

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    Ahmadi, Jamshid; Galal Ahmed, Mohammed; Ali Bayoumi, Fatehia; Abdul Moneenum, Abeer; Alshawa, Haya

    2012-01-01

    Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College. One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ). The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of the participants, 47 (45.6%) were found to be in normal range (GHQ mean College students reported a significant level of psychiatric distress, however, it should not be underestimated, and actions should be taken to encourage Dubai Medical College students to get help from for psychiatric services for their emotional problems. The risk factors as well as the protective factors must be identified in nation-wide studies to promote mental health of medical students.

  2. Serum iron and ferritin in acute neuroleptic akathisia.

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    Hofmann, M; Seifritz, E; Botschev, C; Kräuchi, K; Müller-Spahn, F

    2000-04-10

    Acute akathisia is a common and disturbing side effect of classic antipsychotic medication. Some evidence suggests a role for iron deficiency in chronic and tardive akathisia. In acute akathisia, however, the data are contradictory. Serum iron and ferritin levels of 33 inpatients with acute akathisia during classic neuroleptic medication were compared with those of 23 patients on classic neuroleptics without this side effect. Akathisia was rated by means of the Hillside Akathisia Scale. The groups were balanced for age (mean 38.5+/-14.5), medication (butyrophenone- and phenothiazine-derived neuroleptics) and diagnosis (schizophrenia, schizoaffective disorder, psychotic affective disorder). Patients with acute akathisia had significantly lower serum ferritin levels than the patients in the control group. However, the ferritin (56. 94+/-39.54 ng/ml) and iron (88.52+/-40.0 mg/dl) levels in these patients were within the normal range (ferritin 30-300 ng/dl, iron 80-180 mg/dl). No correlations between serum iron or ferritin and akathisia ratings could be found. Although some reduction in serum ferritin was found in patients with acute akathisia compared to patients without akathisia, the difference was small and the ferritin levels were within the range of the normal population. These findings suggest a minor role for iron deficiency in acute akathisia.

  3. Mental Health of Dubai Medical College Students

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    Ahmadi, Jamshid; Galal Ahmed, Mohammed; Ali Bayoumi, Fatehia; Abdul Moneenum, Abeer; Alshawa, Haya

    2012-01-01

    Objective: Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College. Methods: One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ). Results: The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of the participants, 47 (45.6%) were found to be in normal range (GHQ mean students reported evidence of psychiatric distress. Only 23 (22.3%) were found to have severe psychiatric distress. Conclusions: Early detection of psychiatric distress is important to prevent psychiatric morbidity and its unwanted effects on medical students and young doctors. Our results reveals that although a low percentage of Dubai Medical College students reported a significant level of psychiatric distress, however, it should not be underestimated, and actions should be taken to encourage Dubai Medical College students to get help from for psychiatric services for their emotional problems. The risk factors as well as the protective factors must be identified in nation-wide studies to promote mental health of medical students. PMID:24644486

  4. Acute psychosis followed by fever: Malignant neuroleptic syndrome or viral encephalitis?

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    Stojanović Zvezdana

    2014-01-01

    Full Text Available Introduction. Neuroleptic malignant syndrome is rare, but potentially fatal idiosyncratic reaction to antipsychotic medications. It is sometimes difficult to diagnose some clinical cases as neuroleptic malignant syndrome and differentiate it from the acute viral encephalitis. Case report. We reported a patient diagnosed with acute psychotic reaction which appeared for the first time. The treatment started with typical antipsychotic, which led to febrility. The clinical presentation of the patient was characterised by the signs and symptoms that might have indicated the neuroleptic malignant syndrome as well as central nervous system viral disease. In order to make a detailed diagnosis additional procedures were performed: electroencephalogram, magnetic resonance imaging of the head, lumbar puncture and a serological test of the cerebrospinal fluid. Considering that after the tests viral encephalitis was ruled out and the diagnosis of neuroleptic malignant syndrome made, antipsychotic therapy was immediately stopped. The patient was initially treated with symptomatic therapy and after that with atypical antipsychotic and electroconvulsive therapy, which led to complete recovery. Conclusion. We present the difficulties of early diagnosis at the first episode of acute psychotic disorder associated with acute febrile condition. Concerning the differential diagnosis it is necessary to consider both neuroleptic malignant syndrome and viral encephalitis, i.e. it is necessary to make the neuroradiological diagnosis and conduct cerebrospinal fluid analysis and blood test. In neuroleptic malignant syndrome treatment a combined use of electroconvulsive therapy and low doses of atypical antipsychotic are confirmed to be successful.

  5. Body mass index changes and chronic neuroleptic drug treatment for Tourette syndrome.

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    Degrauw, Roosje S; Li, Jason Z; Gilbert, Donald L

    2009-09-01

    A known risk of neuroleptic medications is weight gain, but few studies have estimated long-term effects in childhood. This study evaluated effects of neuroleptics on body mass index for age and sex (body mass index Z scores) in a matched cohort of neuroleptic-treated (n = 16) and nonneuroleptic-treated (n = 29) children and adolescents with Tourette syndrome. Growth parameters were assessed in 45 children, aged 5-15 years, treated for an average of 3 years (range, 1-6) with low doses of pimozide or risperidone. Effects of neuroleptic treatment, age, duration, and treatment x duration interactions on changes in Z score were assessed with regression, and time course of changes was modeled using repeated measures analysis of variance. Although the mean first-year weight gain differed significantly (13.5 kg neuroleptic vs 3.2 kg nonneuroleptic), the longterm Z score changes did not (0.3 vs 0.1; F(4,44) = 0.87, P = 0.49). Repeated measures analysis of Z scores differed significantly by treatment (F(3,77.6) = 6.34, P = 0.0007), related to first-year changes only. In children and adolescents with Tourette syndrome treated for longer than 1 year with neuroleptics, weight gain is not necessarily excessive.

  6. Antipsychotic Drugs Rechallenge in Multi-antipsychotic Drug Induced Atypical Neuroleptic Malignant Syndrome: A Case of Cotard’s Syndrome

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    Helin Yılmaz; N. Burcu Özbaran; Sezen Köse

    2017-01-01

    Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia. Cotard’s syndrome is characterized by the appearance of nihilistic delusions concerning one’s own body or life. By presenting this case, we aim to discuss the differential diagnosis and treatment plan of a patient with catatonia and Cotard’s syndrome, which were noted af...

  7. Medical Student Attitudes about Mental Illness: Does Medical-School Education Reduce Stigma?

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    Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep

    2012-01-01

    Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…

  8. Overlapping of Serotonin Syndrome with Neuroleptic Malignant Syndrome due to Linezolid-Fluoxetine and Olanzapine-Metoclopramide Interactions: A Case Report of Two Serious Adverse Drug Effects Caused by Medication Reconciliation Failure on Hospital Admission

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    Faizan Mazhar

    2016-01-01

    Full Text Available Antipsychotic and antidepressant are often used in combination for the treatment of neuropsychiatric disorders. The concomitant use of antipsychotic and/or antidepressant with drugs that may interact can lead to rare, life-threatening conditions such as serotonin syndrome and neuroleptic malignant syndrome. We describe a patient who has a history of taking two offending drugs that interact with drugs given during the course of hospital treatment which leads to the development of serotonin syndrome overlapped with neuroleptic malignant syndrome. The physician should be aware that both NMS and SS can appear as overlapping syndrome especially when patients use a combination of both antidepressants and antipsychotics.

  9. Neuroleptic Malignant Syndrome Caused by a Combination of Carbamazepine and Amitriptyline

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    A. Bruce Janati

    2012-01-01

    Full Text Available A 32-year-old female, with a history of secondarily-generalized convulsive epilepsy, mental retardation, and a psychiatric illness, developed neuroleptic malignant syndrome while receiving carbamazepine and amitriptyline concurrently. We hypothesize that the addition of amitriptyline to carbamazepine caused a decrease in the serum level of carbamazepine, resulting in NMS. We conclude that combination therapy with carbamazepine and amitriptyline should be avoided in patients who are predisposed to NMS. The purpose of this paper is to warn physicians against combination therapy with carbamazepine and tricyclic antidepressants which may be conducive to neuroleptic malignant syndrome in susceptible patients.

  10. [Acute catatonic syndrome after neuroleptic malignant syndrome].

    Science.gov (United States)

    Benjelloun, G; Jehel, L; Abgrall, G; Pelissolo, A; Allilaire, Jf

    2005-01-01

    We report the case of a young woman who deve-loped catatonic syndrome a few days after neuroleptic mali-gnant syndrome (NMS), arising the problem of the chronology of both affections. A 20-year old woman with an history of bipolar disorder, experienced an acute manic syndrome that made hospitalization necessary. Fourteen days after loxa-pine prescription, the patient developed a NMS (DSM IV criteria) dyskinesia, dysphagia, fever and alteration of cons-ciousness. Hepatic transaminases and muscular enzymes increased. Neuroleptic was immediately interrupted and benzodiazepines (Lorazepam) was started. Biological parameters were normalized after 7 days, hyperpyrexia decreased and extrapyramidal symptoms disappeared but manic symptoms persisted. Two weeks later, the patient presented nega-tivism, rigidity of the four limb, catalepsia and hyperpyrexia. She also had been anxious for death and presented auditory hallucinations. Bacteriological samples and computed tomography were normal. This catatonic symptoms did not decreased and electroconvulsive therapy (ECT) was necessary. After six ECT, she started standing up, walking, taking food and speaking. After 12 ECT, the clinical state was the same as it was before the acute episod. The patient was then treated with valproate and lorazepam for anxiety symptoms. Acute catatonie, a rare and life-threatening acute syndrome was described in psychosis before the advent of neuroleptic drugs. It's characterized by hyperexia, stupor alternated with exctement, rigidity. Many etiolologic factors have been reported for this affection: psychogenic, organic or toxic. Neuroletic malignant syndrome is a potentially fatal complication of neuroleptic treatment occuring in about 1% of patients treated with neuroleptic. This syndrome is characterised by consciousness alteration, extrapyramidal symptoms, autonomic and thermic disorders. Similar clinical and biological features in catatonia and neuroleptic malignant syndrome (NMS) suggest a

  11. Temporal changes in serum creatine kinase concentration and degree of muscle rigidity in 24 patients with neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Nisijima K

    2013-06-01

    Full Text Available Koichi Nisijima, Katutoshi ShiodaDepartment of Psychiatry, Jichi Medical University, Tochigi, JapanAbstract: Neuroleptic malignant syndrome (NMS is a dangerous adverse response to antipsychotic drugs. It is characterized by the four major clinical symptoms of hyperthermia, severe muscle rigidity, autonomic dysfunction, and altered mental state. Serum creatine kinase (CK elevation occurs in over 90% of NMS cases. In the present study, the detailed temporal changes in serum CK and degree of muscle rigidity, and the relationship between CK concentration and degree of muscle rigidity over the time course from fever onset, were evaluated in 24 affected patients. The results showed that serum CK peaked on day 2 after onset of fever and returned to within normal limits at day 12. Mild muscle rigidity was observed before the onset of fever in 17 of 24 cases (71%. Muscle rigidity was gradually exacerbated and worsened until day 4 after onset of fever. These findings confirm physicians' empirical understanding of serum CK concentrations and muscle rigidity in NMS based on data accumulated from numerous patients with the syndrome, and they indicate that serum CK may contribute to the early detection of NMS.Keywords: neuroleptic malignant syndrome, creatine kinase, muscle rigidity

  12. 75 FR 71632 - Revised Medical Criteria for Evaluating Mental Disorders

    Science.gov (United States)

    2010-11-24

    ... ADMINISTRATION 20 CFR Parts 404 and 416 RIN 0960-AF69 Revised Medical Criteria for Evaluating Mental Disorders... mental disorders that we receive during this reopened comment period. DATES: To ensure that your comments..., 2010 the comment period on one aspect of our proposed rules to revise our mental disorders listings...

  13. Neuroleptic Malignant Syndrome: A Case Aimed at Raising Clinical Awareness

    Directory of Open Access Journals (Sweden)

    Jad Al Danaf

    2015-01-01

    Full Text Available A 60-year-old man with a history of bipolar disorder on risperidone, bupropion, and escitalopram was admitted for community acquired streptococcal pneumonia. Four days later, he developed persistent hyperthermia, dysautonomia, rigidity, hyporeflexia, and marked elevation of serum creatine phosphokinase. He was diagnosed with neuroleptic malignant syndrome (NMS and improved with dantrolene, bromocriptine, and supportive therapy. This case emphasizes the importance of considering a broad differential diagnosis for fever in the ICU, carefully reviewing the medication list for all patients, and considering NMS in patients with fever and rigidity.

  14. Common mental disorders among medical students in Jimma ...

    African Journals Online (AJOL)

    Background: Medical students are at risk of common mental disorders due to difficulties of adjustment to the medical school environment, exposure to death and human suffering. However there is limited data on this aspect. Therefore, the current study assessed the magnitude of common mental disorders and contributing ...

  15. Medical and mental disorders in elderly patients seen at the ...

    African Journals Online (AJOL)

    Cardiovascular diseases were the commonest occurring medical problems; degenerative, neoplastic and infectious diseases were also common. Mental disorders were diagnosed in only 2% of the patients with one case of Alzheimer's disease. No patient with mental disorder was given any second medical diagnosis nor ...

  16. Gamma-aminobutyric acid agonists for neuroleptic-induced tardive dyskinesia.

    Science.gov (United States)

    Alabed, Samer; Latifeh, Youssef; Mohammad, Husam Aldeen; Rifai, Abdullah

    2011-04-13

    Chronic antipsychotic drug treatment may cause tardive dyskinesia (TD), a long-term movement disorder. Gamma-aminobutyric acid (GABA) agonist drugs, which have intense sedative properties and may exacerbate psychotic symptoms, have been used to treat TD. To determine the clinical effects of GABA agonist drugs (baclofen, gamma-vinyl-GABA, gamma-acetylenic-GABA, progabide, muscimol, sodium valproate and tetrahydroisoxazolopyridine (THIP) for people with schizophrenia or other chronic mental illnesses who also developed neuroleptic-induced tardive dyskinesia. We updated the previous Cochrane review by searching the Cochrane Schizophrenia Group Register (June 2010). We included reports if they were controlled trials dealing with people with neuroleptic-induced TD and schizophrenia or other chronic mental illness who had been randomly allocated to either non-benzodiazepine GABA agonist drugs with placebo or no intervention. Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI) with the number needed to treat (NNT). For continuous data we calculated mean differences (MD). We identified eight small poorly reported studies for inclusion. For the outcome of 'no clinically important improvement in tardive dyskinesia' GABA agonist drugs were not clearly better than placebo (n = 108, 3 RCTs, RR 0.83 CI 0.6 to 1.1). Deterioration in mental state was more likely to occur in people receiving GABA medication (n = 95, 4 RCTs, RR 2.47 CI 1.1 to 5.4), but this effect was influenced by the decision to assign a negative outcome to those who left early before the end of the study. A greater proportion of people allocated GABA medication may fail to complete the trial compared with those allocated placebo (20% versus 9%), but this difference was not statistically significant (n = 136, 5 RCTs, RR 1.99 CI 0.8 to 4

  17. Philosophy in medical education: a means of protecting mental health.

    Science.gov (United States)

    Keller, Eric J

    2014-08-01

    This study sought to identify and examine less commonly discussed challenges to positive mental health faced by medical students, residents, and physicians with hopes of improving current efforts to protect the mental health of these groups. Additionally, this work aimed to suggest an innovative means of preventing poor mental health during medical education. Literature on medical student, resident, and physician mental health was carefully reviewed and a number of psychiatrists who treat physician-patients were interviewed. The culture of medicine, medical training, common physician psychology and identity, and conflicting professional expectations all seem to contribute to poor mental health among medical students, residents, and physicians. Many current efforts may be more successful by better addressing the negative effects of these characteristics of modern medicine. Programs aimed at promoting healthy mental lifestyles during medical education should continue to be developed and supported to mitigate the deleterious effects of the challenging environment of modern medicine. To improve these efforts, educators may consider incorporating philosophical discussions on meaning and fulfillment in life between medical students and faculty. Through medical school faculty members sharing and living out their own healthy outlooks on life, students may emulate these habits and the culture of medicine may become less challenging for positive mental health.

  18. Acute cardiac failure in neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  19. Neuroleptic malignant syndrome in adolescents: Four probable ...

    African Journals Online (AJOL)

    ... misuse – in particular methamphetamine. Conclusion. Caution must be applied in the apparent overuse of intramuscular antipsychotics, and especially zuclopenthixol acetate (clopixol acuphase), in neuroleptic-naïve and agitated psychotic adolescents where the short-term use of benzodiazepines is more appropriate.

  20. Delirium followed by neuroleptic malignant syndrome in ...

    African Journals Online (AJOL)

    Delirium and neuroleptic malignant syndrome (NMS) are two uncommon syndromes that are often unrecognized or misdiagnosed by the primary physicians as functional psychiatric disorders. The infrequency and the heterogeneity of clinical manifestation, progression and outcome with which those diagnoses are ...

  1. 21 CFR 862.3645 - Neuroleptic drugs radioreceptor assay test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neuroleptic drugs radioreceptor assay test system. 862.3645 Section 862.3645 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology...

  2. Medication error in mental health: implications for primary care

    OpenAIRE

    Maidment, Ian D; Parmentier, Henk

    2009-01-01

    Medication errors are associated with significant morbidity and people with mental health problems may be particularly susceptible to medication errors due to various factors. Primary care has a key role in improving medication safety in this vulnerable population. The complexity of services, involving primary and secondary care and social services, and potential training issues may increase ...

  3. Evaluating Explicit and Implicit Stigma of Mental Illness in Mental Health Professionals and Medical Students.

    Science.gov (United States)

    Kopera, Maciej; Suszek, Hubert; Bonar, Erin; Myszka, Maciej; Gmaj, Bartłomiej; Ilgen, Mark; Wojnar, Marcin

    2015-07-01

    The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2 years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not require the use of a comparison category. Compared to non-professionals, mental health professionals reported significantly higher approach emotions than non-professionals towards people with mental illness, showed a lesser tendency to discriminate against them, and held less restrictive attitudes. Both groups reported negative implicit attitudes towards mentally ill. Results suggest that both non-professionals and professionals display ambivalent attitudes towards people with mental illness and that professional, long-term contact with people with mental illness does not necessarily modify negative implicit attitudes.

  4. Adherence of mentally stable patients to antipsychotic medications ...

    African Journals Online (AJOL)

    The aim of this study was to determine the level of adherence of mentally stable schizophrenic patients to antipsychotic medication. A descriptive, exploratory and contextual qualitative research design was used. The study site was Thabamoopo Mental Healthcare Institution in the Capricorn District of the Limpopo Province, ...

  5. Attitudes toward people with mental illness among medical students

    Science.gov (United States)

    Poreddi, Vijayalakshmi; Thimmaiah, Rohini; Math, Suresh Bada

    2015-01-01

    Background: Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’ attitudes toward people with mental illness is limited from India. Aim: The aim was to assess and compare the attitudes toward people with mental illness among medical students’. Materials and Methods: A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire. Results: Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P mental illness were the factors that found to be influencing students’ attitudes toward mental illness. Conclusion: The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems. PMID:26167018

  6. Attitudes toward people with mental illness among medical students

    Directory of Open Access Journals (Sweden)

    Vijayalakshmi Poreddi

    2015-01-01

    Full Text Available Background: Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students′ attitudes toward people with mental illness is limited from India. Aim: The aim was to assess and compare the attitudes toward people with mental illness among medical students′. Materials and Methods: A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115 and not exposed (n = 61 to psychiatry training using self-reporting questionnaire. Results: Our findings showed improvement in students′ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013 and stigmatization (t = 2.656, P < 0.009 domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students′ attitudes toward mental illness. Conclusion: The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.

  7. Medicated bodies: Mental distress, social media and affect

    OpenAIRE

    Tucker, Ian M.; Goodings, Lewis

    2016-01-01

    Social media are increasingly being recruited into care practices in mental health. This paper analyses how a major new mental health social media site (www.elefriends.org.uk) is used when trying to manage the impact of psychiatric medication on the body. Drawing on Henri Bergson's concept of affection, analysis shows that Elefriends is used at particular moments of reconfiguration (e.g. change in dosage and/or medication), periods of self-experimentation (when people tailor their regimen by ...

  8. Mental Illness among Us: A New Curriculum to Reduce Mental Illness Stigma among Medical Students

    Science.gov (United States)

    Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.

    2013-01-01

    Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…

  9. Mental Health Conditions and Medical and Surgical Hospital Utilization.

    Science.gov (United States)

    Doupnik, Stephanie K; Lawlor, John; Zima, Bonnie T; Coker, Tumaini R; Bardach, Naomi S; Hall, Matt; Berry, Jay G

    2016-12-01

    Mental health conditions are prevalent among children hospitalized for medical conditions and surgical procedures, but little is known about their influence on hospital resource use. The objectives of this study were to examine how hospitalization characteristics vary by presence of a comorbid mental health condition and estimate the association of a comorbid mental health condition with hospital length of stay (LOS) and costs. Using the 2012 Kids' Inpatient Database, we conducted a retrospective, nationally representative, cross-sectional study of 670 161 hospitalizations for 10 common medical and 10 common surgical conditions among 3- to 20-year-old patients. Associations between mental health conditions and hospital LOS were examined using adjusted generalized linear models. Costs of additional hospital days associated with mental health conditions were estimated using hospital cost-to-charge ratios. A comorbid mental health condition was present in 13.2% of hospitalizations. A comorbid mental health condition was associated with a LOS increase of 8.8% (from 2.5 to 2.7 days, P < .001) for medical hospitalizations and a 16.9% increase (from 3.6 to 4.2 days, P < .001) for surgical hospitalizations. For hospitalizations in this sample, comorbid mental health conditions were associated with an additional 31 729 (95% confidence interval: 29 085 to 33 492) hospital days and $90 million (95% confidence interval: $81 to $101 million) in hospital costs. Medical and surgical hospitalizations with comorbid mental health conditions were associated with longer hospital stay and higher hospital costs. Knowledge about the influence of mental health conditions on pediatric hospital utilization can inform clinical innovation and case-mix adjustment. Copyright © 2016 by the American Academy of Pediatrics.

  10. Antipsychotic Drugs Rechallenge in Multi-antipsychotic Drug Induced Atypical Neuroleptic Malignant Syndrome: A Case of Cotard’s Syndrome

    Directory of Open Access Journals (Sweden)

    Helin Yılmaz

    2017-03-01

    Full Text Available Neuroleptic malignant syndrome (NMS is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia. Cotard’s syndrome is characterized by the appearance of nihilistic delusions concerning one’s own body or life. By presenting this case, we aim to discuss the differential diagnosis and treatment plan of a patient with catatonia and Cotard’s syndrome, which were noted after NMS, in light of the literature.

  11. Electroconvulsive therapy in drug resistant neuroleptic malignant syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Yousefi A

    2010-02-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Neuroleptic malignant syndrome is an idiosyncratic and potentially fatal reaction to neuroleptic drugs and is characterized by fever, muscular rigidity, altered mental status, autonomic dysfunction, elevated serum CPK and leucocytosis Neuroleptic malignant syndrome is treated with dantrolene, bromocriptin, amantadin and electroconvulsive therapy."n"nCase: A 22 years old, schizophrenic female was refered to the Emergency ward of Roozbeh hospital in Tehran, Iran in December 2008 with aggression, impulsivity, and reduced sleep. After injection of haloperidol, the patient developed a high grade fever, diaphoresis and muscular stiffness. She was diagnosed as neuroleptic malignant syndrome and the treatment with dantrolen, bromocriptin and amantadin initiated. Although fever subsided, other signs continued, therefore we applied electroconvulsive therapy to this case."n"nConclusion: Due to excellent response of the patient to electroconvulsive therapy and the rare reports of electroconvulsive therapy in neuroleptic malignant syndrome in the Iranian population, this case may lead to develop studies for further investigations of this issue.

  12. What Influences Mental Illness? Discrepancies Between Medical Education and Conception

    Directory of Open Access Journals (Sweden)

    Evan Hy Einstein

    2017-04-01

    Full Text Available Objective: This preliminary study examined the differences between what was taught during a formal medical education and medical students’ and psychiatry residents’ conceptions of notions regarding the causes and determinants of mental illness. Methods: The authors surveyed 74 medical students and 11 residents via convenience sampling. The survey contained 18 statements which were rated twice based on truthfulness in terms of a participant’s formal education and conception, respectively. Descriptive statistics and a Wilcoxon signed rank test determined differences between education and conception. Results: Results showed that students were less likely to perceive a neurotransmitter imbalance to cause mental illness, as opposed to what was emphasized during a formal medical education. Students and residents also understood the importance of factors such as systemic racism and socioeconomic status in the development of mental illness, which were factors that did not receive heavy emphasis during medical education. Furthermore, students and residents believed that not only did mental illnesses have nonuniform pathologies, but that the Diagnostic and Statistical Manual of Mental Disorders also had the propensity to sometimes arbitrarily categorize individuals with potentially negative consequences. Conclusions: If these notions are therefore part of students’ and residents’ conceptions, as well as documented in the literature, then it seems appropriate for medical education to be further developed to emphasize these ideas.

  13. Afebrile Neuroleptic Malignant Syndrome associated with Fluphenazine decanoate: A case report

    Directory of Open Access Journals (Sweden)

    Marzieh Assareh

    2010-06-01

    Full Text Available "nNeuroleptic Malignant Syndrome (NMS is unusual but could be a lethal reaction associated with neuroleptic drugs. It occurs in almost 0.07-2.2% of patients under treatment with neuroleptics. There are some medical treatments that may also be helpful for its treatment, including dopamine agonists, muscle relaxants, and electroconvulsive therapy (ECT. We present this case to alert the clinicians to the potential for inducing afebrile NMS. Our case is a 41-year-old man with a history of schizophrenia showing signs and symptoms in accordance with NMS, 2 weeks after receiving one dose of 12.5 mg fluphenazine decanoate, abruptly following the 3rdsession of ECT. The patient presented with decreased level of consciousness, muscular rigidity, waxy flexibility, mutism ,generalized tremor, sever diaphoresis and tachycardia which progressed during the previous 24 h. Laboratory data indicated primarily leukocytosis, an increasing level of creatinine phosphokinase and hypokalemia during the next 72h. In patients receiving antipsychotics, any feature of NMS should carefully be evaluated whether it is usual or unusual particularly in patients receiving long acting neuroleptics.

  14. Mental Health of Dubai Medical College Students

    OpenAIRE

    Ahmadi, Jamshid; Galal Ahmed, Mohammed; Ali Bayoumi, Fatehia; Abdul Moneenum, Abeer; Alshawa, Haya

    2012-01-01

    Objective: Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College. Methods: One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ). Results: The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of th...

  15. Mental health among currently enrolled medical students in Germany.

    Science.gov (United States)

    Wege, N; Muth, T; Li, J; Angerer, P

    2016-03-01

    The study identifies the prevalence of common mental disorders according to the patient health questionnaire (PHQ) and the use of psychotropic substances in a sample of currently enrolled medical students. A cross-sectional survey with a self-administrated questionnaire. All newly enrolled medical students at the University of Dusseldorf, with study beginning either in 2012 or 2013, respectively, were invited to participate. The evaluation was based on 590 completed questionnaires. Mental health outcomes were measured by the PHQ, including major depression, other depressive symptoms (subthreshold depression), anxiety, panic disorders and psychosomatic complaints. Moreover, information about psychotropic substances use (including medication) was obtained. Multiple logistic regression analysis was used to estimate associations between sociodemographic and socio-economic factors and mental health outcomes. The prevalence rates, measured by the PHQ, were 4.7% for major depression, 5.8% for other depressive symptoms, 4.4% for anxiety, 1.9% for panic disorders, and 15.7% for psychosomatic complaints. These prevalence rates were higher than those reported in the general population, but lower than in medical students in the course of medical training. In all, 10.7% of the students reported regular psychotropic substance use: 5.1% of students used medication 'to calm down,' 4.6% 'to improve their sleep,' 4.4% 'to elevate mood,' and 3.1% 'to improve cognitive performance.' In the fully adjusted model, expected financial difficulties were significantly associated with poor mental health (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.31-3.48), psychosomatic symptoms (OR:1.85; 95% CI: 1.11-3.09) and psychotropic substances use (OR: 2.68; 95% CI: 1.51-4.75). The high rates of mental disorders among currently enrolled medical students call for the promotion of mental health, with a special emphasis on vulnerable groups. Copyright © 2016 The Royal Society for Public

  16. The medical psychiatrist as physician for the chronically mentally ill.

    Science.gov (United States)

    Schwartz, C E; Steinmuller, R I; Dubler, N

    1998-01-01

    A 60-year-old black female with chronic paranoid schizophrenia was admitted to the Medical Service for a workup because of severe iron deficiency anemia; she refused the workup. She was found to be acutely psychotic and incapable of informed medical decision making. The management of her medical workup by her medical/C-L psychiatrist led to a diagnosis of colon cancer, and subsequent surgery. The case is discussed here by a consultation-liaison psychiatrist and a lawyer bioethicist. It illustrates the role of medical/C-L psychiatrists as physicians for chronically mentally ill patients with serious medical illness in the general hospital, who guide the medical/surgical care of these patients without powerful negative countertransference bias, thus balancing respect for patient autonomy with advocacy for medical "best interests."

  17. Sri Lankan doctors' and medical undergraduates' attitudes towards mental illness.

    Science.gov (United States)

    Fernando, Sunera Mayanthi; Deane, Frank P; McLeod, Hamish J

    2010-07-01

    Stigmatizing attitudes towards mental illness can impede help-seeking and adversely affect treatment outcomes, especially if such attitudes are endorsed by medical personnel. In order to help identify targets for anti-stigma interventions, we comprehensively examined negative attitudes towards mental illness displayed by Sri Lankan doctors and medical students and compared these with equivalent UK and other international data. A self-report questionnaire originally developed in the UK was completed by medical students (n = 574) and doctors (n = 74) from a teaching hospital in Colombo. The questions assessed the presence and intensity of stigmatizing attitudes towards patients with schizophrenia, depression, panic disorder, dementia and drug and alcohol addiction. The study revealed higher levels of stigma towards patients with depression, alcohol and drug addiction in this Sri Lankan sample compared to UK data but attitudes towards schizophrenia were less stigmatized in Sri Lanka. Blaming attitudes were consistently high across diagnoses in the Sri Lankan sample. Sri Lankan medical students displayed more negative attitudes than doctors (P addiction, followed by, alcohol addiction, schizophrenia, depression, panic disorder and dementia. Sri Lankan doctors and undergraduates endorse stigmatizing attitudes towards mental illnesses and are especially prone to see patients as blameworthy. As such attitudes are likely to affect the engagement of patients in treatment and specific interventions that modify negative attitudes towards people with mental illnesses are needed. Ensuring that medical students have contact with recovered patients in community psychiatry settings may be one way of decreasing stigmatizing attitudes.

  18. Medicalization of global health 2: the medicalization of global mental health

    Directory of Open Access Journals (Sweden)

    Jocalyn Clark

    2014-05-01

    Full Text Available Once an orphan field, ‘global mental health’ now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives.

  19. Medicalization of global health 2: The medicalization of global mental health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    Once an orphan field, 'global mental health' now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives.

  20. Mental Health Recovery in the Patient-Centered Medical Home.

    Science.gov (United States)

    Sklar, Marisa; Aarons, Gregory A; O'Connell, Maria; Davidson, Larry; Groessl, Erik J

    2015-09-01

    We examined the impact of transitioning clients from a mental health clinic to a patient-centered medical home (PCMH) on mental health recovery. We drew data from a large US County Behavioral Health Services administrative data set. We used propensity score analysis and multilevel modeling to assess the impact of the PCMH on mental health recovery by comparing PCMH participants (n = 215) to clients receiving service as usual (SAU; n = 22,394) from 2011 to 2013 in San Diego County, California. We repeatedly assessed mental health recovery over time (days since baseline assessment range = 0-1639; mean = 186) with the Illness Management and Recovery (IMR) scale and Recovery Markers Questionnaire. For total IMR (log-likelihood ratio χ(2)[1] = 4696.97; P mental health recovery over time were greater for PCMH than SAU participants. Increases on all other measures over time were similar for PCMH and SAU participants. Greater increases in mental health recovery over time can be expected when patients with severe mental illness are provided treatment through the PCMH. Evaluative efforts should be taken to inform more widespread adoption of the PCMH.

  1. Mental Health, Binge Drinking, and Antihypertension Medication Adherence

    Science.gov (United States)

    Banta, Jim E.; Haskard, Kelly B.; Haviland, Mark G.; Williams, Summer L.; Werner, Leonard S.; Anderson, Donald L.; DiMatteo, M. Robin

    2009-01-01

    Objectives: To evaluate the relationship between self-reported mental health and binge drinking, as well as health status, sociodemographic, social support, economic resource, and health care access indicators to antihypertension medication adherence. Method: Analysis of 2003 California Health Interview Survey data. Results: Having poor mental…

  2. Common mental disorders among medical students in Jimma ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... Cite as: Kerebih H, Ajaeb M, Hailesilassie H. Common mental disorders among medical students in Jimma University, SouthWest Ethiopia. Afri ... paired academic performance, substance abuse, academic ... This is an Open Access article distributed under the termsof the Creative commons Attribution.

  3. Recovery in mental health | Parker | South African Medical Journal

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 104, No 1 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Recovery in mental health. J Parker. Abstract. No Abstract. Full Text:.

  4. Medical and mental disorders in elderly patients seen at the ...

    African Journals Online (AJOL)

    Forty-one patients had more than one disease occurring in an individual. Cardiovascular diseases were the commonest occurring medical problems; degenerative, neoplastic and infectious diseases were also common. Mental disorders were diagnosed in only 2% of the patients with one case of Alzheimer's disease.

  5. Neuroleptic-induced movement disorders in a naturalistic schizophrenia population: diagnostic value of actometric movement patterns.

    Science.gov (United States)

    Janno, Sven; Holi, Matti M; Tuisku, Katinka; Wahlbeck, Kristian

    2008-04-18

    Neuroleptic-induced movement disorders (NIMDs) have overlapping co-morbidity. Earlier studies have described typical clinical movement patterns for individual NIMDs. This study aimed to identify specific movement patterns for each individual NIMD using actometry. A naturalistic population of 99 schizophrenia inpatients using conventional antipsychotics and clozapine was evaluated. Subjects with NIMDs were categorized using the criteria for NIMD found in the Diagnostic and Statistical Manual for Mental Disorders - Fourth Edition (DSM-IV).Two blinded raters evaluated the actometric-controlled rest activity data for activity periods, rhythmical activity, frequencies, and highest acceleration peaks. A simple subjective question was formulated to test patient-based evaluation of NIMD. The patterns of neuroleptic-induced akathisia (NIA) and pseudoakathisia (PsA) were identifiable in actometry with excellent inter-rater reliability. The answers to the subjective question about troubles with movements distinguished NIA patients from other patients rather well. Also actometry had rather good screening performances in distinguishing akathisia from other NIMD. Actometry was not able to reliably detect patterns of neuroleptic-induced parkinsonism and tardive dyskinesia. The present study showed that pooled NIA and PsA patients had a different pattern in lower limb descriptive actometry than other patients in a non-selected sample. Careful questioning of patients is a useful method of diagnosing NIA in a clinical setting.

  6. Neuroleptic-induced movement disorders in a naturalistic schizophrenia population: diagnostic value of actometric movement patterns

    Directory of Open Access Journals (Sweden)

    Tuisku Katinka

    2008-04-01

    Full Text Available Abstract Background Neuroleptic-induced movement disorders (NIMDs have overlapping co-morbidity. Earlier studies have described typical clinical movement patterns for individual NIMDs. This study aimed to identify specific movement patterns for each individual NIMD using actometry. Methods A naturalistic population of 99 schizophrenia inpatients using conventional antipsychotics and clozapine was evaluated. Subjects with NIMDs were categorized using the criteria for NIMD found in the Diagnostic and Statistical Manual for Mental Disorders – Fourth Edition (DSM-IV. Two blinded raters evaluated the actometric-controlled rest activity data for activity periods, rhythmical activity, frequencies, and highest acceleration peaks. A simple subjective question was formulated to test patient-based evaluation of NIMD. Results The patterns of neuroleptic-induced akathisia (NIA and pseudoakathisia (PsA were identifiable in actometry with excellent inter-rater reliability. The answers to the subjective question about troubles with movements distinguished NIA patients from other patients rather well. Also actometry had rather good screening performances in distinguishing akathisia from other NIMD. Actometry was not able to reliably detect patterns of neuroleptic-induced parkinsonism and tardive dyskinesia. Conclusion The present study showed that pooled NIA and PsA patients had a different pattern in lower limb descriptive actometry than other patients in a non-selected sample. Careful questioning of patients is a useful method of diagnosing NIA in a clinical setting.

  7. Neuroleptic malignant syndrome induced by atypical neuroleptics and responsive to lorazepam

    OpenAIRE

    Yacoub, Adeeb; Francis, Andrew

    2006-01-01

    Objective The authors report three cases of neuroleptic malignant syndrome (NMS) induced by atypical antipsychotics (olanzapine and clozapine) which showed classic features of NMS including muscular rigidity and prominent fever. Method Case reports. Results A 66-year-old man with dementia and alcohol abuse developed NMS while on olanzapine for agitation and combativeness. A 62-year-old man with schizophrenia developed NMS 6 days after starting clozapine. A 43-year-old man with bipolar disorde...

  8. Oral health impacts of medications used to treat mental illness.

    Science.gov (United States)

    Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

    2017-12-01

    Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome

    Directory of Open Access Journals (Sweden)

    Zheyu Xu

    2017-05-01

    Full Text Available We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS. The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM. We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.

  10. Mental illness stigma among medical students and teachers.

    Science.gov (United States)

    Janoušková, Miroslava; Weissová, Aneta; Formánek, Tomáš; Pasz, Jiří; Bankovská Motlová, Lucie

    2017-10-01

    Medical school curriculum contributes to future doctors' attitude formation towards people with mental illness. The purpose of this study was to compare stigmatizing attitudes between medical students and faculty, analyse stigmatizing attitudes among students from different years of study and identify factors predicting stigma. A cross-sectional study with the use of scales measuring attitudes and social distance was designed. Online questionnaires were distributed to all students and teachers at a medical faculty in the Czech Republic. The response rate was 32.1% ( n = 308) among students and 26.7% ( n = 149) among teachers. Teachers had a greater prevalence of stigmatizing attitudes than students. Increased tolerant attitudes in students were detected after the fourth year, that is, following introduction to psychiatry. Preferred specialization in psychiatry and attending two psychiatry courses predicted more tolerant attitudes. Among both students and teachers, men possessed more stigmatizing attitudes towards people with mental illness. Age was an important predictor of stigmatizing attitudes among teachers. Educators should pay closer attention to the role of medical psychology and communication training implementation, which may be beneficial to improving skills and increasing medical students' self-esteem and feeling of competence throughout their psychiatry rotation.

  11. Psychological Variables for Identifying Susceptibility to Mental Disorders in Medical

    Directory of Open Access Journals (Sweden)

    Rosa Sender

    2004-05-01

    Full Text Available Introduction: This study analyses some psychological variables related to susceptibility to mental disorders in medical students. Methods: A sample of 209 first- and second-year medical students was evaluated using the State and Trait Anxiety Inventory (STAI, and three questionnaires: Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ, General Health Questionnaire (GHQ-28 and UNCAHS scale of STRAIN. Results: Thirty percent of the students suffered from emotional distress as measured by de GHQ-28, and showed significantly higher scores on trait anxiety, sensitivity to punishment and reward scales, and had higher levels of strain both in the academic environment and their personal life. Women scored significantly higher than men on trait anxiety and sensitivity to reward. Logistical regression found that trait anxiety and strain in non-academic life were the best predictors of the development of a mental disorder. Conclusions: The study confirms the usefulness of the STAI for detecting psychological distress and the validity of the SPSRQ for identifying subjects likely to present emotional distress when facing high environmental demands. Subjects most likely to present with mental illness are those who evaluate their personal (non-academic lives as more stressful.

  12. Attitudes towards mental illness among medical students in China: Impact of medical education on stigma.

    Science.gov (United States)

    Zhu, Yifan; Zhang, Hanwen; Yang, Ge; Hu, Xinran; Liu, Zhening; Guo, Na; He, Hongbo; Sun, Bin; Rosenheck, Robert

    2017-09-12

    Stigma towards people with mental illness impedes effective treatment. A recent study found that Chinese students were less socially accepting of people with mental illness than counterparts from other countries. The current study examined stigma among Chinese medical students at different levels of training. Medical students (N = 1372 from 12 Chinese schools) were surveyed with a questionnaire addressing attitudes and beliefs about people with mental illness. Analysis of variance was used to compare responses from students: (1) with no psychiatry training; (2) who had only taken a didactic course; and (3) who had completed both a course and a clinical rotation. Specific attitudes were identified through factor analysis. Interest in further training and other personal experience were also examined. Factor analysis revealed attitudes favoring: (1) social acceptance of people with mental illness, (2) not believing in supernatural causes of mental illness, (3) bio-psycho-social causation, (4) rehabilitation, and (5) social integration. The absence of consistent trends across training levels suggested that education did not increase nonstigmatized attitudes. Areas of most stigmatization were low social acceptance and little favor for social integration. Measures most strongly correlated with nonstigmatized attitudes were as follows: interest in clinical psychiatry, belief that psychiatry should be more valued, and having friends with mental illness. Although medical school education showed little effect on attitudes, students with more individual experiences such as planning to continue clinical psychiatric training, believing psychiatry should be more valued, and having friends with mental illness had less stigmatized attitudes than others. © 2017 John Wiley & Sons Australia, Ltd.

  13. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ... HUMAN SERVICES Health Resources and Services Administration Lists of Designated Primary Medical Care... geographic areas, population groups, and facilities designated as primary medical care, mental health, and... (primary medical care, dental, psychiatric, vision care, podiatric, pharmacy, and veterinary care). The...

  14. The relationship between neuroleptic drug dose and the performance of psychiatric patients in a maximum security token economy program.

    Science.gov (United States)

    Harris, G T

    1989-03-01

    This study examined the relationship between neuroleptic medication dose and performance in a token economy program on two maximum security psychiatric wards. Patients receiving higher than average doses exhibited poorer than average program performance but there was a small but statistically significant positive relationship between neuroleptic drug dose (measured in CPZ units/kg) and program performance. However, this positive relationship existed only for the first few weeks of patients' hospital stays, and there was a delay (approximately 2 weeks) between the administration of the drug and the maximal positive effect on program performance. Only a very small minority of medication changes were ever followed by improvements in program performance. The results are discussed in terms of what is a rational strategy for the provision of psychiatric medication and other forms of treatment in institutional settings.

  15. Assessment of mental workload and academic motivation in medical students.

    Science.gov (United States)

    Atalay, Kumru Didem; Can, Gulin Feryal; Erdem, Saban Remzi; Muderrisoglu, Ibrahim Haldun

    2016-05-01

    To investigate the level of correlation and direction of linearity between academic motivation and subjective workload. The study was conducted at Baskent University School of Medicine, Ankara, Turkey, from December 2013 to February 2014, and comprised Phase 5 Phase 6 medical students. Subjective workload level was determined by using National Aeronautics and Space Administration Task Load Index scale that was adapted to Turkish. Academic motivation values were obtained with the help of Academic Motivation Scale university form. SPSS 17 was used for statistical analysis. Of the total 105 subjects, 65(62%) students were in Phase 5 and 40(38%) were in Phase 6. Of the Phase 5 students, 18(27.7%) were boys and 47(72.3%) were girls, while of the Phase 6 students, 16(40%) were boys and 24(60%) were girls. There were significant differences in Phase 5 and Phase 6 students for mental effort (p=0.00) and physical effort (p=0.00). The highest correlation in Phase 5 was between mental effort and intrinsic motivation (r=0.343). For Phase 6, highest correlation was between effort and amotivation (r= -0.375). Subjective workload affected academic motivation in medical students.

  16. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care, podiatric...

  17. The Role of Amantadine Withdrawal in 3 Cases of Treatment-Refractory Altered Mental Status.

    Science.gov (United States)

    Fryml, Leah D; Williams, Kristen R; Pelic, Christopher G; Fox, James; Sahlem, Gregory; Robert, Sophie; Revuelta, Gonzalo J; Short, Edward Baron

    2017-05-01

    Amantadine, which was originally developed as an antiviral medication, functions as a dopamine agonist in the central nervous system and consequently is utilized in the treatment of Parkinson disease, drug-induced extrapyramidal reactions, and neuroleptic malignant syndrome. For reasons that are not entirely understood, abrupt changes in amantadine dosage can produce a severe withdrawal syndrome. Existing medical literature describes case reports of amantadine withdrawal leading to delirium, which at times has progressed to neuroleptic malignant syndrome. Amantadine withdrawal may be under-recognized by mental health clinicians, which has the potential to lead to protracted hospital courses and suboptimal outcomes. The goal of this case series is to highlight the role of amantadine withdrawal in the cases of 3 medically complex patients with altered mental status. In the first case, the cognitive side effects of electroconvulsive therapy masked acute amantadine withdrawal in a 64-year-old man with Parkinson disease. In the second case, a 75-year-old depressed patient developed a catatonic delirium when amantadine was discontinued. Finally, a refractory case of neuroleptic malignant syndrome in a 57-year-old patient with schizoaffective disorder rapidly resolved with the reintroduction of outpatient amantadine. These cases highlight several learning objectives regarding amantadine withdrawal syndrome: First, it may be concealed by co-occurring causes of delirium in medically complex patients. Second, its symptoms are likely to be related to a cortical and limbic dopamine shortage, which may be reversed with electroconvulsive therapy or reintroduction of amantadine. Third, its clinical presentation may occur on a spectrum and may include features suggestive of delirium, catatonia, or neuroleptic malignant syndrome.

  18. Chronic medical conditions and mental health in older people : disability and psychosocial resources mediate specific mental health effects

    NARCIS (Netherlands)

    Ormel, J; Kempen, GIJM; Penninx, BWJH; Brilman, EI; Beekman, ATF; VanSonderen, E

    Background. This study describes the differences in psychological distress, disability and psychosocial resources between types of major medical conditions and sensory impairments (collectively denoted as CMCs); and tests whether disability and psychosocial resources mediate CMC-specific mental

  19. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

    National Research Council Canada - National Science Library

    Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

    2015-01-01

    .... To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations...

  20. Mandatory Physical Exercise for the Prevention of Mental Illness in Medical Students

    OpenAIRE

    Bitonte, Robert A.; Donald Joseph II DeSanto

    2014-01-01

    Medical students experience higher rates of mental illness than the general population. With competition rising for success in medical school, and residency, increasing incidence of distress are leading this population to experience higher rates of thoughts of dropping out of school, and even suicide. Since many stigmas deter medical students from receiving mental health counseling, such as the perceived inability to handle the stresses of medical school, and the potential lack of competitive...

  1. The discontinuance of maintenance neuroleptic therapy in chronic schizophrenic patients: drug and social consequences.

    Science.gov (United States)

    Johnson, D A; Pasterski, G; Ludlow, J M; Street, K; Taylor, R D

    1983-05-01

    In a prospective follow-up the outcome of 60 chronic schizophrenic patients who discontinued neuroleptic therapy after remaining stable 12-48 months was compared with controls continuing medication. Not only did the drug-discontinued patients have more relapses (P less than 0.001), but the form of relapse was both more severe and acute, resulting in differences of self-injury (P less than 0.05), anti-social behaviour (P less than 0.01), inpatient admissions (P less than 0.001), and the use of compulsory powers (P less than 0.01). In patients who relapsed, both social and work function was affected adversely for some months. Patients who remained relapse-free without drugs (20%) had a level of work and social function similar to medicated patients. At the end of 18 months the patients who discontinued depot maintenance therapy were found to have been prescribed one-third more neuroleptic drugs than controls, with a possible increase in the risk of long-term tardive dyskinesia.

  2. The Importance of Medication in Consumer Definitions of Recovery from Serious Mental Illness: A Qualitative Study

    OpenAIRE

    Piat, Myra; Sabetti, Judith; Bloom, David

    2009-01-01

    The role of medication in the recovery of mental health consumers is important. In the context of a multi-site Canadian study on the meaning of recovery, five themes related to medication and recovery emerged from qualitative interviews with 60 consumers. For these consumers, recovery meant: finding a medication that works; taking medication in combination with services and supports; complying with medication; having a say about medication; and living without medication. Findings underlined c...

  3. Happy birthday neuroleptics! 50 years later: la folie du doute.

    Science.gov (United States)

    Stip, Emmanuel

    2002-05-01

    Given that we are celebrating the 50th birthday of neuroleptics introduction in psychiatry, the author proposes to take a look at certain results related to therapeutic practice. After a brief chronological literature review of the clinical practices and theoretical models that have controlled drug treatment of schizophrenia, the author presents a critical review of four meta-analyses. Since Delay, Deniker and Harl's initial report, the story of neuroleptics comprises several periods. In 1963, the hyper-dopaminergic theory of psychoses was proposed. Another period began with models mainly based on the serotonin/dopamine relative blockade receptor hypothesis. More recently, a new framework to understand the differential effect of antipsychotics is related to the appropriate modulation (e.g., fast dissociation) of the D2 receptor alone. The concept of atypicality has become a new vista for research and to market new compounds. However, after 50 years of neuroleptic drugs, are we able to answer the following simple questions: Are neuroleptics effective in treating schizophrenia? Is there a difference between atypical and conventional neuroleptics? How do the efficacy and safety of newer antipsychotic drugs compare with those of clozapine? Actually, the answers yielded by these simple questions by meta-analysis should elicit in us a good deal of humility. If we wish to base psychiatry on evidence-based medicine, we run a genuine risk in taking a closer look at what has long been considered fact. Each psychiatrist must continue to be critical, sceptical, optimistic (not overoptimistic) and to learn in order to integrate the positive aspects of our growing knowledge base.

  4. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

    OpenAIRE

    Shane Scahill; Jane L Fowler; H. Laetitia Hattingh; Fiona Kelly; Wheeler, Amanda J.

    2015-01-01

    Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was report...

  5. Medication management and practices in prison for people with mental health problems: a qualitative study

    OpenAIRE

    Rogers Anne; Bowen Robert A; Shaw Jennifer

    2009-01-01

    Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

  6. Hydrotherapy as a possible neuroleptic and sedative treatment.

    Science.gov (United States)

    Shevchuk, Nikolai A

    2008-01-01

    Psychotic symptoms such as delusions and hallucinations can have a devastating effect on a patient's social functioning. Since psychosis is rarely congenital, it is possible that lifestyle factors play a role in its etiology. This paper offers a hypothesis that some of these factors could be: (a) A lifestyle lacking evolutionarily conserved stressors such as frequent exposure to heat and/or cold, resulting in a lack of "thermal exercise" which could lead to malfunctioning of the brain. (b) Partial retention and absorption of toxic waste in the colon, as described in more detail below. (c) Genetic makeup that makes a person vulnerable to the above conditions. To test the hypothesis, three types of hydrotherapy are proposed (to be tested separately) as a putative neuroleptic treatment: head-out hot showers, adapted cold showers (twice daily each), and colon hydrotherapy (every 3-12 weeks, which also includes a dietary change according to Harvard's Healthy Eating Pyramid). The following is supporting evidence: Dopaminergic transmission in the mesolimbic pathway is involved in central processing of pain and negative stimuli (e.g. stress-induced analgesia) in addition to its role in the pathophysiology of psychosis. It is also known that if a neural pathway can perform two different functions, then the execution of one function will often suppress the other (e.g. gate control theory of pain). Thus, a pain-based therapy, such as a moderately hot shower, could have a "crowding out" effect on pathological processes within the mesolimbic system. In addition, hyperthermia is known to induce fatigue and depress activity of the frontal cortex (the sedative effect). As described previously, an adapted cold shower could work as a mild electroshock applied to the sensory cortex and, therefore, it might have an antipsychotic effect similar to that of electroconvulsive therapy. Additionally, a cold shower is a vivid example of stress-induced analgesia and would also be expected to

  7. Malignant Neuroleptic Syndrome following Deep Brain Stimulation Surgery of Globus Pallidus Pars Internus in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Jae Meen Lee

    2016-02-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS surgery in a cerebral palsy (CP patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity, and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired, despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after DBS surgery, irrespective of continued dopaminergic medication.

  8. Surveys of medical seeking preference, mental health literacy, and attitudes toward mental illness in Taiwan, 1990-2000.

    Science.gov (United States)

    Wu, Chia-Yi; Liu, Shen-Ing; Chang, Shu-Sen; Sun, Fang-Ju

    2014-01-01

    Mental health promotion campaigns require a good understanding of public attitudes and mental health literacy. Few studies have investigated changes in these two aspects over time. We aimed to examine such changes and their associations with help-seeking preference in Taiwan. Data were extracted from the Taiwan Social Change Survey (1990, 1995, and 2000) based on national representative samples. Each wave of the surveys included four questions about attitudes toward severe mental illness, a case vignette describing depressive and anxiety symptoms to evaluate respondents' mental health literacy, and their preference of medical and/or informal help-seeking if they develop such symptoms. Mental and physical health statuses measured using the Chinese Health Questionnaire and self-reported chronic physical illnesses were included as covariates. There were 2531, 2075, and 1892 respondents in the three waves of the surveys, respectively. During the 1990 s, approximately one in four to five Taiwanese held some misconceptions toward mental illness. The attitudes toward mental illness were generally not associated with medical or informal help-seeking preference after statistical adjustment. However, respondents viewing symptoms in the vignette as physical or mental in origin were more willing to seek help than those who saw these symptoms as not being an illness. Attribution of depressive and anxiety symptoms appeared to be more likely to influence help-seeking behaviors than attitudes toward mental illness. Enhancing public mental health literacy toward depression may help facilitate help-seeking in response to potential mental illness. Copyright © 2013. Published by Elsevier B.V.

  9. Pharmacokinetics of phenothiazine neuroleptics after chronic coadministration of carbamazepine.

    Science.gov (United States)

    Daniel, W A; Syrek, M; Haduch, A; Wójcikowski, J

    1998-01-01

    The aim of the present study was to assess the influence of carbamazepine on the pharmacokinetics of the two phenothiazine neuroleptics thioridazine and perazine in rats. The obtained results are compared with the results of analogical experiments concerning promazine. Thioridazine or perazine (10 mg/kg i.p.) were administered twice a day for two weeks alone or jointly with carbamazepine (15 mg/kg i.p. during the 1st week, and 20 mg/kg i.p. during the 2nd week of treatment). Concentrations of the neuroleptics and their main metabolites in the plasma and brain were measured at 30 min, 6 and 12 h after the last dose of the drugs. Carbamazepine decreased the concentrations of thioridazine and its metabolites (especially mesoridazine and sulforidazine) in plasma at 30 min and 6 h after the last dose of the drugs. Similar changes in the concentrations of thioridazine and its metabolites were observed at 6 h in the brain. Carbamazepine did not significantly influence the pharmacokinetics of perazine. In vitro studies with liver microsomes of control rats revealed that carbamazepine added to the incubation mixture inhibited N-demethylation of thioridazine via mixed mechanism, but it did not influence significantly 2- or 5-sulfoxidation of the neuroleptic. In the case of perazine, no distinct inhibition of its N-demethylation or sulfoxidation by carbamazepine was observed. Neither carbamazepine nor the neuroleptics, administered separately or jointly for two weeks, significantly influenced the concentrations of cytochromes P-450 and b-5 in the liver. Carbamazepine++ given chronically decreased the rate of N-demethylation and had a tendency to accelerate 2-sulfoxidation of thioridazine, both when given alone (as compared to the control) and when coadministered with thioridazine (as compared to the thioridazine-treated group). In contrast, chronic treatment with carbamazepine alone, significantly increased the rate of perazine N-demethylation. When carbamazepine was

  10. Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions.

    Science.gov (United States)

    Dyrbye, Liselotte N; West, Colin P; Sinsky, Christine A; Goeders, Lindsey E; Satele, Daniel V; Shanafelt, Tait D

    2017-10-01

    To determine whether state medical licensure application questions (MLAQs) about mental health are related to physicians' reluctance to seek help for a mental health condition because of concerns about repercussions to their medical licensure. In 2016, we collected initial and renewal medical licensure application forms from 50 states and the District of Columbia. We coded MLAQs related to physicians' mental health as "consistent" if they inquired only about current impairment from a mental health condition or did not ask about mental health conditions. We obtained data on care-seeking attitudes for a mental health problem from a nationally representative convenience sample of 5829 physicians who completed a survey between August 28, 2014, and October 6, 2014. Analyses explored relationships between state of employment, MLAQs, and physicians' reluctance to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. We obtained initial licensure applications from 51 of 51 (100%) and renewal applications from 48 of 51 (94.1%) medical licensing boards. Only one-third of states currently have MLAQs about mental health on their initial and renewal application forms that are considered consistent. Nearly 40% of physicians (2325 of 5829) reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. Physicians working in a state in which neither the initial nor the renewal application was consistent were more likely to be reluctant to seek help (odds ratio, 1.21; 95% CI, 1.07-1.37; P=.002 vs both applications consistent). Our findings support that MLAQs regarding mental health conditions present a barrier to physicians seeking help. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

    Science.gov (United States)

    Stone, Amanda M; Merlo, Lisa J

    2011-02-01

    Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P < .001). Psychiatric medication misusers reported less stigmatized beliefs toward mental illness, including lower anxiety around the mentally ill (t = 3.26, P < .001) as well as more favorable attitudes toward psychiatric medications (t = 2.78, P < .01) and stronger beliefs in the potential for recovery from mental illness (t = -2.11, P < .05). Students with more stigmatized beliefs had greater concerns about psychiatric medications and less favorable beliefs regarding their effectiveness. Reasons for misuse varied by medication class, with 57.1% of stimulant misusers noting help with studying as their primary reason for use and 33.3% of benzodiazepine misusers noting attempts to get high or "party" as their primary reason for misuse. Results suggest the need for improved education regarding the

  12. Prevalence of neuroleptic-induced movement disorders in chronic schizophrenia inpatients.

    Science.gov (United States)

    Janno, Sven; Holi, Matti; Tuisku, Katinka; Wahlbeck, Kristian

    2004-01-01

    Since most of the world's schizophrenia patients are treated with conventional antipsychotics, the authors evaluated various methods for establishing the prevalence of neuroleptic-induced movement disorders in these patients. DSM-IV criteria and established score thresholds on a movement disorder rating scale were used to identify cases of neuroleptic-induced movement disorder in a representative Estonian patient sample of 99 chronic institutionalized schizophrenia patients, 18-65 years old, treated with conventional neuroleptics (79.8%) or clozapine (20.2%). Neuroleptic-induced movement disorders according to DSM-IV criteria were found in 61.6% of the group: 31.3% had neuroleptic-induced akathisia, 23.2% had neuroleptic-induced parkinsonism, and 32.3% had neuroleptic-induced tardive dyskinesia. Prevalence rates for akathisia and tardive dyskinesia were similar when either DSM-IV criteria or rating scale scores were used, but the prevalence rate for parkinsonism was much lower per DSM-IV criteria than according to rating scale score. Nearly two-thirds of chronic schizophrenia patients suffered from a neuroleptic-induced movement disorder. Globally, extrapyramidal adverse effects still impose a huge burden on the majority of neuroleptic-treated individuals with schizophrenia. The discrepancy between the standard identification methods for neuroleptic-induced movement disorder indicate the need for further research.

  13. Analysis of the barriers of mental distress disclosure in medical inpatients in Taiwan.

    Science.gov (United States)

    Han, Der-Yan; Lin, Yi-Yin; Liao, Shih-Cheng; Lee, Ming-Been; Thornicroft, Graham; Wu, Chia-Yi

    2015-08-01

    Disclosure of mental distress to physicians is important for mental illness identification, early referrals and proper treatment to prevent suicide. Little is known about what affects mental health communication in the clinical settings in the Chinese societies. The study aimed to identify the demographic, psychosocial and medical factors related to people with non-disclosure of their mental distress. We interviewed a series of consecutive inpatients from two medical wards of a general hospital in northern Taiwan. We collected depressive symptoms (the Patient Health Questionnaire, PHQ-9), living arrangement, threatening life events, suicide risks (i.e. past self-harm history, lifetime suicide ideas and hopelessness) and recent experience of mental distress disclosure. Furthermore, we explored the reasons of non-disclosure. A total of 230 medical inpatients agreed to participate (53.5% males). The results indicated that only 5.7% actually communicated their mental health concerns, and that 12.3% were willing to talk about their mental health problems. Among the 69 (30%) depressed participants (PHQ-9 score ≥ 10 points), the disclosure rate was low (8.7%) and the wish to talk about mental distress was also low (10.3%). After adjustment, living alone (OR = 7.58, 95% CI =  1.56-36.91) and having stressful life events (OR = 3.68, 95% CI = 1.09-12.46) remained significant in predicting disclosure of mental distress. The 109 participants attributed their refusal of communicating mental distress as medical-related attributes, subjective perceptions or sociocultural factors. Communication of mental distress in medical settings was uncommon due to medical or psychosocial barriers in Taiwan. Skill training to facilitate disclosure in medical education and public campaigns to improve knowledge of depression and enhance help-seeking deserve more attention, particularly under the influence of stigma in the Chinese societies. © The Author(s) 2014.

  14. Medical diplomacy and global mental health: from community and national institutions to regional centers of excellence.

    Science.gov (United States)

    Aggarwal, Neil Krishan; Kohrt, Brandon A

    2013-12-01

    We explore how regional medical diplomacy can increase funding for global mental health initiatives. Interventions for infectious diseases have dominated medical diplomacy by focusing on security concerns. The global mental health movement has adopted similar strategies, but unsuccessfully since mental illnesses do not cause international epidemics. Instead, realpolitik arguments may increase funding by prioritizing economic productivity and regional diplomacy based on cultural ties to advance mental health services and research at the community level. In South Asia, initiatives to train personnel and provide refugee services offer a foundation for regional centers of excellence. This model can be expanded elsewhere.

  15. Antipsychotic dose escalation as a trigger for Neuroleptic Malignant Syndrome (NMS: literature review and case series report

    Directory of Open Access Journals (Sweden)

    Langan Julie

    2012-11-01

    Full Text Available Abstract Background “Neuroleptic malignant syndrome” (NMS is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition. Mortality rates may be as high as 55% and many risk factors have been reported. Although rapid escalation of antipsychotic dose is thought to be an important risk factor, to date it has not been the focus of a published case series or scientifically defined. Description We aimed to identify cases of NMS and review risk factors for its development with a particular focus on rapid dose escalation in the 30 days prior to onset. A review of the literature on rapid dose escalation was undertaken and a pragmatic definition of “rapid dose escalation” was made. NMS cases were defined using DSM-IV criteria and systematically identified within a secondary care mental health service. A ratio of titration rate was calculated for each NMS patient and “rapid escalators” and “non rapid escalators” were compared. 13 cases of NMS were identified. A progressive mean dose increase 15 days prior to the confirmed episode of NMS was observed (241.7 mg/day during days 1–15 to 346.9 mg/day during days 16–30 and the mean ratio of dose escalation for NMS patients was 1.4. Rapid dose escalation was seen in 5/13 cases and non rapid escalators had markedly higher daily cumulative antipsychotic dose compared to rapid escalators. Conclusions Rapid dose escalation occurred in less than half of this case series (n = 5, 38.5%, although there is currently no consensus on the precise definition of rapid dose escalation. Cumulative antipsychotic dose – alongside other known risk factors - may also be important in the development of NMS.

  16. Measuring neuroleptic-induced akathisia by three-channel actometry.

    Science.gov (United States)

    Tuisku, K; Lauerma, H; Holi, M; Markkula, J; Rimon, R

    1999-11-30

    Three-channel actometry was used to study neuroleptic-induced akathisia (NIA), a common and often serious disorder in association of traditional neuroleptic therapy. The aim was to explore the diagnostic possibilities of actometry in NIA and to examine in detail the motor phenomenology of the disorder in detail. The actometers were attached to the ankles and waists of ten patients, suffering from NIA, and to ten matched healthy controls. Five of the patients were changed to olanzapine treatment, and these patients were re-examined during the no-NIA condition. NIA was associated with manyfold movement activity during controlled rest (sitting) but not with increased daily overall motor activity. Movement frequencies in NIA seemed to be pathognomonic. Actometry is promising for investigation and clinical assessment of NIA. Olanzapine proved to be an adequate treatment choice for NIA patients.

  17. Extrapyramidal side effects as a consequence of treatment with neuroleptics

    OpenAIRE

    Shirley Fumi Taniguchi; Maria de Lourdes Rabelo Pequeno; Wanessa Alves Frederico; Seizi Oga

    2008-01-01

    Objective: To check the occurrence of extrapyramidal side effects inpatients receiving neuroleptic drugs, how these effects are treated,and to observe the occurrence of hallucinations caused by treatmentof extrapyramidal symptoms. Methods: The present study analyzedmedical records and interviewed 39 schizophrenic patients beingtreated in a public primary care clinic located in the southern partof the city of São Paulo, who had previously agreed to participatein the project. Results: Among 39 ...

  18. Experience from mental health clinics held during medical service camps in Fiji.

    Science.gov (United States)

    Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir

    2015-12-01

    We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  19. Attitudes of Students at a US Medical School Toward Mental Illness and Its Causes.

    Science.gov (United States)

    Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert

    2017-06-01

    Stigma among health care providers toward people with mental illness is a worldwide problem. This study at a large US university examined medical student attitudes toward mental illness and its causes, and whether student attitudes change as they progress in their education. An electronic questionnaire focusing on attitudes toward people with mental illness, causes of mental illness, and treatment efficacy was used to survey medical students at all levels of training. Exploratory factor analysis was used to establish attitudinal factors, and analysis of variance was used to identify differences in student attitudes among these factors. Independent-samples t tests were used to assess attitudes toward efficacy of treatments for six common psychiatric and medical conditions. The study response rate was 42.6 % (n = 289). Exploratory factor analysis identified three factors reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Stages of student education did not differ across these factors. Students who had completed the psychiatry clerkship were more likely to believe that anxiety disorders and diabetes could be treated effectively. Students reporting personal experiences with mental illness showed significantly more social acceptance, and people born outside the USA were more likely to endorse supernatural causes of mental illness. Sociocultural influences and personal experience with mental illness have a greater effect than medical education on attitudes toward people with mental illness. Psychiatric education appears to have a small but significant effect on student attitudes regarding treatment efficacy.

  20. Mental health first aid training for Australian medical and nursing students: an evaluation study.

    Science.gov (United States)

    Bond, Kathy S; Jorm, Anthony F; Kitchener, Betty A; Reavley, Nicola J

    2015-01-01

    The role and demands of studying nursing and medicine involve specific stressors that may contribute to an increased risk for mental health problems. Stigma is a barrier to help-seeking for mental health problems in nursing and medical students, making these students vulnerable to negative outcomes including higher failure rates and discontinuation of study. Mental Health First Aid (MHFA) is a potential intervention to increase the likelihood that medical and nursing students will support their peers to seek help for mental health problems. This study aimed to evaluate the effectiveness of a tailored MHFA course for nursing and medical students. Nursing and medical students self-selected into either a face-to-face or online tailored MHFA course. Four hundred and thirty-four nursing and medical students completed pre- and post-course surveys measuring mental health first aid intentions, mental health literacy, confidence in providing help, stigmatising attitudes and satisfaction with the course. The results of the study showed that both the online and face-to-face courses improved the quality of first aid intentions towards a person experiencing depression, and increased mental health literacy and confidence in providing help. The training also decreased stigmatizing attitudes and desire for social distance from a person with depression. Both online and face-to-face tailored MHFA courses have the potential to improve outcomes for students with mental health problems, and may benefit the students in their future professional careers.

  1. Psychotropic Medication Adherence among Community-Based Individuals with Developmental Disabilities and Mental Illness

    Science.gov (United States)

    Tan, Xi; Marshall, Vincent D.; Balkrishnan, Rajesh; Patel, Isha; Chang, Jongwha; Erickson, Steven R.

    2015-01-01

    Psychotropic medications are a common treatment for mental illness in people with developmental disabilities. Medication adherence is a critical determinant of the effectiveness of psychotropic drugs, but psychotropic medication adherence research specific to this population remains limited. This retrospective study analyzed Marketscan®…

  2. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... HUMAN SERVICES Health Resources and Services Administration Lists of Designated Primary Medical Care... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1.... Criteria then were defined for each of seven health professional types (primary medical care, dental...

  3. Mental depression and coping strategies among medical students of ...

    African Journals Online (AJOL)

    Background/Objectives: Many students are daily exposed academic, psychosocial and health related stressors which predispose them to mental depression. This in turn impairs students' behavior, diminish learning and ultimately affect patient care. This study was carried out to ascertain the degrees of mental depression ...

  4. (KAP) of mental illness among staff in general medical facilities

    African Journals Online (AJOL)

    characteristics, professional qualifications and knowledge, attitudes and practice (KAP) toward mental illness. Results: A total of 684 general ... emotional reactions to the illness, the stress of coping with disturbed behaviour, the .... attitude to mental illness and implied stigma in relation to depression. The items in this section ...

  5. Teaching mental health skills to general practitioners and medical officers.

    Science.gov (United States)

    Goldberg, David; Gask, Linda

    2002-01-01

    David Goldberg opened by describing the research that had led up to the present WPA teaching package. Early research had demonstrated that many psychological illnesses were not detected in primary care settings (Goldberg & Huxley 1980; ibid 1992), and these findings have been replicated in 14 centres round the world, with broadly similar results (Ustun & Sartorius 1995). We have found that in the UK the problem is not defects in factual knowledge, but not having clinical skills to assist in the management of mental disorders in general medical settings. The clinical skills needed in primary care are seldom taught in medical schools, and cannot be learned by listening to a lecture: it is necessary to practice them after they have been demonstrated. To do this it is convenient to break complex clinical skills down into their components: these are called "micro-skills", and we will deal later with the way in which these are taught. The most powerful method for improving mental health skills in this setting is to provide doctors with feedback--either video or audio--of their interview with real patients. The emphasis of such teaching must be on the interview techniques used by the doctor, rather than the clinical problems displayed by the particular patient being interviewed (Gask et al 1991). The problem with this is that video-feedback teaching of the necessary type is not always available, so we have developed videotapes that we can send out to distant locations, and which focus the attention of both local tutor and postgraduates on what should be learned. Because it is essential that most of the teaching is done by the live teacher rather than the videotape, there are always several "discussion points" so that postgraduates can ask questions, or describe their own way of dealing with particular situations. The videotapes are supplied together with teaching notes for the tutor, power points slides which can be adapted to suit local conditions, "role plays" to allow

  6. Prevalence of common mental disorders among Dutch medical students and related use and need of mental health care: a cross-sectional study

    NARCIS (Netherlands)

    Gaspersz, Roxanne; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2012-01-01

    The purpose of the study was to assess common mental disorders and the related use and need for mental health care among clinically not yet active and clinically active medical students. All medical students (n=2266) at one Dutch medical university were approached. Students from study years 1-4 were

  7. Mental ill health in the elderly: medical students’ social representations in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Bruno Medeiros

    2014-12-01

    Full Text Available Objective This study aims to explore medical students’ social representations of mental ill health in older adults. Method It comprises an exploratory and qualitative investigation based on the theory of social representations. Two focus groups with pre-clinical medics (group 1, N=4; group 2, N=4 and 10 individual interviews with clinical medical students were conducted. Thematic analysis at a latent level explored meanings and differences between groups. Results Three overarching themes reflect participants’ representations of mental health problems in later life – mental ill health in old age, polarisation of care, and challenges to care. Primary health care appears as an important strategy to overcome barriers to mental health care in the community. Nevertheless, disqualifying representations, stigma and organization of services constitute the main challenges to quality mental health care in later life. Conclusion This paper highlights the need to address cultural and organizational barriers to promote quality care.

  8. The use of herbal medications and dietary supplements by people with mental illness.

    Science.gov (United States)

    Niv, Noosha; Shatkin, Jess P; Hamilton, Alison B; Unützer, Jürgen; Klap, Ruth; Young, Alexander S

    2010-12-01

    This study examined the relationship between herbal medication and dietary supplement (HMDS) use and mental health characteristics. Data are drawn from a national household survey of the United States' civilian, non-institutionalized population (N = 9,585). Psychiatric medication and HMDS use, psychiatric diagnoses and treatment needs, utilization and satisfaction were assessed. Compared to non-users, HMDS users were more likely to perceive themselves as having mental health needs, to have received mental health and primary care treatment, and to be dissatisfied with their overall healthcare. Psychiatric medication use was not related to HMDS use, and in multivariate analyses, HMDS use was associated with perceived mental health needs. Differences in use of specific HMDS between those with and without a psychiatric disorder were also examined. The use of HMDS warrants particular attention in persons with perceived mental health problems as these individuals may be turning to HMDS use for treatment of their symptoms.

  9. Long-term 'treatment' of schizophrenics with typical neuroleptics: a crime against humanity?

    Science.gov (United States)

    Elomaa, E

    1993-11-01

    It is well documented that neuroleptics acting on dopamine receptors induce suppression of reward-directed behaviors in animals (1). Since the need for reward and pleasure is evidently also a powerful determinant of human behavior, it is suggested that compulsory treatment of schizophrenics in remission with anhedonic neuroleptics should be regarded as a crime against humanity, comparable with the scientifically approved use of frontal lobotomy in the management of poor psychotics before the advent of neuroleptics.

  10. How Mental Illness is Perceived by Iranian Medical Students: A Preliminary Study

    Science.gov (United States)

    Amini, Homayoun; Majdzadeh, Reza; Eftekhar-Ardebili, Hasan; Shabani, Amir; Davari-Ashtiani, Rozita

    2013-01-01

    The study aimed to assess medical students' attitudes toward mental illness following a 4-week psychiatry clerkship. All fifth-year medical students from three academic centers in Tehran were asked to participate in the study. They completed the questionnaire on the last day of their 4-week psychiatry clerkship. A self-administered questionnaire was used to examine participants' Attitudes Toward Mental Illness (ATMI). One hundred and sixty eight students completed the questionnaires (88.9% response rate). In general, the students had favorable attitudes toward mental illness at the end of their clerkship, with mean (± SD) ATMI total score of 78.6 (± 8.1) (neutral score, 66.0). The students showed the most favorable opinion (95.2%) about Category 5 (stereotypic attitude toward people with mental illness) whilst they revealed the least favorable opinion (64.3%) regarding Category 1 (social relations with people affected by mental illness). In addition, the students thought that movies were on the top of influential media on shaping the attitudes toward mental illness. Overall, most of Iranian medical students had generally favorable attitudes toward people with mental illness at the end of their clerkship. Therefore, it may be expected next generation of medical doctors show more favorable attitude toward mental illness. PMID:23878611

  11. An exploratory study of the role of trust in medication management within mental health services

    NARCIS (Netherlands)

    Maidment, I.D.; Brown, P.; Calnan, M.

    2011-01-01

    Objective: To develop understandings of the nature and influence of trust in the safe management of medication within mental health services. Setting: Mental health services in the UK. Method: Qualitative methods were applied through focus groups across three different categories of service

  12. Complementary and alternative medicines (CAMs) and adherence to mental health medications

    National Research Council Canada - National Science Library

    Ennis, Edel

    2014-01-01

    .... The dynamics underlying non-adherence are less understood. This paper examines adherence to prescription medications for mental health difficulties in relation to the use of complementary and alternative medicines (CAMs...

  13. Smoking Behaviors and Medical Co-Morbidities in Patients With Mental Illnesses.

    Science.gov (United States)

    El-Mallakh, Peggy; McPeak, Danielle; Khara, Milan; Okoli, Chizimuzo T

    2016-12-01

    Correlations among smoking behaviors and co-morbid medical illnesses were examined among 982 smokers with mental illnesses enrolled in a smoking cessation program within Mental Health and Addictions Services in Vancouver, Canada. Significant correlates among individuals with psychotic disorders included associations between a history of emphysema/chronic obstructive pulmonary (COPD) disease and cigarettes smoked per day (r's=.35, p≤.01), Confidence in quitting (r's=-.33, p≤.01), and nicotine dependence (r's=.32, p≤.01). Study findings may have implications for the development of integrated medical-psychiatric treatment delivery models that include comprehensive tobacco cessation programs tailored toward people with mental illnesses. Copyright © 2016. Published by Elsevier Inc.

  14. Potentially dangerous behavior in the mentally ill: attitudes of journalists and medical students toward compulsory admission.

    Science.gov (United States)

    Holzinger, Anita; Kaup, Barbara; Gutiérrez-Lobos, Karin

    2002-08-01

    Compulsory admission is a critical measure that may lead to stigmatization of patients. The authors investigated what medical students and journalists consider legitimate conditions for compulsory admission. The most frequently quoted conditions in both groups were violent attempts against others. About one third of each group considered continuous neglect as a reason. Students significantly more often than journalists advocated for civil commitment in the case of suicide attempts and violent attempts. Medical students with personal contact with mentally disordered persons advocated significantly more often for coercive measures in the case of suicide attempts. Comparing journalists and medical students having personal contact with mentally disordered persons revealed that medical students significantly more often supported commitment. Journalists displayed a more liberal attitude toward the mentally ill than did medical students.

  15. Stigma towards mental illness among medical students in Australia and Ghana.

    Science.gov (United States)

    Lyons, Zaza; Laugharne, Jonathan; Laugharne, Richard; Appiah-Poku, John

    2015-06-01

    Stigma towards mental illness has been found to impact adversely on medical students' attitudes towards psychiatry. This study aimed to assess the impact of stigma among final year students at the University of Science and Technology in Kumasi, Ghana, and the University of Western Australia. A 28-item "Attitudes and stigma towards mental health" questionnaire was distributed to final year students at both universities. There was a significant difference in questionnaire scores, with Australian students showing more positive attitudes towards mental illness and lower levels of stigma compared with Ghanaian students. Stigmatization was expressed by Australian and Ghanaian students. A combination of medical school experiences and wider societal and cultural beliefs could be responsible for students' attitudes towards mental illness. Educators can develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students' attitudes towards psychiatry as a discipline and mental illness in general.

  16. Good Mental Health Status of Medical Students: Is There A Role for Physical Activity?

    Directory of Open Access Journals (Sweden)

    Deepthi R

    2015-01-01

    Full Text Available Background: Mental health problems are more commonly seen in youth, more so in medical students. Physical activity though known to improve mental health is difficult to follow among medical students. Aims & Objectives: This study aimed to investigate self-reported levels of anxiety and depression and compare these with self-reported physical activity among medical students in an institution of India. Material & Methods: A Cross sectional study was done among 430 medical students and interns of a medical college of rural Karnataka, India. Hospital Anxiety and Depression Scale (HADS and International Physical Activity Questionnaire (IPAQ were administered to assess mental health status and physical activity levels respectively. Results: The prevalence of anxiety (65.1%, depression (39.5% and anxiety with depression (34.4% was high among medical students. Only 18.1% of students were highly active while 35.9% were inactive when physical activity levels were measured. Students who were highly active and minimally active in physical activity showed lower levels of depression and anxiety compared to low physical activity group. Conclusion: Mental health problems are high and physical activity levels are low among medical undergraduate students. Engagement in physical activity can be an important contributory factor in positive mental health of future doctors.

  17. Influence of the Exercise-psychology Adjustment Mode on the Mental Health of Medical Workers.

    Science.gov (United States)

    Xu, Wenxin; Ceng, Mengjuan; Yao, Jiwei; Chen, Longfei

    2017-06-01

    Chinese medical workers suffer from a high incidence of mental health problems, resulting in reduced efficiency, increased medical malpractice, rising medical costs, and other issues. The effective alleviation of mental health problems among medical workers is therefore an important focus of research and social attention. The mental health of 842 medical workers from the First Affiliated Hospital of Fujian Medical University and the Second Affiliated Hospital of Fujian Medical University in Fuzhou, China was evaluated between February 2016 and March 2016. Sixty-two workers with positive SCL-90 screening results were selected as the subjects to be investigated in the intervention experiment, with 31 in the intervention group and 31 in the control group. The control group did not participate in any regular physical exercise activity for the 4-month duration of the study, whereas the exercise-psychology adjustment mode was applied to the intervention group. Medical workers had a higher total SCL-90 score and number of positive items than the national norm (P psychology adjustment is an effective intervention mode for the mental health of medical workers.

  18. Descriptive Analysis Of Mental Health-Related Presentations To Emergency Medical Services.

    Science.gov (United States)

    Roggenkamp, Renee; Andrew, Emily; Nehme, Ziad; Cox, Shelley; Smith, Karen

    2018-01-24

    In many developed countries, a lack of community-based mental health services is driving increased utilization of emergency medical services (EMS). In this descriptive study, we sought to describe the demographic and clinical characteristics of mental health-related EMS presentations in Victoria, Australia. A retrospective observational study of EMS presentations occurring between January and December 2015. Computer Aided Dispatch and electronic patient care record data were extracted from an electronic data warehouse. Characteristics of EMS-attended mental health presentations were described and compared to other EMS-attended patients using descriptive statistics. Of the total 504,676 EMS attendances, 48,041 (9.5%) were mental health presentations. In addition, 4,708 (6.6%) cases managed by a paramedic or nurse via the EMS secondary telephone triage service also involved mental health complaints. EMS-attended mental health patients were younger and more often female compared to other patients attended by EMS. Most mental health patients were transported to hospital (74.4%); however, paramedics provided treatment to significantly fewer mental health patients compared to other EMS-attended patients (12.4% vs. 50.3%, p mental health patients (76.8%) had a documented mental health history. Social or emotional issues were the most common presentation in mental health patients aged ≤15 years (19.1%); whereas, for patients aged ≥65 years, anxiety was the most common clinical presentation (41.2%). For patients undergoing secondary triage, 52.5% were frequent callers or anxiety presentations. A total of 27.7% of triaged patients were referred to an alternative service, while 24.6% were managed under an existing care plan. Mental health-related cases represent one in ten EMS attendances in Victoria. A large proportion of mental health presentations receive little intervention by EMS, and could benefit from community-based services provided by mental health clinicians.

  19. Mental health self-care in medical students: a comprehensive look at help-seeking.

    Science.gov (United States)

    Gold, Jessica A; Johnson, Benjamin; Leydon, Gary; Rohrbaugh, Robert M; Wilkins, Kirsten M

    2015-02-01

    The authors characterize medical student help-seeking behaviors and examine the relationship with stress, burnout, stigma, depression, and personal health behaviors. In 2013, the authors administered an electronic survey of all enrolled students at Yale School of Medicine (183 responders, response rate=35 %), inquiring about students' primary medical and mental health care, personal health behaviors, support systems, and help-seeking behaviors. Students completed the Attitudes to Mental Health Questionnaire, the Patient Health Questionnaire-2, and a modified Maslach Burnout Inventory. The authors analyzed the results with logistic regression, the Wilcoxon rank-sum test, the Kruskal-Wallis test, or a test for significance of Kendall rank correlation. Most students reported having a primary care provider (PCP), yet few reported seeking care when sick (33 %). Nineteen percent of students reported having a mental health provider, fewer than reported having a PCP (pstudents reported increased mental health needs since beginning medical school, and these students were more likely to agree that their needs were untreated. The majority of students endorsed stress, which correlated with increased and unmet mental health needs (pBurnout peaked in second- and third-year students and correlated with stress and increased and untreated needs. Most students reported comfort with asking for academic help; those uncomfortable were more likely to have mental health needs for which they did not seek treatment (p=0.004). Mental health stigma was low. Medical students had a significant unmet need for health care, influenced by barriers to accessing care, stress, burnout, and depression. Academic help seeking and supportive faculty relationships appear related to mental health treatment seeking. Targeted interventions for stress and burnout reduction, as well as incorporation of reflective practice, may have an impact on overall care seeking among medical students. Future studies should

  20. Evidence for an inhibitory presynaptic component of neuroleptic drug action.

    OpenAIRE

    de Belleroche, J. S.; Bradford, H. F.

    1981-01-01

    1 The action of five neuroleptic drugs (haloperidol, cis-flupenthixol, chlorpromazine, fluphenazine and thioridazine) was studied on the synthesis and release of dopamine from rat striatal synaptosomes. 2. In vitro application of the drugs induced an inhibition of synthesis of [14C]-dopamine from L-[U-14C]-tyrosine and a decrease in the tissue content of [14-C]-dopamine, with IC50 values for the latter effect ranging from 3.6 x 10(-7) to 5.9 x 10(-5) M. The rank of their potency was similar t...

  1. Subjective Well-Being Under Neuroleptics Scale short form (SWN-K): reliability and validity in an Estonian speaking sample.

    Science.gov (United States)

    Haring, Liina; Mõttus, René; Jaanson, Peeter; Pilli, Raine; Mägi, Kairi; Maron, Eduard

    2013-09-11

    The Subjective Well-Being Under Neuroleptic Treatment Scale short form (SWN-K) is a self-rating scale developed to measure mentally ill patients' well-being under the antipsychotic drug treatment. This paper reports on adaptation and psychometric properties of the instrument in an Estonian psychiatric sample. In a naturalistic study design, 124 inpatients or outpatients suffering from the first psychotic episode or chronic psychotic illness completed the translated SWN-K instrument. Item content analysis, internal consistency analysis, exploratory principal components analysis, and confirmatory factor analysis were used to construct the Estonian version of the SWN-K (SWN-K-E). Additionally, socio-demographic and clinical data, observer-rated psychopathology, medication side effects, daily antipsychotic drug dosages, and general functioning were assessed at two time points, at baseline and after a 29-week period; the associations of the SWN-K-E scores with these variables were explored. After having selected 20 items for the Estonian adaptation, the internal consistency of the total SWN-K-E was 0.93 and the subscale consistencies ranged from 0.70 to 0.80. Good test-retest reliabilities were observed for the adapted scale scores, with the correlation of the total score over about 6 months being r = 0.70. Confirmatory factor analysis replicated the presence of a higher-order factor (general well-being) and five first-order factors (mental functioning, physical functioning, social integration, emotional regulation, and self-control); the model fitted the data well. The results indicated a moderate-high correlations r = 0.54 between the SWN-K-E total score and the evaluation how satisfied patients were with their lives in generally. No significant correlations were found between the overall subjective well-being score and age, severity of the psychopathology, drug adverse effects, or prescribed drug dosage. Taken together, the results demonstrated that the Estonian

  2. Medication management and practices in prison for people with mental health problems: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rogers Anne

    2009-10-01

    Full Text Available Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS. Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. Methods The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Results and Discussion Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely

  3. Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry.

    Science.gov (United States)

    Gulati, Prannay; Das, Subhash; Chavan, B S

    2014-07-01

    Attitude of fresh graduates toward psychiatric patients is important to bridge the treatment gap due to mental illness. Psychiatry as a subject has been neglected in the undergraduates of MBBS. (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry. (2) To assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. Cross-sectional, single assessment study conducted at a tertiary hospital. Participants consisted of medical students of 1(st) and 2(nd) year who didn't have any exposure to psychiatry and interns, who had completed their compulsory 2 week clinical posting in psychiatry. Participants were individually administered sociodemographic proforma, General Health Questionnaire-12 (GHQ-12), opinion about mental illness (OMI) scale, and attitude to psychiatry-29 (ATP-29) scale. Standard descriptive statistics (mean, percentage), Chi-square test. A total of 135 participants formed the study sample, with 48, 47, and 40 participants from 1(st) year, 2(nd) year and interns, respectively. Mean GHQ score was 14.03 for the entire sample. There was better outlook of interns toward psychiatry and patients with mental disorders in comparison to fresh graduate students in some areas. Overall, negative attitude toward mental illness and psychiatry was reflected. Exposure to psychiatry as per the current curriculum seems to have a limited influence in bringing a positive change in OMI and psychiatry.

  4. Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry

    Science.gov (United States)

    Gulati, Prannay; Das, Subhash; Chavan, B. S.

    2014-01-01

    Context: Attitude of fresh graduates toward psychiatric patients is important to bridge the treatment gap due to mental illness. Psychiatry as a subject has been neglected in the undergraduates of MBBS. Aims: (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry. (2) To assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. Settings and Design: Cross-sectional, single assessment study conducted at a tertiary hospital. Subjects and Methods: Participants consisted of medical students of 1st and 2nd year who didn’t have any exposure to psychiatry and interns, who had completed their compulsory 2 week clinical posting in psychiatry. Participants were individually administered sociodemographic proforma, General Health Questionnaire-12 (GHQ-12), opinion about mental illness (OMI) scale, and attitude to psychiatry-29 (ATP-29) scale. Statistical Analysis: Standard descriptive statistics (mean, percentage), Chi-square test. Results: A total of 135 participants formed the study sample, with 48, 47, and 40 participants from 1st year, 2nd year and interns, respectively. Mean GHQ score was 14.03 for the entire sample. There was better outlook of interns toward psychiatry and patients with mental disorders in comparison to fresh graduate students in some areas. Overall, negative attitude toward mental illness and psychiatry was reflected. Conclusions: Exposure to psychiatry as per the current curriculum seems to have a limited influence in bringing a positive change in OMI and psychiatry. PMID:25316938

  5. Extrapyramidal side effects as a consequence of treatment with neuroleptics

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    Shirley Fumi Taniguchi

    2008-03-01

    Full Text Available Objective: To check the occurrence of extrapyramidal side effects inpatients receiving neuroleptic drugs, how these effects are treated,and to observe the occurrence of hallucinations caused by treatmentof extrapyramidal symptoms. Methods: The present study analyzedmedical records and interviewed 39 schizophrenic patients beingtreated in a public primary care clinic located in the southern partof the city of São Paulo, who had previously agreed to participatein the project. Results: Among 39 patients studied, 85% presentedextrapyramidal symptoms. Of these, 69.7% were treated for theside effects, 73.9% were treated with biperiden and 26.09% hadtheir neuroleptic drug reduced. Out of those patients treated withbiperiden, 70.5% had side effects, such as hallucination and delusion,blurred vision, somnolence and verbal memory deficit. Conclusions:The majority of patients (85% undergoing treatment with neurolepticdrugs developed motor side effects. When these extrapyramidalsymptoms were treated with central action anticholinergic drugs(biperiden, hallucination and/or delusion occurred in 52.94% ofpatients – probably because of increased dopaminergic activity asa consequence of cholinergic activity reduction caused by biperidenin the mesocortical and mesolimbic pathways.

  6. Improving mental health service users' physical health through medication monitoring: a literature review.

    Science.gov (United States)

    Nash, Michael

    2011-04-01

    To explore the importance of improving physical health in mental health service users through medication monitoring. Mental health service users' physical health is frequently poor, although many have contact with health-care services. Adverse drug reactions are a unique risk factor for poor physical health. However, medication monitoring remains inconsistent. A literature review was conducted using search terms: medication monitoring, adverse drug reactions, physical health/illness, mental health/psychiatric nursing. Databases searched included PsychINFO, Pubmed, CINHAL and the British Nursing Index. Structured medication monitoring is required to enhance physical health and reduce the risk of adverse events. Nurse managers should promote a culture of evidence-based practice in medication monitoring. Practitioner learning needs and competencies should be assessed to provide relevant education and skills training. Nurse managers require strategic leadership to transform practice and enhance mental health service users' physical health through medication monitoring. Good practice guidelines should be implemented to improve quality of care and reduce the risk of adverse events. ADDITION TO CURRENT KNOWLEDGE: This paper illustrates the importance of medication monitoring in improving physical health. © 2011 The Author. Journal compilation © 2011 Blackwell Publishing Ltd.

  7. A controlled trial of mental illness related stigma training for medical students

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    Leese Morven

    2011-07-01

    Full Text Available Abstract Background The evidence base for mental illness related stigma interventions in health care professionals and trainees is underdeveloped. This study aimed to examine the impact of mental illness related stigma training on third year medical students' knowledge, attitudes and behaviour related to people with mental illness. Methods A non-randomised controlled trial was conducted with 110 third year medical students at a medical school in England to determine the effectiveness of a mental illness related stigma training package that targeted their knowledge, attitudes and behaviour. Results We detected a significant positive effect of factual content and personal testimonies training upon an improvement in knowledge, F(1, 61 = 16.3, p = 0.0002. No such difference was determined with attitudes or for behaviour. Conclusions Knowledge, attitudes and behaviour may need to be separately targeted in stigma reduction interventions, and separately assessed. The inter-relationships between these components in mental health promotion and medical education warrant further research. The study next needs to be replicated with larger, representative samples using appropriate evaluation instruments. More intensive training for medical students may also be required.

  8. Prevalence of poor mental health among medical students in Nepal: a cross-sectional study.

    Science.gov (United States)

    Adhikari, Arjab; Dutta, Aman; Sapkota, Supriya; Chapagain, Abina; Aryal, Anurag; Pradhan, Amita

    2017-11-28

    Poor mental health among medical students is widely acknowledged. Studies on mental health among medical students of Nepal are lacking. Therefore, we conducted a study to determine the prevalence of mental disorders. A cross-sectional study was conducted among medical students at KIST Medical College and Teaching Hospital, Nepal from December 2016 to February 2017. Our survey instrument consisted of the Patient Health Questionnaire (PHQ) and questions about socio-demographic factors, smoking, marijuana use, suicidal ideation and thoughts of dropping out of medical school. The prevalence rates were 29.2% (95% CI, 24.4% - 34.3%) depression, 22.4% (95% CI, 18.0% - 26.9%) medium to highly severe somatic symptoms, 4.1% (95% CI, 2.0% - 6.2%) panic syndrome, 5.8% (95% CI, 3.4% - 8.3%) other anxiety syndrome, 5% (95% CI, 2.7% - 7.3%) binge eating disorder and 1.2% (95% CI, 0.0% - 2.3%) bulimia nervosa. Sixteen students [4.7% (95% CI, 2.4% - 6.9%)] seriously considered committing suicide while in medical school. Thirty-four students [9.9% (95% CI, 6.8% - 13.1%)] considered dropping out of medical school within the past month. About 15% (95% CI, 11.1% - 18.6%) of the students reported use of marijuana during medical school. We found high prevalence of poor mental health among medical students of Nepal. Future studies are required to identify the factors associated with poor mental health.

  9. Mandatory physical exercise for the prevention of mental illness in medical students.

    Science.gov (United States)

    Bitonte, Robert A; DeSanto, Donald Joseph

    2014-09-02

    Medical students experience higher rates of mental illness than the general population. With competition rising for success in medical school, and residency, increasing incidence of distress are leading this population to experience higher rates of thoughts of dropping out of school, and even suicide. Since many stigmas deter medical students from receiving mental health counseling, such as the perceived inability to handle the stresses of medical school, and the potential lack of competitiveness for residencies if reported, prevention of mental illness may be a better course to take in reducing prevalence in this population. Regular exercise has demonstrated a positive effect on not only promoting physical health, but also mental health. Exercise encourages a healthy mood, positive self esteem, and better cognition, while decreasing the chances of depression, anxiety, and burnout. Implementing exercise time into medical school curriculums, just like the basic sciences, albeit for less time in the day, could provide a feasible way to ensure that all students are taking time to partake in this important activity for their well being. Though medical schools are rigid with attempts to make changes in their curriculum, thirty minutes a day, three to five times a week of exercise of the students' choice not only is more cost effective than counseling, but it also reduces the chances that they will experience burnout, which if left untreated could transcend into a compromised training experience.

  10. Mandatory physical exercise for the prevention of mental illness in medical students

    Directory of Open Access Journals (Sweden)

    Robert A. Bitonte

    2014-09-01

    Full Text Available Medical students experience higher rates of mental illness than the general population. With competition rising for success in medical school, and residency, increasing incidence of distress are leading this population to experience higher rates of thoughts of dropping out of school, and even suicide. Since many stigmas deter medical students from receiving mental health counseling, such as the perceived inability to handle the stresses of medical school, and the potential lack of competitiveness for residencies if reported, prevention of mental illness may be a better course to take in reducing prevalence in this population. Regular exercise has demonstrated a positive effect on not only promoting physical health, but also mental health. Exercise encourages a healthy mood, positive self esteem, and better cognition, while decreasing the chances of depression, anxiety, and burnout. Implementing exercise time into medical school curriculums, just like the basic sciences, albeit for less time in the day, could provide a feasible way to ensure that all students are taking time to partake in this important activity for their well being. Though medical schools are rigid with attempts to make changes in their curriculum, thirty minutes a day, three to five times a week of exercise of the students’ choice not only is more cost effective than counseling, but it also reduces the chances that they will experience burnout, which if left untreated could transcend into a compromised training experience.

  11. Sleep, mental health status, and medical errors among hospital nurses in Japan.

    Science.gov (United States)

    Arimura, Mayumi; Imai, Makoto; Okawa, Masako; Fujimura, Toshimasa; Yamada, Naoto

    2010-01-01

    Medical error involving nurses is a critical issue since nurses' actions will have a direct and often significant effect on the prognosis of their patients. To investigate the significance of nurse health in Japan and its potential impact on patient services, a questionnaire-based survey amongst nurses working in hospitals was conducted, with the specific purpose of examining the relationship between shift work, mental health and self-reported medical errors. Multivariate analysis revealed significant associations between the shift work system, General Health Questionnaire (GHQ) scores and nurse errors: the odds ratios for shift system and GHQ were 2.1 and 1.1, respectively. It was confirmed that both sleep and mental health status among hospital nurses were relatively poor, and that shift work and poor mental health were significant factors contributing to medical errors.

  12. Mental health workshops delivered by medical students in Cambridge secondary schools: an evaluation of learning.

    Science.gov (United States)

    Bentham, Chloe; Daunt, Anna; Taylor, Stephanie; Simmons, Meinou

    2013-09-01

    For a group of medical students to design and deliver a mental health workshop in Cambridge secondary schools. Subsequently, to evaluate any improvements in pupils' knowledge of mental health issues, including knowledge of common mental illnesses, stigma and where to access help with mental health problems. A group of three medical students undertook a five week Student Selected Component to develop a mental health workshop in Spring 2013. The workshop was designed to include interactive components, such as role play, models and video. It was delivered to eight classes of 12-13 year old pupils across two local secondary schools, a total of 230 students. Questionnaires were completed before and after each workshop to test knowledge acquisition of mental health issues, stigma and where pupils could get help with mental health problems. Comparisons between data from the pre- and post-workshop questionnaires were made to assess learning. The responses from the questionnaires showed a global improvement in knowledge of mental health. This is highlighted by the increase in awareness of the prevalence of mental health problems amongst young people from 47.0% before the workshops to 97.8% after the workshops. The ability to identify symptoms of anxiety rose from 21.7% to 44.8% and the ability to identify depression rose from 29.0% to 53.5% respectively. Whilst only 15.2% pupils disagreed with a stigmatising statement about mental illness before the workshops, 61.3% pupils disagreed afterwards. The students were also better informed about how to access help and identified areas that they found useful to learn about. Comparison of the pre- and post-workshop questionnaires indicate that medical student-led workshops are an effective method for improving knowledge of mental health topics amongst 12-13 year old school pupils, as well as encouraging positive attitudes towards mental health. The project highlights a demand for mental health education in schools and brings to

  13. Integrative Review of Mobile Phone Contacts and Medication Adherence in Severe Mental Illness.

    Science.gov (United States)

    Bright, Cordellia E

    2018-02-01

    Poor medication adherence is a significant problem in individuals with severe mental illness (SMI). About 50% of people with SMI become nonadherent to treatment in the first month following discharge from the hospital. This study examined literature in the past decade (2006-2016) on the use of mobile phone contacts in individuals with SMI to improve medication adherence post hospital discharge. This integrative review used the search terms texting, text messaging, SMS, cell/mobile phone, medication adherence, medication compliance, and mental illness. Databases (CINAHL, PubMed, PsycINFO, and Scopus) and manual searching of reference lists were done. The main inclusion criteria were the use of mobile phone contacts on medication adherence in individuals with SMI. Adults 18 years and older, studies conducted from 2006 to 2016, and studies conducted in English were also criteria for inclusion. Only five studies met criteria for inclusion. Outcomes from the review showed that mobile phone contacts have been used to improve medication adherence in individuals with SMI and able to provide the four types of social support (instrumental, informational, emotional, and, appraisal). When phone contacts especially text messaging was used as an adjunct to other interventions, it yielded better medication adherence than when used alone. However, results on medication adherence rates were mixed in participants on both psychiatric and nonpsychiatric medications. Although mobile phone contacts are a promising tool to enhance medication adherence after hospital discharge, its effectiveness to increase medication adherence in this population remains inconclusive.

  14. Atypical and typical neuroleptic treatments induce distinct programs of transcription factor expression in the striatum.

    Science.gov (United States)

    Hiroi, N; Graybiel, A M

    1996-10-07

    Atypical and typical neuroleptics, when administered chronically, can bring about profound but contrasting changes in schizophrenic symptoms and motor activation and dramatically modulate brain neurochemistry. To explore the transcriptional events that might be involved in this neurochemical regulation, we used immunohistochemistry and immunoblotting to examine the expression patterns of two bZip transcription factors, c-Fos and FosB, in the striatum of rats treated acutely and chronically with neuroleptic drugs of different classes. Typical and atypical neuroleptic drugs produced contrasting regulatory effects on a FosB-like protein of ca. 36-39 kDa, the molecular weight of truncated FosB (delta FosB). Chronic treatments with two typical neuroleptics, haloperidol and metoclopramide, but not with the atypical neuroleptic clozapine, led to markedly enhanced FosB-like immunoreactivity in the caudoputamen. Further, c-Fos-like protein in the striatum, considered a marker for the induction of antipsychotic actions by neuroleptic treatments, was downregulated by chronic treatment with the two potent antipsychotic drugs tested, but not by chronic treatment with metoclopramide, which has low antipsychotic efficacy but induces extrapyramidal side effects. These results suggest that chronic treatments with neuroleptics having different effects on cognitive and motor behavior induce different long-term changes in transcription factor expression in the striatum. Nevertheless, we found that neuroleptics of both classes regulated transcription factor expression in overlapping populations of striatal neurons expressing enkephalin or DARPP-32. Contrasting patterns of transcriptional regulation in these neurons may thus contribute to the distinct neurochemical and behavioral effects that characterize neuroleptics of different classes.

  15. Decisions about Confidentiality in Medical Student Mental Health Settings.

    Science.gov (United States)

    Lindenthal, Jacob Jay; And Others

    1984-01-01

    Examined responses of psychologists and psychiatrists in medical schools (N=59) to vignettes representing student problems. Results suggested practitioners were generally unwilling to break confidentiality in response to problems involving suicidal tendencies, sexual coercion/seduction, social transgressions, or falsifying data. Only suggestions…

  16. A case of neuroleptic malignant syndrome following cardiac surgery

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    Atsushi Tamura

    2017-06-01

    Full Text Available Neuroleptic malignant syndrome (NMS is rare but sometimes causes life-threatening conditions. We report the case of a 53-year-old male patient who developed NMS following cardiac surgery. He was diagnosed with schizophrenia and pre- scribed blonanserin, chlorpromazine, and biperiden. From postoperative day 3, hyperthermia, disturbed consciousness, and involuntary movement were observed. Subsequently, his serum creatine phosphokinase (CPK levels increased. After NMS was suspected, chlorpromazine and biperiden were stopped. From postoperative day 7, intravenous administration of dant- rolene was initiated. Following this treatment, his serum CPK levels gradually decreased, and the other symptoms improved. The treatment of NMS remains controversial. There is no evidence that dantrolene is effective for treating NMS; however, it may be one of the important options for treating NMS. We present the case and discuss the diagnosis and management of NMS following cardiac surgery. [Arch Clin Exp Surg 2017; 6(2.000: 117-119

  17. Neuroleptic Malignant Syndrome Associated with Refractory Acute Disseminated Encephalomyelitis

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    Silvia R. Delgado

    2016-04-01

    Full Text Available We present the case of a young man who was transferred to our hospital with worsening acute disseminated encephalomyelitis (ADEM despite treatment with intravenous methylprednisolone, intravenous immunoglobulin and plasma exchange. He developed neuroleptic malignant syndrome (NMS without the use of dopamine-modulating drugs. His progressive clinical improvement started after treatment with intravenous cyclophosphamide and methylprednisolone. In our patient, acute demyelination with severe bilateral inflammation of the basal ganglia could have caused a state of central dopamine depletion, creating proper conditions for the development of NMS. Significant clinical improvement of our case after treatment with intravenous cyclophosphamide and steroids provides further evidence for a possible role of the inflammatory lesions in the pathogenesis of NMS in association with ADEM.

  18. Mental Health Status of Medical Students in Tehran: A Cross Sectional Study

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    Mohammad-Reza Sohrabi

    2015-12-01

    Full Text Available Background: Mental health of medical students who will be responsible for community health has great importance. This study was designed to determine the prevalence of probable mental disorders during the internship period of medical students.    Methods: This descriptive cross sectional study evaluated 404 medical students of Shahid Beheshti University of Medical Sciences, in Tehran, the capital of Iran. The data collecting instrument was a self-rated questionnaire including standard mental health questionnaire SCL-90-R, demographic and socio-economic data. The score 0.7 and above were designated as possible cases of mental disorders. Analysis performed by SPSS software, version 14 (SPSS Inc, Chicago, Il, USA. p-value<0.05 was considered significant.  Results: 53.8% of participants were female, and 79.4% were single. From all participants, 14.1% had Global Severity Index (GSI score more than 0.7. Mean and standard deviation of GSI score was 0.32 (0.27. The frequency of probable mental disorder in medical students was 16.3% in somatization; 24.5% in obsessive-compulsive; 15.6% in interpersonal sensitivity; 16.8% in depression; 18.8% in anxiety; 14.6% in hostility; 11.4% in phobic anxiety; 16.8% in paranoid ideation and 13.9% in psychoticism. Students who had no children, lived in dormitory, had good economic status and were satisfied with their private life and studying course had significantly lower GSI scores.  Conclusion: Between 11 to 24% of the students had mental disorders in different dimensions and economic status, living place and number of children were related to the disorders.

  19. Impact of psychiatric education and training on attitude of medical students towards mentally ill: A comparative analysis

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    Tarun Yadav

    2012-01-01

    Full Text Available Background: A number of studies from the western world have explored the negative beliefs held by individuals towards people with mental illness. The knowledge of attitude and awareness of undergraduate medical students towards psychiatry, mental health and mental disorders is of utmost importance. Objective: The current study aims at assessment of attitudes of medical students towards mental illness and mentally ill. Materials and Methods: The study used a cross-sectional survey design. The instruments used included Beliefs toward Mental Illness (BMI scale, Attitudes to Mental Illness Questionnaire (AMIQ. ANOVA was carried out to compare the in between group differences for the four study groups. Additionally Bonferroni correction was used to conduct the post hoc analysis. Results: The interns were significantly more likely to agree with the statement that the mental disorders are recurrent; less likely to be of thought that the behavior of people with mental disorders is unpredictable; more likely to disagree with the fact that diagnosis of depression as described in the case vignette was going to damage the career of the individual; more likely to agree with the option of inviting a depressed person to a party; more likely to believe in fact that mentally ill individuals are more likely to be criminals as compared to medical students in different professional years. Conclusions: Adequate modifications to existing medical curriculum would help improve attitude of medical students towards mentally ill.

  20. Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medication, and Barriers to Care in the United States Military

    Science.gov (United States)

    2012-10-01

    treatment and etiology of psychological disorders relate to seeking professional help at a military mental health clinic and to general healthcare...beliefs about six different disorders or diseases (Cocaine Addiction, Mental Retardation , AIDS, Psychosis, Depression, and Cancer). The PDAQ has three...08-2-0702 TITLE: Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medication, and Barriers to Care in the United

  1. General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector.

    Science.gov (United States)

    Papathanasiou, Ioanna V; Kleisiaris, Christos F; Tsaras, Konstantinos; Fradelos, Evangelos C; Kourkouta, Lambrini

    2015-08-01

    General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values age of the sample was 41.8 ± 7.9 years. The Cronbach alpha coefficient for GSQ was 0.79. The total mean score of general satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

  2. Medical students' subjective ratings of stress levels and awareness of student support services about mental health.

    Science.gov (United States)

    Walter, Garry; Soh, Nerissa Li-Wey; Norgren Jaconelli, Sanna; Lampe, Lisa; Malhi, Gin S; Hunt, Glenn

    2013-06-01

    To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals.

  3. Mental health issues amongst medical students in Asia: a systematic review [2000–2015

    Science.gov (United States)

    Sayampanathan, Andrew Arjun; Ho, Roger Chun-Man

    2016-01-01

    Background Studies have shown that the stress experienced by medical students is far greater than that experienced by other university students. In this study, we aim to understand the consequent mental health issues that are experienced by medical students, particularly in Asia, via a systematic review of the current literature. Methods Initial searches on MEDLINE, Embase and SpringerLink came up with a total of 1,033 unique articles. Studies not focusing on medical students alone, not mentioning mental health issues or not containing prevalence values were excluded. Results We included 14 articles in our analysis. ADs had a prevalence of 7.04% (100/1,420). Depression was prevalent in 11.0% (1,115/10,147) of students. A total of 12.9% (54/420) and 12.9% (41/319) of male and female medical students respectively were screened for depression. Preclinical students were also 1.63 times more likely to be depressed compared to clinical students, with 98.0% (48/49) pre-clinical students having screened for depression, compared to 60% (27/45) clinical students. Home staying medical students are 1.33 times more likely to be depressed compared to hostel-stayers, with 12.1% (29/239) of home stayers being depressed compared to 9.2% (37/402) of hostel stayers. Conclusions We found that mental health issues affect a significant proportion of medical students and they are more prevalent in certain subpopulations of medical students. Our data revealed that preclinical and home staying students can be more susceptible to depression. More research should be done regarding this issue. With such information, it is hoped that appropriate interventions can be designed to improve the mental health of medical students. PMID:27004219

  4. Mental health issues amongst medical students in Asia: a systematic review [2000-2015].

    Science.gov (United States)

    Cuttilan, Amit Nirmal; Sayampanathan, Andrew Arjun; Ho, Roger Chun-Man

    2016-02-01

    Studies have shown that the stress experienced by medical students is far greater than that experienced by other university students. In this study, we aim to understand the consequent mental health issues that are experienced by medical students, particularly in Asia, via a systematic review of the current literature. Initial searches on MEDLINE, Embase and SpringerLink came up with a total of 1,033 unique articles. Studies not focusing on medical students alone, not mentioning mental health issues or not containing prevalence values were excluded. We included 14 articles in our analysis. ADs had a prevalence of 7.04% (100/1,420). Depression was prevalent in 11.0% (1,115/10,147) of students. A total of 12.9% (54/420) and 12.9% (41/319) of male and female medical students respectively were screened for depression. Preclinical students were also 1.63 times more likely to be depressed compared to clinical students, with 98.0% (48/49) pre-clinical students having screened for depression, compared to 60% (27/45) clinical students. Home staying medical students are 1.33 times more likely to be depressed compared to hostel-stayers, with 12.1% (29/239) of home stayers being depressed compared to 9.2% (37/402) of hostel stayers. We found that mental health issues affect a significant proportion of medical students and they are more prevalent in certain subpopulations of medical students. Our data revealed that preclinical and home staying students can be more susceptible to depression. More research should be done regarding this issue. With such information, it is hoped that appropriate interventions can be designed to improve the mental health of medical students.

  5. Learning styles, academic achievement, and mental health problems among medical students in Thailand

    OpenAIRE

    Paiboonsithiwong, Salilthip; Kunanitthaworn, Natchaya; Songtrijuck, Natchaphon; Wongpakaran, Nahathai; Wongpakaran, Tinakon

    2016-01-01

    Purpose This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. Methods This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK) questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 type...

  6. Altered functional connectivity links in neuroleptic-naïve and neuroleptic-treated patients with schizophrenia, and their relation to symptoms including volition

    Directory of Open Access Journals (Sweden)

    Weidan Pu

    2014-01-01

    Full Text Available In order to analyze functional connectivity in untreated and treated patients with schizophrenia, resting-state fMRI data were obtained for whole-brain functional connectivity analysis from 22 first-episode neuroleptic-naïve schizophrenia (NNS, 61 first-episode neuroleptic-treated schizophrenia (NTS patients, and 60 healthy controls (HC. Reductions were found in untreated and treated patients in the functional connectivity between the posterior cingulate gyrus and precuneus, and this was correlated with the reduction in volition from the Positive and Negative Symptoms Scale (PANSS, that is in the willful initiation, sustenance, and control of thoughts, behavior, movements, and speech, and with the general and negative symptoms. In addition in both patient groups interhemispheric functional connectivity was weaker between the orbitofrontal cortex, amygdala and temporal pole. These functional connectivity changes and the related symptoms were not treated by the neuroleptics. Differences between the patient groups were that there were more strong functional connectivity links in the NNS patients (including in hippocampal, frontal, and striatal circuits than in the NTS patients. These findings with a whole brain analysis in untreated and treated patients with schizophrenia provide evidence on some of the brain regions implicated in the volitional, other general, and negative symptoms, of schizophrenia that are not treated by neuroleptics so have implications for the development of other treatments; and provide evidence on some brain systems in which neuroleptics do alter the functional connectivity.

  7. Olanzapine versus typical neuroleptics for schizophrenia: evaluation of social and economic costs

    Directory of Open Access Journals (Sweden)

    Giorgio Mariani

    2006-06-01

    Full Text Available An important number of publications is reporting results from health outcomes studies comparing atypical antipsychotics (AA with typical neuroleptics (TN over 1 year of observation. Our study has prolonged the period observation of the economical and social outcomes to 4 years: 31 patients with schizophrenia were observed retrospectively during two years of TN treatment and then followed during 2 more years of olanzapine treatment after naturalistic switch. The results show a general reduction of health care interventions (territory and hospital during the olanzapine treatment period. Global costs during olanzapine treatment were lower than during TN treatment (10506 euros with TN vs 6193 euros with olanzapine over 2 years. The social outcome, measured through the registration of the number of working days in the two periods of the study (retrospective with TN and prospective with olanzapine, was better during olanzapine treatment, probably due to increased patient compliance to the rehabilitative activities offered by the Department of Mental Health. In our experience, olanzapine appeared to dominate TN treatment, as its higher acquisition costs were offset by the reduction of territorial and nosocomial health care interventions over two years of observation, and associated with higher involvement in rehabilitative and social activities.

  8. Mobile phones as medical devices in mental disorder treatment: an overview

    DEFF Research Database (Denmark)

    Gravenhorst, Franz; Muaremi, Amir; Bardram, Jakob

    2015-01-01

    , monitoring mental disorders relies on subjective clinical self-reporting rating scales, which were developed more than 50 years ago. In this paper, we discuss how mobile phones can support the treatment of mental disorders by (1) implementing human–computer interfaces to support therapy and (2) collecting...... advantages and drawbacks of the most promising mobile phone technologies for detecting mood disorders like depression or bipolar disorder. Finally, we discuss practical implementation details, legal issues and business models for the introduction of mobile phones as medical devices....... relevant data from patients’ daily lives to monitor the current state and development of their mental disorders. Concerning the first point, we review various systems that utilize mobile phones for the treatment of mental disorders. We also evaluate how their core design features and dimensions can...

  9. Mental health stigma and attitudes to psychiatry among Bangladeshi medical students.

    Science.gov (United States)

    Giasuddin, Noor Ahmed; Levav, Itzhak; Gal, Gilad

    2015-03-01

    The shortage of specialized human resources in mental health in Bangladesh requires active recruitment of psychiatric residents. In addition, the involvement of positively inclined health personnel, for example, medical doctors, emerges as an immediate priority. To explore stigma among medical students toward persons with mental disorders (PMDs) and their attitudes toward psychiatry. A cross-sectional study was conducted at Faridpur Medical College in Bangladesh before (First year) and following psychiatric rotation (Fifth year). Students (N = 200) filled anonymous questionnaires measuring stigma toward PMDs and attitudes to psychiatry. Upper medical school year (p = .028), older age (p = .005), mother's lower academic level (p = .043), upper and lower socioeconomic level affiliation (p = .008) and self-consultation for mental or neurological complaints (p = .032) were associated with increased stigma toward PMDs. More favorable attitudes toward psychiatry were found in upper medical school year (p = .073) and were significantly associated with female gender (p = .018) and middle socioeconomic level affiliation (p = .013). The relative improvement in attitudes toward psychiatry in the upper medical school year is overshadowed by the increased stigma toward PMDs. Specific anti-stigma program in the curriculum and strategies to improve the attitudes are required. © The Author(s) 2014.

  10. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    Science.gov (United States)

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

  11. Children on Medication: Volume I. Hyperactivity, Learning Disabilities, and Mental Retardation.

    Science.gov (United States)

    Gadow, Kenneth D.

    Intended for caregivers, the book provides basic information about the use of medication for children with hyperactivity, learning disabilities, and mental retardation. The main emphasis is on psychotropic drug use for hyperactivity and aggressiveness. Chapter 1 explains fundamental terms and concepts relating to drug therapy. Major stresses…

  12. Common mental disorders among medical students at Universidade Federal de Sergipe: a cross-sectional study.

    Science.gov (United States)

    Costa, Edméa Fontes de Oliva; Andrade, Tarcísio Matos de; Silvany Neto, Annibal Muniz; Melo, Enaldo Vieira de; Rosa, Ana Carolina Aquino; Alencar, Mariana Amorim; Silva, Angela Maria da

    2010-03-01

    Estimate the prevalence of common mental disorder and its associated factors among medical students of the Universidade Federal de Sergipe. A cross-sectional study was carried out, applying Self Reporting Questionnaire-20 to 473 students from the 512 medical students enrolled in 2006 and compared with compared with a structured questionnaire by the authors containing information on the socio-demographic characteristics, the teaching-learning process and the psycho-emotional experiences of the students. Freshmen were excluded after initial comparison with the students already exposed to the medical course. Statistical analysis by multiple logistic regression after calculating simple and adjusted odds ratio (OR). The general prevalence of common mental disorder was 40% (n = 473); after exclusion of the freshmen it increased to 42.5% among students from the 2nd to the 12th semester. It was higher among those who did not have faith in their acquisition of the skills needed to become a good doctor (OR = 2.82), who felt less comfortable about course activities (OR = 3.75), who considered themselves emotionally stressed (OR = 2.14), among those who did not consider themselves happy (OR = 2.85), who believed that the course did not match their expectations (OR = 1.64) and those who had a prior diagnosis of mental disorder by a psychiatrist (OR = 3.78). The results suggest the necessity of changes to the teaching-learning process and the establishment of a preventive mental health program for medical students.

  13. Longitudinal Mental Health Service and Medication Use of ADHD among Puerto Rican Youth in Two Contexts

    Science.gov (United States)

    Bird, Hector R.; Shrout, Patrick E.; Duarte, Cristiane S.; Shen, Sa; Bauermeister, Jose J.; Canino, Glorisa

    2008-01-01

    The study discusses the differences in the prevalence of attention-deficit/hyperactivity disorder (ADHD) among Puerto Rican children and the influence of risk factors on mental health services, medication and psychostimulant use among them in two different contexts. The conclusion states that prevalence was similar regardless of context and…

  14. Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background The stigma of mental illness among medical students is a prevalent concern that has far reaching negative consequences. Attempts to combat this stigma through educational initiatives have had mixed results. This study examined the impact of a one-time contact-based educational intervention on the stigma of mental illness among medical students and compared this with a multimodal undergraduate psychiatry course at the University of Calgary, Canada that integrates contact-based educational strategies. Attitudes towards mental illness were compared with those towards type 2 diabetes mellitus (T2DM). Method A cluster-randomized trial design was used to evaluate the impact of contact-based educational interventions delivered at two points in time. The impact was assessed by collecting data at 4 time points using the Opening Minds Scale for Health Care Providers (OMS-HC) to assess changes in stigma. Results Baseline surveys were completed by 62% (n=111) of students before the start of the course and post-intervention ratings were available from 90 of these. Stigma scores for both groups were significantly reduced upon course completion (p mental illness and interest in a psychiatric career was increased at the end of the course. Stigma towards mental illness remained greater than for T2DM at all time points. Conclusions Psychiatric education can decrease the stigma of mental illness and increase student confidence. However, one-time, contact-based educational interventions require further evaluation in this context. The key components are postulated to be contact, knowledge and attention to process, where attending to the student’s internal experience of working with people with mental illness is an integral factor in modulating perceptions of mental illness and a psychiatric career. PMID:24156397

  15. Development and implementation of a 'Mental Health Finder' software tool within an electronic medical record system.

    Science.gov (United States)

    Swan, D; Hannigan, A; Higgins, S; McDonnell, R; Meagher, D; Cullen, W

    2017-02-01

    In Ireland, as in many other healthcare systems, mental health service provision is being reconfigured with a move toward more care in the community, and particularly primary care. Recording and surveillance systems for mental health information and activities in primary care are needed for service planning and quality improvement. We describe the development and initial implementation of a software tool ('mental health finder') within a widely used primary care electronic medical record system (EMR) in Ireland to enable large-scale data collection on the epidemiology and management of mental health and substance use problems among patients attending general practice. In collaboration with the Irish Primary Care Research Network (IPCRN), we developed the 'Mental Health Finder' as a software plug-in to a commonly used primary care EMR system to facilitate data collection on mental health diagnoses and pharmacological treatments among patients. The finder searches for and identifies patients based on diagnostic coding and/or prescribed medicines. It was initially implemented among a convenience sample of six GP practices. Prevalence of mental health and substance use problems across the six practices, as identified by the finder, was 9.4% (range 6.9-12.7%). 61.9% of identified patients were female; 25.8% were private patients. One-third (33.4%) of identified patients were prescribed more than one class of psychotropic medication. Of the patients identified by the finder, 89.9% were identifiable via prescribing data, 23.7% via diagnostic coding. The finder is a feasible and promising methodology for large-scale data collection on mental health problems in primary care.

  16. [Trial of interruption of antiparkinson drugs in long term treatments with neuroleptics].

    Science.gov (United States)

    Caroli, F; Littre-Poirier, M F; Ginestet, D; Deniker, P

    1975-01-01

    The authors by placebo methods interrupted the antiparkinsonian treatment in chronic psychotic patients who had a neuroleptic treatment for at least three months. Three weeks after: 72 percent had to receive the antiparkinsonian they took before, in consequence of extrapyramidal manifestations (an half of the sample receive this antiparkinsonian during the first week), and more than a third presented an acute psychotic outbreak. However, 28 percent of the total sample were still with placebo. Authors are questioning the psychotropic activity of antiparkinsonians, the influence of neuroleptic doses and the specificity of each administred neuroleptic. They conclude in opposition with other authors, to the necessity of prescribing continuously antiparkinsonians in most of the cases of chronic psychoses, in long-term neuroleptic treatment.

  17. The effects of neuroleptics on the GABA-induced Cl- current in rat dorsal root ganglion neurons: differences between some neuroleptics.

    Science.gov (United States)

    Yokota, Kenjiro; Tatebayashi, Hideharu; Matsuo, Tadashi; Shoge, Takashi; Motomura, Haruhiko; Matsuno, Toshiyuki; Fukuda, Akira; Tashiro, Nobutada

    2002-03-01

    1. Several neuroleptics inhibited the 3 microM gamma-aminobutyric acid induced-chloride current (GABA-current) on dissociated rat dorsal root ganglion neurons in whole-cell patch-clamp investigations. 2. The IC(50) for clozapine, zotepine, olanzapine, risperidone and chlorpromazine were 6.95, 18.26, 20.30, 106.01 and 114.56 microM, respectively. The values for the inhibitory effects of neuroleptics on the GABA (3 microM)-current, which were calculated by the fitting Hill's equations where the concentrations represent the mean therapeutic blood concentrations, were ranked clozapine>zotepine>chlorpromazine>olanzapine>risperidone. These inhibitory effects, weighted with the therapeutic concentrations of neuroleptics, were correlated with the clinical incidences of seizure during treatment with neuroleptics. 3. Clozapine reduced the picrotoxin-inhibiton, and may compete with a ligand of the t-butylbicyclophosphorothionate (TBPS) binding site. 4. Haloperidol and quetiapine did not affect the peak amplitude of the GABA (3 microM)-current. However, haloperidol reduced the clozapine-inhibition, and may antagonize ligand binding to TBPS binding site. 5. Neuroleptics including haloperidol and quetiapine enhanced the desensitization of the GABA (3 microM)-current. However, haloperidol and quetiapine at 100 microM inhibited the desensitization at the beginning of application. 6. Blonanserin (AD-5423) at 30 and 50 microM potentiated the GABA (3 microM)-current to 170.1+/-6.9 and 192.0+/-10.6% of the control current, respectively. Blonanserin shifted GABA concentration-response curve leftward. Blonanserin only partly negatively interacted with diazepam. The blonanserin-potentiation was not reversed by flumazenil. Blonanserin is not a benzodiazepine receptor agonist. 7. The various effects of neuroleptics on the GABA-current may be related to the clinical effects including modifying the seizure threshold.

  18. The effects of neuroleptics on the GABA-induced Cl− current in rat dorsal root ganglion neurons: differences between some neuroleptics

    Science.gov (United States)

    Yokota, Kenjiro; Tatebayashi, Hideharu; Matsuo, Tadashi; Shoge, Takashi; Motomura, Haruhiko; Matsuno, Toshiyuki; Fukuda, Akira; Tashiro, Nobutada

    2002-01-01

    Several neuroleptics inhibited the 3 μM γ-aminobutyric acid induced-chloride current (GABA-current) on dissociated rat dorsal root ganglion neurons in whole-cell patch-clamp investigations. The IC50 for clozapine, zotepine, olanzapine, risperidone and chlorpromazine were 6.95, 18.26, 20.30, 106.01 and 114.56 μM, respectively. The values for the inhibitory effects of neuroleptics on the GABA (3 μM)-current, which were calculated by the fitting Hill's equations where the concentrations represent the mean therapeutic blood concentrations, were ranked clozapine>zotepine>chlorpromazine>olanzapine>risperidone. These inhibitory effects, weighted with the therapeutic concentrations of neuroleptics, were correlated with the clinical incidences of seizure during treatment with neuroleptics. Clozapine reduced the picrotoxin-inhibiton, and may compete with a ligand of the t-butylbicyclophosphorothionate (TBPS) binding site. Haloperidol and quetiapine did not affect the peak amplitude of the GABA (3 μM)-current. However, haloperidol reduced the clozapine-inhibition, and may antagonize ligand binding to TBPS binding site. Neuroleptics including haloperidol and quetiapine enhanced the desensitization of the GABA (3 μM)-current. However, haloperidol and quetiapine at 100 μM inhibited the desensitization at the beginning of application. Blonanserin (AD-5423) at 30 and 50 μM potentiated the GABA (3 μM)-current to 170.1±6.9 and 192.0±10.6% of the control current, respectively. Blonanserin shifted GABA concentration-response curve leftward. Blonanserin only partly negatively interacted with diazepam. The blonanserin-potentiation was not reversed by flumazenil. Blonanserin is not a benzodiazepine receptor agonist. The various effects of neuroleptics on the GABA-current may be related to the clinical effects including modifying the seizure threshold. PMID:11906969

  19. Mental health in medical residents: relationship with personal, work-related, and sociodemographic variables.

    Science.gov (United States)

    Pereira-Lima, Karina; Loureiro, Sonia R; Crippa, José A

    2016-01-01

    To examine association of sociodemographic characteristics, personality traits, social skills, and work variables with anxiety, depression, and alcohol dependence in medical residents. A total of 270 medical residents completed the following self-report instruments: sociodemographic and work questionnaire, Patient Health Questionnaire-4 (PHQ-4), Alcohol Use Disorders Identification Test-3 (AUDIT-3), Revised NEO-Five Factor Inventory (NEO-FFI-R), and Social Skills Inventory (SSI-Del-Prette). Data were analyzed using descriptive statistics and univariate and multivariate logistic regression analyses. Multivariate analysis showed an association of neuroticism (odds ratio [OR] 2.60, p mental health problems in medical residents, in addition to providing data that may assist in the design of preventive measures to protect the mental health of this group.

  20. Unreasonable adjustments: medical education, mental disorder, disability discrimination and public safety.

    Science.gov (United States)

    Parker, Malcolm

    2014-09-01

    Recently the Civil and Administrative Tribunal of New South Wales found that the, University of Newcastle had discriminated against a medical student with borderline personality disorder and bipolar disorder on the grounds of her disability. This column summarises the case, and integrates a psychodynamic account of borderline personality disorder with Fulford's conceptual analysis of mental disorder as action failure, that is no different in principle from physical illnesses, some instances of which appear to uncontroversially rule out of contention some applicants for medical training. It is argued that some applicants for medical and health care programs with mental disorders should not be selected, because their disabilities are not amenable to satisfactory accommodation in the university training period, and they are incompatible with clinical training and practice. Universities should develop "Inherent Requirement" policies that better integrate their responsibility to support disabled students with the responsibility, currently reserved entirely to regulators, to ensure safe practice by their graduates.

  1. An assessment of attitudes towards people with mental illness among medical students and physicians in Ibadan, Nigeria.

    Science.gov (United States)

    Ighodaro, Adesuwa; Stefanovics, Elina; Makanjuola, Victor; Rosenheck, Robert

    2015-06-01

    The authors surveyed attitudes towards mental illness among Nigerian medical personnel at three different levels of training and experience: medical students who had not completed their psychiatry rotation, medical students who had competed their psychiatry rotation, and graduate physicians. Six questions addressed beliefs about the effectiveness of treatments for four specific mental illnesses (schizophrenia, bipolar disorder, depression, and anxiety) and two medical illnesses (diabetes and hypertension) among the three groups. A self-report questionnaire including 56 dichotomous items was used to compare beliefs about and attitudes towards people with mental illness. Factor analysis was used to identify key attitudes and analysis of covariance (ANCOVA) was used to compare the groups adjusting for age and personal experience with people with mental illness. There were no significant trends in attitudes towards the effectiveness of medication. Exploratory factor analysis of the beliefs and attitudes items identified four factors: (1) comfort socializing with people with mental, illness; (2) non-superstitious beliefs about the causes of mental illness; (3) neighborly feelings towards people with mental illness; and (4) belief that stress and abuse are part of the etiology of mental illness. ANCOVA comparing attitudes among the three groups showed that on three (1, 2, and 4) of the four factors medical students who had completed a rotation in psychiatry had significantly higher scores than the medical students who had not completed a rotation in psychiatry. Graduate physicians showed a similar pattern scoring higher than the medical students who had not completed a rotation in psychiatry in two factors (1 and 4) but showed no differences from students who had completed their psychiatry rotation. While beliefs about medication effectiveness do not differ between medical trainees and graduate professionals, stigmatizing attitudes towards people with mental illness seem

  2. Treatment recidivism in adolescents with mental illness: A focused applied medical ethnography.

    Science.gov (United States)

    Ekwemalor, Chukwudi C; Rozmus, Cathy L; Engebretson, Joan C; Marcus, Marianne T; Casarez, Rebecca L; Harper, Andrew R

    2017-02-01

    Treatment recidivism, described as frequent unplanned relapse readmissions, is a national problem predominant in adolescents with mental illness. Because the main triggers of treatment recidivism are not fully understood, the purpose of this study was to explore treatment recidivism (i) to better understand treatment recidivism from the perspectives of recidivist adolescents with mental illness, (ii) to describe major factors that contribute to treatment recidivism and how best to minimize them from the perspectives of these adolescents, and (iii) to describe their interaction with the medical culture. A focused applied medical ethnography was used to study 16 purposively selected adolescents. Interviews were conducted together with unobtrusive unit observation of the participants and collection of demographic and clinical information. The participants were nearly unanimous in identifying the "additional stressors" of problematic parental relations and school bullying as the main triggers of treatment recidivism over and above their "routine stressors" of adolescence and mental illness. They had mixed perceptions of treatment recidivism and described their interaction with the medical culture as positive. Further research is needed to determine the impact of parental relations and school bullying on recidivism in adolescents with mental illness. © 2017 Wiley Periodicals, Inc.

  3. Attitudes toward consumer involvement in mental health services: a cross-sectional survey of Indian medical and nursing undergraduates.

    Science.gov (United States)

    Poreddi, Vijayalakshmi; Gandhi, Sailaxmi; Thimmaiah, Rohini; Bm, Suresh

    2016-06-01

    To understand the views of medical and nursing undergraduates regarding consumer involvement in mental health services. A descriptive cross sectional survey was conducted in Bangalore, South India, among medical (n=155) and nursing (n=116) undergraduates using self-reported the Mental Health Consumer Participation Questionnaire of Happell et al. ''Mental health consumer'' or ''consumer'' is defined as a person who is currently using mental health services as either an in-patient or out-patient. The overall mean score on Mental Health Consumer Participation Questionnaire (54.1±6.7) implies that 64% of the participants hold positive attitudes towards consumer involvement in mental health services. Medical students possessed more positive attitudes than nursing in: consumer capacity (pundergraduate level.

  4. Supernatural versus medical: Responses to mental illness from undergraduate university students in Trinidad.

    Science.gov (United States)

    Ramkissoon, AnMarie Kamanie; Donald, Casswina; Hutchinson, Gerard

    2017-06-01

    Background/Introduction: Perceptions about the aetiology of mental illness are likely to influence help-seeking behaviour. Understanding help-seeking behaviour will improve service provision and access. Therefore, this is likely to improve treatment outcomes. We assessed the perceptions and help-seeking behaviours surrounding mental illness in a Trinidadian population of 158 tertiary-level students (136 female, 22 male; mean age 30) by analysing their responses to a questionnaire which asked for responses regarding a case vignette of a 25-year-old young woman exhibiting symptoms suggestive of schizophrenia. Of the respondents, 32.3% attributed the symptoms to supernatural causes. Specifically, 27.8% to someone doing her bad and 24.1% to evil spirits. In all, 77.2% of respondents indicated that mental illness was caused by medical problems and 63.3% to work stress. A minimum of 9.5% of the students therefore have dual perceptions regarding causation (77.2 + 32.3 = 109.5) Those who perceived causation to be supernatural said they would seek help from both medical ( p = .000) and supernatural ( p = .000) modalities. This also applied significantly to those who said the causation was medical, that is, seeking both religious intervention ( p = .000) and medical intervention (.000) as the first path in the health-seeking pathway. Dual help-seeking behaviour seems to be the functional result of an integration of religious and medical models of mental illness causation even in respondents who clearly identified only one of these as the likely cause of the illness behaviour.

  5. Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report

    Directory of Open Access Journals (Sweden)

    Young Kyoung Sa

    2013-03-01

    Full Text Available Atypical antipsychotics have replaced conventional antipsychotics in the treatment of schizophrenia because they have less of a propensity to cause undesirable neurologic adverse events including extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome (NMS. However, atypical antipsychotics have been known to result in various metabolic complications such as impaired glucose tolerance, diabetes and even diabetic ketoacidosis (DKA. In addition, a number of NMS cases have been reported in patients treated with atypical antipsychotics, although the absolute incidence of neurologic side effects is currently significantly low. Here, we report a patient who simultaneously developed DKA, acute renal failure and NMS with rhabdomyolysis after olanzapine treatment. Olanzapine-induced metabolic complications and NMS were dramatically improved with cessation of the olanzapine treatment and initiation of supportive management including fluid therapy, hemodialysis, and intensive glycemic control using insulin. At short-term follow-up, insulin secretion was markedly recovered as evidenced by a restoration of serum C-peptide level, and the patient no longer required any hypoglycemic medications. Despite the dramatic increase in the use of atypical antipsychotics treatment, individualized treatments along with careful monitoring may be prudent for high risk or vulnerable patients in order to avoid the development of metabolic side effects.

  6. Possible interactions between zolpidem, a new sleep inducer and chlorpromazine, a phenothiazine neuroleptic.

    Science.gov (United States)

    Desager, J P; Hulhoven, R; Harvengt, C; Hermann, P; Guillet, P; Thiercelin, J F

    1988-01-01

    The combined use of a hypnotic and a neuroleptic is a rather frequent situation, encountered especially in the psychiatric sphere. We therefore tested zolpidem and chlorpromazine in six healthy subjects by using a double-blind latin square design. All of them received single doses of 20 mg zolpidem (ZOL), 50 mg chlorpromazine (CPZ) and the combination of ZOL + CPZ. The medication was given as a single dose in the morning and each treatment being separated by a 1-week interval. Zolpidem produced moderate to severe sedation varying according to the subjects. Psychometric performances (manual dexterity, Stroop test), alertness and psychomotricity (visual analogue scales) were reduced up to 3 h after drug intake. Chlorpromazine alone did not have much effect. Combined administration of ZOL and CPZ was rather more effective than ZOL alone. The pharmacokinetics of ZOL or CPZ remained unchanged except for the elimination half-life of CPZ, which increased significantly when administered along with ZOL. No other pharmacodynamic or pharmacokinetic interaction between ZOL and CPZ was evident. The fact that the ZOL and CPZ combination accentuated the pharmacodynamical effects can be explained to result from the summation of each of their own pharmacological effect.

  7. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

    Science.gov (United States)

    Moir, Fiona; Henning, Marcus; Hassed, Craig; Moyes, Simon A; Elley, C Raina

    2016-01-01

    There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. Although

  8. Anger Management among Medical Undergraduate Students and Its Impact on Their Mental Health and Curricular Activities

    Directory of Open Access Journals (Sweden)

    Gayathri S. Prabhu

    2016-01-01

    Full Text Available Background. This study was intended to determine the practice of students in good anger management skills and to what extent their anger can affect their studies, work, and social interactions. In this study the relationship between anger management and the effects on the mental health of medical students was evaluated. A survey was also done to determine duration of the feeling of anger which lasts among medical students and its consequences. Materials and Methods. A newly developed questionnaire was utilized which included a simplified version of the Novaco Anger Scale and Provocation Inventory and the modified Patient Health Questionnaire 9 (to measure the mental health. Results. The data suggests that although students with high anger tendencies display poor mental health, there is no lowering of the mental health/PHQ-9 score as the anger management technique’s effectiveness rises. “Friends” was cited as the major triggering factor for anger, whereby the feelings can last for up to a day and somewhat affect their concentration on normal activities. Conclusion. When anger is suppressed and not let out, it can be an underlying factor for anxiety and depression. Therefore, more emphasis needs to be placed on educating students on how to manage their anger especially in a stressful environment away from home.

  9. Mental Well-Being in First Year Medical Students: A Comparison by Race and Gender

    Science.gov (United States)

    Hardeman, Rachel R.; Przedworski, Julia M.; Burke, Sara E.; Burgess, Diana J.; Phelan, Sean M.; Dovidio, John F.; Nelson, Dave; Rockwood, Todd; van Ryn, Michelle

    2015-01-01

    Purpose In this study, authors sought to characterize race and gender disparities in mental health in a national sample of first year medical students early in their medical school experience. Method This study used cross-sectional baseline data of Medical Student CHANGES, a large national longitudinal study of a cohort of medical students surveyed in the winter of 2010. Authors ascertained respondents via the American Association of Medical Colleges questionnaire, a third-party vendor-compiled list, and referral sampling. Results A total of 4732 first year medical students completed the baseline survey; of these, 301 were African American and 2890 were White. Compared to White students and after adjusting for relevant covariates, African American students had a greater risk of being classified as having depressive (relative risk (RR)=1.59 [95 % confidence interval, 1.37–2.40]) and anxiety symptoms (RR=1.66 [1.08–2.71]). Women also had a greater risk of being classified as having depressive (RR=1.36 [1.07–1.63]) and anxiety symptoms (RR−1.95 [1.39–2.84]). Conclusions At the start of their first year of medical school, African American and female medical students were at a higher risk for depressive symptoms and anxiety than their White and male counterparts, respectively. The findings of this study have practical implications as poor mental and overall health inhibit learning and success in medical school, and physician distress negatively affects quality of clinical care. PMID:26413458

  10. [Asylum Law and Mental Health: An Interdisciplinary Analysis of the Coaction of Medical and Legal Aspects].

    Science.gov (United States)

    Hanewald, Bernd; Gieseking, Janina; Vogelbusch, Oliver; Markus, Inessa; Gallhofer, Bernd; Knipper, Michael

    2016-04-01

    Interdisciplinary analysis of the consequences of laws and legal practice for mental health conditions of asylum seekers and psychiatric care. Based on the case study of a Kurdish woman with complex trauma-related psychiatric disorder, who had been in psychiatric hospital care for 25 months, the legal and medical facts are exposed, followed by a discussion referring to theoretical approaches from medical anthropology. Immigration laws and legal practice can have harmful consequences, which can be interpreted as "structural violence". In case of traumatized refugees, the coaction of legal and medical aspects has to be acknowledged seriously by the medical, legal and political parts involved. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Mental problems among first-year conservatory students compared with medical students.

    Science.gov (United States)

    van Fenema, E M; van Geel, C C J

    2014-06-01

    Musical education and the musical profession can be stressful, which may make musicians vulnerable for stress-related disorders. To determine if music students are particularly at risk for mental problems, we used the Standardised Assessment of Personality-Abbreviated Scale (SAPAS) and the Symptom Questionnaire (SQ48S) to compare symptoms in first-year conservatory students (n=33) and first-year medical students (n=43). On the SAPAS, we found that medical students have significantly more difficulty making and keeping friends (p=0.015). Also, we observed a trend that conservatory students lose their temper more easily (p=0.040). Both student groups showed high scores for the personality trait "perfectionism." On the SQ48, we observed a trend that both conservatory and medical students experience more psychological problems than the general population, but there were no significant differences between conservatory students and medical students in the total scores of both questionnaires.

  12. Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Furiak Nicolas M

    2009-01-01

    Full Text Available Abstract Background Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre- to post-psychiatric hospitalization. Methods We analyzed data from a large prospective, non-interventional study of patients treated for schizophrenia in the United States, conducted between 7/1997 and 9/2003. Detailed mental-health resource utilization was systematically abstracted from medical records and augmented with patients' self report. Medication possession ratio (MPR with any antipsychotic in the 6 months prior to enrollment was used to categorize patients as: adherent (MPR ≥ 80%, N = 1758, partially adherent (MPR ≥ 60% Results Adherent patients had a lower rate of psychiatric hospitalization compared with partially adherent and non-adherent patients (p Conclusion Adherence is associated with lower utilization of acute care services and greater engagement in outpatient mental-health treatment. Adherence is a potentially dynamic phenomenon, which may improve, at least temporarily, following patients' psychiatric hospitalizations.

  13. Mental health problems among medical students in Brazil: a systematic review and meta-analysis

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    João P. Pacheco

    2017-08-01

    Full Text Available Objective: To provide a comprehensive picture of mental health problems (MHPs in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%, common mental disorders (13 studies, prevalence 31.5%, burnout (three studies, prevalence 13.1%, problematic alcohol use (three studies, prevalence 32.9%, stress (six studies, prevalence 49.9%, low sleep quality (four studies, prevalence 51.5%, excessive daytime sleepiness (four studies, prevalence 46.1%, and anxiety (six studies, prevalence 32.9%. Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.

  14. A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

    Science.gov (United States)

    Kreyenbuhl, Julie; Leith, Jaclyn; Medoff, Deborah R.; Fang, LiJuan; Dickerson, Faith B.; Brown, Clayton H.; Goldberg, Richard W.; Potts, Wendy; Dixon, Lisa B.

    2011-01-01

    Inadequate self-management of chronic medical conditions like Type 2 diabetes may play a role in the poor health status of individuals with serious mental illnesses. We compared adherence to hypoglycemic medications and blood glucose control between 44 diabetes patients with a serious mental illness and 30 patients without a psychiatric illness. The two groups did not differ in their ability to manage a complex medication regimen as assessed by a performance-based measure of medication management capacity. However, significantly fewer patients with a mental illness self-reported nonadherence to their hypoglycemic regimens compared to those without a mental illness. Although individuals with mental illnesses also had better control of blood glucose, this metabolic parameter was not correlated with adherence to hypoglycemic medications in either patient group. The experience of managing a chronic mental illness may confer advantages to individuals with serious mental illnesses in the self-care of co-occurring medical conditions like Type 2 diabetes. PMID:21459458

  15. Medication Management in Primary and Secondary Schools: Evaluation of Mental Health Related In-Service Education in Local Schools

    Science.gov (United States)

    Reutzel, Thomas J.; Desai, Archana; Workman, Gloria; Atkin, John A.; Grady, Sarah; Todd, Timothy; Nguyen, Nhu; Watkins, Melissa; Tran, Kim; Liu, Nian; Rafinski, Michelle; Dang, Thanh

    2008-01-01

    An increasing number of students are taking medications while they are in school or are under the influence of medication during school hours. In a novel effort, clinical pharmacists and mental health therapists worked together to provide "mini-in-service" educational programs on psychological disorders and medications used to treat…

  16. Parental attitudes and opinions on the use of psychotropic medication in mental disorders of childhood

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    Haviara Fotini

    2007-11-01

    Full Text Available Abstract Background The limited number of systematic, controlled studies that assess the safety and efficacy of psychotropic medications for children reinforce the hesitation and reluctance of parents to administer such medications. The aim of this study was to investigate the attitudes of parents of children with psychiatric disorders, towards psychotropic medication. Methods A 20-item questionnaire was distributed to 140 parents during their first contact with an outpatient child psychiatric service. The questionnaire comprised of questions regarding the opinions, knowledge and attitudes of parents towards children's psychotropic medication. Sociodemographic data concerning parents and children were also recorded. Frequency tables were created and the chi-square test and Fisher's exact tests were used for the comparison of the participants' responses according to sex, educational level, age and gender of the child and use of medication. Results Respondents were mostly mothers aged 25–45 years. Children for whom they asked for help with were mostly boys, aged between 6 and 12 years old. A total of 83% of the subjects stated that they knew psychotropic drugs are classified into categories, each having a distinct mechanism of action and effectiveness. A total of 40% believe that there is a proper use of psychotropic medication, while 20% believe that psychiatrists unnecessarily use high doses of psychotropic medication. A total of 80% fear psychotropic agents more than other types of medication. Most parents are afraid to administer psychotropic medication to their child when compared to any other medication, and believe that psychotherapy is the most effective method of dealing with every kind of mental disorders, including childhood schizophrenia (65%. The belief that children who take psychotropic medication from early childhood are more likely to develop drug addiction later is correlated with the parental level of education. Conclusion

  17. The effect of regular medication on the outcome of paracetamol poisoning

    DEFF Research Database (Denmark)

    Schmidt, L E; Dalhoff, K

    2002-01-01

    hepatocellular injury was evaluated by multivariate analysis. RESULTS: Regular medication was received by 332 patients (45%). Medication with benzodiazepines (105 cases), antidepressants (100 cases), neuroleptics (75 cases), paracetamol (58 cases), oral contraceptives (51 cases), beta-agonists (40 cases), opioid......, neuroleptics, paracetamol, oral contraceptives, beta-agonists or anticonvulsants in the multivariate analysis. CONCLUSIONS: Regular medication with psychotropic medication, analgesics, oral contraceptives, beta-agonists or anticonvulsants was frequent in patients admitted with paracetamol poisoning. Medication...

  18. Olanzapine-induced neuroleptic malignant syndrome in a patient with bipolar affective disorder: Does quetiapine holds the solution?

    Directory of Open Access Journals (Sweden)

    Praveen Tripathi

    2013-01-01

    Full Text Available Neuroleptic Malignant Syndrome (NMS is a rare, severe and life threatening condition induced by antipsychotic medications. It is commonly encountered with the use of first generation antipsychotics, however cases of NMS have been reported with the use of second generation antipsychotics like Olanzapine, Risperidone, Paliperidone, Aripiprazole, Ziprasidone, Amisulpride, Quetiapine and Clozapine, though the incidence of such reports is rare. Due to decreased use of first generation antipsychotics, NMS is reported less frequently now a days. In this case report- we highlight the management issues of a patient suffering from bipolar affective disorder, who had developed NMS following intramuscular injection of haloperidol, which was withdrawn and olanzapine was given later on. The patient had again developed NMS with olanzapine. Finally the patient was managed with modified electroconvulsive therapy and discharged on Lithium carbonate and Quetiapine.

  19. Comparing Mental Health of Female Athlete and Non-Athlete Students of Shahid Sadoughi University of Medical Sciences

    OpenAIRE

    Seyyed Saeid Mazloomy Mahmoudabad; Nahid Ardian; Ibrahim Salmani; Nadjme Hajian

    2013-01-01

    Introduction: During the recent decades, many scholars focused on the physical activities as an influencing factor on psychological and mental status. Concerning the importance of university students’ mental health, this paper investigates the effects of physical activities on promoting their mental health. Materials & Methods: In this descriptive analytical study, 200 female students of Shaheed Sadoughi University of Medical Sciences were selected as the participants. The case group con...

  20. Barriers to medication counselling for people with mental health disorders: a six country study

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    Aaltonen SE

    2010-06-01

    Full Text Available Provision of medication information may improve adherence and prevent medication related problems. People with mental health disorders commonly receive less medication counselling from pharmacists than people with other common long term and persistent disorders.Objective: The objective of this study was to compare and contrast barriers pharmacy students perceive toward providing medication counselling for people with mental health disorders in Australia, Belgium, Estonia, Finland, India and Latvia.Methods: Barriers identified by third-year pharmacy students as part of the International Pharmacy Students’ Health Survey were content analysed using a directed approach. Students’ responses were categorised as pharmacist related, patient related, health-system related, or social or cultural related. Quantitative data were analysed using SPSS version 14.0.Results: Survey instruments were returned by 649 students. Of the respondents, 480 identified one or more barriers to medication counselling for people with mental health disorders. Patient related factors accounted for between 25.3% and 36.2% of barriers identified by the pharmacy students. Pharmacist related factors accounted for between 17.6% and 45.1% of the barriers identified by the pharmacy students. Students in India were more likely to attribute barriers to pharmacist and social and cultural related factors, and less likely to health-system related factors, than students studying in other countries.Conclusion: The nature of barriers identified by pharmacy students differed according to the country in which they studied. Undergraduate and postgraduate pharmacy education programs may need to be amended to address common misconceptions among pharmacy students.

  1. Who is responsible for metabolic screening for mental health clients taking antipsychotic medications?

    Science.gov (United States)

    Ward, Tamara; Wynaden, Dianne; Heslop, Karen

    2018-02-01

    Metabolic syndrome is common in mental health consumer populations, and is linked to cardiovascular disease, stroke and diabetes. Metabolic screening is a way of recognising consumers who are at risk of developing metabolic syndrome but internationally screening rates remain low. A retrospective audit was completed at one Australian public mental health service on the case files of 100 randomly selected consumers to determine nurses level of compliance with metabolic screening policies over a 12 month period. Consumers included in the review were prescribed antipsychotic medications for at least 12 months and had their care in the community coordinated by mental health nurses. Data were entered into an Excel spreadsheet for analysis. Low levels of metabolic screening were identified and these levels decreased over the 12 months under review. No consumers had metabolic screening that recorded all parameters at three monthly intervals over the 12 month period. Only one consumer had every metabolic parameter recorded on the physical health screen tool at baseline assessment. The findings demonstrated that while there is increased awareness of co-morbid physical health issues in this consumer population, the translation of guidelines and policy directives to clinical practice to address this disparity remains low. Improving physical health outcomes is the responsibility of all health professionals, particularly doctors who prescribe and nurses who administer antipsychotic medications regularly to mental health consumers. Moreover, nurses are well placed to demonstrate leadership in reducing the rate of metabolic syndrome through the delivery of holistic care that includes effective screening programs. © 2017 Australian College of Mental Health Nurses Inc.

  2. Spiritual care may impact mental health and medication adherence in HIV+ populations

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    Oji VU

    2017-04-01

    Full Text Available Valerie U Oji,1–3 Leslie C Hung,3 Reza Abbasgholizadeh,1,4 Flora Terrell Hamilton,5 E James Essien,6 Evaristus Nwulia7 1Lifefountain Center Ministries Inc, Houston, TX, USA; 2Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA; 3University of Texas, College of Pharmacy, Austin, TX, USA; 4University of Houston, Houston, TX, USA; 5Administration, Family & Medical Counseling Service, Inc. (FMCS, Washington, DC, USA; 6University of Houston Institute for Community Health, Houston, TX, USA; 7Psychiatry, Howard University Translational Neuroscience Laboratory, Washington, DC, USA Objective: To explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations. Method: A systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS, major depressive disorder (MDD incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale. Results: The literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005 and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of

  3. Arabic-speaking religious leaders' perceptions of the causes of mental illness and the use of medication for treatment.

    Science.gov (United States)

    Youssef, Jacqueline; Deane, Frank P

    2013-11-01

    The Arabic-speaking clergy is highly revered and considered the first point of contact for people who suffer from mental illness within their community. The current study aimed to explore the beliefs of Arabic-speaking religious leaders regarding the causes of mental illness and the use of medication for their treatment. Participants consisted of 170 Arabic-speaking clerics of Muslim (n = 85) and Christian (n = 85) denominations residing in Sydney, Australia. A questionnaire was administered during face-to-face interviews and included items regarding the causes of mental illness and beliefs about whether psychiatric medications were viewed as helpful or harmful. Most of the Arabic-speaking clerics viewed drug and alcohol addiction and psychosocial factors as the most important causes of mental illness. Biological causes such as a chemical imbalance in the brain were less frequently endorsed. Although medications were viewed by most religious clerics as helpful in the treatment of mental illness, there were also concerns about the potential harms of medications, particularly among Muslim clerics. Muslim clerics also endorsed the religious causes for mental illness, such as spiritual poverty, as being more important more so than did Christian clerics. The beliefs of Arabic-speaking religious leaders influence how they respond to people with mental illness and may determine whether they refer people to professional mental health services or not. Understanding their perspectives allows opportunities to share information to facilitate collaborative work in the care of Arabic-speaking people with mental illness. Arabic-speaking religious leaders need to be better educated about the mechanisms of action and benefits of medication in the treatment of mental illness.

  4. Spanish medical students' attitudes and views towards mental health and psychiatry: a multicentric cross-sectional study.

    Science.gov (United States)

    Failde, Inmaculada; Salazar, Alejandro; Elorza, Julian; Casais, Leonardo; Pérez, Víctor; Martínez, Luis Caballero; Gilaberte, Inmaculada

    2014-06-01

    The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students. The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n = 113), Madrid; San Pablo-CEU (n = 22), and Barcelona; UAB (n = 36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon's adapted questionnaire to investigate their view towards psychiatry. The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry. Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student's attitudes could favor an appropriate management of patients suffering from mental illness.

  5. Investigation of Mental Health in Patients with Medically Unexplained Physical Symptoms‎.

    Science.gov (United States)

    Riahi, Frough; Izadi-Mazidi, Maryam; Khajeddin, Niloufar; Nasirzadeh, Shahriar; Shafieian, Fatemeh; Helalinasab, Ammar; Deilamani, Mozhgan

    2016-01-01

    Medically unexplained symptoms are physical symptoms, which cannot be explained by organic ‎causes. This study aimed to investigate mental health in patients with medically unexplained ‎physical symptoms. ‎ One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini ‎hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, ‎paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance ‎‎ (MANOVA), Chi-square test and Fisher's exact test. ‎ The findings revealed significant differences between clients with medically explained and ‎unexplained symptoms in obsessive compulsive and somatization (p0.05).‎ The present study suggested an association between some psychological problems and somatic ‎symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.‎.

  6. Providing psychiatric services in general medical settings in South Africa: Mental health-friendly services in mental health-friendly hoaspitals

    Directory of Open Access Journals (Sweden)

    Margaretha S van Heerden

    2008-03-01

    Full Text Available Neuropsychiatric disorders rank high on the list of the mostdisabling medical disorders in both the developed anddeveloping worlds.1Significant comorbidity also exists betweenneuropsychiatric disorders and general medical disorders;2this iskey in the South African context where HIV/AIDS and substanceuse disorders are highly prevalent.3,4It has therefore becomeessential to provide mental health services in a range of settings,including those that focus on the delivery of general medicalservices. Furthermore, the Mental Health Care Act 17 of 2002underlines the importance of providing integrated, accessiblemental health care in the local community.

  7. Conversational pursuit of medication compliance in a Therapeutic Community for persons diagnosed with mental disorders*

    Science.gov (United States)

    Mortari, Luigina

    2014-01-01

    Purpose In this article, we contribute to the debate on medication compliance by exploring the conversational “technologies” entailed in the process of promoting clients’ adherence to psychopharmacological prescriptions. Using a case study approach, we explore how medication-related problems are dealt with in conversational interaction between the staff members and the clients of a mental health Therapeutic Community (TC) in Italy. Method Four meetings between two staff members (Barbara and Massimo) and the clients of the TC were audio-recorded. The data were transcribed and analyzed using the method of Conversation Analysis. Results Barbara and Massimo recur to practices of topic articulation to promote talk that references the clients’ failure to take the medications. Through these practices they deal with the practical problem of mobilizing the clients’ cooperation in courses of action that fit into the institutional agenda of fostering medication adherence. Conclusions Barbara and Massimo’s conversational practices appear to reflect the assumption that medication-related problems can be reduced to compliance problems. This assumption works to make the clients accountable for their failure to take the medications while shaping a conversational environment that is unreceptive to their complaints about side effects. Implications for the understanding of mental health rehabilitation practice in TCs are discussed. Implications of RehabilitationTherapeutic community staff members should be aware of the challenges and blocks in communicating with their clients.Therapeutic communities can promote staff members’ awareness of communication challenges through reflective workshops in which they can jointly view and comment on interaction with their clients.Reflective workshops can be used to raise awareness of the presuppositions underlying therapeutic community staff members’ communication practices. PMID:24053481

  8. Rocuronium-sugammadex for electroconvulsive therapy management in neuroleptic malignant syndrome: A case report.

    Science.gov (United States)

    Casas Reza, P; Gestal Vázquez, M; Outeiro Rosato, Á; López Álvarez, S; Diéguez García, P

    2017-02-01

    Neuroleptics are a group of drugs widely used in the treatment of psychotic symptoms. Among their adverse effects is the ability to trigger a neuroleptic malignant syndrome (NMS). The diagnosis of NMS is determined by exclusion, and its initial therapeutic management should be the withdrawal of neuroleptics, the administration of benzodiazepines, and electroconvulsive therapy (ECT). ECT is an effective treatment in these patients, and in those cases with a poor response to treatment with antipsychotic drugs. A review is presented on the treatment options and anaesthetic implications of ECT used to handle a patient diagnosed with paranoid schizophrenia in the context of NMS. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Combination of Steven-Johnson syndrome and neuroleptic malignant syndrome following carbamazepine therapy: a rare occurrence.

    Science.gov (United States)

    Sharma, Bhawna; Sannegowda, Raghavendra Bakki; Gandhi, Pankaj; Dubey, Parul; Panagariya, Ashok

    2013-06-11

    Stevens-Johnson syndrome (SJS) is a severe, episodic, acute mucocutaneous reaction that is most often elicited by drugs and occasionally by infections. The drugs commonly implicated as the cause of SJS are anticonvulsants, sulfonamides, non-steroidal anti-inflammatory drugs and antibiotics. Carbamazepine (CBZ) has been commonly implicated in SJS. Neuroleptic malignant syndrome (NMS) is a rare, life-threatening but potentially treatable condition. Among the neuroleptics, haloperidol (parenteral) is implicated as a most common drug for NMS. Though rare, association of NMS with CBZ and association of NMS with toxic epidermal necrolysis (TEN) in a single patient after administration of neuroleptics has been reported in the literature before. However, a combination of NMS and SJS in a single patient after administration of CBZ has not been reported so far. We present a patient with seizure who developed SJS and NMS following administration of CBZ.

  10. Surveys of medical seeking preference, mental health literacy, and attitudes toward mental illness in Taiwan, 1990–2000

    Directory of Open Access Journals (Sweden)

    Chia-Yi Wu

    2014-01-01

    Conclusion: Attribution of depressive and anxiety symptoms appeared to be more likely to influence help-seeking behaviors than attitudes toward mental illness. Enhancing public mental health literacy toward depression may help facilitate help-seeking in response to potential mental illness.

  11. Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

    Science.gov (United States)

    Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

    Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of individual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that

  12. Negative life events and mental health of Chinese medical students: the effect of resilience, personality and social support.

    Science.gov (United States)

    Peng, Li; Zhang, Jiajia; Li, Min; Li, Peipei; Zhang, Yu; Zuo, Xin; Miao, Yi; Xu, Ying

    2012-03-30

    The present study was conducted on a large sample of Chinese medical students to test the moderating effect of resilience between negative life events and mental health problems, and investigate the factors that affect the mental health problems of the students. The Adolescent Self-Rating Life Events Check List, Eysenck Adult Personality Questionnaire-Revised, Social Support Rating Scale, Connor-Davidson Resilience Scale, and Symptom Check List were adopted for a survey with 1,998 Chinese medical students as respondents. Mental health problems had a positive correlation with negative life events and neuroticism. On the other hand, mental health problems had a negative correlation with social support, extraversion, and resilience. Regression analysis showed that resilience moderated negative life events and mental health problems. Promoting resilience may be helpful for the adjustment of college students. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Porcine stress syndrome: an animal model for the neuroleptic malignant syndrome?

    Science.gov (United States)

    Keck, P E; Seeler, D C; Pope, H G; McElroy, S L

    1990-07-01

    The porcine stress syndrome is a genetic disorder of swine which, like neuroleptic malignant syndrome, is characterized by hyperthermia, muscle rigidity, and autonomic dysfunction. We investigated the porcine stress syndrome as a possible animal model for neuroleptic malignant syndrome in two ways. First, we administered haloperidol and lithium carbonate, alone and in combination, to susceptible and resistant swine. Second, we attempted to prevent the syndrome by pretreating animals with bromocriptine. Porcine stress syndrome was induced in 2 of 3 susceptible and 1 of 3 resistant swine by combined treatment with lithium and haloperidol, but was not triggered by treatment with lithium or haloperidol alone. Pretreatment with bromocriptine conferred no protection against the syndrome.

  14. Mental health in medical residents: relationship with personal, work-related, and sociodemographic variables

    Directory of Open Access Journals (Sweden)

    Karina Pereira-Lima

    2016-01-01

    Full Text Available Objective: To examine association of sociodemographic characteristics, personality traits, social skills, and work variables with anxiety, depression, and alcohol dependence in medical residents. Methods: A total of 270 medical residents completed the following self-report instruments: sociodemographic and work questionnaire, Patient Health Questionnaire-4 (PHQ-4, Alcohol Use Disorders Identification Test-3 (AUDIT-3, Revised NEO-Five Factor Inventory (NEO-FFI-R, and Social Skills Inventory (SSI-Del-Prette. Data were analyzed using descriptive statistics and univariate and multivariate logistic regression analyses. Results: Multivariate analysis showed an association of neuroticism (odds ratio [OR] 2.60, p < 0.001, social skills (OR 0.41, p < 0.01, and number of shifts (OR 1.91, p = 0.03 with anxiety or depression, and of male sex (OR 3.14, p = 0.01, surgical residency (OR 4.40, p = 0.001, extraversion (OR 1.80, p < 0.01, and number of shifts (OR 2.32, p = 0.04 with alcohol dependence. Conclusion: The findings support a multidetermined nature of mental health problems in medical residents, in addition to providing data that may assist in the design of preventive measures to protect the mental health of this group.

  15. Child maltreatment and the transition to adult-based medical and mental health care.

    Science.gov (United States)

    Christian, Cindy W; Schwarz, Donald F

    2011-01-01

    Child maltreatment is a public health problem with lifelong health consequences for survivors. Each year, >29 000 adolescents leave foster care via emancipation without achieving family permanency. The previous 30 years of research has revealed the significant physical and mental health consequences of child maltreatment, yet health and well-being have not been a priority for the child welfare system. To describe the health outcomes of maltreated children and those in foster care and barriers to transitioning these adolescents to adult systems of care. We reviewed the literature about pediatric and adult health outcomes for maltreated children, barriers to transition, and recent efforts to improve health and well-being for this population. The health of child and adult survivors of child maltreatment is poor. Both physical and mental health problems are significant, and many maltreated children have special health care needs. Barriers to care include medical, child welfare, and social issues. Although children often have complex medical problems, they infrequently have a medical home, their complex health care needs are poorly understood by the child welfare system that is responsible for them, and they lack the family supports that most young adults require for success. Recent federal legislation requires states and local child welfare agencies to assess and improve health and well-being for foster children. Few successful transition data are available for maltreated children and those in foster care, but opportunities for improvement have been highlighted by recent federal legislation.

  16. Stigmatising attitudes towards persons with mental illness: a survey of medical students and interns from Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Joyce Ohiole Omoaregba

    2012-01-01

    Full Text Available Stigmatising attitudes towards persons with mental illness are commonly reported among health professionals. Familiarity with mental illness has been reported to improve these attitudes. Very few studies have compared future medical doctors’ attitudes toward types of mental illness, substance use disorders and physical illness. A cross-sectional survey of 5th and 6th year medical students as well as recently graduated medical doctors was conducted in April 2011. The 12-item level of contact report  and the Attitude towards Mental Illness Questionnaire were administered. Participants endorsed stigmatising attitudes towards mental illness; with attitudes more adverse for schizophrenia compared to depression. Stigmatising attitudes were similarly endorsed for substance use disorders. Paradoxically, attitudes towards HIV/AIDS were positive and similar to diabetes mellitus. Increasing familiarity with mental illness was weakly associated with better attitudes towards depression and schizophrenia. Stigmatising attitudes towards depression and schizophrenia are common among future doctors. Efforts to combat stigma are urgently needed and should be promoted among medical students and recent medical graduates.

  17. A multidimensional perspective of the mental health of preclinical medical students.

    Science.gov (United States)

    Michalec, Barret; Keyes, Corey L M

    2013-01-01

    Previous research on medical students' mental health has focused almost exclusively on students' emotional well-being and/or their personal psychological functioning, neglecting the more public side of medical training - the students' social health. A total of 237 preclinical students completed surveys at the beginning and the end of their academic year assessing their emotional, psychological, and social well-being, respectively, as well as the overall negative impact medical school stressors had on their lives. Although first and second year students were found to significantly decrease in emotional well-being, first year students were found to increase in social well-being, with further analysis showing an increase among first year students specifically in the feelings of social integration and social acceptance. The overall negative impact from the stressors was found to predict the change in emotional well-being, but not other dimensions of well-being. However, the negative impact from stressors was also found to indirectly impact students' emotional well-being through negatively affecting their psychological and social well-being. The authors present the value in measuring medical students' well-being from a multidimensional perspective as well as highlight the potential "condensing" of students' social world as early as their first year of training. Recommendations are made that researchers continue to focus on the promotion and protection of students' positive mental health in the preliminary stages of medical education, as well as endorse programs that cultivate the benefits of solidarity and integration experienced by first year students.

  18. Impact of comorbid mental health needs on racial/ethnic disparities in general medical care utilization among older adults.

    Science.gov (United States)

    Jimenez, Daniel E; Schmidt, Andrew C; Kim, Giyeon; Cook, Benjamin Le

    2017-08-01

    The objective is to apply the Institute of Medicine definition of healthcare disparities in order to compare (1) racial/ethnic disparities in general medical care use among older adults with and without comorbid mental health need and (2) racial/ethnic disparities in general medical care use within the group with comorbid mental health need. Data were obtained from the Medical Expenditure Panel Survey (years 2004-2012). The sample included 21,263 participants aged 65+ years (14,973 non-Latino Caucasians, 3530 African-Americans, and 2760 Latinos). Physical illness was determined by having one of the 11 priority chronic health illnesses. Comorbid mental health need was defined as having one of the chronic illnesses plus a Kessler-6 Scale >12, or two-item Patient Health Questionnaire >2. General medical care use refers to receipt of non-mental health specialty care. Two-part generalized linear models were used to estimate and compare general medical care use and expenditures among older adults with and without a comorbid mental health need. Racial/ethnic disparities in general medical care expenditures were greater among those with comorbid mental health need compared with those without. Among those with comorbid mental health need, non-Latino Caucasians had significantly greater expenditures on prescription drug use than African-Americans and Latinos. Expenditure disparities reflect differences in the amount of resources provided to African-Americans and Latinos compared with non-Latino Caucasians. This is not equivalent to disparities in quality of care. Interventions and policies are needed to ensure that racial/ethnic minority older adults receive equitable services that enable them to manage effectively their comorbid mental and physical health needs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. [Facts visualized through job support activities for mentally disordered persons--what is the objective of medical treatment for mental disorder?].

    Science.gov (United States)

    Tagawa, Seiji

    2014-01-01

    According to a recent investigation by the Public Employment Security Office, the rate of employing mentally disordered persons is increasing. In the report, it was predicted that the number of employed mentally disordered persons will exceed the number of physically disordered persons within a few years, and will become the highest of the main three disabled types. Despite the strong desire of mentally disordered persons to work, supporting systems have been inadequate. In 2007, mental clinic doctors in Osaka took the lead and established the NPO Osaka Job Support Network for Mentally Disordered Persons (JSN) to support their employment persons. We aimed to establish a support system for mentally disordered persons who have a strong will to work, stating "I would like to work" to their family doctors, who introduce JSN to the patients, and then the family doctors and JSN cooperate to support the patients to realize the desire to "work". Since April 2013, 49 persons have found a job and "graduated" from JSN. Over 6 years until the end of March, 2013, a total of 154 persons found jobs and "graduated" from JSN. From now on, it is expected that around 50 persons will find jobs and "graduate" from JSN every year. It is definitely insufficient just to repeat "temporary" medical treatment for mental disorders with a long course like schizophrenia. A care management view that values the hopes and dreams of patients is required in psychiatric treatment.

  20. Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose

    Science.gov (United States)

    Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul

    2012-01-01

    Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

  1. Typology of sleep medication users and associated mental health and substance use from a Montreal epidemiological study.

    Science.gov (United States)

    Perreault, Michel; Mitchell, Emma; Touré, El Hadj; Fleury, Marie-Josée; Caron, Jean

    2014-01-01

    Sleep medication is often reported as one of the most highly used psychotropic drugs in terms of past-year prevalence. Since their use often varies according to the characteristics of individuals, it is important to better understand these particular utilization patterns. The study aims to develop a typology of sleep medication users' characteristics, including their associated mental health and substance use. Residents from the epidemiological area of south-west Montreal, Quebec aged 15 years and older responded to a questionnaire in 2009 and 2011. Among the 1822 people who participated at both T1 and T2, 306 (17%) reported use of medication to help them sleep. These participants were selected for cluster analysis based on five variables related to mental health. The identified clusters were then tested for association with sociodemographic, psychosocial, and service use characteristics. A three-cluster solution emerged: 1) older individuals without mental health problems, drug use or psychotropic medication use; 2) individuals with elevated psychological distress, drug use and low social support, and 3) individuals with mood and anxiety disorders, using services for mental health and taking two or more psychotropic medications. The results establish the significance of problems related to mental health in differentiating sleep medication users. Consideration of these differences may improve the ability of health professionals to provide services that are better suited for patients, including interventions that increase the ability to cope with stress (cluster 2) and more integrated services for those with concurrent disorders (cluster 3).

  2. Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

    Science.gov (United States)

    Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

    2016-10-01

    Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low

  3. Development of Geriatric Mental Health Learning Objectives for Medical Students: A Response to the Institute of Medicine 2012 Report.

    Science.gov (United States)

    Lehmann, Susan W; Brooks, William B; Popeo, Dennis; Wilkins, Kirsten M; Blazek, Mary C

    2017-10-01

    America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students. The authors describe the development of a set of such learning objectives that all medical students should achieve by graduation. The iterative process included initial drafting by content experts from five medical schools with input and feedback from a wider group of geriatric psychiatrists, geriatricians, internists, and medical educators. The final document builds upon previously published work and includes specific knowledge, attitudes and skills in six key domains: Normal Aging, Mental Health Assessment of the Geriatric Patient, Psychopharmacology, Delirium, Depression, and Dementia. These objectives address a pressing need, providing a framework for national standards and curriculum development. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions.

    Science.gov (United States)

    Dindo, Lilian; Van Liew, Julia R; Arch, Joanna J

    2017-07-01

    Psychological interventions have a long history of successful treatment of patients suffering from mental health and certain medical conditions. At the same time, psychotherapy research has revealed key areas of growth for optimizing patient care. These include identifying novel treatment delivery methods that increase treatment adherence, developing new strategies to more effectively address the ever-growing population of patients with comorbid conditions, and elucidating the mechanisms by which effective treatments work in order to further refine their design. Acceptance and commitment therapy (ACT) is an empirically supported psychotherapy that offers promise for patients suffering from a wide range of mental and physical conditions, while addressing these gaps and challenges in the field. ACT rests on the fundamental premise that pain, grief, disappointment, illness, and anxiety are inevitable features of human life, with the therapeutic goal of helping individuals productively adapt to these types of challenges by developing greater psychological flexibility rather than engaging in counterproductive attempts to eliminate or suppress undesirable experiences. This is achieved through committed pursuit of valued life areas and directions, even in the face of the natural desire to escape or avoid painful and troubling experiences, emotions, and thoughts. ACT is transdiagnostic (applies to more than one condition), process-focused, and flexibly delivered. In a relatively short period of time, ACT has been effectively implemented across a broad range of therapeutic settings, including mental health, primary care, and specialty medical clinics. ACT has also been delivered in a variety of formats, including 1-day group workshops, online and smartphone applications, and telehealth. Focus on how best to package and deliver treatment to meet the unique needs of different patient populations helps to ensure treatment adherence and has fostered successful application of

  5. Increased Postdeployment Use of Medication for Common Mental Disorders in Danish Gulf War Veterans.

    Science.gov (United States)

    Nissen, Lars Ravnborg; Stoltenberg, Christian; Vedtofte, Mia Sadowa; Nielsen, Anni Brit Sternhagen; Marott, Jacob Louis; Gyntelberg, Finn; Guldager, Bernadette

    2017-03-01

    Gulf War veterans (GWVs) have an elevated risk of reporting symptoms of mental disorders as compared with nondeployed military controls. A difficulty in the Gulf War health research is that most health outcomes are self-reported; therefore, it is highly relevant to study objective outcomes in this line of research. The Danish National Prescription Registry provides an opportunity to use the prescription of drugs as an objective evaluation of the impact of mental health disorders at the individual level. In this study, we investigated the prescription of drugs and postdeployment hospitalizations for mental disorders among GWVs compared with a control population of nonveterans (NVs). A prospective registry study including a cohort of 721 GWVs and a control cohort of 3,629 NVs. Main outcome measures were incidence of (1) use of antidepressants, (2) use of anxiolytic/hypnotic medication, and (3) number of postdeployment psychiatric contacts. The association between outcomes and GWVs status was studied by using time-to-event analysis. The index date was the return date from the last deployment to the Gulf. The follow-up period was the time from index date until December 31, 2014. GWVs had an elevated average risk over time for use of both types of medication compared with NV. For use of antidepressants the average hazard rate (HR) was 2.56, with 95% confidence interval (CI) = 2.04-3.21 (p < 0.0001); for use of anxiolytic/hypnotic medication the corresponding results were HR = 1.78, CI = 1.37-2.31 (p < 0.0001). The interaction with time was statistically significant with HR increasing with time for both outcomes. Incident use of antidepressants in GWVs after 10 years was two times higher than among NV, after 20 years it was nearly four times higher than among NV. Incident use of anxiolytic/hypnotic medication was one and a half that of NV after 10 years, but nearly three times that of NV after 20 years. There was no difference in rate of postdeployment psychiatric

  6. Effects of phenothiazine neuroleptics on the rate of caffeine demethylation and hydroxylation in the rat liver.

    Science.gov (United States)

    Daniel, W A; Syrek, M; Ryłko, Z; Kot, M

    2001-01-01

    The primary metabolic pathways of caffeine are 3-N-demethylation to paraxanthine (CYP1A2), 1-N-demethylation to theobromine and 7-N-demethylation to theophylline (CYP1A2 and other enzymes), and 8-hydroxylation to 1,3,7-trimethyluric acid (CYP3A). The aim of the present study was to investigate the influence of phenothiazine neuroleptics (chlorpromazine, levomepromazine, thioridazine, perazine) on cytochrome P-450 activity measured by caffeine oxidation in rat liver microsomes. The obtained results showed that all the investigated neuroleptics competitively inhibited caffeine oxidation in the rat liver, though their potency to inhibit particular metabolic pathways was not equal. Levomepromazine exerted the most potent inhibitory effect on caffeine oxidation pathways, the effect on 8-hydroxylation being the most pronounced. This indicates inhibition of CYP 1 A2 (inhibition of 3-N- and 1-N-demethylation; Ki = 36 and 32 microM, respectively), CYP3A2 (inhibition of 8-hydroxylations; Ki = 20 microM), and possibly other CYP isoenzymes (inhibition of 7-N-demethylation; Ki = 58 microM) by the neuroleptics. The potency of inhibition of caffeine oxidation by perazine was similar to levomepromazine. Thioridazine was a weaker inhibitor of caffeine 3-N- and 7-N-demethylation, while chlorpromazine was weaker in inhibiting caffeine 1-N- and 7-N-demethylation, compared to levomepromazine. In summary, the obtained results showed that all the investigated neuroleptics had a broad spectra of CYP inhibition in the rat liver. The isoenzymes CYP1A2 and CYP3A2 were distinctly inhibited by all the investigated neuroleptics, while other CYP isoenzymes (CYP2B and/or 2E1) by perazine and levomepromazine. The CYP3A2 inhibition was most pronounced. (Ki = 20-40 microM).

  7. Learning styles, academic achievement, and mental health problems among medical students in Thailand

    Directory of Open Access Journals (Sweden)

    Salilthip Paiboonsithiwong

    2016-10-01

    Full Text Available Purpose This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. Methods This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10 and the 21-item Outcome Inventory (OI-21 were also used. The participants’ demographic data, grade point average (GPA, and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Results Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%. Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043. Moreover, neither VARK modes nor VARK types were correlated with GPA. Conclusion The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

  8. Learning styles, academic achievement, and mental health problems among medical students in Thailand.

    Science.gov (United States)

    Paiboonsithiwong, Salilthip; Kunanitthaworn, Natchaya; Songtrijuck, Natchaphon; Wongpakaran, Nahathai; Wongpakaran, Tinakon

    2016-01-01

    This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK) questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10) and the 21-item Outcome Inventory (OI-21) were also used. The participants' demographic data, grade point average (GPA), and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%). Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043). Moreover, neither VARK modes nor VARK types were correlated with GPA. The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

  9. Integrated Pharmacies at Community Mental Health Centers: Medication Adherence and Outcomes.

    Science.gov (United States)

    Wright, W Abel; Gorman, Jack M; Odorzynski, Melissa; Peterson, Mark J; Clayton, Carol

    2016-11-01

    Patients receiving psychiatric services at community mental health centers (CMHCs) are often prescribed medication that is critical to the treatment of behavioral health conditions, including schizophrenia, bipolar disorder, anxiety, and depression. Previous studies have shown correlation between rates of medication adherence and risk of hospitalization, but potential differences in medication adherence and other outcomes for patients of CMHCs by pharmacy type have not been widely studied. To determine potential benefits of placing a pharmacy within a mental health service delivery setting on both adherence to medication and health outcomes. A retrospective cohort analysis of medication adherence rates, hospital and emergency department (ED) use, and related costs between patients of CMHCs was conducted using integrated pharmacies versus community pharmacies. Data were from Medicaid claims paid by Southwest Michigan Behavioral Health for all (behavioral and nonbehavioral) inpatient and outpatient services as well as pharmacy prescriptions filled from April 1, 2014, through April 30, 2015. The primary study analysis was composed of an adult dataset representing persons served from 1 of the 2 CMHCs who had filled at least 2 prescriptions for a specific medication from 1 of 2 Genoa pharmacies located in a CMHC during the study period. Each unique patient dataset in the treatment group was matched to a corresponding control patient dataset prescribed the same medication using a modified version of the Gale-Shapley algorithm. The primary analysis compared medication possession ratio, which is a measure of adherence that indicates gaps or oversupply in a patient's medication use history. Statistical tests were performed using the R statistical programming language and Microsoft Excel. Patients using pharmacies integrated within the CMHCs had higher medication adherence rates, lower rates of hospitalization, and lower ED use than those filling their prescriptions at

  10. Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial.

    Science.gov (United States)

    Druss, Benjamin G; Singh, Manasvini; von Esenwein, Silke A; Glick, Gretl E; Tapscott, Stephanie; Tucker, Sherry Jenkins; Lally, Cathy A; Sterling, Evelina W

    2018-02-01

    Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population. This randomized study enrolled 400 participants with a serious mental illness and one or more chronic general medical conditions across three community mental health clinics. Participants were randomly assigned to the Health and Recovery Peer (HARP) program, a self-management program for general medical conditions led by certified peer specialists (N=198), or to usual care (N=202). Assessments were conducted at baseline and three and six months. At six months, participants in the intervention group demonstrated a significant differential improvement in the primary study outcome, health-related quality of life. Specifically, compared with the usual care group, intervention participants had greater improvement in the Short-Form Health Survey physical component summary (an increase of 2.7 versus 1.4 points, p=.046) and mental component summary (4.6 versus 2.5 points, p=.039). Significantly greater six-month improvements in mental health recovery were seen for the intervention group (p=.02), but no other between-group differences in secondary outcome measures were significant. The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.

  11. Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Melese, Biniam; Bayu, Birhanu; Wondwossen, Fikir; Tilahun, Kalkidan; Lema, Seti; Ayehu, Moges; Loha, Eskindir

    2016-11-08

    Mental distress is a mental health problem expressed with variable levels of depressive, anxiety, panic or somatic symptoms. Owing to several factors tertiary level students are among the population with higher prevalence of mental distress and an even more higher prevalence has been reported in medical students. The aim of this study was to determine the prevalence of mental distress among medical students, and to evaluate contextually relevant associated factors. A cross-sectional study was conducted among medical students attending Hawassa University College of Medicine and Health Sciences in 2013/2014 academic year. Stratified random sampling was implemented with each strata representing the year of study of the students. Data on mental distress was collected using the Self-Reporting Questionnaire-20 (SRQ-20). Data was entered into and analyzed using IBM SPSS statistics 21. A cut-off point of 8 and above was used to classify students as having mental distress. Among 240 students included in the study, 72 (30%) of them were found to have mental distress. There was no significant difference in mental distress between males and females (COR = 1.18, 95% CI = 0.62-2.25). On bivariate analysis, students with age less than or equal to 21 years showed higher odds of having mental distress (COR = 2.3, 95% CI: 1.26-4.22), but because of having high correlation with students' year of study, age was excluded from the multivariate model. In this study being a pre-medicine student (AOR = 3.61, 95% CI: 1.45-8.97), perceiving medical school as very stressful (AOR = 3.89, 95% CI: 1.52-9.94), perceiving living environment as very crowded (AOR = 2.43, 95% CI: 1.24-4.77) and having a feeling of insecurity about one's safety (AOR = 2.93, 95% CI: 1.51-5.68) had statistically significant association with mental distress. In this study one-third of medical students were found to have mental distress. Designing prevention and treatment programs to address contextually

  12. Apraxia in Parkinson's disease, progressive supranuclear palsy, multiple system atrophy and neuroleptic-induced parkinsonism.

    Science.gov (United States)

    Leiguarda, R C; Pramstaller, P P; Merello, M; Starkstein, S; Lees, A J; Marsden, C D

    1997-01-01

    We studied 45 non-demented patients with Parkinson's disease (PD), 12 with progressive supranuclear palsy (PSP), 10 with multiple system atrophy (MSA) and 12 with neuroleptic-induced parkinsonism (NIP) for the presence of apraxia. Our aim was to determine whether a standard comprehensive assessment of different praxic functions would demonstrate specific types of errors not attributable to bradykinesia, rigidity, tremor or any other abnormal elementary motor deficit. PD patients on chronic levodopa treatment were examined in the 'on' and 'off' (treatment) states. Based on apraxia assessment scores, bilateral ideomotor apraxia for transitive movements was found in eight (75%) and 12 (27%) of PSP and PD patients, respectively. Ideomotor apraxia was mainly characterized by spatial errors (i.e., external and internal configuration, body-part-as-object and trajectory). Four PSP but no PD patients exhibited ideomotor apraxia for intransitive movements. PSP as well as PD patients with ideomotor apraxia also had difficulties in imitating hand and finger postures, but none of them failed on pantomime comprehension and pantomime recognition/discrimination. Some PSP patients exhibited, in addition, a limbkinetic type of apraxia and a minority of them displayed deficits on tasks involving multiple steps. Neither MSA nor NIP patients showed any disturbance of praxic functions. There were no differences in age, disease duration, Mini Mental State Examination (MMSE), Unified Parkinson's disease Rating Scale and Hoehn-Yahr scores between apraxic and non-apraxic PD patients, and ideomotor apraxia scores were similar in the 'on' and 'off' states. A correlation was found between ideomotor apraxia scores in PD patients and deficits in frontal lobe-related neuropsychological tasks such as the Tower of Hanoi, verbal fluency and the Trail Making Test. Furthermore, PD patients with apraxia showed higher Hamilton depression scores than non-apraxic PD patients. In PSP patients, ideomotor

  13. Economic Utility: Combinatorial Pharmacogenomics and Medication Cost Savings for Mental Health Care in a Primary Care Setting.

    Science.gov (United States)

    Brown, Lisa C; Lorenz, Raymond A; Li, James; Dechairo, Bryan M

    2017-03-01

    This study was an analysis based on a previously completed prospective study investigating medication costs of patients with mental illness guided by using the GeneSight proprietary combinatorial pharmacogenomic (PGx) test. The primary objective of this study was to determine potential cost savings of combinatorial PGx testing over the course of 1 year in patients with mental illness treated by primary care providers (PCPs) and psychiatrists who had switched or added a new psychiatric medication after patients failed to respond to monotherapy. The current evaluation details cost savings of treatment decisions congruent and incongruent with the combinatorial PGx test recommendations specific to PCPs and psychiatrists. This study was a subanalysis of a 1-year, prospective trial comparing medication costs of 2168 patients undergoing GeneSight testing. Pharmacy claims were provided by a pharmacy benefits manager, comparing medication costs 6 months before combinatorial PGx testing and followed up for 1 year after the testing. This analysis compared congruence and cost savings per patient based on the type of health care provider administering care. Using data from a large pharmacy benefits manager, we found that PCPs treat the majority of mental health patients receiving psychotropic medication prescriptions, including treatment-resistant patients. PCPs congruent with combinatorial PGx testing provided the most medication cost savings for payers and patients at $3988 per member per year (P Health care providers treating patients with mental illness can significantly reduce medication costs by following the combinatorial PGx report recommendations. PCPs, who treat the majority of patients with mental illness, reported a significant reduction in medication costs for both central nervous system and non-central nervous system drugs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Cross-cultural Differences in Mental Health, Quality of Life, Empathy, and Burnout between US and Brazilian Medical Students.

    Science.gov (United States)

    Lucchetti, Giancarlo; Damiano, Rodolfo Furlan; DiLalla, Lisabeth F; Lucchetti, Alessandra Lamas Granero; Moutinho, Ivana Lúcia Damásio; da Silva Ezequiel, Oscarina; Kevin Dorsey, J

    2017-08-31

    This study aimed to compare mental health, quality of life, empathy, and burnout in medical students from a medical institution in the USA and another one in Brazil. This cross-cultural study included students enrolled in the first and second years of their undergraduate medical training. We evaluated depression, anxiety, and stress (DASS 21), empathy, openness to spirituality, and wellness (ESWIM), burnout (Oldenburg), and quality of life (WHOQOL-Bref) and compared them between schools. A total of 138 Brazilian and 73 US medical students were included. The comparison between all US medical students and all Brazilian medical students revealed that Brazilians reported more depression and stress and US students reported greater wellness, less exhaustion, and greater environmental quality of life. In order to address a possible response bias favoring respondents with better mental health, we also compared all US medical students with the 50% of Brazilian medical students who reported better mental health. In this comparison, we found Brazilian medical students had higher physical quality of life and US students again reported greater environmental quality of life. Cultural, social, infrastructural, and curricular differences were compared between institutions. Some noted differences were that students at the US institution were older and were exposed to smaller class sizes, earlier patient encounters, problem-based learning, and psychological support. We found important differences between Brazilian and US medical students, particularly in mental health and wellness. These findings could be explained by a complex interaction between several factors, highlighting the importance of considering cultural and school-level influences on well-being.

  15. Investigation of Mental Health in Patients with Medically ‎Unexplained Physical Symptoms‎

    Directory of Open Access Journals (Sweden)

    Frough Riahi

    2016-02-01

    Full Text Available Objective: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic ‎causes. This study aimed to investigate mental health in patients with medically unexplained ‎physical symptoms. ‎Method: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini ‎hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, ‎paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance ‎‎ (MANOVA, Chi-square test and Fisher’s exact test. ‎Results: The findings revealed significant differences between clients with medically explained and ‎unexplained symptoms in obsessive compulsive and somatization (p<0.05. Differences in ‎depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05.‎Conclusion: The present study suggested an association between some psychological problems and somatic ‎symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.

  16. Nicotine Withdrawal, Relapse of Mental Illness, or Medication Side-Effect? Implementing a Monitoring Tool for People With Mental Illness Into Quitline Counseling.

    Science.gov (United States)

    Segan, Catherine J; Baker, Amanda L; Turner, Alyna; Williams, Jill M

    2017-01-01

    Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine-dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal. The aim of this research was to examine the acceptability and feasibility to quitline counselors of implementing structured assessments of nicotine withdrawal and common medication side effects in people with mental illness who are quitting smoking using a telephone smoking cessation service. Monitoring involves administering (once pre-cessation and at each contact post-cessation) (1) the Minnesota Nicotine Withdrawal Scale, assessing eight symptoms: anger, anxiety, depression, cravings, difficulty concentrating, increased appetite, insomnia, and restlessness and (2) an adverse side effects checklist of 5 to 10 symptoms, for example, dry mouth and increased thirst. Following a 1-day update training in mental health, quitline counselors were asked to offer these assessments to callers disclosing mental illness in addition to usual counseling. Group interviews with counselors were conducted 2 months later to examine implementation barriers and benefits. Barriers included awkwardness in integrating a new structured practice into counseling, difficulty in limiting some callers to only the content of new items, and initial anxieties about how to respond to changes in some symptoms. Benefits included the ability to provide objective feedback on changes in symptoms, as this

  17. Empathy is Associated with Meaning of Life and Mental Health Treatment but not Religiosity Among Brazilian Medical Students.

    Science.gov (United States)

    Damiano, Rodolfo Furlan; de Andrade Ribeiro, Luciana Maria; Dos Santos, Amanda Guedes; da Silva, Barbara Almeida; Lucchetti, Giancarlo

    2017-06-01

    The purpose of this study was to investigate the influence of spirituality, religiosity, personal beliefs, and previous contact with health issues on the level of empathy in medical students. Jefferson Scale of Empathy-Student Version, WHOQOL-Spirituality, Religiousness and Personal Beliefs, and Duke University Religion Index were applied to 285 Brazilian medical students. The findings suggest that meaning of life and previous mental health treatment but not Religiosity were positively related to empathy. We suggest that more attention should be given for prevention and treatment of mental health issues, and further studies are needed to understand and replicate these findings.

  18. Mental Well-Being in First Year Medical Students: A Comparison by Race and Gender: A Report from the Medical Student CHANGE Study.

    Science.gov (United States)

    Hardeman, Rachel R; Przedworski, Julia M; Burke, Sara E; Burgess, Diana J; Phelan, Sean M; Dovidio, John F; Nelson, Dave; Rockwood, Todd; van Ryn, Michelle

    2015-09-01

    In this study, authors sought to characterize race and gender disparities in mental health in a national sample of first year medical students early in their medical school experience. This study used cross-sectional baseline data of Medical Student CHANGES, a large national longitudinal study of a cohort of medical students surveyed in the winter of 2010. Authors ascertained respondents via the American Association of Medical Colleges questionnaire, a third-party vendor-compiled list, and referral sampling. A total of 4732 first year medical students completed the baseline survey; of these, 301 were African American and 2890 were White. Compared to White students and after adjusting for relevant covariates, African American students had a greater risk of being classified as having depressive (relative risk (RR)=1.59 [95 % confidence interval, 1.37-2.40]) and anxiety symptoms (RR=1.66 [1.08-2.71]). Women also had a greater risk of being classified as having depressive (RR=1.36 [1.07-1.63]) and anxiety symptoms (RR-1.95 [1.39-2.84]). At the start of their first year of medical school, African American and female medical students were at a higher risk for depressive symptoms and anxiety than their White and male counterparts, respectively. The findings of this study have practical implications as poor mental and overall health inhibit learning and success in medical school, and physician distress negatively affects quality of clinical care.

  19. Medical withdrawals from college for mental health reasons and their relation to academic performance.

    Science.gov (United States)

    Meilman, P W; Manley, C; Gaylor, M S; Turco, J H

    1992-03-01

    A collaborative study among the university health service, the dean's office, and the registrar's office examined the academic performance of 77 students who took medical withdrawals for mental health reasons from Dartmouth College during a 3-year period. In 71.4% of the cases, students withdrew from a term in progress; the remainder arranged to withdraw after they had completed a term but before starting a new term. Depression was a major factor in approximately half of the withdrawals. Grade point average improved significantly after return from the withdrawal, with a large jump in individual term averages occurring between the terms immediately preceding and immediately following return. We found no significant difference between the number of students who experienced disciplinary trouble before withdrawal and those who were disciplined afterward. Students who were depressed at the time of withdrawal did not fare as well academically upon return as those students who had not been depressed. The data suggest that procedures for handling mental health withdrawals and readmission are important ways in which the campus counseling center can support the university's academic mission.

  20. Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    J M Lucca

    2015-01-01

    Full Text Available Background: In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. Materials and Methods: A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS. Results: Of the 400 patients, 172 (43% were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001, number of drugs (P = 0.002, family income (P = 0.013, and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32% and disease-related factors (31%. Conclusion: The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.

  1. Examining the Role of Predictor Variables of Mental Health and Personality Subscales in Internet Addiction of Students in Medical and non-Medical Universities of Sanandaj in 2014

    Directory of Open Access Journals (Sweden)

    Afshin Salahian

    2015-12-01

    Full Text Available Background and objective: According to the high and increasing prevalence of internet addiction, and the fact that little research has been done on the predictors of internet addiction in Iran, the purpose of this study was to examine the role of predictor variables of mental health and personality subscales in internet addiction of students in medical and non-medical universities of Sanandaj in 2014. Methods: The Method of this research was correlation and the statistical population were all of medical and non-medical students of Sanandaj Universities in 2014. In this study, 250 students (125 female and 125 male, were randomly selected, and completed the checklist of mental health symptoms, NEO personality questionnaire, and internet addiction questionnaire. Data were analyzed using Pearson Correlation, stepwise regression, and T test by SPSS software version 20. Results: The results indicated that obsession-compulsion, openness, consciousness, aggression and somatization subscales had predictor roles in internet addiction, and totally 51 percent of variances predicted the internet addiction (F=29.97; P=0.001. Conclusion: The internet addiction of university students is dependent upon their mental health and personality, and one can predict the internet addiction of students via subscales of mental health and personality.

  2. Common mental disorders among medical students Transtornos mentais comuns entre estudantes de medicina

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    Alessandro de Moura Almeida

    2007-01-01

    Full Text Available OBJECTIVE: Common mental disorders (CMD have a high impact on interpersonal relationships and quality of life and are potential underlying causes for the development of more serious disorders. Medical students have been indicated as a risk population for the development of CMD. The aim of this study was to determine the frequency of CMD in undergraduate medical students and to identify related factors. METHODS: A cross-sectional study was performed in a sample population of medical students. CMD was identified according to the 20-item Self-Report Questionnaire. RESULTS: Two hundred and twenty-three students completed the questionnaire. The overall prevalence of CMD was 29.6% and its presence was independently associated with sleep disorders, not owning a car, not working and sedentary lifestyle. CONCLUSIONS: These findings indicate a high prevalence of CMD in the sample studied and are important for supporting actions to prevent mental disorders in future doctors and for reflecting on the curricula currently in use in medical schools.OBJETIVO: Transtornos mentais comuns (TMC possuem alto impacto nos relacionamentos interpessoais e na qualidade de vida, sendo potenciais substratos para o desenvolvimento de transtornos mais graves. Estudantes de medicina vêm sendo apresentados como população de risco para o desenvolvimento de TMC. O objetivo deste estudo é estimar a freqüência de TMC em acadêmicos de medicina da Universidade Federal da Bahia e identificar fatores relacionados. MÉTODOS: Realizou-se estudo transversal entre uma amostra de estudantes de medicina. A identificação dos TMC foi feita por meio do 20-item Self-Report Questionnaire. RESULTADOS: Foram avaliados 223 estudantes. A prevalência de TMC foi de 29,6%, sendo independentemente associada a alterações do padrão do sono, não possuir transporte próprio, não trabalhar e não realizar exercício físico. CONCLUSÕES: Estes dados demonstram uma elevada prevalência de TMC

  3. The contribution of cytochrome P-450 isoenzymes to the metabolism of phenothiazine neuroleptics.

    Science.gov (United States)

    Daniel, W A; Syrek, M; Haduch, A

    2002-10-01

    The aim of the present study was to determine optimum conditions for studying promazine and perazine metabolism in rat liver microsomes, and to investigate the influence of specific cytochrome P-450 inhibitors on 5-sulfoxidation and N-demethylation of these neuroleptics. Based on the developed method, the metabolism of neuroleptics in liver microsomes was studied at linear dependence of product formation on time, and protein and substrate concentrations (incubation time: 10 min; concentration of microsomal proteins: promazine-0.7 mg ml(-1), perazine-0.5 mg ml(-1); substrate concentrations: promazine-25, 40 and 75 nmol ml(-1), perazine-20, 35, 50 nmol ml(-1)). A Dixon analysis of the metabolism of neuroleptics showed that quinine (a CYP2D1 inhibitor), metyrapone (a CYP2B1/B2 inhibitor) and alpha-naphthoflavone (a CYP1A1/2 inhibitor) affected, whereas erythromycin (a CYP3A inhibitor) and sulfaphenazole (a CYP2C inhibitor) did not change the neuroleptic biotransformation. N-Demethylation of promazine was competitively inhibited by quinine (K(i)=20 microM) and metyrapone (K(i)=83 microM), while that of perazine-by quinine (K(i)=46.5 microM), metyrapone (K(i)=46 microM) and alpha-naphthoflavone (K(i)=78.8 microM). 5-Sulfoxidation of promazine was inhibited only by quinine (K(i)=28.6 microM), whereas that of perazine-by quinine (K(i)=10 microM) and metyrapone (K(i)=96 microM). The results obtained are compared with our previous findings of analogous experiments concerning thioridazine, and with the data on other phenothiazines and species. In summary, it is proposed that N-demethylation of the mentioned phenothiazine neuroleptics in the rat is catalyzed by the isoenzymes CYP2D1, CYP2B2 and CYP1A2 (CYP1A2 does not refer to promazine). 5-Sulfoxidation of these drugs may be mediated by different isoenzymes, e.g. CYP2D1 (promazine and perazine), CYP2B2 (perazine) and CYP1A2 (thioridazine). Isoenzymes belonging to subfamilies CYP2C and CYP3A do not seem to be involved in the

  4. Medication safety at the interface: evaluating risks associated with discharge prescriptions from mental health hospitals.

    Science.gov (United States)

    Keers, R N; Williams, S D; Vattakatuchery, J J; Brown, P; Miller, J; Prescott, L; Ashcroft, D M

    2015-12-01

    handwritten discharges, respectively. Similar findings were reported at the individually prescribed item level. Middle-grade prescribers were also more likely to make both non-psychotropic and psychotropic prescribing errors than their junior colleagues [individual item OR 4·24 (2·14-8·40) and OR 1·70 (1·16-2·48), respectively]. Discharge prescriptions issued by mental health NHS hospitals are affected by high levels of prescribing, clerical and communication errors. Important targets for intervention have been identified to improve medication safety problems at care transfer. © 2015 John Wiley & Sons Ltd.

  5. Sources of patients' knowledge of the adverse effects of psychotropic medication and the perceived influence of adverse effects on compliance among service users attending community mental health services.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2009-12-01

    Noncompliance with medication has been a complex issue with patients with severe mental illness during the last few decades, and adverse effects of medication have been identified as a major contributor to noncompliance.

  6. Neuroleptic malignant syndrome: A review of the clinical/diagnostic features and report of a case without fever

    Directory of Open Access Journals (Sweden)

    Okwudili Obayi

    2017-01-01

    Full Text Available Neuroleptic malignant syndrome (NMS is an uncommon but potentially fatal idiosyncratic reaction characterized by the development of altered consciousness, hyperthermia, autonomic dysfunction, and muscular rigidity on exposure to antipsychotic (or some other psychotropic medications. It is a medical emergency that requires early prompt identification and intervention. Fever is a predominant symptom in NMS. However, there have been reports that the classical high temperature usually associated with NMS may, on rare occasions, be absent. Case presentation This review and case report focus on the clinical/diagnostic features of NMS and a report of an unusual case without the classical high grade fever in a 27- year old male patient with schizophrenia who had been on high doses of multiple typical and atypical antipsychotic drugs. Conclusion This case report serves to remind clinicians of the essential features in the diagnosis of NMS and supports earlier reports that the classical high temperature usually associated with NMS may, on rare occasions, be absent and that would not exclude the diagnosis.

  7. Assessment of Relationship between Mental Health and Educational Success in the Students of Qom University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hassan Sadeghi

    2013-07-01

    Full Text Available Background and Objectives: Mental health is one of factors affecting various aspects of life and attention to this issue is of particular importance in educational status of students as society’s assets. The present study was conducted to determine the relationship between mental health and educational success of students in Qom University of Medical Sciences 2011.Methods: This cross-sectional study was performed on 240 students of Qom University of Medical Sciences. The Samples were selected through stratified random sampling method from the students of Medicine, Health, and Nursing & Midwifery. The data collection tool was consisted of two parts, including students’ demographic information and General Mental Health Questionnaire (GHQ-28. Student with grade-point average above 14 were considered as successful students. The data were analyzed by descriptive statistics, chi-square and Pearson’s correlation tests. The significance level was considered to be p0.05. No significant relationship was observed between aspects of mental health and grade-point average (p>0.05. There was significant relationship between mental health and economic status (p<0/05.Conclusion: According to the results of this study and lack of significant relationship between mental health and educational success, implementation of further studies is necessary for recognition of other aspects of health and factors affecting academic status.

  8. [Cooperation, Job Satisfaction and Burn Out - Sustainability in Outpatient Mental Health Care among Medical Specialists in Germany].

    Science.gov (United States)

    Baumgardt, Johanna; Moock, Jörn; Rössler, Wulf; Kawohl, Wolfram

    2017-04-01

    Objective Cooperation, job satisfaction, and burn out risk are indicators of sustainability in mental health services. Thus they were assessed among registered medical specialists in outpatient mental health care in Germany. Method A postal survey consisting of three questionnaires about cooperation, job satisfaction, and burnout was carried out among all registered medical specialists in outpatient mental health care in Germany (n = 4,430). Results 14.1 % (n = 626) of the specialists responded to the survey. Quality and quantity of cooperation regarding mental health care services were rated diverse, job satisfaction was assessed medium to high, and burnout risk was low to medium. Higher job satisfaction correlated with good quality of cooperation, fewer years of practice, fewer patients' chronically ill, more patients who as well seek psychotherapy, and less time spent on cooperation. Low burn out risk correlated with good quality of cooperation, higher age, single practice setting and a higher amount of patients who as well seek psychotherapy. Conclusion Quality and quantity of cooperation in outpatient mental health care - especially regarding community mental health care institutions - should be fostered. Aspects to be considered to reinforce job satisfaction and minimize burn out risk are age, years of practice, quality and quantity of cooperation, practice setting, and the mixture of patients. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students.

    Science.gov (United States)

    Brimstone, Renee; Thistlethwaite, Jill E; Quirk, Frances

    2007-01-01

    Doctors are often reluctant to seek health care through the usual channels and tend to self-diagnose and prescribe. Medical students learn attitudes and values from clinician role models and may also adopt behaviour patterns that lead them to seek help for physical and mental health problems from informal sources. This study aimed to explore the behaviour of students in seeking health care for physical and mental health problems, comparing medical with psychology students, and to understand what barriers to conventional routes of seeking health care may affect this. We administered a questionnaire asking for demographic details and responses to 2 vignettes in which a student from the respondent's discipline was experiencing firstly symptoms of a mental health problem and secondly symptoms of a physical health problem. Data were analysed with spss and univariate anovas to examine differences between respondents. A total of 172 students at the psychology and medical schools at James Cook University in Australia participated. We identified a number of barriers affecting student behaviour in seeking help, which included worries about knowing the doctor they could consult at the university health centre or having future dealings with him or her, and cost of treatment. There were differences between the 2 groups of students. There are several barriers for both psychology and medical students to accessing appropriate professional mental health care. Medical students also experience barriers to attaining appropriate physical health care when needed. Psychology and medical students were more likely to seek advice informally from friends and/or family with regard to mental health care.

  10. Comparison of adherence rates for antiretroviral, blood pressure, or mental health medications for HIV-positive patients at an academic medical center outpatient pharmacy.

    Science.gov (United States)

    Langness, Jacob; Cook, Paul F; Gill, Jasjit; Boggs, Rachael; Netsanet, Nathan

    2014-08-01

    Despite advances in safety, tolerability, and decreased pill burden for human immunodeficiency virus (HIV) antiretroviral therapy (ART), nonadherence continues to be a major cause of HIV-related morbidity and mortality. Adherence to these medications presents particular challenges because persons living with HIV (PLWH) must use medication more consistently (≥ 95%) than persons with other chronic diseases, such as hypertension or diabetes mellitus (≥ 80%). To (a) quantify PLWH adherence rates to scheduled ART, blood pressure medications, or mental health medications, (b) examine how pill burden and dosing schedule affected adherence, and (c) analyze a non-HIV comparator group for comparison with PLWH patients on adherence rates. Patients ≥ 18 years of age, on any prescribed HIV ART, scheduled prescription blood pressure medication, or scheduled prescription mental health medication filled between March 1, 2012, and March 31, 2013, were included in the analysis of data from the University of Colorado Hospital outpatient pharmacy system. The proportion of days covered (PDC) was calculated to measure adherence. Statistical analyses were performed to compare adherence rates between groups. The study included 865 PLWH, who filled 1,943 antiviral prescriptions with an average PDC of 84.5%. However, only 40% of patients had high enough adherence to achieve therapeutic benefits based on a criterion of at least 95% of scheduled doses taken. When separated by regimen, 282 patients filled single-tablet once-daily regimens; 295 patients filled multitablet once-daily regimens; and 288 patients filled multitablet twice-daily regimens. The calculated PDC of PLWH on a single-tablet once-daily regimen was 89.7% versus 81.0% for PLWH on a multitablet once-daily regimen (P  less than  0.001). The average PDC for PLWH (n = 269) who filled 460 scheduled blood pressure prescriptions was 82.7%. The average PDC for PLWH (n = 295) filling 467 scheduled mental health

  11. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

    NARCIS (Netherlands)

    Aschbrenner, K.A.; Pepin, R.; Mueser, K.T.; Naslund, J.A.; Rolin, S.A.; Faber, M.J.; Bartels, S.J.

    2014-01-01

    OBJECTIVE: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received

  12. Mental health of medical school students and the effects of their strategy for enhancing self-esteem.

    Science.gov (United States)

    Kim, Jin-Hee; Jang, Eun-Young; Kim, Daeho; Choi, Joon Ho; Park, Yong-Chon

    2011-12-01

    This study investigated the mental health status, self-esteem, social comparison, and narcissism among medical school students. In addition, the mediational effect of social comparison between self-esteem and narcissism was also tested with regard to whether the students compared themselves with others to enhance their own self-esteem. Data were collected from 427 medical school students at a medical school in Seoul. The questionnaire included the Minnesota Multiphasic Personality Inventory (MMPI) 383 scale, the self-esteem scale, the Iowa-Netherlands Comparison Orientation Measure, and the narcissism scale. Using the MMPI findings, a clinical psychologist screened for possible clinical cases. Then, the frequencies of those with distress were compared between three groups, based on affiliation; premedical, medical, and graduate medical students. Also, the level of self-esteem, social comparison, and narcissism was tested by analysis of (ANCOVA), and the mediational role of social comparison was explored. Irrespective of affiliation, almost 10% of medical school students showed mental illness or distress. Of the clinical scales on the MMPI, the T scores of the Pa (Paranoia), Sc (Schizophrenia), and Ma (Hypomania) scales were higher in premedical and medical school students than in graduate medical school students. In addition, the mediational role of social comparison was confirmed only in medical school students. We demonstrated that subjective distress in certain medical school students needs to be addressed. Also, self-esteem was an important factor that correlated with mental health and distress indices. However, comparing oneself with others to enhance self-esteem by derogating or focusing could result in increased narcissism.

  13. Neuroleptic Malignant Syndrome in a Patient with Tongue Cancer: A Report of a Rare Case

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    Osamu Baba

    2013-01-01

    Full Text Available Background. Neuroleptic malignant syndrome (NMS is a rare but life-threatening complication of neuroleptic drugs, which are used widely in head and neck cancer (HANC patients who develop delirium. Methods and Results. Postoperative delirium in a 39-year-old man with tongue cancer was treated with haloperidol and chlorpromazine. Three days after the first administration of antipsychotics, the patient exhibited elevated body temperature, autonomic and extrapyramidal symptoms, and impaired consciousness. A definitive diagnosis was made using the research diagnostic criteria for NMS in the DSM-IV, and the antipsychotics were immediately discontinued. The patient was given dantrolene and bromocriptine to treat the NMS. The patient’s hyperthermia, elevated creatinin kinase (CK, and muscle rigidity improved gradually, with all symptoms of NMS resolving completely by 13 days after the diagnosis. Conclusions. HANC surgeons must be alert for early signs of NMS and use antipsychotics conservatively to avoid NMS and its potentially fatal outcome.

  14. Building integrated mental health and medical programs for vulnerable populations post-disaster: connecting children and families to a medical home.

    Science.gov (United States)

    Madrid, Paula A; Sinclair, Heidi; Bankston, Antoinette Q; Overholt, Sarah; Brito, Arturo; Domnitz, Rita; Grant, Roy

    2008-01-01

    Hurricane Katrina, a Category 3 hurricane, made landfall in August 2005. Approximately 1,500 deaths have been directly attributed to the hurricane, primarily in Louisiana and Mississippi. In New Orleans, Louisiana, most of the healthcare infrastructure was destroyed by flooding, and > 200,000 residents became homeless. Many of these internally displaced persons received transitional housing in trailer parks ("villages") under the auspices of the [US] Federal Emergency Management Agency (FEMA). The FEMA villages are isolated from residential communities, lack access to healthcare services, and have become unsafe environments. The trailers that house families have been found to be contaminated with formaldehyde. The Children's Health Fund, in partnership with the Mailman School of Public Health at Columbia University, began a program ("Operation Assist") to provide health and mental health services within a medical home model. This program includes the Baton Rouge Children's Health Project (BRCHP), which consists of two mobile medical units (one medical and one mental health). Licensed professionals at the FEMA villages and other isolated communities provide care on these mobile units. Medical and psychiatric diagnoses from the BRCHP are summarized and case vignettes presented. Immediately after the hurricane, prescription medications were difficult to obtain. Complaints of headache, nosebleeds, and stomachache were observed at an unusually frequent degree for young children, and were potentially attributable to formaldehyde exposure. Dermatological conditions included eczema, impetigo, methicillin-resistant staphylococcus aureus (MRSA) abscesses, and tinea corporis and capitis. These were especially difficult to treat because of unhygienic conditions in the trailers and ongoing formaldehyde exposure. Signs of pediatric under-nutrition included anemia, failure to thrive, and obesity. Utilization of initial mental health services was low due to pressing survival needs

  15. A cross-sectional examination of psychological distress, positive mental health and their predictors in medical students in their clinical clerkships

    OpenAIRE

    Inge van Dijk; Peter L. B. J. Lucassen; Chris van Weel; Anne E. M. Speckens

    2017-01-01

    Abstract Background Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called ‘positive mental health’. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores...

  16. The muscle findings in the neuroleptic malignant syndrome associated with lysergic acid diethylamide.

    OpenAIRE

    Behan, W M; Bakheit, A M; Behan, P O; More, I A

    1991-01-01

    A detailed pathological description of the muscle findings in a case of the neuroleptic malignant syndrome (NMS) following ingestion of lysergic acid diethylamide (LSD) is given, including the first ultrastructural analysis. Focal necrosis, oedema, and hypercontraction of fibres with glycogen and lipid depletion, were identified, all of which had resolved completely a year later. The findings are compared with those in malignant hyperthermia. It is suggested that the results support the view ...

  17. Actometry and Barnes Akathisia Rating Scale in neuroleptic-induced akathisia.

    Science.gov (United States)

    Janno, Sven; Holi, Matti M; Tuisku, Katinka; Wahlbeck, Kristian

    2005-01-01

    We evaluated Barnes Akathisia Rating Scale (BARS) and standardized lower limb actometry in quantifying neuroleptic-induced akathisia (NIA) in 99 schizophrenia patients. Both instruments discriminated well between NIA and non-NIA patients and they correlated weakly but significantly. BARS was superior to actometry in screening DSM-IV diagnosed NIA patients. The results of this methodological study provide BARS with objective validation through movement measuring, that it has been suggested to need.

  18. Effects of neuroleptics administration on adult neurogenesis in the rat hypothalamus.

    Science.gov (United States)

    Rojczyk, Ewa; Pałasz, Artur; Wiaderkiewicz, Ryszard

    2015-12-01

    Among many factors influencing adult neurogenesis, pharmacological modulation has been broadly studied. It is proven that neuroleptics positively affect new neuron formation in canonical neurogenic sites - subgranular zone of the hippocampal dentate gyrus and subventricular zone of the lateral ventricles. Latest findings suggest that adult neurogenesis also occurs in several additional regions like the hypothalamus, amygdala, neocortex and striatum. As the hypothalamus is considered an important target of neuroleptics, a hypothesis can be made that these substances are able to modulate local neural proliferation. Experiments were performed on adult male rats injected for 28 days or 1 day by three neuroleptics: olanzapine, chlorpromazine and haloperidol. Immunohistochemistry was used to determine expression of proliferation marker (Ki-67) and the marker of neuroblasts - doublecortin (DCX) - which may inform about drug influence on adult neurogenesis at the level of the hypothalamus. It was shown that a single injection of antipsychotics causes significant decrease in hypothalamic DCX expression, but after chronic treatment with chlorpromazine, but not olanzapine, there is an increase in the number of newly formed neuroblasts. Haloperidol has the opposite effect - its long-term administration decreases the number of DCX-positive cells. Cell proliferation levels (Ki-67 expression) increase after long-term drug administration, whereas their single doses do not have any modulatory effect on proliferation potential. Our results throw a new light on the neuroleptics mechanism of action. They also support the potential role of antipsychotics as a factor that can modulate hypothalamic neurogenesis with putative clinical applications. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. Attitudes of U.S. Psychiatry Residents and Fellows towards Mental Illness and its Causes: a Comparison Study with Medical Students.

    Science.gov (United States)

    Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert

    2018-01-13

    Stigma towards people with mental illness remains a burden for patients and healthcare providers. This study at a large US university examined the attitudes of psychiatry residents and fellows towards mental illness and its causes, and whether their attitudes differed from the medical student attitudes previously studied utilizing the same survey method. An electronic questionnaire examining attitudes toward people with mental illness, causes of mental Illness, and treatment efficacy was used to survey the attitudes of psychiatry residents and fellows. Exploratory factor analysis derived from the authors' medical student survey was used to examine attitudinal factors. The study response rate was 54.2% (n = 94). Factor analysis employed three factors previously identified reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Residents and fellows reporting more personal experiences with mental illness, both as a group and when compared with medical students, were significantly more willing to socialize with the mentally ill. Respondents who had more professional (work) experience other than medical school or post-graduate training were less likely to believe in supernatural causes of mental illness. Female residents and fellows were more willing to socialize with the mentally ill, and were less likely to believe in supernatural causes for mental illness than their male counterparts. In our study, increased social acceptance of the mentally ill relates to having personal experiences, advanced training in psychiatry, and female gender. Both professional experiences outside of training and female gender reduced the belief in supernatural causes.

  20. [The initial dysphoric reaction (IDR) to the first dose of neuroleptics].

    Science.gov (United States)

    Schimmelmann, B Graf; Schacht, M; Perro, C; Lambert, M

    2004-01-01

    Initial dysphoric response (IDR) is characterized by a negative affective reaction within 48 h after a neuroleptic test dose. Currently, there are three scales for measuring the IDR (Neuroleptic Dysphoria Scale, Dysphoric Response Index, Drug Attitude Inventory). The debate continues about the definition, measurement, and underlying aetiology of IDR. Nevertheless, with a prevalence of 30%, the response is a clinically relevant phenomenon. Empirical data give some evidence of an association between IDR and short-term outcome. No correlation of IDR with pretreatment variables has been found yet (e.g. age, gender, and psychopathology at baseline, especially depression and hostility). With respect to aetiology, a negative subjective reaction to concurrent extrapyramidal side effects and direct dysaffective effects of some neuroleptics have been discussed. Other studies found that IDR might not be a specifically antipsychotic effect. Our first results give some evidence that patients treated with atypical antipsychotics experience IDR less often and less severely than those treated with conventional antipsychotics described in the literature. Further research should include placebo-controlled studies and the evaluation of specific pretreatment variables. To assess the aetiology of IDR, further basic research is needed.

  1. Effects of neuroleptics displaying antidepressant activity on behavior of rats in the forced swimming test.

    Science.gov (United States)

    Górka, Z; Janus, K

    1985-08-01

    Levomepromazine, thioridazine and cis-chlorprothixene, neuroleptics with antidepressant activity, trans-chlorprothixene, the therapeutically inactive isomer of chlorprothixene, clozapine, an atypical neuroleptic, and imipramine, a classical antidepressant, were studied in the forced swimming test in rats after single or chronic administration. Levomepromazine (1.5 mg/kg), clozapine (2.5 and 5.0 mg/kg) and imipramine (10 mg/kg) after single administration, 1 hr before the test, shortened the period of the immobility. After chronic administration only imipramine (10 mg/kg orally, twice daily, for 10 days) diminished the immobility. Levomepromazine, thioridazine, cis-chlorprothixene and trans-chlorprothixene (1.5 mg, orally, twice daily, for 10 days), 15-18 hr after the last dose did not influence the immobility, although the behavioral parameters in the open field test were not depressed. It is concluded that the forced swimming test is not a suitable pharmacological model for revealing antidepressant activities of certain neuroleptics that are useful in treating certain forms of human depression.

  2. Neuroleptic induced tardive dyskinesa in a patient on treatment for ...

    African Journals Online (AJOL)

    In this case, a thirty six year old patient on treatment for schizophrenia is described with severe tardive dyskinesia. The most likely cause is long term treatment with two highly potent typical antipsychotic medications. The patient was initially treated with Benzhexol, an anticholinergic agent with the potential to induce or ...

  3. Investigation of the Relationship Between Mental Health and Organizational Employees’ work Fatigue and Deputyships of Yasouj Medical Science University

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    A Mahmoodi

    2015-08-01

    Full Text Available Background & aim: Peoples’ mental health in improvement of society’s national and ideal aims have the main and most importance such as thriftiness in material and spiritual costs. Work fatigue is the result of severe decrease of person’s capabilities sources that counter with long –time stress, especially work stress. This study was designed with the aim of investigating the relationship between mental health and work fatigue at Yasuj University of Medical Sciences. Method of investigation: The present co-operation – descriptive study was conducted on 274 participants from 961 organization employees and deputyships of Yasuj University of Medical Sciences in 2013-2014 who were chosen randomly. In order to collect data, Maslach questionnaire of mental health condition and work fatigue was used. Data were analysed with statistical tests of the interconnection index Pearson and Friedman’s test. Findings: There was no significant relationship between mental health and work fatigue dimensions (p<0/05. A meaningful relationship was observed between studied models after usage. High attention and metamorphosis of personality had the least importance. Conclusion: When employees have full mental health and job satisfaction, the ability to achieve maximum efficiency in the organization is reachable.

  4. Socially restrictive attitudes towards people with mental illness among the non-psychiatry medical professionals in a university teaching hospital in South India.

    Science.gov (United States)

    Sathyanath, Shashwath; Mendonsa, Rohan Dilip; Thattil, Anitha Maria; Chandran, Varikkara Mohan; Karkal, Ravichandra S

    2016-05-01

    Unfortunately, stigmatizing attitudes towards mentally ill are common among medical students, nurses as well as doctors. This is a major obstacle in the delivery of mental health services. To assess the socially restrictive attitudes towards mentally ill among the medical professionals and to investigate the association between such attitudes and relevant variables. We assessed the attitudes towards people with mental illness among the medical professionals (N = 130) in a medical university using shortened version of the 40-item Community Attitudes toward the Mentally Ill (CAMI) scale. We found that socially restrictive attitudes were endorsed by quite a number of faculty members and trainees. Significantly higher number of faculty members (22.5%) compared to the trainees (9.1%) endorsed unfavourable attitudes towards previously mentally ill man getting married. Similarly, significantly more number of faculty (22.5%) were averse to the idea of living next door to someone who has been mentally ill compared to the trainees (9.1%). However, significantly lesser number of faculty members (16.1%) compared to the trainees (30.3%) believed that previously mentally ill people should be excluded from taking public office. Personal acquaintance with a mentally ill individual was the only variable that was associated with significantly lesser socially restrictive attitudes among the medical professionals, irrespective of their age, gender and clinical exposure to people with mental illness. Socially restrictive attitudes towards people with mental illness are prevalent among substantial number of medical professionals in a low-income country like India. Personal acquaintance with people who have mental illness appears to be the only significant factor that reduces medical professionals' socially restrictive attitudes towards them. © The Author(s) 2016.

  5. The Relationship Between Critical Thinking Skills with Mental Health and Academic Achievement of Qom University of Medical Sciences Students

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    Zahra Moslemi

    2017-06-01

    Full Text Available Background and Objective: Critical thinking is one of the goals in higher education and a key element in students' mental health. This study aims to investigate the relationship between critical thinking skills with mental health and academic achievement of Qom University of Medical Sciences students. Materials and Methods: In this descriptive­-correlation study in 1394,a sample of 303students at Qom University of Medical Sciences were selected through stratified random sampling method with a view to gender.The data were collected through two standard questionnaires on critical thinking skills CCTST form(B and mental health questionnaire of GHQ-28.Then the data were analyzed simultaneously using descriptive statistics methods, Pearson correlation and independent t-test, and multiple regression analysis. Results: Students’ mean score of critical thinking skills was (9.16 ± 3.15 which was interpreted as under average. The results of Pearson correlation test showed that there was no significant relationship between critical thinking skills and mental health (P=0.702, r=0.039 and academic achievement (P=0.284, r=0.081.There was also no significant relationship between mental health and academic achievement (P=0.141, r=-0.150. According to independent t-test results, there was no significant difference between male and female students’ average scores in critical thinking skills and mental health. But there was a significant difference between male and female students in academic achievement. Finally multiple regression analysis revealed that mental health and academic achievement did not predict any critical thinking skills. Conclusion: Considering that strengthening critical thinking in students and enhancing learning methods can improve learning skills and factors affecting their learning Therefore, by modifying and providing appropriate educational practices, critical thinking of students can be enhanced.

  6. Comparing Mental Illness Stigma among Nurses in Psychiatric and Non-Psychiatric Wards in Tabriz University of Medical Sciences

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    Ebrahimi Hossein

    2017-03-01

    Full Text Available Stigma can complicate people’s mental health problems by affecting different sides of personal life, increasing negative attitudes, causing discriminatory behavior towards them, and reducing the chances of recovery and returning to normal life. This research aims to compare the stigma of mental illness among nurses working in psychiatric and non-psychiatric wards in Tabriz University of Medical Sciences. A total of 240 nurses participated in this descriptive and analytic study. The data were collected using a demographic questionnaire and the Community Attitudes towards the Mentally Ill (CAMI Scale, which is a 40-item self-report questionnaire. All data were analyzed using SPSS 13. The majority of nurses have a medium level of stigma toward people with mental illness, and there is no significant relation between the type of wards and mean stigma scores. After eliminating factors such as mental illness in nurses and their families, it seems that only working with people with mental illness in psychiatric wards is not enough to create a positive attitude toward them. Additionally, the less physical activity and taking advantage of legal benefits of work hardship for psychiatric nurses, low income, and stigma toward psychiatric nursing, probably may make a difference in inclining to work in psychiatry ward between the two groups in spite of relatively equal stigma scores.

  7. Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum.

    Science.gov (United States)

    Sperling, Jeremy D; Clark, Sunday; Kang, Yoon

    2013-04-03

    Simulation-based medical education (SBME) is increasingly being utilized for teaching clinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teaching clinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS) is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students' knowledge acquisition, comfort, and perceived competence with regards to the AMS patient. AMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS. A total of 154 students completed the post-test and survey and 65 (42%) attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (papproach to treating AMS patients (p=0.05). They were also more likely to state that they could articulate a differential diagnosis (p=0.03), know what initial diagnostic tests are needed (p=0.01), and understand what interventions are useful in the first few minutes (p=0.003). Students who participated in a simulation session were more likely to find the overall AMS curriculum useful (pclinical approach to AMS. SBME shows significant promise for teaching clinical

  8. Teaching medical students a clinical approach to altered mental status: simulation enhances traditional curriculum

    Directory of Open Access Journals (Sweden)

    Jeremy D. Sperling

    2013-04-01

    Full Text Available Introduction: Simulation-based medical education (SBME is increasingly being utilized for teaching clinical skills in undergraduate medical education. Studies have evaluated the impact of adding SBME to third- and fourth-year curriculum; however, very little research has assessed its efficacy for teaching clinical skills in pre-clerkship coursework. To measure the impact of a simulation exercise during a pre-clinical curriculum, a simulation session was added to a pre-clerkship course at our medical school where the clinical approach to altered mental status (AMS is traditionally taught using a lecture and an interactive case-based session in a small group format. The objective was to measure simulation's impact on students’ knowledge acquisition, comfort, and perceived competence with regards to the AMS patient. Methods: AMS simulation exercises were added to the lecture and small group case sessions in June 2010 and 2011. Simulation sessions consisted of two clinical cases using a high-fidelity full-body simulator followed by a faculty debriefing after each case. Student participation in a simulation session was voluntary. Students who did and did not participate in a simulation session completed a post-test to assess knowledge and a survey to understand comfort and perceived competence in their approach to AMS. Results: A total of 154 students completed the post-test and survey and 65 (42% attended a simulation session. Post-test scores were higher in students who attended a simulation session compared to those who did not (p<0.001. Students who participated in a simulation session were more comfortable in their overall approach to treating AMS patients (p=0.05. They were also more likely to state that they could articulate a differential diagnosis (p=0.03, know what initial diagnostic tests are needed (p=0.01, and understand what interventions are useful in the first few minutes (p=0.003. Students who participated in a simulation session

  9. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

    Science.gov (United States)

    van Eck van der Sluijs, Jonna F; ten Have, Margreet; Rijnders, Cees A; van Marwijk, Harm WJ; de Graaf, Ron; van der Feltz-Cornelis, Christina M

    2016-01-01

    Objective The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18–64 years. We selected subjects with medically unexplained symptoms (MUS) only (MUSonly; n=177), explained physical symptoms only (PHYonly, n=1,952), combined MUS and explained physical symptoms (MUS + PHY, n=209), and controls without physical symptoms (NONE, n=4,168). We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95) for MUSonly, 1.55 (1.13, 2.12) for PHYonly, and 2.25 (1.41, 3.57) for MUS + PHY. At the specialized mental health care level, this was the case only for MUSonly subjects (adjusted odds ratio 1.65 [1.04, 2.61]). In both the primary and specialized mental health care, there were no significant differences between the four groups in the number of treatment contacts once they entered into treatment. Conclusion All sorts of physical symptoms, unexplained as well as explained, were associated with significant higher entry into primary care for mental problems. In specialized mental health care, this was true only for MUSonly. No differences were found in the number of treatment contacts. This warrants further research aimed at the content of the treatment contacts. PMID

  10. Investigating the relation between mental models with employees empowerment in medical sciences university of shahid sadoghi in yazd

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    mohammad montazeri

    2017-03-01

    Full Text Available Introduction: Empowerment is considered in organizatins due to the enough attention  to the staff’s need, in order to achieve further growth and therefore its impact on the productivity and efficiency of the organization. So The purpose of this study is to clarify the position and the role of mental models and to determine its relationship with empowerment of Yazd medical college staff. Methods: The research method in this descriptive study was correlative. To collect data, a questionnaire has been used which containing 51 items, 36 items related to mental models derived from the questionnaire of  Danayifard et al (2010, with the dimensions of the goal orientation, unison orientation,  application orientation, stability orientation, balance orientation and performance orientation. Also, 15 items related to empowerment of staff with the dimensions of competence, autonomy, effectiveness, significance and confidence that Spertizer and Mischa questionnaire has been used for them. Reliability and validity of the .  questionnaires was evaluated and confirmed. Data analysis was performed by using SPSS (V.19.   Results: The findings show that there is a significant relationship among mental models of staff’s Shahid Sadughi medical university of Yazd and empowerment of them. Also, there is a significant relationship among the components of goal orientation, unison orientation, application orientation, balance orientation, performance orientation and empowerment of Yazd medical university. But there is no significant relationship between components of stability orientation and performance orientation of staff and empowerment of them. Conclusion: According to the research topic and existence of significant and positive relationship among the four components of mental models of staff’s Shahid Sadughi medical university of Yazd and empowerment of them, managers of the organizations can improve staff’s empowerment by Strengthening their mental

  11. Stress and mental health problems in 1st year medical students: a survey of two medical colleges in Kanpur, India

    OpenAIRE

    Shivendra Jena; Harish Chandra Tiwari

    2015-01-01

    Background: Incidence of stress among medical students has been reported to be between high and very high. Medical students in pre-clinical phase are more likely to develop psychological distress than medical students in clinical phase. It may affect academic performance and lead to anxiety, depression and substance abuse. Methods: First year students of one government medical college and one private medical college of Kanpur, Uttar Pradesh, India, were surveyed to find out stress and men...

  12. Relations of income inequality and family income to chronic medical conditions and mental health disorders: national survey

    Science.gov (United States)

    Sturm, Roland; Gresenz, Carole Roan

    2002-01-01

    Objectives To analyse the relation between geographical inequalities in income and the prevalence of common chronic medical conditions and mental health disorders, and to compare it with the relation between family income and these health problems. Design Nationally representative household telephone survey conducted in 1997-8. Setting 60 metropolitan areas or economic areas of the United States. Participants 9585 adults who participated in the community tracking study. Main outcome measures Self report of 17 common chronic medical conditions; current depressive disorder or anxiety disorder assessed by clinical screeners. Results A strong continuous association was seen between health and education or family income. No relation was found between income inequality and the prevalence of chronic medical problems or depressive disorders and anxiety disorders, either across the whole population or among poorer people. Only self reported overall health, the measure used in previous studies, was significantly correlated with inequality at the population level, but this correlation disappeared after adjustment for individual characteristics. Conclusions This study provides no evidence for the hypothesis that income inequality is a major risk factor for common disorders of physical or mental health. What is already known on this topicSeveral studies have found a relation between income inequality and self reported health or mortalityWhat this study addsThere is a strong social gradient in health, as measured by the prevalence of chronic medical conditions and specific mental health disorders, by income or educationNo such association is seen between income inequality and health PMID:11777799

  13. Medical comorbidities in patients with serious mental illness: a retrospective study of mental health patients attending an outpatient clinic in Qatar

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    Zolezzi M

    2017-09-01

    Full Text Available Monica Zolezzi,1 Sara Abdulrhim,2 Nour Isleem,2 Farah Zahrah,2 Yassin Eltorki3 1Clinical Pharmacy and Practice, 2College of Pharmacy, Qatar University, 3Department of Pharmacy, Hamad Medical Corporation Mental Health Hospital, Doha, Qatar Background: The life span of individuals with serious mental illness (SMI is shorter compared to the general population. This excess mortality is mainly due to physical illness. The aim of the study was to investigate the prevalence rates of different physical illnesses in individuals with SMI and to examine how these are being managed.Methods: The study was a cross-sectional retrospective chart review of a cohort of patients with SMI. A comprehensive electronic data extraction tool using SurveyMonkey® was used to collect patient demographics, psychiatric and medical comorbidities, medications and all relevant physical assessments. Data were then first extrapolated into an Excel® spreadsheet and later to SPSS® for data analysis. A descriptive statistical approach was used to analyze the demographic and clinical data. Chi-square test for categorical variables and t-test for continuous variables were used to compare the demographic and clinical characteristics of the cohort.Results: A total of 336 patients with SMI were included for the retrospective chart review. The majority of these patients had a diagnosis of depression (50.3%, followed by schizophrenia (33.0% and bipolar disorder (19.6%. Diabetes was the most frequent medical comorbidity, diagnosed in 16.1% of SMI patients, followed by hypertension (9.2% and dyslipidemia (9.8%. Monitoring of comorbidity-associated risk factors and other relevant physical assessment parameters (such as blood pressure, weight, hemoglobin A1c [HbA1c], blood glucose and lipids were documented in less than 50% of patients, and some parameters, such as smoking status, were not documented at all.Conclusion: Both, the literature and our cohort provide evidence that individuals

  14. Medication management in primary and secondary schools: evaluation of mental health related in-service education in local schools.

    Science.gov (United States)

    Reutzel, Thomas J; Desai, Archana; Workman, Gloria; Atkin, John A; Grady, Sarah; Todd, Timothy; Nguyen, Nhu; Watkins, Melissa; Tran, Kim; Nian Liu; Rafinski, Michelle; Dang, Thanh

    2008-08-01

    An increasing number of students are taking medications while they are in school or are under the influence of medication during school hours. In a novel effort, clinical pharmacists and mental health therapists worked together to provide "mini-in-service" educational programs on psychological disorders and medications used to treat these disorders. The purpose of this study was to implement and evaluate the effectiveness of these educational programs presented to school nurses, teachers, school administrators, and other personnel. The study compared participant responses before and after attending a medication in-service session on a psychological disorder and its related medications. Results indicated that in-service education on attention deficit/hyperactivity disorder (ADHD) and depression improved the knowledge and confidence levels of school personnel regarding medications and symptoms. Feedback indicated school personnel wanted longer educational sessions and more information on these disorders and treatments. School nurses working with health professionals can improve education for staff, families, and students about mental health disorders and their treatment.

  15. Impact of short term yoga intervention on mental well being of medical students posted in community medicine: A pilot study

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    Rahul Bansal

    2013-01-01

    Full Text Available Background: High level of stress, anxiety and depression is seen among medical students. Aims: To assess the impact of brief structured yoga intervention on mental well being of MBBS students. Materials and Methods: The participants consisted of 82 MBBS students of 3 rd semester in the age group of 18-23 years. The students were assessed at baseline and at the end of one month of specific yoga intervention by using General Health Questionnaire-28 (GHQ-28. Results: The students reported improvement in general and mental well being following the intervention and difference was found to be highly significant. Conclusion: A short term specific yoga intervention may be effective in improving general and mental well being in MBBS students. It is feasible and practical to include yoga practice in block postings of community medicine.

  16. Depression screening for prescribed medications with mental health risk: Considerations for clinical decision support, workflow redesign, and health information exchange arrangements.

    Science.gov (United States)

    Miller, Michael J; Burns, Craig F; Kapusnik-Uner, Joan; Carreno, Roberto; Matuszewski, Karl A

    Depression screening should be increased when prevailing knowledge underscoring medication-associated mental health risk is highest. Depression screening in primary care practices when medications with mental health risk were prescribed was estimated while considering the absence and presence of clinical decision support systems. A cross-sectional, descriptive study using the National Ambulatory Medical Care Survey (NAMCS) data from 2008 to 2010 was conducted. Primary care physician visits were classified based on whether a medication prescribed had a contraindication, severe warning, moderate warning, adverse event only, or no documented mental health risk. Adjusted odds of depression screening for each risk warning level were estimated while controlling for important sociodemographic factors and presence of computerized systems for medication warnings and guideline recommendations. Depression screening at primary care practice visits when medications were prescribed was 2.1% and increased to 2.8% or higher when medications had a moderate or severe mental health risk warning or medication-disease contraindication. Depression screening was increased at visits when at least one medication was prescribed that had a contraindication (AOR = 6.31, P mental health risk, but not for mental health adverse event only warnings alone (AOR = 1.54, P = 0.074). Depression screening is increased when medications were prescribed with a documented mental health risk. Presence of clinical decision support systems may help discern between minor and major medication-associated mental health risks. Appropriately, positioned warning systems with targeted content, workflow redesign, and health information exchange may improve depression screening in at-risk patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Identifying the relationship between spiritual quotient and mental health in the students of Lorestan university of medical sciences

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    sharareh khodabakhshi

    2014-06-01

    Full Text Available Background: In recent years, the students' mental health has attracted a lot of attention. Many factors effect on the mental health. Nowadays, spirituality is considered as one of the important aspects of the humanistic action, which has a permanent relation with health and recovery, so the main goal of this investigation is to identify the relationship between spiritual Quotient and mental health of the students of Lorestan university of medical sciences. Materials and Methods: The descriptive correlation method was applied in this investigation. The statistical population of this research consistsed of all the students (2238 of Lorestan university of medical sciences. Cochran's formula was used to determine the sample size, and 330 students were selected by the arbitrary relative categorized method. The instruments for data gathering were Goldberg's GHa-23 (1972 and spiritual intelligence of Badie et al. The instruments credit was measured through content validty and the reliability of the questionnaires using Cronbach's alpha method. Besides the indexes of the descriptive statistics such as mean and standard deviation, inferential statistics tests such as Pearson's coefficient correlation and multiple regression analysis and independent T test were utilized to analyze the data and testing the research hypothesizes. Results: The results showed that there is a positive relationship between spiritual quotient and the dimensions of the mental health (community orientation and moral dimension. "The ability to confront and deal with the problem", "moral virtues", "self-consciousness, love and interest". The dimension of "self-consciousness, love and interest" and "community orientation" have a significant role in predicting the mental health. Conclusion: Spiritual quotient has a positive influence on the individuals' mental health. The results show that people with a moral life are more healthy from the viewpoint of phycology.

  18. [Clinical-chemical studies in schizophrenic out-patients under neuroleptic long-term treatment with particular consideration of the hepatic metabolism (author's transl)].

    Science.gov (United States)

    Gonçalves, N; Grüneberg, F

    1977-01-01

    A series of clinical-chemical tests was conducted in 68 schizophrenic out-patients under long-term neuroleptic medication, with particular consideration of the hepatic metabolism, i.e.: Erythrocyte sedimentation rate, alpha 1-glycoprotein, ceruloplasmin, fibrinogen, GPT, GOT, gamma-GT, total protein and serum-protein-electrophoresis. Furthermore, the glucose tolerance tests was carried out. In 44% of the patients an increased erythrocyte sedimentation rate and positive correlations with increased fibrinogen values were found. Increased gamma-GT-values were proven in 33% of the patients; they correlated positively with the increased GPT-and/or GOT-values as well as with pathological glucose tolerance values. Overweight of more than 10 kilos was found in 46% of the patients. A significant correlation between overweight and pathological glucose tolerance values existed. The results were interpreted as consequence of a light fatty liver.

  19. Study on the prescribing patterns of antipsychotic medication in a rural England Community Mental Health Team.

    Science.gov (United States)

    Seshadri, Madhavan; Elsemary, Ahmed; Thalitaya, Madhusudan Deepak; Chikodzore, Lawrence; Nagalingam, Priya

    2017-09-01

    Providing comprehensive services for about 400 patients in the South Herefordshire area, the community mental health team manages cases of varying severity and complexity, ranging from Schizophrenia, to neuroses and disorders of adult personality. Antipsychotic medication remains a mainstay of treatment and management for patients under the team case load; hence a need exists for a detailed look into the prescription patterns of such medications. The aim of this study was to look into the prescribing patterns of antipsychotics for a sample of 50 patients in the South Herefordshire community team during the year of 2016 (from Jan 2016 to Dec 2016), as well as investigate whether these antipsychotics were licensed to be used for the corresponding diagnoses of these patients. We also looked into whether patients were prescribed antipsychotics within BNF limits. As a part of this audit we looked into whether patients were made aware that they were on unlicensed antipsychotics or on above the BNF maximum doses of antipsychotics. A random sample of 50 patients was taken from the case load of the South community team as is documented on RIO. The mean age of the patients in the sample was 46.1 (SD= ±14.6) Sample selection was done by selecting every seventh patient in the patient case load (if not using antipsychotics the next patient was chosen). Patients studied involved those with F1-F19 Mental and behavioural disorders due to psychoactive substance use, F20-F29 Schizophrenia/Schizotypal/Delusional disorder, F31 Bipolar affective disorders, F32 Depression, F40-F48 Anxiety Neurotic and stress related disorders and somatoform disorders, F50-F59 Behaviour syndromes associated with physiological disturbances and physical factors, F60-F69 Disorders of adult personality and behaviour. The patients selected had to be followed up by the recovery team during the year 2016 and they had to be on an antipsychotic medication at any point during that time period. A scale was

  20. The psychosocial evaluation of medically-ill inpatients - accordance between mental disorders and self-rated psychosocial distress

    OpenAIRE

    Fritzsche, Kurt; Burger, Thorsten; Hartmann, Armin; N?bling, Matthias; Spahn, Claudia

    2005-01-01

    Background: Both psychometric questionnaires and structured psychodiagnostic interviews are used to identify medically-ill inpatients requiring psychotherapeutic treatment. The study examines the accordance between the diagnosis of a mental disorder (ICD-10) and self-rated psychosocial distress of unselected inpatients within the framework of a psychosomatic liaison service. Methods: Of n=532 consecutive patients hospitalized in five departments of the University Hospital Freiburg, n=357 pati...

  1. Mental Health and Resilience: Soldiers’ Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military

    Science.gov (United States)

    2014-08-01

    psychotherapy. Scale items were derived via confirmatory factor analysis of (n = 232) participants enrolled in the Collaborative Care for Anxiety and Panic (CCAP...for anxiety and depression are highly addictive . Rate how each of the possible concerns might affect your decision to receive mental health counseling...anxiety and depression do not help a person cope better. 6. Most medications for anxiety and depression are highly addictive . Strongly Strongly DISAGREE

  2. Improving mental health service users' with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study.

    Science.gov (United States)

    Cranwell, Kate; Polacsek, Meg; McCann, Terence V

    2016-07-26

    Mental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users' with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services. Experience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken. Thirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants' perspectives about factors that facilitated (clinicians' expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians' attitudes; and increasing caregiver participation) to service users' progress through tertiary medical and primary care services. A sixth theme, enhancing service users' transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services. EBCD is a useful approach to collaboratively develop strategies to improve service users' with medical co-morbidity and their caregivers' transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for

  3. Trauma and mental health of medics in eastern Myanmar's conflict zones: a cross-sectional and mixed methods investigation.

    Science.gov (United States)

    Lim, Andrew George; Stock, Lawrence; Shwe Oo, Eh Kalu; Jutte, Douglas P

    2013-07-30

    In conflict and disaster settings, medical personnel are exposed to psychological stressors that threaten their wellbeing and increase their risk of developing burnout, depression, anxiety, and PTSD. As lay medics frequently function as the primary health providers in these situations, their mental health is crucial to the delivery of services to afflicted populations. This study examines a population of community health workers in Karen State, eastern Myanmar to explore the manifestations of health providers' psychological distress in a low-resource conflict environment. Mental health screening surveys were administered to 74 medics, incorporating the 12-item general health questionnaire (GHQ-12) and the posttraumatic checklist for civilians (PCL-C). Semi-structured qualitative interviews were conducted with 30 medics to investigate local idioms of distress, sources of distress, and the support and management of medics' stressors. The GHQ-12 mean was 10.7 (SD 5.0, range 0-23) and PCL-C mean was 36.2 (SD 9.7, range 17-69). There was fair internal consistency for the GHQ-12 and PCL-C (Cronbach's alpha coeffecients 0.74 and 0.80, respectively) and significant correlation between the two scales (Pearson's R-correlation 0.47, Pcommunities, threats of military violence including landmine injury, and early life trauma resulting from conflict and displacement. Medics also discussed mechanisms to manage stressors, including peer support, group-based and individual forms of coping. The results suggest significant sources and manifestations of mental distress among this under-studied population. The discrepancy between qualitative evidence of abundant stressors and the comparatively low symptom scores may suggest marked mental resilience among subjects. The observed symptom score means in contrast with the qualitative evidence of abundant stressors may suggest the development of marked mental resilience among subjects. Alternatively, the discrepancy may reflect the

  4. Management of Older Inpatients Who Refuse Nonpsychiatric Medication Within Birmingham and Solihull Mental Health NHS Foundation Trust: Audit.

    Science.gov (United States)

    Umotong, Eno

    2016-12-01

    The effects of poor medication compliance are well documented and include increased morbidity, early mortality, and financial costs to the society. According to national guidelines, when a competent patient refuses medication, the doctor on duty has a responsibility to ensure the patient understands their proposed course of action. The aims of this audit were to evaluate whether this consultation was taking place within older in-patient units across Birmingham and Solihull Mental Health NHS Foundation Trust when patients refuse nonpsychiatric medicines. Poor compliance was defined as more than five refusals of a nonpsychiatric medication over a 4-week period. A discussion with the duty doctor occurred in 75% of cases (27/36), which resulted in a change in prescription or compliance in 59% (16/27 patients). After patient refusal of medication, a consultation with the duty doctor is likely to improve compliance and uncover salient issues particularly in regards to capacity and drug suitability.

  5. Mental Health Issues and Psychotropic Medication: Current Applications for Children and Adolescents in Residential Treatment

    Science.gov (United States)

    Worley, Julie

    2005-01-01

    Severe mental and emotional conditions are much more prominent in juvenile resident treatment facilities than they are within the general adolescent population. These conditions are often painful to the juveniles and create management difficulties for the facility. Several mental illnesses are particularly severe and troublesome when not properly…

  6. The muscle findings in the neuroleptic malignant syndrome associated with lysergic acid diethylamide.

    Science.gov (United States)

    Behan, W M; Bakheit, A M; Behan, P O; More, I A

    1991-01-01

    A detailed pathological description of the muscle findings in a case of the neuroleptic malignant syndrome (NMS) following ingestion of lysergic acid diethylamide (LSD) is given, including the first ultrastructural analysis. Focal necrosis, oedema, and hypercontraction of fibres with glycogen and lipid depletion, were identified, all of which had resolved completely a year later. The findings are compared with those in malignant hyperthermia. It is suggested that the results support the view that in NMS, the muscle rigidity is due to central mechanisms and, in both this disorder and malignant hyperthermia, it is responsible for the hyperpyrexia and its life-threatening complications. Images PMID:1940949

  7. In vitro interaction of neuroleptics and tricylic antidepressants with coffee, tea, and gallotannic acid.

    Science.gov (United States)

    Lasswell, W L; Weber, S S; Wilkins, J M

    1984-08-01

    The in vitro interaction of selected drugs with coffee, tea, gallic acid, and gallotannic acid was examined by mixing solutions of drug with each of these four preparations. Results of these experiments indicate that significant precipitation occurs for a variety of agents, including several phenothiazines, amitriptyline, haloperidol, imipramine, and loxapine. The strong complex which is formed between these drugs and tannins is probably the basis of the interaction of these drugs with coffee and tea. Although precipitates did occur with a number of neuroleptics, two members of this drug class, thiothixene and molindone, failed to interact with the solutions used.

  8. Drug information update. Atypical antipsychotics and neuroleptic malignant syndrome: nuances and pragmatics of the association.

    Science.gov (United States)

    Sarkar, Siddharth; Gupta, Nitin

    2017-08-01

    Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal adverse event associated with the use of antipsychotics. Although atypical antipsychotics were initially considered to carry no risk of NMS, reports have accumulated over time implicating them in NMS causation. Almost all atypical antipsychotics have been reported to be associated with NMS. The clinical profile of NMS caused by certain atypical antipsychotics such as clozapine has been reported to be considerably different from the NMS produced by typical antipsychotics, with diaphoresis encountered more commonly, and rigidity and tremor encountered less frequently. This article briefly discusses the evidence relating to the occurrence, presentation and management of NMS induced by atypical antipsychotics.

  9. The association between perceived unmet medical need and mental health among the Republic of Korea Armed Forces.

    Science.gov (United States)

    Kim, Tae Kyung; Lee, S G; Han, K-T; Choi, Y; Lee, S Y; Park, E-C

    2017-06-01

    We investigated the effect of unmet medical need on the mental health of Republic of Korea (ROK) Armed Forces personnel, as most of the service members work in remote areas and often experience such unmet needs. This study used secondary data from the 2014 Military Health Survey (MHS), conducted by the ROK School of Military Medicine and designed to collect military health determinants. Descriptive statistics showed the general characteristics of the study populations by variable. We specifically compared the population after stratifying participants by suicide ideation. An analysis of variance was also carried out to compare Kessler Psychological Distress Scale 10 Scores. Additionally, dependent spouses and children of both active-duty service members and retirees are included among those entitled to Military Health System healthcare. Among the 4967 military personnel, 681 (13.7%) individuals reported an experience of unmet medical need within the past 12 months and gave reasons of 'no time (5.15%)', 'long office wait (2.6%)', 'no money (0.22%)', 'long distance from base (1.19%)', 'illness but not very serious (1.65%)', 'mistrust in doctors (1.95%)' and 'pressure due to performance appraisal (0.95%)'. Regression analysis revealed that unmet medical need was significantly associated with negative mental health (β=1.753, pmental health effects. Our study indicates that unmet medical need is significantly associated with soldiers' mental health decline and suicide ideation, highlighting the importance of providing military personnel with timely, affordable and sufficient medical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Use of interactive teaching techniques to introduce mental health training to medical schools in a resource poor setting.

    Science.gov (United States)

    Syed Sheriff, R J; Bass, N; Hughes, P; Ade-Odunlade, P; Ismail, A; Whitwell, S; Jenkins, R

    2013-07-01

    There are currently no practising psychiatrists in Somaliland. In 2007 the first medical students graduated from universities in Somaliland without mental health training. We aimed to pilot an intensive but flexible package of mental health training to all senior medical students and interns using interactive training techniques and to evaluate its effectiveness by assessing knowledge, skills and attitudes. Teaching techniques included didactic lectures, case based discussion groups and role playing. Informal feedback informed a flexible teaching package. Assessment tools designed specifically for this course included a pre and post course MCQ exam and an OSCE. Changes in students' attitudes were evaluated using a questionnaire administered before and after the course. In addition, a questionnaire administered following the course evaluated the changes students perceived in their knowledge and attitudes to mental health. The MCQ improved from 50.7% pre course to 64.4% post course (p = 9.73 E-08). Students achieved an average overall OSCE mark of 71%. The pre and post attitudes questionnaire was most significantly different for statements relevant to aetiology, stigma and the overlap between mental and physical health. The statement most strongly agreed with after the course was 'I now understand more about the overlap between mental and physical health'. Interactive teaching provided a learning experience for both students and trainers. On site and distance learning based on the teaching described here has widened the scope of the training possible in psychiatry and allowed the provision of regular teaching, supervision and peer support in Somaliland. However, the current lack of local expertise means that important issues of sustainability need to be considered in future work.

  11. The effect of life skills education on the mental health of First year student in Ilam university of medical science in 2013 year

    National Research Council Canada - National Science Library

    L Naseri; Y Azizpour; MR Saiedy; M Rahmani; K Syaehmiri

    2015-01-01

    .... The deals with these changes require psycho-social abilities. In the present paper it had been reviewed the effect of educating life skills on the mental health of students of Ilam University of medical sciences. Methods...

  12. Mental distress, alcohol use and help-seeking among medical and business students: a cross-sectional comparative study

    Directory of Open Access Journals (Sweden)

    Dahlin Marie

    2011-11-01

    Full Text Available Abstract Background Stress and distress among medical students are thoroughly studied and presumed to be particularly high, but comparative studies including other student groups are rare. Methods A web-based survey was distributed to 500 medical students and 500 business students. We compared levels of study stress (HESI, burnout (OLBI, alcohol habits (AUDIT and depression (MDI, and analysed their relationship with self-assessed mental health problems by logistic regression, with respect to gender. Results Medical students' response rate was 81.6% and that of business students 69.4%. Business students scored higher on several study stress factors and on disengagement. Depression (OR 0.61, CI95 0.37;0.98 and harmful alcohol use (OR 0.55, CI95 0.37; 0.75 were both less common among medical students. However, harmful alcohol use was highly prevalent among male students in both groups (medical students 28.0%, business students 35.4%, and among female business students (25.0%. Mental health problems in need of treatment were equally common in both groups; 22.1% and 19.3%, respectively, and was associated with female sex (OR 2.01, CI95 1.32;3.04, exhaustion (OR 2.56, CI95 1.60;4.10, lower commitment to studies (OR 1.95, CI95 1.09;3.51 and financial concerns (OR 1.81 CI95 1.18;2.80 Conclusions Medical students may not be more stressed than other high achieving student populations. The more cohesive structure of medical school and a higher awareness of a healthy lifestyle may be beneficial factors.

  13. Exposure to Direct-to-Consumer Pharmaceutical Advertising and Medication Nonadherence Among Patients With Serious Mental Illness.

    Science.gov (United States)

    Green, Charee E; Mojtabai, Ramin; Cullen, Bernadette A; Spivak, Amethyst; Mitchell, Melissa; Spivak, Stanislav

    2017-09-15

    This study explored the association of exposure to direct-to-consumer advertising (DTCA) with medication nonadherence among individuals with serious mental disorders. Results of an anonymous survey administered at an inner-city mental health clinic were examined by using logistic regression. Nonadherence was defined as not taking prescribed medications for at least two out of seven days. Of 246 respondents, 48% reported DTCA exposure and 43% reported nonadherence. Sixty-one percent of those exposed to DTCA reported nonadherence, compared with 26% of those not exposed (adjusted odds ratio=4.96, 95% confidence interval=2.64-9.33, padvertisements and reporting nonadherence, 59% reported changing medication-taking behaviors or stopping prescribed medications because of side effect information in advertisements. Only a minority communicated with providers before becoming nonadherent. This study found an association between self-report of DTCA exposure and self-reported nonadherence. These results support further research on DTCA as a possible risk factor for nonadherence.

  14. [Definition of the antineurotic, antipsychotic, neuroplegic and neuroleptic properties of psychotropic substances used in anesthesia and resuscitation].

    Science.gov (United States)

    Deligné, P

    1976-01-01

    There is a great deal of evidences (pharmacological, experimental and clinical, therapeutic, biological, biochemical, metabolic, toxicological and neurophysiological) which permits one to characterise among the psychotropic substances, the antineurotic or antipsychotic properties of certain psycholeptic drugs. They authorize also the differentiation in the sub-group of "antipsychotics" of substances with a dominant neuroplegic or neuroleptic activity and others, such as lithium, which do not have this activity. This revision of the terminology avoids the confusion maintained by the use of terms "tranquillisers" and "neuroleptics" in the classification of psychotropic drugs.

  15. The neuroleptic activity of haloperidol increases after its solubilization in surfactant micelles. Micelles as microcontainers for drug targeting.

    Science.gov (United States)

    Kabanov, A V; Chekhonin, V P; Alakhov VYu; Batrakova, E V; Lebedev, A S; Melik-Nubarov, N S; Arzhakov, S A; Levashov, A V; Morozov, G V; Severin, E S

    1989-12-04

    It has been suggested to use surfactant micelles as microcontainers for increasing the efficiency of neuroleptic targeting from blood flow into the brain. The neuroleptic action of haloperidol, intraperitoneally injected into mice in micellar solution of non-ionic block copolymer surfactant (pluronic P-85) in water, increased several-fold if compared with that observed for haloperidol aqueous solution. Incorporation of brain-specific antibodies into haloperidol-containing micelles resulted in additional drastic increase (more than by 2 orders of magnitude) in the drug effect.

  16. [Effects of psychosocial risk at work on mental health of the forensic medical service officials in Chile].

    Science.gov (United States)

    Ansoleaga, Elisa; Urra, Marcelo

    2015-01-01

    Although numerous studies have shown the harmful effects of exposure to psychosocial risk at work on the mental health of workers, there are particularly hazardous occupations product of their nature and the conditions under which the work is done. This article analyzes the associations between psychosocial risk at work and mental health in the Forensic Medical Service (SML) in Chile. The national and representative sample of 757 employees (46% men and 54% women) of SML, answered an online survey in 2013, to measure risk exposure to psychosocial risk and mental health outcomes. Data analysis considered descriptive and inferential statistics. The results show that workers have a high psychosocial risk: high psychological demands (83%), low social support (53%), Jobstrain (15%), Isostrain (12%), effort- rewards imbalance (69%). Also, one in three reported depressive symptoms, distress and consumption of psychotropic drugs. The workers reported that the problems of work contribute to the symptoms or consumption. Finally, subjects exposed to psychosocial risk had a greater chance of experiencing mental health problems than those not exposed. Diligent preventive interventions are needed to address this high risk population.

  17. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  18. Risk Factors for Incident Postdeployment Mental Health Conditions Among U.S. Air Force Medical Service Personnel.

    Science.gov (United States)

    Maupin, Genny M; Tvaryanas, Anthony P; White, Edward D; Lysfjord, Heather J

    2017-03-01

    The prevalence of postdeployment mental health (PDMH) conditions in military health care personnel appears to be on par with that of other military personnel. However, there is no comprehensive analysis of incident PDMH conditions within the overall population of U.S. Air Force Medical Service personnel. This study explored the epidemiology of incident PDMH conditions among Air Force Medical Service personnel returning from deployment. A cohort survival analysis was conducted of 24,409 subjects without preexisting mental health conditions and at least one deployment during 2003-2013. Electronic health record data were used to ascertain the diagnosis of a PDMH condition. The primary outcome measure was an incident PDMH condition defined as a mental health diagnosis on at least two separate clinical encounters. The incidence of PDMH conditions was 59.74 per 1,000 person-years. Adjustment, anxiety, mood, sleep, and post-traumatic stress disorders accounted for 78% diagnoses. Protective factors included officer, surgeon, specific enlisted career fields, Air National Guard or Air Force Reserve, and multiple deployments. Risk factors included nurse, other specific enlisted career fields, female, and unmarried with dependents. Most subjects (73%) were diagnosed within the standard 30-month surveillance time period; median time to diagnosis was 13 months. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  19. The use of psychotropic medication in patients with emotionally unstable personality disorder under the care of UK mental health services.

    Science.gov (United States)

    Paton, Carol; Crawford, Michael J; Bhatti, Sumera F; Patel, Maxine X; Barnes, Thomas R E

    2015-04-01

    Guideline recommendations for the pharmacologic treatment of personality disorder lack consensus, particularly for emotionally unstable personality disorder (EUPD), and there is limited information on current prescribing practice in the United Kingdom. To characterize the nature and quality of current prescribing practice for personality disorder across the United Kingdom, as part of a quality improvement program. A cross-sectional survey of self-selected psychiatric services providing care for adults with personality disorder (ICD-10 criteria) was conducted. Data were collected during May 2012. Of 2,600 patients with a diagnosis of personality disorder, more than two-thirds (68%) had a diagnosis of EUPD. Almost all (92%) patients in the EUPD subgroup were prescribed psychotropic medication, most commonly an antidepressant or antipsychotic, principally for symptoms and behaviors that characterize EUPD, particularly affective dysregulation. Prescribing patterns were similar between those who had a diagnosed comorbid mental illness and those who had EUPD alone, but the latter group was less likely to have had their medication reviewed over the previous year, particularly with respect to tolerability (53% vs 43%). The use of psychotropic medication in EUPD in the United Kingdom is largely outside the licensed indications. Whether the treatment target is identified as intrinsic symptoms of EUPD or comorbid mental illness may depend on the diagnostic threshold of individual clinicians. Compared with prescribing for EUPD where there is judged to be a comorbid mental illness, the use of off-label medication for EUPD alone is less systematically reviewed and monitored, so opportunities for learning may be lost. Treatment may be continued long term by default. © Copyright 2015 Physicians Postgraduate Press, Inc.

  20. Lithium Toxicity and Neurologic Effects: Probable Neuroleptic Malignant Syndrome Resulting from Lithium Toxicity

    Directory of Open Access Journals (Sweden)

    Osamede Edokpolo

    2012-01-01

    Full Text Available Introduction. We present the case of a patient who developed lithium toxicity with normal therapeutic levels, as a result of pharmacokinetic interaction with Valsartan, and probable Neuroleptic Malignant Syndrome from the ensuing lithium toxicity. Case Presentation. A 59-year old black male with bipolar disorder maintained on lithium and fluphenazine therapy presented with a 2 week history of worsening confusion, tremor, and gait abnormality. He recently had his dose of Valsartan increased. At presentation, patient had signs of autonomic instability, he was confused, dehydrated, and had rigidity of upper extremities. Significant labs on admission were lithium level-1.2, elevated CK-6008, leukocytosis WBC-22, and renal impairment; Creatinine-4.1, BUN-35, HCO3-20.1, and blood glucose 145. CT/MRI brain showed old cerebral infarcts, and there was no evidence of an infective process. Lithium and fluphenazine were discontinued, his lithium levels gradually decreased, and he improved with supportive treatment including rehydration and correction of electrolyte imbalance. Conclusions. This case illustrates that lithium toxicity can occur within therapeutic levels, and the neurotoxic effect of lithium can include Neuroleptic Malignant Syndrome. Clinicians should be aware of the risk associated with drug interactions with lithium.

  1. PROBLEMATIC ISSUES OF DIAGNOSTICS AND THERAPY OF NON-PSYCHOTIC MENTAL DISORDERS IN FEMALE PATIENTS OF CLIMACTERIC AGE WITH HYSTERICAL SYMPTOM COMPLEX (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Ye. V. Lukiyanova

    2013-01-01

    Full Text Available In the article, problematic questions of diagnostics and therapy of non-psychotic mental disorders (NPMD in female patients of climacteric age with hysterical symptom complex are considered. Efficacy of psychotherapy (PT in NPMD, hypnopsychotherapy in hysterical states: hysterical neurosis, neurasthenia and obsessive-compulsive neurosis is indicated. In treatment of NPMD, PT by creative selfexpression is successfully used. It is highlighted that PT forms conscious-critical attitude of patients toward themselves. Combination of PT with physiotherapy in hysterical conversional symptoms has been described. In hysterical manifestations neuroleptics are recommended, in neurotic depressions – antidepressants of mild action. In severe hysterical state, psychopharmacotherapy (PPhT with tranquilizers and neuroleptics is applied on long-term basis. Stable recovery in dissociative and hysterical disorders has been shown. In vegetovascular disorders in structure of climacteric syndrome (CS vinpocetine, in psychoemotional manifestations phenibut was administered. In therapy of hysterical neurosis, “minor neuroleptics”, hypnosuggestive therapy, social rehabilitation were applied. Effective group PT of psychogenically conditioned disorders in asthenicand anxiety-depressive symptoms is effective. Complex therapy of NPMD in hysterical and asthenic neurosis, obsessive-compulsive neurosis has been suggested. Organization of specialized preventive examinations for early revealing of persons with personality pathology is based. Efficacy of a number of medications in periand post-menopause – SSRIs and gabapentin, during menopause paroxetine, in depressions of non-psychotic level – pyrazidol, coaxil, in neurotic hypochondriasis sulpiride and quetiapine, diazepam, in climacteric vegetative and mental disorders hormone replacement therapy (HRT, hormonal therapy, PPhT and PT, in neurovegetative symptoms of CS – antidepressants, in psychovegetative syndromes

  2. Are carer attitudes toward medications related to self-reported medication adherence amongst people with mental illness?

    Science.gov (United States)

    Deane, Frank P; McAlpine, Elizabeth; Byrne, Mitchell K; Davis, Esther L; Mortimer, Christine

    2017-11-22

    Medication nonadherence among consumers with psychiatric disorders can significantly affect the health and wellbeing of the consumer and their family. Previous research has suggested that carers have an impact on consumer attitudes toward medication and adherence. Yet, how carer attitudes toward medication may be related to consumer attitudes and adherence has received little investigation. This exploratory study aimed to investigate the relationships between carer and consumer attitudes toward medication and consumer adherence behaviour. A cross-sectional survey assessing consumer and carer attitudes toward medication and consumer adherence was conducted amongst 42 consumer-carer dyads. Correlation analyses showed a positive association between consumer and carer attitudes toward medication and between consumer and carer attitudes with adherence. There was a general indication that the greater the difference between consumer and carer attitudes, the lower the level of adherence. Regression analyses revealed that while neither consumer nor carer attitudes were significant predictors of adherence, carer attitudes appeared to have a stronger role in adherence than consumer attitudes. These preliminary results highlight the importance of carer attitudes in relation to patient perceptions and behaviours toward medication, and thus the potential benefits of addressing both consumer and carer attitudes in any intervention for improving adherence. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Recurrent paroxysmal episodes characterized by perceptual alteration in three schizophrenic patients on neuroleptic medication

    National Research Council Canada - National Science Library

    Higuchi, H; Shimizu, T; Hishikawa, Y

    1997-01-01

    .... Perceptual alteration showed some distinct features that were different from acute symptoms of schizophrenia, and was accompanied by mood changes such as severe anxiety and agitation and, in one...

  4. The psychosocial evaluation of medically-ill inpatients - accordance between mental disorders and self-rated psychosocial distress.

    Science.gov (United States)

    Fritzsche, Kurt; Burger, Thorsten; Hartmann, Armin; Nübling, Matthias; Spahn, Claudia

    2005-12-15

    Both psychometric questionnaires and structured psychodiagnostic interviews are used to identify medically-ill inpatients requiring psychotherapeutic treatment. The study examines the accordance between the diagnosis of a mental disorder (ICD-10) and self-rated psychosocial distress of unselected inpatients within the framework of a psychosomatic liaison service. Of n=532 consecutive patients hospitalized in five departments of the University Hospital Freiburg, n=357 patients underwent a structured psychodiagnostic interview (Mini-DIPS) to obtain diagnoses according to ICD-10 F. Psychosocial distress (HADS), somatoform symptoms (SOMS-2 J), quality of life (EDLQ) and coping strategies (FQCI) were evaluated by self-rating questionnaires. A mental disorder requiring treatment was diagnosed in 44% of the patients. Predictors for the diagnosis of a mental disorder were the depression subscale of the HADS, the frequency of somatoform symptoms and depressive coping. The greatest accordance between mental disorders and screening instruments was found for the depression subscale of the HADS at a cut-off 8+. The area under the curve (AUC) was 0.75. With a specificity of 87% and a sensitivity of 53%, nearly half of all mental disorders requiring treatment were not identified by the HADS, especially in patients with neurotic, stress-related and somatoform disorders (F4), most of them cancer patients with adjustment disorders. Case selection by the HADS is successfull in disorders, where depressive symptoms are prevalent. For F4-diagnoses a lower cut-off of 6+ is recommended. The importance of a clinical interview is underlined. Other screening procedures, specific for the general hospital population, are discussed.

  5. Medically unexplained and explained physical symptoms in the general population: association with prevalent and incident mental disorders.

    Directory of Open Access Journals (Sweden)

    Jonna van Eck van der Sluijs

    Full Text Available Clinical studies have shown that Medically Unexplained Symptoms (MUS are related to common mental disorders. It is unknown how often common mental disorders occur in subjects who have explained physical symptoms (PHY, MUS or both, in the general population, what the incidence rates are, and whether there is a difference between PHY and MUS in this respect.To study the prevalence and incidence rates of mood, anxiety and substance use disorders in groups with PHY, MUS and combined MUS and PHY compared to a no-symptoms reference group in the general population.Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2, a nationally representative face-to-face survey of the general population aged 18-64 years. We selected subjects with explained physical symptoms only (n=1952, with MUS only (n=177, with both MUS and PHY (n=209, and a reference group with no physical symptoms (n=4168. The assessment of common mental disorders was through the Composite International Diagnostic Interview 3.0. Multivariate logistic regression analyses were used to examine the association between group membership and the prevalence and first-incidence rates of comorbid mental disorders, adjusted for socio-demographic characteristics.MUS were associated with the highest prevalence rates of mood and anxiety disorders, and combined MUS and PHY with the highest prevalence rates of substance disorder. Combined MUS and PHY were associated with a higher incidence rate of mood disorder only (OR 2.9 (95%CI:1.27,6.74.In the general population, PHY, MUS and the combination of both are related to mood and anxiety disorder, but odds are highest for combined MUS and PHY in relation to substance use disorder. Combined MUS and PHY are related to a greater incidence of mood disorder. These findings warrant further research into possibilities to improve recognition and early intervention in subjects with combined MUS and PHY.

  6. A Randomized, Controlled Multisite Study of Behavioral Interventions for Veterans with Mental Illness and Antipsychotic Medication-Associated Obesity.

    Science.gov (United States)

    Erickson, Zachary D; Kwan, Crystal L; Gelberg, Hollie A; Arnold, Irina Y; Chamberlin, Valery; Rosen, Jennifer A; Shah, Chandresh; Nguyen, Charles T; Hellemann, Gerhard; Aragaki, Dixie R; Kunkel, Charles F; Lewis, Melissa M; Sachinvala, Neena; Sonza, Patrick A; Pierre, Joseph M; Ames, Donna

    2017-04-01

    Weight gain and other metabolic sequelae of antipsychotic medications can lead to medication non-adherence, reduced quality of life, increased costs, and premature mortality. Of the approaches to address this, behavioral interventions are less invasive, cost less, and can result in sustained long-term benefits. We investigated behavioral weight management interventions for veterans with mental illness across four medical centers within the Veterans Affairs (VA) Healthcare System. We conducted a 12-month, multi-site extension of our previous randomized, controlled study, comparing treatment and control groups. Veterans (and some non-veteran women) diagnosed with mental illness, overweight (defined as having a BMI over 25), and required ongoing antipsychotic therapy. One group received "Lifestyle Balance" (LB; modified from the Diabetes Prevention Program) consisting of classes and individual nutritional counseling with a dietitian. A second group received less intensive "Usual Care" (UC) consisting of weight monitoring and provision of self-help. Participants completed anthropometric and nutrition assessments weekly for 8 weeks, then monthly. Psychiatric, behavioral, and physical assessments were conducted at baseline and months 2, 6, and 12. Metabolic and lipid laboratory tests were performed quarterly. Participants in both groups lost weight. LB participants had a greater decrease in average waist circumference [F(1,1244) = 11.9, p Behavioral interventions specifically designed for individuals with mental illness can be effective for weight loss and improve dietary behaviors. "Lifestyle Balance" integrates well with VA healthcare's patient-centered "Whole Health" approach. ClinicalTrials.gov identifier NCT01052714.

  7. Subjective well-being in schizophrenia as measured with the Subjective Well-Being under Neuroleptic Treatment scale : a review

    NARCIS (Netherlands)

    Vothknecht, Sylke; Schoevers, Robert A.; de Haan, Lieuwe

    Objective: The Subjective Well-being under Neuroleptic Treatment scale (SWN) is the most widely used self-rating scale in recent research of subjective well-being in schizophrenia. We reviewed all available publications on relevant research of subjective well-being using the SWN, in order to

  8. Subjective well-being in schizophrenia as measured with the Subjective Well-Being under Neuroleptic Treatment scale: a review

    NARCIS (Netherlands)

    Vothknecht, Sylke; Schoevers, Robert A.; de Haan, Lieuwe

    2011-01-01

    Objective: The Subjective Well-being under Neuroleptic Treatment scale (SWN) is the most widely used self-rating scale in recent research of subjective well-being in schizophrenia. We reviewed all available publications on relevant research of subjective well-being using the SWN, in order to

  9. Rocuronium and sugammadex: An alternative to succinylcholine for electro convulsive therapy in patients with suspected neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Ramamoorthy, Karthik G

    2012-01-31

    We report a case of presumptive neuroleptic malignant syndrome requiring muscle relaxation for electro-convulsive therapy. short acting muscle relaxation without the use of succinylcholine was achieved using rocvronivm reversed with the novel reversal agent sugammadex. We suggest that this combination is a safe and effective alternative to succinylcholine in such cases.

  10. The effects of psychoactive drugs and neuroleptics on language in normal subjects and schizophrenic patients: a review.

    Science.gov (United States)

    Salomé, F; Boyer, P; Fayol, M

    2000-12-01

    The aim of this survey is to present an overview of research into psychopharmacology as regards the effects of different psychoactive drugs and neuroleptics (NL) on language in normal subjects and schizophrenic patients. Eighteen studies that have investigated the effects of different drugs (alcohol, amphetamines, secobarbital, L-dopa, psilocybin, ketamine, fenfluramine) and neuroleptics (conventional and atypical) on language are reviewed. There are no studies concerning the effects of neuroleptics on language in healthy subjects. The results of the effects of other molecules indicate that language production can be increased (alcohol, amphetamine, secobarbital), rendered more complex (d-amphetamine), more focused (L-dopa) or more unfocused (psilocybin) and clearly impaired (ketamine). For schizophrenic patients, most studies show that conventional neuroleptic treatments, at a therapeutic dosage and in acute or chronic mode, reduce language disorders at all levels (clinic, linguistic, psycholinguistic). In conjunction with other molecules, the classical NL, when administered at a moderate dosage and in chronic mode, modify language in schizophrenia, either by improving the verbal flow and reducing pauses and positive thought disorder (NL + amphetamine) or by inducing an impairment in the language measurements (NL + fenfluramine). Clinical, methodological and theoretical considerations of results are debated in the framework of schizophrenic language disorders.

  11. Infant Mental Health for Medically Fragile Babies in Intensive Care and Their Families

    Science.gov (United States)

    Browne, Joy V.; Talmi, Ayelet

    2017-01-01

    Infants who begin their lives in intensive care are impacted physically and socioemotionally for many months and years to come. Likewise, stressful experiences of caring for a baby hospitalized in intensive care have an impact on primary caregivers, typically the baby's parents. Infant mental health (IMH) is an expanding, evidence-based field that…

  12. Mental disturbances and perceived complexity of nursing care in medical inpatients : results from a European study

    NARCIS (Netherlands)

    De Jonge, P; Zomerdijk, MM; Huyse, FJ; Fink, P; Herzog, T; Lobo, A; Slaets, JPJ; Arolt, [No Value; Balogh, N; Cardoso, G; Rigatelli, M

    2001-01-01

    Aims and objectives. The relationship between mental disturbances-anxiety and depression, somatization and alcohol abuse-on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal Was to Study the utility of short screeners

  13. Slow accumulation of psychotropic substances in the human brain. Relationship to therapeutic latency of neuroleptic and antidepressant drugs?

    Science.gov (United States)

    Kornhuber, J; Retz, W; Riederer, P

    1995-01-01

    The mechanism of therapeutic latency of antidepressant and neuroleptic drugs is not clearly understood. Current hypotheses include slow adaptive processes after fast access to primary drug targets. Here, we present a hypothesis explaining therapeutic latency by slow accumulation of the drugs in acidic intracellular compartments. We have studied the pharmacokinetics of amantadine, a lysosomotropic model substance. It's fast therapeutic response is mediated by fast access to cell surface receptors. However, it slowly accumulates intracellularly in human brain tissue. Half-maximal and plateau concentrations are reached after 8 and at least 70 days of treatment, respectively. The concentration in brain tissue relative to CSF and serum is about 20:1. The high storage capacity of brain tissue is probably related to lysosomotropic properties of amantadine. This means that amantadine, as other lysosomotropic substances, is trapped by protonation in acidic intracellular compartments and may disturb biochemical processes that require an acidic milieu, such as the proton-driven transport of monoamines into synaptic vesicles. The mean daily oral dose of amantadine is low compared to the high storage capacity of brain and other tissues thus explaining the slow accumulation. Many psychotropic drugs including antidepressant and neuroleptic substances also have lysosomotropic properties. A slow accumulation in brain tissue is therefore likely for many antidepressant and neuroleptic drugs and has been directly demonstrated for fluoxetine. While lysosomotropism alone is not a sufficient explanation for antidepressant or neuroleptic properties of a certain drug, it contributes to high storage capacity and slow accumulation in brain tissue and results in disturbances of several biochemical processes. Slow accumulation in brain tissue might be related to the therapeutic latency of neuroleptic and antidepressant drugs.

  14. Intentional misuse of over-the-counter medications, mental health, and polysubstance use in young adults.

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    Benotsch, Eric G; Koester, Stephen; Martin, Aaron M; Cejka, Anna; Luckman, Diana; Jeffers, Amy J

    2014-08-01

    In recent years, the non-medical use of prescription drugs (without a doctor's prescription) has increased dramatically. Less attention has been paid to the intentional misuse of over-the-counter (OTC) medications. Misuse of OTC medications has negative health consequences similar to those of illicit drugs, including psychosis, tachycardia, seizures and agitation. When mixed with alcohol or other drugs, these medications can also be dangerous: OTC-related emergency room visits increased 70% from 2004 to 2008. This study examined the intentional misuse of OTC medications, the non-medical use of prescription drugs, the use of alcohol and illicit drugs, and psychological factors in two samples of young adults (ages 18-25) from different areas of the United States (Total N = 1,197). Overall, 18.6% of the Colorado sample and 13.0% of the Virginia sample reported lifetime misuse of an OTC medication. Participants who reported misusing OTC medications were also significantly more likely to report using marijuana, ecstasy, cocaine, and non-medical use of prescription analgesics, stimulants, anxiolytics, and sedatives. Participants who reported misusing OTC medications were more than twice as likely to report hazardous alcohol use, relative to individuals who denied misusing OTC medications. Individuals who had misused OTC medications scored significantly higher in sensation seeking and hopelessness and reported more symptoms of depression, anxiety, and somatic distress, relative to those who denied OTC misuse. Results suggest that a considerable minority of young adults are jeopardizing their health with the misuse of OTC medications as part of a pattern of polysubstance use.

  15. Attitudes of Brazilian Medical Students Towards Psychiatric Patients and Mental Illness: A Quantitative Study Before and After Completing the Psychiatric Clerkship.

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    da Rocha Neto, Helio Gomes; Rosenheck, Robert A; Stefanovics, Elina A; Cavalcanti, Maria Tavares

    2017-06-01

    The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.

  16. A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.

    Science.gov (United States)

    Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D

    2012-08-01

    Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P burnout (all P students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.

  17. A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From the Medical Student CHANGE Study.

    Science.gov (United States)

    Przedworski, Julia M; Dovidio, John F; Hardeman, Rachel R; Phelan, Sean M; Burke, Sara E; Ruben, Mollie A; Perry, Sylvia P; Burgess, Diana J; Nelson, David B; Yeazel, Mark W; Knudsen, John M; van Ryn, Michelle

    2015-05-01

    Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15-2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P sexual identity and mental and self-reported health measures. First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

  18. A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From Medical Student CHANGES

    Science.gov (United States)

    Przedworski, Julia M.; Dovidio, John F.; Hardeman, Rachel R.; Phelan, Sean M.; Burke, Sara E.; Ruben, Mollie A.; Perry, Sylvia P.; Burgess, Diana J.; Nelson, David B.; Yeazel, Mark W.; Knudsen, John M.; van Ryn, Michelle

    2014-01-01

    Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as non-heterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students with self-reported sexual orientation data in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of the 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] =1.59 [95% CI, 1.24–2.04]) anxiety symptoms (ARR = 1.64 [1.08–2.49]), and low self-rated health (ARR = 1.77 [1.15–2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% vs 12.7%, P sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being. PMID:25674912

  19. Medical students' health behaviour and self-reported mental health status by their country of origin: a cross-sectional study.

    Science.gov (United States)

    Terebessy, András; Czeglédi, Edit; Balla, Bettina Claudia; Horváth, Ferenc; Balázs, Péter

    2016-05-28

    Numerous previous studies have investigated the lifestyle and self-perceived health status of medical students. This study examined whether students' country of origin contributed to their mental health and health risk behaviour. We conducted our cross-sectional questionnaire survey over four consecutive years (2009-2012). The target population was fourth-year English- and Hungarian-language course medical students at Semmelweis University, Hungary. We gathered data on medical students' health behaviour (tobacco smoking, alcohol consumption, dietary habits and exercise) and mental health status and used analysis of variance (ANOVA) to examine the association between country of origin and mental health. The response rate was 76.1 % for the Hungarian and 63.4 % for the English course students. The mean age of our sample was 24.1 years (SD = 2.42). Only 15.3 % of students reported following dietary recommendations, but 75.0 % reported engaging in vigorous and regular physical exercise. The prevalence of tobacco smoking was 18.6 % and 13.8 % overconsumed alcoholic beverages. Hungarian and Iranian students reported lower mental well-being than Mediterranean, Israeli and Scandinavian students (F(4) = 18.943, p Results of the multiway ANOVA indicated that both country of origin and exercise showed a significant relationship with mental health: vigorous exercise was associated with better mental health status (F(1) = 5.505, p = 0.019). Medical students' mental health and health behaviour are associated with multiple factors. One of these is country of origin but exercise may also influence mental health. Health promotion programmes organised for medical students should take their country of origin into consideration and should include physical activity.

  20. Unique Characteristics of High-Cost Users of Medical Care With Comorbid Mental Illness or Addiction in a Population-Based Cohort.

    Science.gov (United States)

    Hensel, Jennifer M; Taylor, Valerie H; Fung, Kinwah; de Oliveira, Claire; Vigod, Simone N

    2017-10-16

    To understand whether high-cost users of medical care with and without comorbid mental illness or addiction differ in terms of their sociodemographic and health characteristics. Unique characteristics would warrant different considerations for interventions and service design aimed at reducing unnecessary health care utilization and associated costs. From the top 10% of Ontarians ranked by total medical care costs during fiscal year 2011/2012 (N = 314,936), prior 2-year mental illness or addiction diagnoses were determined from administrative data. Sociodemographics, medical illness characteristics, medical costs, and utilization were compared between those high-cost users of medical care with and without comorbid mental illness or addiction. Odds of being a frequent user of inpatient (≥3 admissions) and emergency (≥5 visits) services were compared between groups, adjusting for age, sex, socioeconomic status and medical illness characteristics. High-cost users of medical care with comorbid mental illness or addiction were younger, had a lower socioeconomic status, had greater historical medical morbidity, and had higher total medical care costs (mean excess of $2,031/user) than those without. They were more likely to be frequent users of inpatient (12.8% vs 10.2%; adjusted OR, 1.14; 95% CI: 1.12-1.17) and emergency (8.4% vs 4.8%; adjusted OR, 1.55; 95% CI: 1.50-1.59) services. Effect sizes were larger in major mood, psychotic, and substance use disorder subgroups. High-cost medical care users with mental illness or addiction have unique characteristics with respect to sociodemographics and service utilization patterns to consider in interventions and policies for this patient group. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  1. The prevalence of mental disorders in adults in different level general medical facilities in Kenya: a cross-sectional study

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    Kuria Mary W

    2009-01-01

    Full Text Available Abstract Background The possibility that a significant proportion of the patients attending a general health facility may have a mental disorder means that psychiatric conditions must be recognised and managed appropriately. This study sought to determine the prevalence of common psychiatric disorders in adult (aged 18 years and over inpatients and outpatients seen in public, private and faith-based general hospitals, health centres and specialised clinics and units of general hospitals. Methods This was a descriptive cross-sectional study conducted in 10 health facilities. All the patients in psychiatric wards and clinics were excluded. Stratified and systematic sampling methods were used. Informed consent was obtained from all study participants. Data were collected over a 4-week period in November 2005 using various psychiatric instruments for adults. Descriptive statistics were generated using SPSS V. 11.5. Results A total of 2,770 male and female inpatients and outpatients participated in the study. In all, 42% of the subjects had symptoms of mild and severe depression. Only 114 (4.1% subjects had a file or working diagnosis of a psychiatric condition, which included bipolar mood disorder, schizophrenia, psychosis and depression. Conclusion The 4.1% clinician detection rate for mental disorders means that most psychiatric disorders in general medical facilities remain undiagnosed and thus, unmanaged. This calls for improved diagnostic practices in general medical facilities in Kenya and in other similar countries.

  2. A cross-sectional examination of psychological distress, positive mental health and their predictors in medical students in their clinical clerkships.

    Science.gov (United States)

    van Dijk, Inge; Lucassen, Peter L B J; van Weel, Chris; Speckens, Anne E M

    2017-11-17

    Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called 'positive mental health'. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores possible predictors in a Dutch sample of clinical clerkship students. Fourth-year medical students in their first year of clinical clerkships were invited to complete an online questionnaire assessing demographics, psychological distress (Brief Symptom Inventory), positive mental health (Mental Health Continuum- SF), dysfunctional cognitions (Irrational Beliefs Inventory) and dispositional mindfulness skills (Five Facet Mindfulness Questionnaire). Multiple linear regression analysis was used to explore relationships between psychological distress, positive mental health (dependent variables) and demographics, dysfunctional cognitions and dispositional mindfulness skills (predictors). Of 454 eligible students, 406 (89%) completed the assessment of whom 21% scored in the clinical range of psychological distress and 41% reported a flourishing mental health. These proportions partially overlap each other. Female students reported a significantly higher mean level of psychological distress than males. In the regression analysis the strongest predictors of psychological distress were 'acting with awareness' (negative) and 'worrying' (positive). Strongest predictors of positive mental health were 'problem avoidance' (negative) and 'emotional irresponsibility' (negative). The prevalence of psychopathology in our sample of Dutch clinical clerkship students is slightly higher than in the general population. Our results support conclusions of previous research that psychological distress and positive mental

  3. A cross-sectional examination of psychological distress, positive mental health and their predictors in medical students in their clinical clerkships

    Directory of Open Access Journals (Sweden)

    Inge van Dijk

    2017-11-01

    Full Text Available Abstract Background Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called ‘positive mental health’. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores possible predictors in a Dutch sample of clinical clerkship students. Methods Fourth-year medical students in their first year of clinical clerkships were invited to complete an online questionnaire assessing demographics, psychological distress (Brief Symptom Inventory, positive mental health (Mental Health Continuum- SF, dysfunctional cognitions (Irrational Beliefs Inventory and dispositional mindfulness skills (Five Facet Mindfulness Questionnaire. Multiple linear regression analysis was used to explore relationships between psychological distress, positive mental health (dependent variables and demographics, dysfunctional cognitions and dispositional mindfulness skills (predictors. Results Of 454 eligible students, 406 (89% completed the assessment of whom 21% scored in the clinical range of psychological distress and 41% reported a flourishing mental health. These proportions partially overlap each other. Female students reported a significantly higher mean level of psychological distress than males. In the regression analysis the strongest predictors of psychological distress were ‘acting with awareness’ (negative and ‘worrying’ (positive. Strongest predictors of positive mental health were ‘problem avoidance’ (negative and ‘emotional irresponsibility’ (negative. Conclusions The prevalence of psychopathology in our sample of Dutch clinical clerkship students is slightly higher than in the general population. Our results support

  4. Síndrome neuroléptico maligno Neuroleptic malignant syndrome

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    Ricardo J. Toro

    1989-02-01

    Full Text Available

    El síndrome neuroléptico maligno (SNM es una complicación rara, idiosincrática y potencialmente fatal, relacionada con el uso de drogas que afectan el sistema dopaminérgico; su cuadro clínico consiste en síntomas extrapiramidales, signos de disfunción autonómica y trastornos en el estado de conciencia, asociados a leucocitosis ya cifras muy elevadas de creatina fosfoquinasa. Reportamos el caso de un hombre de 32 años que presentó un síndrome catatónico severo después del uso intrahospitalario de antipsicóticos potentes a altas dosis para el control de una depresión psicótica. Se discuten las características clínicas del paciente y los hallazgos comunes en el SNM.

    The Neuroleptic Malignant Syndrome (NMS Is a rare, idiosyncratic and potentially fatal complication of therapy with many drugs affecting the dopaminergic system; It Includes extrapyramidal symptoms, signs of autonomic dysfunction, disorders of consciousness, leucocytosis and an increase in serum creatine phosphokinase .We report the case of a 32 years old man, who developed a severe catatonic syndrome after receiving high doses of potent neuroleptics to control a psychotic depression. Clinical features of this case and common findings of NMS are discussed.

  5. 3-Hydroxykynurenine and clinical symptoms in first-episode neuroleptic-naive patients with schizophrenia.

    Science.gov (United States)

    Condray, Ruth; Dougherty, George G; Keshavan, Matcheri S; Reddy, Ravinder D; Haas, Gretchen L; Montrose, Debra M; Matson, Wayne R; McEvoy, Joseph; Kaddurah-Daouk, Rima; Yao, Jeffrey K

    2011-07-01

    One branch of the tryptophan catabolic cascade is the kynurenine pathway, which produces neurotoxic [3-hydroxykynurenine (3-OHKY), quinolinic acid] and neuroinhibitory (kynurenic acid) compounds. Kynurenic acid acts as a competitive antagonist at the glycine site of N-methyl-d-asparate receptors at high concentrations and as a non-competitive antagonist on the α7-nicotinic acetylcholine receptor at low concentrations. Kynurenine compounds also influence cognitive functions known to be disrupted in schizophrenia. Alterations in tryptophan metabolism are therefore of potential significance for the pathophysiology of this disorder. In this paper, tryptophan metabolites were measured from plasma using high-pressure liquid chromatography coupled with electrochemical coulometric array detection, and relationships were tested between these metabolic signatures and clinical symptoms for 25 first-episode neuroleptic-naive schizophrenia patients. Blood samples were collected and clinical and neurological symptoms were rated at baseline and again at 4 wk following initiation of treatment. Level of 3-OHKY and total clinical symptom scores were correlated when patients were unmedicated and neuroleptic-naive, and this relationship differed significantly from the correlation observed for patients 4 wk after beginning treatment. Baseline psychosis symptoms were predicted only by neurological symptoms. Moreover, baseline 3-OHKY predicted clinical change at 4 wk, with the lowest concentrations of 3-OHKY being associated with the greatest improvement in symptoms. Taken together, our findings suggest a neurotoxic product of tryptophan metabolism, 3-OHKY, predicts severity of clinical symptoms during the early phase of illness and before exposure to antipsychotic drugs. Baseline level of 3-OHKY may also predict the degree of clinical improvement following brief treatment with antipsychotics.

  6. Medication Interventions for ADHD Youth: A Primer for School and Mental Health Counselors.

    Science.gov (United States)

    Hall, Alex S.; Gushee, Arlinn G.

    2002-01-01

    This primer on the medical aspects of treating Attention Deficit Hyperactivity Disorder (ADHD) youth will help counselors feel better informed about the types of medications available, possible side effects, and the advantages and disadvantages for use. It also offers a discussion of the consequences for using interventions requiring medication…

  7. Psychiatric Correlates of Medical Care Costs among Veterans Receiving Mental Health Care

    Science.gov (United States)

    Simpson, Tracy L.; Moore, Sally A.; Luterek, Jane; Varra, Alethea A.; Hyerle, Lynne; Bush, Kristen; Mariano, Mary Jean; Liu, Chaun-Fen; Kivlahan, Daniel R.

    2012-01-01

    Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether…

  8. Effect of Medical Education on Students' Attitudes toward Psychiatry and Individuals with Mental Disorders

    Science.gov (United States)

    Hofmann, Marzellus; Harendza, Sigrid; Meyer, Jelka; Drabik, Anna; Reimer, Jens; Kuhnigk, Olaf

    2013-01-01

    Objective: This study aimed to explore the effect of medical education on students' attitudes toward psychiatry and psychiatric patients, and examined the usefulness of a new evaluation tool: the 6-item Psychiatric Experience, Attitudes, and Knowledge (PEAK-6). Method: Authors studied the attitudes of 116 medical students toward psychiatry…

  9. Integrating Maternal Mental Health Care in the Pediatric Medical Home: Treatment Engagement and Child Outcomes.

    Science.gov (United States)

    Kimmel, Mary C; Platt, Rheanna E; Steinberg, Danielle N; Cluxton-Keller, Fallon; Osborne, Lauren M; Carter, Tracy; Payne, Jennifer L; Solomon, Barry S

    2017-10-01

    Maternal depression is associated with an array of poor child health outcomes, and low-income women face many barriers to accessing treatment. In this pilot study, we assessed treatment engagement in a maternal mental health clinic staffed by a case manager and psychiatrist in an urban pediatric practice. We also examined factors associated with engagement as well as child health outcomes and health care use. Nearly half of the women enrolled attended at least 4 sessions with a psychiatrist in 6 months. Text messaging with the case manager was associated with a greater compliance with psychiatrist sessions. Comparing index children with their siblings prior to enrollment, a higher percentage had immunizations up to date at 1 year of age (82% vs 43%, P = .01), and well-child visit compliance trended toward significance (65% vs 35%, P = .06). The pediatric setting holds promise as an innovative venue to deliver maternal mental health care.

  10. The Mental Health Status of Librarians in Shahid Sadoughi University of Medical Sciences

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    Leila Nemati Anaraki

    2017-03-01

    Full Text Available Human resource is an organizational capital and its mental health is one of the most important dimensions. The mental health has a significant effect on performance of staffs. The current research aimed to examine the mental health and its dimensions in librarians of Shahid Sadoughi university in 2016. This is a descriptive-analytical study with correlational design among librarians working in libraries of Shahid Sadoughi university. Goldberg & Hiller general health questionnaire was used to evaluate general health of librarians. Data were then analyzed using descriptive statistics, independent T test, variance analysis, and Pearson correlation coefficient through SPSS software version 19. Results indicated that the mean score of librarians' general health was 22.8±10.38 which shows that participants were healthy. Furthermore, marital status was associated with health and its components so that married individuals were less healthy. Depression rate of librarians was low but most of them suffered from physical problems, anxiety, sleep disorders, and social conflicts. Therefore, librarians' authorities should  consider such problems and develop strategic plans for them. 

  11. An Interventional Study on the Clinical Usefulness and Outcomes of Electroconvulsive Therapy in Medication-Resistant Mental Disorders.

    Science.gov (United States)

    Manhas, Rameshwar S; Mushtaq, Raheel; Tarfarosh, Shah Faisal Ahmad; Shoib, Sheikh; Dar, Mohammad Maqbool; Hussain, Arshad; Shah, Tabindah; Shah, Sahil; Manzoor, Mushbiq

    2016-10-17

    Resistance to recommended medications has been an issue in dealing with a number of psychiatric ailments, and it is showing up as an ongoing challenge for contemporary mental health experts. Resistant psychiatric disorders not only increase the morbidity of patients suffering from such severe conditions but also intensify the problems of their caretakers. This has vigorously started to cause the costs to increase for healthcare services. Thanks to electroconvulsive therapy (ECT), we now have an effective method that is proving to be a fruitful final course of action in this micro-epidemic of resistant psychiatric diseases. However, the medical literature of case reports or studies in this niche is scarce. Also, no such comprehensive study has been carried out in the Southeast Asian region to date for the assessment of the effectiveness of electroconvulsive therapy in patients with medication-resistant psychiatric disorders. To assess the effectiveness of ECT in medication-resistant psychiatric patients at the post-ECT course, three-month follow-up, and six-month follow-up. The study was a prospective and interventional study (without controls) conducted in the Institute of Mental Health and Neurosciences (IMHANS), Srinagar, India. Fifty-six patients with pharmacotherapy-resistant psychiatric disorders were included in the study. The patients were assessed at the end of the ECT course, at the three-month follow-up, and at the six-month follow-up by the Clinical Global Impression (CGI), Montgomery Asberg Depression Rating Scale (MADRS), Young Manic Rating Scale (YMRS) and the Yale-Brown Obsessive Compulsive Scale (YBOCS). Improvement was defined with the help of the CGI subscale by comparing the position of the patient at admission to the projected condition with ECT. Analysis of Variance (ANOVA) was used for analysis of the quantitative data. For the pair-wise comparison of the groups, the post hoc tests were used. Pearson's chi-square test was used for analysis of

  12. The Health and Recovery Peer (HARP) Program: a peer-led intervention to improve medical self-management for persons with serious mental illness.

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    Druss, Benjamin G; Zhao, Liping; von Esenwein, Silke A; Bona, Joseph R; Fricks, Larry; Jenkins-Tucker, Sherry; Sterling, Evelina; Diclemente, Ralph; Lorig, Kate

    2010-05-01

    Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group *time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group *time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  13. Could Nursing Educational Courses Change the Attitudes of Students to Mental Disorders stigma? A Quasi- Experimental Study in Alborz University of Medical Sciences

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    F. Kordlou

    2015-11-01

    Full Text Available Introduction: The prevalence mental disorders and its burden in the world is one of the most important challenges for health system and service delivery to people with mental disorders need enough and trained manpower. Stigma of mental disorders not only influence patients and their families but also is a barrier for delivering mental health services to the patients, hence beyond the knowledge and expertise, health care providers must have an appropriate attitude especially toward the stigma of mental disorder. The aim of this study was to determine the effect of mental health related courses of nursing curriculum on the nursing student’s attitude about mental disorders in Alborz University of Medical Sciences. Methods: A quasi-experimental study with before and after design was used. All 197 nursing students who had one of the related courses of mental health, were studied for attitudes about mental disorder stigma before and after the semester. Farsi version of OMSHC questionnaire was used to measure nursing student’s attitude. One way ANOVAs, Pearson Correlation and Paired T-Test used for Data analysis. Results: Student’s attitude about mental health stigma didn’t improve after the course lessons. Mental health attitude score was different based on gender (P<0/035 and marital status (P<0.006. There was a weak negative correlation between age and attitude score (r=-0.22, P<0/003. Conclusion: The current educational course and lessons can’t improve the nursing student’s attitudes about the stigma of mental disorders. To get desired outcomes, changing lesson plans and the presentation styles must be considered.

  14. Acute Care Use for Ambulatory Care-Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions.

    Science.gov (United States)

    Hensel, Jennifer M; Taylor, Valerie H; Fung, Kinwah; Yang, Rebecca; Vigod, Simone N

    2018-01-01

    The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care. A retrospective, population-based cohort study using data from Ontario, Canada. Among the top 10% of medical care users ranked by cost, we determined rates of any and repeat care use (hospitalizations and emergency department [ED] visits) between April 1, 2011, and March 31, 2012, for 14 consensus established ACSCs and compared them between those with and without diagnosed mental illness or addiction during the 2 years prior. Risk ratios were adjusted (aRR) for age, sex, residence, and income quintile. Among 314,936 high-cost users, 35.9% had a mental illness or addiction. Compared to those without, individuals with mental illness or addiction were more likely to have an ED visit or hospitalization for any ACSC (22.8% vs. 19.6%; aRR, 1.21; 95% confidence interval [CI], 1.20-1.23). They were also more likely to have repeat ED visits or hospitalizations for the same ACSC (6.2% vs. 4.4% of those without; aRR, 1.48; 95% CI, 1.44-1.53). These associations were stronger in stratifications by mental illness diagnostic subgroup, particularly for those with a major mental illness. The presence of mental illness and addiction among high-cost users of medical services may represent an unmet need for quality ambulatory and primary care.

  15. The economic burden of eating disorders and related mental health comorbidities: An exploratory analysis using the U.S. Medical Expenditures Panel Survey

    OpenAIRE

    Samnaliev, Mihail; Noh, H. LeAnn; Sonneville, Kendrin R.; Austin, S. Bryn

    2014-01-01

    Background: Very little is known about the economic burden of eating disorders (ED) and related mental health comorbidities. Methods: Using 5 years of data from the U.S. Medical Expenditures Panel Survey, we estimated the difference in annual health care costs, employment status, and earned income (2011 US$) between individuals with current ED compared to those without ED. We further estimated the contribution of mental health comorbidities to these disparities in health care costs, employ...

  16. Application of the basic constructs of social cognitive theory for predicting mental health in student of Bushehr University Medical Sciences 2012-13

    OpenAIRE

    Makyea Jamali; Azita Noroozi; Rahim Tahmasebi

    2015-01-01

    Background: mental health is one of the health assessment topics in different communities which plays an important role in ensuring the dynamism and efficiency, especially in the students. Thus, the aim of this study is to application of basic constructs of social cognitive theory for predicting mental health in student of Bushehr University Medical Sciences. Materials and Methods: This cross– sectional study was conducted with using a systematic random sampling method in 428 studen...

  17. Associations between the patient-centered medical home and preventive care and healthcare quality for non-elderly adults with mental illness: A surveillance study analysis

    OpenAIRE

    Bowdoin, Jennifer J.; Rodriguez-Monguio, Rosa; Puleo, Elaine; Keller, David; Roche, Joan

    2016-01-01

    Background Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness, but the extent to which PCMHs are associated with preventive care and healthcare quality for this population is largely unknown. Our study addresses this gap by assessing the associations between receipt of care consistent with the PCMH and preventive care and healthcare quality for non-elderly adults with mental illness. Methods This surveillance study used self-reported data fo...

  18. The effects of training mental health practitioners in medication management to address nonadherence: a systematic review of clinician-related outcomes

    OpenAIRE

    Bressington, D.; Coren, E.; MacInnes, D. L.

    2013-01-01

    Daniel Bressington,1 Esther Coren,1 Douglas MacInnes21Department of Health, Well-Being and Family, 2Centre for Health and Social Care Research, Canterbury Christ Church University, Canterbury, UKBackground: Nonadherence with medicine prescribed for mental health is a common problem that results in poor clinical outcomes for service users. Studies that provide medication management-related training for the mental health workforce have demonstrated that improvements in the knowledge, attitudes,...

  19. Increased Postdeployment Use of Medication for Common Mental Disorders in Danish Gulf War Veterans

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Stoltenberg, Christian Ditlev Gabriel; Vedtofte, Mia Sadowa

    2017-01-01

    /hypnotic medication, and (3) number of postdeployment psychiatric contacts. The association between outcomes and GWVs status was studied by using time-to-event analysis. The index date was the return date from the last deployment to the Gulf. The follow-up period was the time from index date until December 31, 2014....... FINDINGS: GWVs had an elevated average risk over time for use of both types of medication compared with NV. For use of antidepressants the average hazard rate (HR) was 2.56, with 95% confidence interval (CI) = 2.04-3.21 (p medication the corresponding results were....... Incident use of anxiolytic/hypnotic medication was one and a half that of NV after 10 years, but nearly three times that of NV after 20 years. There was no difference in rate of postdeployment psychiatric contacts. DISCUSSION/IMPACT/RECOMMENDATIONS: The findings of increased use of antidepressants...

  20. A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial.

    Directory of Open Access Journals (Sweden)

    Clive Ballard

    2008-04-01

    Full Text Available BACKGROUND: There have been increasing concerns regarding the safety and efficacy of neuroleptics in people with dementia, but there are very few long-term trials to inform clinical practice. The aim of this study was to determine the impact of long-term treatment with neuroleptic agents upon global cognitive decline and neuropsychiatric symptoms in patients with Alzheimer disease. METHODS AND FINDINGS: DESIGN: Randomised, blinded, placebo-controlled parallel two-group treatment discontinuation trial. SETTING: Oxfordshire, Newcastle and Gateshead, London and Edinburgh, United Kingdom. PARTICIPANTS: Patients currently prescribed the neuroleptics thioridazine, chlorpromazine, haloperidol trifluoperazine or risperidone for behavioural or psychiatric disturbance in dementia for at least 3 mo. INTERVENTIONS: Continue neuroleptic treatment for 12 mo or switch to an identical placebo. OUTCOME MEASURES: Primary outcome was total Severe Impairment Battery (SIB score. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory (NPI. RESULTS: 165 patients were randomised (83 to continue treatment and 82 to placebo, i.e., discontinue treatment, of whom 128 (78% commenced treatment (64 continue/64 placebo. Of those, 26 were lost to follow-up (13 per arm, resulting in 51 patients per arm analysed for the primary outcome. There was no significant difference between the continue treatment and placebo groups in the estimated mean change in SIB scores between baseline and 6 mo; estimated mean difference in deterioration (favouring placebo -0.4 (95% confidence interval [CI] -6.4 to 5.5, adjusted for baseline value (p = 0.9. For neuropsychiatric symptoms, there was no significant difference between the continue treatment and placebo groups (n = 56 and 53, respectively in the estimated mean change in NPI scores between baseline and 6 mo; estimated mean difference in deterioration (favouring continue treatment -2.4 (95% CI -8.2 to 3.5, adjusted for

  1. A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial).

    Science.gov (United States)

    Ballard, Clive; Lana, Marisa Margallo; Theodoulou, Megan; Douglas, Simon; McShane, Rupert; Jacoby, Robin; Kossakowski, Katja; Yu, Ly-Mee; Juszczak, Edmund

    2008-04-01

    There have been increasing concerns regarding the safety and efficacy of neuroleptics in people with dementia, but there are very few long-term trials to inform clinical practice. The aim of this study was to determine the impact of long-term treatment with neuroleptic agents upon global cognitive decline and neuropsychiatric symptoms in patients with Alzheimer disease. Randomised, blinded, placebo-controlled parallel two-group treatment discontinuation trial. Oxfordshire, Newcastle and Gateshead, London and Edinburgh, United Kingdom. Patients currently prescribed the neuroleptics thioridazine, chlorpromazine, haloperidol trifluoperazine or risperidone for behavioural or psychiatric disturbance in dementia for at least 3 mo. Continue neuroleptic treatment for 12 mo or switch to an identical placebo. Primary outcome was total Severe Impairment Battery (SIB) score. Neuropsychiatric symptoms were evaluated with the Neuropsychiatric Inventory (NPI). 165 patients were randomised (83 to continue treatment and 82 to placebo, i.e., discontinue treatment), of whom 128 (78%) commenced treatment (64 continue/64 placebo). Of those, 26 were lost to follow-up (13 per arm), resulting in 51 patients per arm analysed for the primary outcome. There was no significant difference between the continue treatment and placebo groups in the estimated mean change in SIB scores between baseline and 6 mo; estimated mean difference in deterioration (favouring placebo) -0.4 (95% confidence interval [CI] -6.4 to 5.5), adjusted for baseline value (p = 0.9). For neuropsychiatric symptoms, there was no significant difference between the continue treatment and placebo groups (n = 56 and 53, respectively) in the estimated mean change in NPI scores between baseline and 6 mo; estimated mean difference in deterioration (favouring continue treatment) -2.4 (95% CI -8.2 to 3.5), adjusted for baseline value (p = 0.4). Both results became more pronounced at 12 mo. There was some evidence to suggest that

  2. Life and mental health of medical students after the Great East Japan Earthquake.

    Science.gov (United States)

    Arata, Yutaro; Horii, Akira; Saito, Hidemitsu; Miyamoto, Manabu; Matsuoka, Hiroo; Kanatsuka, Hiroshi

    2015-04-01

    Students of the Tohoku University School of Medicine experienced the Great East Japan Earthquake on March 11, 2011. We conducted a series of surveys to examine the relationships among their experiences and activities on the day of the earthquake, their physical, mental, and economic problems following the disaster, and how their problems changed over time. The initial survey was performed in April 2011, with three follow-up surveys in July 2011, February 2012, and April 2013. The initial survey focused on students' experiences and living conditions during the disaster, which contained questions on their locations and circumstances, family circumstances, lives after the earthquake, voluntary works, physical or mental health problems, and desire for counseling. The follow-up surveys included new items regarding their circumstances, changes in their health problems, and their desire for economic assistance. Students who answered the first survey to the 4th one, with response rates in the following bracket, were as follows: 472 (28.0%), 640 (29.9%), 681 (36.0%), and 678 (39.0%), respectively. Six months after the earthquake, about 20% having experienced physical and/or mental problems. Although there was a trend toward a reduction in suffering and health problems over time, some students' conditions remained unchanged or worsened. It is notable that students who had participated in voluntary activities, despite their own suffering of harm and distress, were identified as the group that required the closest attention. Our present results can be applied to appropriate supports for students in future large-scale disasters.

  3. Potential and challenges for learning during acute medical/surgical placement for intellectual disability, mental health and midwifery students.

    Science.gov (United States)

    Mc Carthy, Jane; Graham, Margaret M; Tuohy, Dympna; O'Brien, Brid; Fahy, Anne; Hennessy, Therese; O'Sullivan, Deirdre; Markey, Kathleen

    2017-10-18

    In Ireland nursing and midwifery degree programmes involve four pathways to registration. Three of which, intellectual disability and mental health nursing and midwifery require students to undertake acute medical/surgical placements offering learning opportunities caring for patients with complex needs in settings beyond their core discipline. This paper focuses on findings from a descriptive qualitative study exploring intellectual disability and mental health nursing and midwifery students experiences of such placements. Data analysis identified three themes: Getting ready, Navigating the way and Getting through. Feelings of stress and uncertainty are described by participants when moving from familiarity within a chosen discipline to an unfamiliar environment. Findings have influenced specific placement structures with local health service partners. While our study focuses on an Irish context, findings have relevance for student education in other jurisdictions. Enhancing preparation and support for students undertaking unfamiliar placements needs to be a constant endeavour. Such foundations will foster valuable experiences where students can feel part of a team, gain confidence, enhance skills and transfer meaningful learning to their core practice discipline. Further research is needed to explore the views of preceptors, ward managers and Clinical Placement Coordinators. Copyright © 2017. Published by Elsevier Ltd.

  4. What can the medical education do for eliminating stigma and discrimination associated with mental illness among future doctors? effect of clerkship training on chinese students' attitudes.

    Science.gov (United States)

    Shen, Yidong; Dong, Huixi; Fan, Xiaoduo; Zhang, Zhanchou; Li, Lehua; Lv, Hailong; Xue, Zhimin; Guo, Xiaofeng

    2014-01-01

    The study was to examine the changes in attitudes towards psychiatry and mental illness among Chinese medical students during their psychiatry clerkship training. The Attitudes Towards Mental Illness (AMI) and the Attitudes Towards Psychiatry-30 (ATP-30) questionnaires were administered to 325 fourth-year Chinese medical students before and after they completed an 8-week psychiatry clerkship training. After the clerkship training, there was a significant improvement in attitudes towards psychiatry and mental health as reflected by the total scores on ATP-30 (103.4 ± 8.6 versus 111.8 ± 9.6, p level (6.5% versus 11.4%, before versus after rotation, p = 0.028). The results of our study suggested that psychiatry clerkship training may improve medical students' attitudes towards psychiatry and mental illness, but its influence on medical students' consideration to choose psychiatry as a future medical career is limited. The students who did not consider psychiatry as a future career held less positive attitudes to psychiatrists, psychiatric patients and the treatment.

  5. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review

    Science.gov (United States)

    McGinty, Emma E.; Baller, Julia; Azrin, Susan T.; Juliano-Bult, Denise; Daumit, Gail L.

    2016-01-01

    People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings. PMID:26221050

  6. Patient-oriented randomisation: A new trial design applied in the Neuroleptic Strategy Study.

    Science.gov (United States)

    Schulz, Constanze; Timm, Jürgen; Cordes, Joachim; Gründer, Gerhard; Mühlbauer, Bernd; Rüther, Eckart; Heinze, Martin

    2016-06-01

    clinical trial, the Neuroleptic Strategy Study, with a randomised design comparing efficacy and safety of two different strategies: either to use first-generation antipsychotics (haloperidol and flupentixol) or second-generation antipsychotics (olanzapine, aripiprazole and quetiapine) in patients suffering from schizophrenia. In the course of the Neuroleptic Strategy Study, feasibility of this design was demonstrated. All aspects of the new design were implemented: randomisation process, documentation of responses from investigators as well as patients and drug logistic experience. In implementing the design, furthermore, we could investigate its theoretical properties. The physicians' preferences for specific drugs used for the respective patients were analysed. The idea of patient-oriented randomisation can be generalised. In light of the heterogeneity and complexity of patient-drug interaction, this design should prove particularly useful. © The Author(s) 2016.

  7. Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence.

    Science.gov (United States)

    Kretchy, Irene A; Owusu-Daaku, Frances T; Danquah, Samuel A

    2014-01-01

    Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for the development of mental health disorders particularly anxiety and depression. For Ghanaian patients with hypertension, the interaction between hypertension and symptoms of anxiety, depression and stress remains largely unexplored. To fill this knowledge gap, the study sought to ascertain the prevalence and role of these negative emotions on anti-hypertensive medication adherence while taking into account patients' belief systems. The hospital-based cross-sectional study involving 400 hypertensive patients was conducted in two tertiary hospitals in Ghana. Data were gathered on patient's socio-demographic characteristics, anxiety, depression and stress symptoms, spiritual beliefs, and medication adherence. Hypertensive patients experienced symptoms of anxiety (56%), stress (20%) and depression (4%). As a coping mechanism, a significant relation was observed between spiritual beliefs and anxiety (x (2) = 13.352, p = 0.010), depression (x (2) = 6.205, p = 0.045) and stress (x (2) = 14.833, p = 0.001). Stress among patients increased their likelihood of medication non-adherence [odds ratio (OR) = 2.42 (95% CI 1.06 - 5.5), p = 0.035]. The study has demonstrated the need for clinicians to pay attention to negative emotions and their role in medication non-adherence. The recommendation is that attention should be directed toward the use of spirituality as a possible mechanism by which negative emotions could be managed among hypertensive patients.

  8. [Common mental disorders and use of psychotropic medications in women consulting at primary care units in a Brazilian urban area].

    Science.gov (United States)

    Borges, Tatiana Longo; Hegadoren, Kathleen Mary; Miasso, Adriana Inocenti

    2015-09-01

    To investigate the prevalence of common mental disorders (CMD) in women consulting at primary health care units in a Brazilian urban area, as well as to determine the impact of CMD on quality of life (QoL), the association of sociodemographic factors with CMD and QoL, and the prevalence and pattern of psychotropic medication use in the study sample. In this quantitative, cross-sectional, correlational-descriptive study, a stratified sample of 365 women was interviewed between May 2012 and January 2013 in five primary health care units in Brazil. Data were collected using sociodemographic and drug use questionnaires. The self-reporting questionnaire (SRQ-20) was used to estimate the prevalence of CMD; and the World Health Organization Quality of Life (WHOQOL)-bref instrument was used to assess quality of life. To evaluate the impact of CMD on QoL, the t test and linear regression models were employed. The chi-square test was used to verify associations between CMD and sociodemographic variables. Descriptive analysis was used for psychotropic drug use. The prevalence of CMD was 44.1%. The prevalence of psychotropic medication use was 27.1%. Only 5.6% of participants had a psychiatric diagnosis recorded in their medical chart. Psychotropic drugs were used by 41.6% of participants with CMD according to the SRQ-20 and by 15.7% of those without CMD. There was no association between CMD and sociodemographic variables, but CMD and QoL were significantly associated. Women with CMD had the worst QoL, without impact of sociodemographic variables. Further attention should be given to the pattern of psychotropic medication use and prescription in primary care settings. Women with CMD had functional impairment, as shown by significantly lower QoL scores. The fact that sociodemographic factors did not impact the present results seems to support the notion of a different basis for CMD in women.

  9. Predictors of patient communication in psychiatric medication encounters among veterans with serious mental illnesses.

    Science.gov (United States)

    Hack, Samantha M; Medoff, Deborah R; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Klingaman, Elizabeth A; Park, Stephanie G; Kreyenbuhl, Julie A

    2016-06-01

    Person-centered psychiatric services rely on consumers actively sharing personal information, opinions, and preferences with their providers. This research examined predictors of consumer communication during appointments for psychiatric medication prescriptions. The Roter Interaction Analysis System was used to code recorded Veterans Affairs psychiatric appointments with 175 consumers and 21 psychiatric medication prescribers and categorize communication by purpose: biomedical, psychosocial, facilitation, or rapport-building. Regression analyses found that greater provider communication, symptomology, orientation to psychiatric recovery, and functioning on the Repeatable Battery for the Assessment of Neuropsychological Status Attention and Language indices, as well as consumer diagnostic label, were positive predictors of consumer communication, though the types of communication impacted varied. Provider communication is the easiest variable to intervene on to create changes in consumer communication. Future research should also consider how cognitive and symptom factors may impact specific types of consumer communication in order to identify subgroups for targeted interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Spiritual care may impact mental health and medication adherence in HIV+ populations

    OpenAIRE

    Oji VU; Hung LC; Abbasgholizadeh R; Terrell Hamilton F; EJ, Essien; Nwulia EA

    2017-01-01

    Valerie U Oji,1–3 Leslie C Hung,3 Reza Abbasgholizadeh,1,4 Flora Terrell Hamilton,5 E James Essien,6 Evaristus Nwulia7 1Lifefountain Center Ministries Inc, Houston, TX, USA; 2Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA; 3University of Texas, College of Pharmacy, Austin, TX, USA; 4University of Houston, Houston, TX, USA; 5Administration, Family & Medical Counseling Service, Inc. (FMCS), Washington, DC, USA; 6University of Houston Institute ...

  11. Developing Korean Academy of Medical Sciences Guideline for Rating the Impairment in Mental and Behavioral Disorders; A Comparative Study of KNPA's New Guidelines and AMA's 6th Guides

    Science.gov (United States)

    Ryu, Seong Gon; Hong, Narei; Hwang, Sun-Chul; Jung, Han-Young; Jeong, Dushin; Rah, Ueon Woo; Suh, Dong-Soo

    2009-01-01

    Quantifying and rating the impairments due to mental and behavior disorders are difficult for their own characteristics. Korean Academy of Medical Sciences (KAMS) is developing guidelines of rating impairment in mental and behavioral disorders based on Korean Neuropsychiatric Association (KNPA)'s new guidelines. We compared the new KNPA's guidelines and the American Medical Association (AMA)'s 6th Guides in assessing impairment due to mental and behavioral disorders to develop new guidelines of KAMS. Two guidelines are different in diagnosing system, applicable disorders, qualification of assessors, application of scales, contents of assessment and rate of impairment of the whole person. Both AMA's and the proposed guidelines have individual merits and characteristics. There is a limitation in using the 6th AMA's Guides in Korean situation. However to improve objectivity in Korean assessment of psychiatric impairment, the new AMA's Guides can serve as a good reference. PMID:19503692

  12. [Applying Neuman's Systems Model to a neuroleptic malignant syndrome psychiatric patient and his caregiver].

    Science.gov (United States)

    Wang, Shu-Mi; Lai, Chien-Yu

    2010-04-01

    This article describes a nurse's experience using Neuman's Systems Model to care for a chronic psychiatric patient and his caregiver. The patient was diagnosed as suffering from neuroleptic malignant syndrome (NMS). Nursing care described in this article was administered from October 23 to December 4, 2007. The patient developed NMS in the third month of a three-month period of hospitalization, which endangered his life as well as the health of his caregiver. Nursing care was provided to the patient and his caregiver based on Neuman's Systems Model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the health of the patient and his caregiver. The four nursing care issues identified included: existing self-care deficit, sensory/perceptual alteration, sleep pattern disturbance, and caregiver role strain. Following Neuman's systems model, primary, secondary, and tertiary prevention were used to strengthen the flexible lines of defense, internal lines of resistance, and supporting existing strengths of both patient and caregiver, as well as to conserve client system energy. Significant improvements in patient and caregiver abilities were apparent in nursing intervention outcomes. This experience shows the Neuman's systems model to be an efficient model in psychiatric nursing care.

  13. Influence of inhalational, neuroleptic and local anaesthesia on lymphocyte subset distribution.

    Science.gov (United States)

    Corsi, M; Mariconti, P; Calvillo, L; Falchi, M; Tiengo, M; Ferrero, M E

    1995-01-01

    We previously demonstrated that anaesthetics affect leukocyte response by inhibiting lymphocyte capping and metabolism and the phagocytic activity of neutrophils in some experimental models. In the present study, we investigated the effects of the clinical use of three different types of anaesthesia on lymphocyte subset distribution and activity: inhalational anaesthesia (isoflurane), a neuroleptoanalgesia, or local anaesthesia was used in patients submitted to the same operation (hysterectomy). At time 0 (before administering the anaesthesia) and at 10 min and 48 h from the start of the operation, heparinized blood was obtained from each of the 30 patients studied; three lymphocyte subpopulations were isolated (CD4+, CD8+ and CD19+). Cell number was identified for each lymphocyte subset, and (as an indication of cellular function) the intracellular contents of ATP and cAMP were evaluated by luminescence methods. The relevant results for each of the 3 anaesthetic methods were as follows: i) treatment with isoflurane induced a significant reduction in the number and function of CD4+ cells at 10 min, which was reversed at 48 h; a functional but not reversible decrease of CD19+ cells was obtained, ii) treatment with neuroleptic drugs induced a significant progressive functional impairment of CD4+ and CD19+ cells, and iii) local anaesthesia caused a significant functional impairment of CD8+ cells at 48 h and a significant functional impairment of CD19+ cells at 10 min and 48 h.

  14. Preliminary data concerning the reliability and psychometric properties of the Greek translation of the 20-item Subjective Well-Being Under Neuroleptic Treatment Scale (SWN-20

    Directory of Open Access Journals (Sweden)

    Arapidis Konstantinos

    2009-01-01

    Full Text Available Abstract Background The 20-item Subjective Well-Being Under Neuroleptic Treatment Scale (SWN-20 is a self-report scale developed in order to assess the well-being of patients receiving antipsychotic medication independent of the improvement in their psychotic symptoms. The current study reports on the reliability and the psychometric properties of the Greek translation of the SWN-20. Methods A total of 100 inpatients or outpatients with schizophrenia (79 males and 21 females, aged 42.6 ± 11.35 years old from 3 different facilities were assessed with the Positive and Negative Symptoms Scale (PANSS, the Calgary Depression Scale and the Simpson-Angus Scale, and completed the SWN-20. The statistical analysis included the calculation of Pearson product moment correlation coefficient, the Cronbach α and factor analysis with Varimax normalised rotation. Results The SWN-20 had an α value equal to 0.79 and all the items were equal. The factor analysis revealed the presence of seven factors explaining 66% of total variance. The correlation matrix revealed a moderate relationship of the SWN-20 and its factors with the PANSS-Negative (PANSS-N, PANSS-General Psychopathology (PANSS-G, the Simpson-Angus and the Calgary scales, and no relationship to age, education and income class. Discussion The Greek translation of the SWN-20 is reliable, with psychometric properties close to the original scale.

  15. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: Development and Testing of Electronic Decision Support System and Formative Research to Understand Perceptions about Mental Health in Rural India.

    Science.gov (United States)

    Maulik, Pallab K; Tewari, Abha; Devarapalli, Siddhardha; Kallakuri, Sudha; Patel, Anushka

    2016-01-01

    Common mental disorders (CMD) such as depression, suicidal risk and emotional/medically unexplained complaints affect a large number of people in India, but few receive appropriate care. Key reasons for this include few trained mental health professionals and stigma associated with mental health. A potential approach to address poor access to care is by training village healthcare workers in providing basic mental health care, and harnessing India's vast mobile network to support such workers using mobile-based applications. We propose an intervention to implement such an approach that incorporates the use of mobile-based electronic decision support systems (EDSS) to provide mental health services for CMD, combined with a community-based anti-stigma campaign. This will be implemented and evaluated across 42 villages in Andhra Pradesh, a south Indian state. This paper discusses the development and testing of the EDSS, and the formative research that informed the anti-stigma campaign. The development of the EDSS used an iterative process that was validated against clinical diagnosis. A mixed methods approach tested the user acceptability of the EDSS. Focus group discussions and in-depth interviews provided community-level perceptions about mental health. This study involved 3 villages and one primary health centre. The EDSS application was found to be acceptable, but some modifications were needed. The community lacked adequate knowledge about CMD and its treatment and there was stigma associated with mental illness. Faith and traditional healers were considered to be important mental health service providers. A number of barriers and facilitators were identified in implementing the intervention analysed in a framework using Andersen's behavioural model of health services use. The findings assisted with refining the intervention prior to large-scale implementation and evaluation.

  16. "Are You Saying She's Mentally Ill Then?" Explaining Medically Unexplained Seizures in Clinical Encounters

    Directory of Open Access Journals (Sweden)

    Catherine M. Robson

    2015-11-01

    Full Text Available Bodily phenomena that are difficult to identify, localize, explain and cure with the aid of modern biomedical knowledge and technology leave ample room for cultural influence. That makes them a perfect case for studying the cultural dimension of medical knowledge and practice. Building on this assumption we qualitatively explore the communication between neurologists and women with seizure disorders of uncertain etiology, often labeled psychogenic non-epileptic seizures (PNES, in a specialist clinic in England. Based on an interpretation of film-recordings of eight naturally-occurring clinical consultations we discuss the following questions: How do neurologists explain the name, the cause and the treatment options to these patients? How do patients and their companions respond to these explanations? And finally, what makes these interactions so difficult? Our interpretation of the data is inspired by critical discourse analysis, and framed within a social constructionist perspective on medical knowledge and practice. We found that the neurologists presented the diagnosis and its cause—inappropriate stress management—through objective language that conveyed a high degree of certainty. Patient-parties often disagreed, and found it hard to believe that these physical symptoms had a psychological origin. Companions often acted as advocates for the patients in negotiations with the doctors. The polarized debate between psychogenic and somatic understandings of the seizures that emerged illuminates how the Cartesian dualism between body and mind complicates clinical encounters—a dualism doctors explicitly reject, but presumably accept. We argue that it is impossible to overcome this polarization without acknowledging the cultural dimension of medical knowledge and practice. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs160122

  17. Association between mental health screening by self-report questionnaire and insomnia in medical students

    Directory of Open Access Journals (Sweden)

    Loayza H. Maria Paz

    2001-01-01

    Full Text Available Epidemiological research points to the high prevalence of psychiatric disorders among insomniacs. We carried out a cross-sectional study with medical students with the aim of evaluating the association between insomnia and suspicion of psychiatric disorder; 302 medical students were included (184 males and 118 females; mean age = 20.47±1.89 years. The main association was tested by logistic regression analysis. The overall prevalence of positivity in a screening test for psychiatric disorder was 22.19%; and of insomnia, 28.15%. Difficulty initiating sleep (OR=3.45, difficulty maintaining sleep (OR=7.61, falling asleep later (OR=1.99 and waking up earlier (OR=1.91 were associated with suspicion of psychiatric disorder. As a group, the variables difficulty initiating sleep, difficulty maintaining sleep, falling asleep after 11 pm, and waking up before 6 am presented an odds ratio of 5.96 for positivity in the screening for psychiatric disorder. Furthermore, difficulty maintaining sleep (OR=2.24 was associated with "being female," and falling asleep later (OR=0.43 was associated with "being male". These results underscore the importance of determining in what cases difficulty sleeping may have severe clinical repercussions or affect performance.

  18. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    Science.gov (United States)

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  19. The impact of a pharmacist assisted clinic upon medication adherence and quality of life in mental health patients

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    Lizer MH

    2011-09-01

    Full Text Available Objectives: To determine if a pharmacist assisted psychiatric clinic would improve adherence to medications and quality of life over 6 months. The primary study endpoints were the change from baseline in Medication Adherence Rating Scale (MARS, Brief Evaluation of Medication Influences and Beliefs (BEMIB, World Health Organization Quality of Life - BREF (WHOQOL-BREF scales as well as hospitalizations and emergency room visits. Secondary endpoints included metabolic and physiologic parameters.Methods: A prospective, single-center study conducted at an outpatient psychiatric clinic. Subjects were required to attend 3 clinic visits (baseline, 3 and 6 months with the pharmacist. Subject and medication histories were obtained at each visit. Subjects’ records within the local health system were reviewed for emergency room visits and hospitalizations. Metabolic parameters were assessed at each visit.Results: Twenty-seven subjects enrolled and twenty subjects completed. Total MARS score at baseline and study end were 7.90 and 8.65, respectively. At baseline, 10 (50% were nonadherent based on the BEMIB and 9 (45% were nonadherent at 6 months. Statistically significant improvements were seen in 2 domains of the WHOQOL-BREF. Reductions in both ER visits and hospitalizations were achieved. There were significant improvements in total cholesterol and LDL.Conclusions: Improvements were seen in two domains of the WHOQOL-BREF – physical capacity and psychological well-being over the 6 month period. While improvements were seen in various rating scales, due to small sample sizes, these were insignificant improvements. Reductions in hospitalizations and ER visits were also seen during the study and up to 6 months post study. Statistically significant improvements were also seen in both total cholesterol and LDL. The lack of improvement in many of the study outcomes reflects the difficulty of the mental health population to adhere to treatment recommendations

  20. Strengthening the Coordination of Pediatric Mental Health and Medical Care: Piloting a Collaborative Model for Freestanding Practices

    Science.gov (United States)

    Greene, Carolyn A.; Ford, Julian D.; Ward-Zimmerman, Barbara; Honigfeld, Lisa; Pidano, Anne E.

    2016-01-01

    Background: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It…

  1. Mental health care use in medically unexplained and explained physical symptoms : findings from a general population study

    NARCIS (Netherlands)

    van Eck van der Sluijs, J.F.; Ten Have, M.; Rijnders, C.A.; Van Marwijk, H.W.; de Graaf, R.; van der Feltz-Cornelis, C.M.

    Objective: The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods: Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence

  2. Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study.

    Science.gov (United States)

    Brown, George R; Jones, Kenneth T

    2016-04-01

    There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status. Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case-control design to determine if medical and/or mental health disparities exist in the TG veteran population. In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups. This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

  3. Medical and Welfare Officers beliefs about post-deployment screening for mental health disorders in the UK Armed Forces: a qualitative study.

    Science.gov (United States)

    Bull, Samantha; Thandi, Gursimran; Keeling, Mary; Chesnokov, Melanie; Greenberg, Neil; Jones, Norman; Rona, Roberto; Hatch, Stephani L

    2015-04-09

    This study aimed to examine currently serving United Kingdom (UK) military Medical and Welfare Officers views on the potential introduction of post-deployment screening for mental ill health. Semi-structured interviews were conducted with 21 Medical and Welfare Officers. Interview transcripts were analysed using data-driven thematic analysis. Four themes were identified: positive views of screening; reliability of responses; impact on workload; and suggestions for implementation. Interviewees viewed the introduction of screening post-deployment as likely to increase awareness of mental health problems whilst also reporting that service personnel were likely to conceal their true mental health status by providing misleading responses to any screening tool. Concern over reliability of responses may provide one explanation for the reluctance of service personnel to seek help for problems, as they could feel they will not be taken seriously. Welfare Officers felt they would not have the knowledge or experience to respond to help-seeking. Although participants were concerned about potential impact on their personal workload, they indicated a desire to positively engage with the screening programme if research showed it was an effective tool to improve mental health care. Welfare and healthcare providers are well disposed towards a screening programme for mental health but highlight a few concerns in its implementation. In particular Welfare Officers appear to require more training in how to respond to mental ill health. Concerns about available funding and resources to respond to increased workload will need to be addressed should post-deployment screening for mental health be introduced in the UK military.

  4. Application of the basic constructs of social cognitive theory for predicting mental health in student of Bushehr University Medical Sciences 2012-13

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    Makyea Jamali

    2015-01-01

    Full Text Available Background: mental health is one of the health assessment topics in different communities which plays an important role in ensuring the dynamism and efficiency, especially in the students. Thus, the aim of this study is to application of basic constructs of social cognitive theory for predicting mental health in student of Bushehr University Medical Sciences. Materials and Methods: This cross– sectional study was conducted with using a systematic random sampling method in 428 students of Bushehr University Medical Sciences in 2012-13. Information was collected by using five standard questionnaires including academic self efficacy, academic stress, multidimensional social support, student outcome expectancy and Quality of life (SF-36 scales. After data collection, all data was analyzed by SPSS statistical software with using Pearson correlation coefficient test and multiple linear regressions. Results: In this study, mental health had a significant correlation with social support (P =0.000, r=0.37, academic stress (P= 0.000, r= -0.45 and academic self-efficacy (P =0.000 , r =0. 24. In the liner regression model, predictor factors of mental health were faculty type and curriculum counseling and noncurriculum counseling evaluation variables and self efficacy (P=0.031, B= 1.49, academic stress (P=0.000, B=- 4.35, and social support constructs (P=0.000, B =4.77. Also, gender, mother's education and father's job had indirect effects to mental health through social support and acceptance quota and curriculum counseling evaluation had indirect effects to mental health through self efficacy. Conclusion: Utilization of strategies to increase self- efficacy, creating social support environment and also stress reduction particularly with organization of curriculum and non-curriculum counseling sessions can promote mental health in students.

  5. Health- and Performance-Related Outcomes in Air Force Medical Service Personnel with a Post-Deployment Mental Health Condition.

    Science.gov (United States)

    Kaiser, Jacob L; Tvaryanas, Anthony P; Maupin, Genny M

    2018-01-01

    This study examined associations between incident post-deployment mental health (PDMH) conditions and health- and performance-related outcomes in the population of Air Force Medical Service personnel on active duty between 2003 and 2013 who had at least one deployment. Using a posttest-only with nonequivalent groups design, the study cohort was divided into two groups based on the occurrence of an incident PDMH condition, and the groups were then compared in terms of the following health- and performance-related outcomes: health care and pharmaceutical utilization, duty and mobility restrictions, and physical fitness assessment exemptions and composite fitness score. Archival data were extracted from existing databases and associations were assessed using both parametric and nonparametric approaches. The cohort comprised 12,216 participants, from which subcohorts were drawn to assess specific outcome measures. Participants with an incident PDMH used health care at 1.8 times the rate and were 6.2 times more likely to be classified as a high utilizer of health care as compared with those without a PDMH condition (controls). They were 2.1-103.0 times more likely to be prescribed one of 22 therapeutic classes of medication and were 2.4 times more likely to have polypharmacy than controls. They were 2.5 times more likely to have a duty or mobility restriction, and the ratio of days spent with a restriction to days without a restriction was 1.8 times that of controls. Lastly, they were 2.4 times more likely to have a physical fitness assessment exemption, but there was no significant difference in the likelihood of a composite fitness score of <90 points. The presence of an incident PDMH condition was associated with increased health care and pharmaceutical utilization and decreased occupational performance as assessed in terms of restricted duty status and participation in physical fitness assessments.

  6. The consolidation of neuroleptic therapy: Janssen, the discovery of haloperidol and its introduction into clinical practice.

    Science.gov (United States)

    López-Muñoz, Francisco; Alamo, Cecilio

    2009-04-29

    The discovery of haloperidol at the end of the 1950s constitutes one of the greatest advances of 20th century psychiatry. This antipsychotic drug has their origin in the research process of central analgesic molecules derived from pethidine and methadone, carried out by the Belgian company Janssen Phamaceutica. After the synthesis of phenoperidine, numerous analogues of this compound were studied, and chemists at Janssen took the decision to substitute the propiophenone group for a butyrophenone group. One of these compounds went the R-1625, a stronger agent with specifically neuroleptic properties but lacking morphine-like activity. This substance was synthesized on the 11th February 1958 and received the generic name of haloperidol because of the two halogenated substitutes incorporated into the molecule. Clinical development of haloperidol was conducted, primarily, by psychiatric research team at the University of Liège that confirmed its efficacy in the treatment of various psychiatric disorders such as acute and chronic paranoid psychosis, mania, or chronic treatment-resistant schizophrenia. Under the brand name Haldol((R)), haloperidol was licensed and marketed in Belgium in October 1959. The direct and differed consequences of its introduction into the psychiatric practice have been multiple, involving different areas of socio-sanitary reality. Moreover, haloperidol has contributed substantially to the development of biological psychiatry and currently neuroscience, because it made possible the development of new experimental models for predicting the effects of antipsychotics, and allowed the postulate of the firsts biological hypotheses about the schizophrenia etiology. Haloperidol has been included in the World Health Organisation's list of essential medicines.

  7. The neuroleptic chlorpromazine inhibits the cationic and stimulates the anionic phospholipid precursor synthesis in human lymphocytes.

    Science.gov (United States)

    Staub, M; Stenger, A; Sumeg, R; Spasokoukotskaja, T; Fairbanks, L D; Simmonds, H A; Keszler, G

    2006-01-01

    The widely used neuroleptic drug chlorpromazine (CPZ) influences membrane functions at the levels of ionic channels and receptors as shown. Here we show the effect of short term treatments by CPZ (30 microM), on the nucleotide-containing phospholipid precursors in human lymphocyte primary cultures. During 60 minutes incubation of the cells, the CDP-ethanolamine (CDP-EA) content was only slightly reduced (87 to 76 pmol/10(6) cells), the amount of CDP-choline (CDP-Ch) was inhibited totally (from 25 to 0 pmol) upon the treatment with 30 microM CPZ under the same conditions. It has been shown earlier, that dCTP can be used as well as CTP for biosynthesis of phospholipids. Thus, the separation of the corresponding ribo- and deoxyribo-liponucleotides was developed. CPZ almost completely inhibited the synthesis of both dCDP-EA and dCDP-Ch under the same conditions The synthesis of the activated liponucleotide precursors, can be measured by incorporation of extracellular 14C-dCyt into both dCDP-EA and dCDP-Ch, as shown earlier. While the cationic deoxyribo-liponucleotide content (dCDP-Ch, dCDP-EA) was decreased, the labelling of the anionic phospholipid precursor dCDP-diacylglycerol (dCDP-DAG) was enhanced several times, it could be labelled only in the presence of CPZ from 14C-dCyd. Thus, a principal disturbance of the membrane phospholipid synthesis is presented (i.e., inhibition of the cationic and enhancement of the anionic dCDP-DAG synthesis). This profound influence on the membrane phospholipids by chlorpromazine, might be the primary effect that contributes to the wide spectrum of CPZ effects on neuronal cells.

  8. Responding to Moral Distress and Ethical Concerns at the Intersection of Medical Illness and Unmet Mental Health Needs.

    Science.gov (United States)

    McKlindon, Donna D; Nathanson, Pamela; Feudtner, Chris

    2017-01-01

    Some of the most difficult clinical ethics consultations involve patients who have both medical and mental health needs, as these cases can result in considerable moral distress on the part of the bedside staff. In this article we examine the issues that such consults raise through the illustrative example of a particular case: several years ago our ethics consultation service received a request from a critical care attending physician who was considering a rarely performed psychosurgical intervention to address intractable and life-threatening agitation and aggression in an adolescent patient for whom standard treatments had proven unsuccessful. We consider strategies that may be useful in addressing not only the ethical dilemmas or the clinical problems, but also the emotional, social, and moral distress that arise in delivering care in such complex cases, in which standard routine practices of care have been exhausted. In addition, we explore the processes that led to this situation and suggest ways to promote early recognition and intervention for similar cases in the future. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

  9. Effects of chronic academic stress on mental state and expression of glucocorticoid receptor α and β isoforms in healthy Japanese medical students.

    Science.gov (United States)

    Kurokawa, Ken; Tanahashi, Toshihito; Murata, Akiho; Akaike, Yoko; Katsuura, Sakurako; Nishida, Kensei; Masuda, Kiyoshi; Kuwano, Yuki; Kawai, Tomoko; Rokutan, Kazuhito

    2011-07-01

    Chronic academic stress responses were assessed by measuring mental state, salivary cortisol levels, and the glucocorticoid receptor (GR) gene expression in healthy Japanese medical students challenging the national medical license examination. Mental states of 17 male and 9 female medical undergraduates, aged 25.0 ± 1.2 years (mean ± SD), were assessed by the State and Trait Anxiety Inventory (STAI) and the Self-Rating Depression Scale (SDS) 2 months before, 2 days before, and 1 month after the examination. At the same time points, saliva and blood were collected. STAI-state scores peaked 2 days before the examination. Scores on STAI-trait and SDS, and salivary cortisol levels were consistently higher during the pre-examination period. One month after the examination, all these measures had significantly decreased to baseline levels. Real-time reverse transcription PCR showed that this chronic anxious state did not change the expression of the functional GRα mRNA isoform in peripheral leukocytes, while it resulted in reduced expression of the GRβ isoform 2 days before the examination. Our results replicate and extend a significant impact of chronic academic stressors on the mental state of healthy Japanese medical students and suggest a possible association of GRβ gene in response to psychological stress.

  10. Class side effects: decreased pressure in the lower oesophageal and the pyloric sphincters after the administration of dopamine antagonists, neuroleptics, anti-emetics, L-NAME, pentadecapeptide BPC 157 and L-arginine.

    Science.gov (United States)

    Belosic Halle, Zeljka; Vlainic, Josipa; Drmic, Domagoj; Strinic, Dean; Luetic, Kresimir; Sucic, Mario; Medvidovic-Grubisic, Maria; Pavelic Turudic, Tatjana; Petrovic, Igor; Seiwerth, Sven; Sikiric, Predrag

    2017-05-17

    The ulcerogenic potential of dopamine antagonists and L-NAME in rats provides unresolved issues of anti-emetic neuroleptic application in both patients and experimental studies. Therefore, in a 1-week study, we examined the pressures within the lower oesophageal and the pyloric sphincters in rats [assessed manometrically (cm H2O)] after dopamine neuroleptics/prokinetics, L-NAME, L-arginine and stable gastric pentadecapeptide BPC 157 were administered alone and/or in combination. Medication (/kg) was given once daily intraperitoneally throughout the 7 days, with the last dose at 24 h before pressure assessment. Given as individual agents to healthy rats, all dopamine antagonists (central [haloperidol (6.25 mg, 16 mg, 25 mg), fluphenazine (5 mg), levomepromazine (50 mg), chlorpromazine (10 mg), quetiapine (10 mg), olanzapine (5 mg), clozapine (100 mg), sulpiride (160 mg), metoclopramide (25 mg)) and peripheral(domperidone (10 mg)], L-NAME (5 mg) and L-arginine (100 mg) decreased the pressure within both sphincters. As a common effect, this decreased pressure was rescued, dose-dependently, by BPC 157 (10 µg, 10 ng) (also note that L-arginine and L-NAME given together antagonized each other's responses). With haloperidol, L-NAME worsened both the lower oesophageal and the pyloric sphincter pressure, while L-arginine ameliorated lower oesophageal sphincter but not pyloric sphincter pressure, and antagonized L-NAME effect. With domperidone, L-arginine originally had no effect, while L-NAME worsened pyloric sphincter pressure. This effect was opposed by L-arginine. All these effects were further reversed towards a stronger beneficial effect, close to normal pressure values, by the addition of BPC 157. In addition, NO level was determined in plasma, sphincters and brain tissue. Thiobarbituric acid reactive substances (TBARS) were also assessed. Haloperidol increased NO levels (in both sphincters, the plasma and brain), consistently producing increased

  11. [Economic evaluation of the demand of medical care for mental health in Mexico: schizophrenia and depression, 1996-2000].

    Science.gov (United States)

    Arredondo, Armando; Ramos, René; Zúñiga, Alexis

    2003-01-01

    Financing protection for both, users and providers of health care services is one of the main objectives of National Program of Health in Mexico, 2001-2006. In fact one of the elements of the present health care reform initiatives is need for the efficient allocation of financial resources, using resource allocation schemes by specific health care demands that combine both the economic, clinical and the epidemiological perspectives. The evaluation of such schemes has been approached in several ways; however, in the case of mental health services, there is dearth of studies that use economic assessment methods. Moreover, such studies are of limited scope, often a response to unmated health needs, disregarding the economic implication for health services production and financing and ensuing medical care market imbalances. This paper presents the results of an evaluative research work aimed to assess the average cost of depression and schizophrenia case management, the financial resources required to meet the health care demands by type of institution, period 1996-2000, in Mexico by type of health care provider. The case management average cost for schizophrenia was $211.00 US, and that for depression was $221.00 US. The demand of services for both conditions in each type of institution showed that the greatest relative demands (96% of the national total for depression and 94% of the national total for schizophrenia) occur in three institutions: IMSS, SSA and ISSSTE. The greatest demand of the health services for the two study condition corresponded to those insured by the IMSS, followed by those uninsured who use the SSA services, and those insured by the ISSSTE. The case management costs for mental conditions are in the middle range between hypertension and diabetes in the upper end, pneumonia and diarrhea in the lower end. The case managment costs of health care demands for the selected tracer conditions differ considerably among institutions for insure populations

  12. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

    Science.gov (United States)

    McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

    2012-06-01

    Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

  13. ‘At-risk’ places: inequities in the distribution of environmental stressors and prescription rates of mental health medications in Glasgow, Scotland

    Science.gov (United States)

    Maantay, Juliana; Maroko, Andrew

    2015-11-01

    Using geospatial analytical methods, this study examines the association between one aspect of the built environment, namely, the concentration of vacant and derelict land (VDL), and the prevalence of mental health disorders (using the proxy variable of mental health medication prescription rates) in Glasgow, Scotland. This study builds on our previous research, which demonstrated the spatial correspondence between the locations of VDL in Glasgow and several physical health outcomes. Numerous studies of other locales have found similar correspondence between different elements of the built environment and various health outcomes. This is the first study of its kind to look at the spatial concentration of vacant and derelict land in relation to mental health, socio-economic indicators, environmental justice, and health inequities. The findings of this study demonstrate an inequity with respect to the distribution of vacant and derelict land, as confirmed by Pearson correlations between VDL density and deprivation (r = .521, p medication for anxiety, depression, or psychosis and the density of vacant and derelict land while adjusting for socio-demographic characteristics. This indicates that areas with higher VDL densities tend to exhibit higher rates of mental health issues. Based on these findings, strategies for constructive re-use of VDL are proposed.

  14. Length of hospital stay and health services use of medical inpatients with comorbid noncognitive mental disorders: a review of the literature.

    Science.gov (United States)

    Koopmans, Gerrit T; Donker, Marianne C H; Rutten, Frans H H

    2005-01-01

    We reviewed 23 studies on the association between noncognitive mental disorders and the use of general health care services by medical patients admitted to a general hospital. Only studies with a prospective design and with a correction for possible confounding factors were included. In most studies, only service use during index admission was observed, but eight studies included a longer observation period during follow-up after hospital discharge. The 15 studies that were restricted to service use during index admission showed mixed results: length of hospital stay was related to common mental disorders in some studies, but other studies did not find such an association. The eight studies that used a longer observation period showed findings that are more consistent. They demonstrated mainly that symptoms or complaints of depression are related to a higher resource use within general medical services.

  15. Human Rights That Influence The Mentally Ill Patient In South African Medical Law: A Discussion of Sections 9; 27; 30 and 31 of the Constitution

    Directory of Open Access Journals (Sweden)

    M Swanepoel

    2011-12-01

    Full Text Available The personalised nature of mental illness obscures from general view the intolerable burden of private and public distress that people with serious mental illness carry. Invariably the mentally ill person encounters rejection and humiliation that are in some way tantamount to a "second illness." The combination either disrupts or puts beyond reach the usual personal and social life stages of marriage, family life, raising children, sexual relationships, the choice of treatment, affordable housing, transportation, education and gainful employment. As a result of their lack of financial and social support and their experience of rejection from society, persons with mental illness tend to neglect themselves and their diet, and frequently delay seeking treatment. Against this background, this contribution critically focuses on the human rights that influence the mentally ill patient in South African medical law. Specific attention is paid to the relevance and meaning of sections 9 (the equality clause, 27 (access to health care services, 30 and 31 (language, culture and religion of the Constitution of the Republic of South Africa, 1996.

  16. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

    Science.gov (United States)

    van Melle, Marije A; Lamkaddem, Majda; Stuiver, Martijn M; Gerritsen, Annette A M; Devillé, Walter L J M; Essink-Bot, Marie-Louise

    2014-09-23

    A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we examined: a) general practitioners' (GP) recognition of common mental disorders (CMD) (depression and anxiety, and post-traumatic stress disorder (PTSD) symptoms); b) patients' awareness of diabetes type II (DMII) and hypertension (HT); and c) GPs' adherence to guidelines for CMD, DMII and HT. From 172 refugees resettled in the Netherlands, interview data (2010-2011) and medical records (n = 106), were examined. Inclusion was based on medical record diagnoses for DMII and HT, and on questionnaire-based CMD measures (Hopkins Symptom Checklist for depression and anxiety; Harvard Trauma Questionnaire for PTSD). GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews. Patient awareness of HT and DMII was scored as the percentage of subjects diagnosed by the GP who reported their condition during the interview. GPs' adherence to guidelines for CMD, DMII and HT was measured using established indicators. We identified 37 resettled refugees with CMD of which 18 (49%) had been recognised by the GP. We identified 16 refugees with DMII and 14 with HT from the medical record; 24 (80%) were aware of their condition. Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment. This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

  17. Computer Assisted Learning for the Mind (CALM): the mental health of medical students and their use of a self-help website.

    Science.gov (United States)

    Moir, Fiona; Fernando, Antonio T; Kumar, Shailesh; Henning, Marcus; Moyes, Simon A; Elley, C Raina

    2015-03-27

    The aim of this study was to develop an evidence-based self-help website, Computer Assisted Learning for the Mind (CALM) designed to improve mental health amongst medical students; and to assess the proportion, demographics and mental health of students who chose to use the site. All 2nd and 3rd year medical students from one New Zealand university were invited to participate. Demographics and mental health scores of those accessing CALM were compared with those not accessing it. Outcome measures included depression (PHQ-9) and anxiety (GADS-7) scores recorded at baseline. Anonymous identifiers were used to track website use. Baseline questionnaires were completed by 279/321 (87%) of eligible students. CALM was accessed by 80/321 (25%) of the students over a 5 week period. Those who accessed CALM and could be linked by unique identifier (n=49) had significantly higher anxiety scores (p=0.01) but not higher depression scores (p=0.067) at baseline, than those who did not access CALM (n=230). Of those students with both PHQ-9 scores and GAD-7 scores =10 (at risk of significant depression and anxiety) at baseline, 41% went on to access CALM. The CALM website was used by 25% of medical students, particularly those with poorer anxiety scores. Self-selection to a web-based resource may provide assistance to those most in need, but further research would be needed to assess effectiveness.

  18. High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance.

    Science.gov (United States)

    Johnsen, Bjørn Helge; Westli, Heidi Kristina; Espevik, Roar; Wisborg, Torben; Brattebø, Guttorm

    2017-11-10

    High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of "push" of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. The results of this study emphasize the team leader's role in initiating and updating a team's shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

  19. Feasibility of integrating mental health and noncommunicable disease risk factor screening in periodical medical examination of employees in industries: An exploratory initiative.

    Science.gov (United States)

    Sukumar, Gautham Melur; Kupatira, Kowshik; Gururaj, G

    2015-01-01

    Noncommunicable disease (NCDs), psychological, substance use disorders, and stress-related issues have been less understood in Indian industrial settings. Systems for screening and early identification of the above have not been integrated in workplaces, nor there is a strong regulatory backing for the same. To explore the feasibility of integrating mental health and select NCD risk factor screening with the periodical medical examination of employees. To identify proportion of employees with select NCD risk factors and symptoms suggestive of mental health problems. Around 10% of employees from a leading motor industry in Bangalore, (706) participated in this cross-sectional voluntary screening program. This screening was conducted as a part of their annual medical examination. A mixed method of self-report and interview administered technique was adopted for the same. Descriptive statistical methods (proportions, median, mean, and standard deviation (SD)) and Chi-square test of significance. Screening revealed the following; tobacco use (18%), alcohol use (57%), perceived work stress (10%), and obesity (3%). Nearly 23% screened positive for psychological distress. Time consumed for this assessment was 1-5 min. Initial attempts point out that it is feasible to integrate screening for mental health, substance use, and NCD risk factors in periodic medical examination using a combination of self-report and interview-administered method, though further detailed assessments for confirmation is necessary.

  20. Measuring mental health following the 6-year American invasion of Iraq. A general health questionnaire analysis of Iraqi medical and dentistry students.

    Science.gov (United States)

    Al-Nimer, Marwan S

    2010-01-01

    To explore the current psychological problems among Iraqi medical and dentistry students using a General Health Questionnaire after 6 years of armed conflicts. This study was carried out in the Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq from January to May 2009. A total of 440 medical and dentistry students were asked to complete the 12-item (GHQ-12) and 30-item (GHQ-30) General Health Questionnaire-Arabic version to measure the level of their psychological distress. The analysis of this cross-sectional study is based on a voluntary self-rating questionnaire survey of the assessment of common mental problems. Based on the GHQ-12, using simple Likert scoring, probable psychiatric illness (score >12) was approximately equal in dentistry (50.6%; 89 out of 176) and medical (51.1%; 135 out of 264) students, with an odds ratio of 1.138. Based on GHQ-30 using binary scoring, the probable cases (score > or = 5) were reported significantly (pdentistry students, with an odds ratio of 3.251. The means of overall categorized psychiatric morbidity, other than social dysfunction, reported in male dentistry students were non-significantly higher than corresponding medical students. The impact of armed conflicts is obvious, therefore, medical and dentistry students need to receive effective mental health outreach and treatment, including lifestyle modification, at each stage of college life.

  1. Relationship Between Mental Health and Job Satisfaction Among Employees in a Medical Center Department of Laboratory Medicine

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    Mo Siu-Mei Lee

    2009-02-01

    Conclusion: The prevalence of psychiatric morbidity in the workplace is high. The severity of psychological distress is negatively associated with job satisfaction. Early detection of psychiatric morbidity through self-administered screening questionnaires, as well as implementation of organizational mental-health promotion programs, is recommended to improve employees' mental health and job satisfaction.

  2. Stigmatisation of Mental Illness and Its Impact on Recruitment of Medical Students to a Career in Psychiatry

    Science.gov (United States)

    Lyons, Zaza; Hood, Sean

    2011-01-01

    The stigmatisation of mental illness in Australian and other Western societies is now well documented. This article presents a description of the "stigmatisation" problem associated with mental illness, and discusses the impact that this problem has had on the demand for Psychiatry as a career. The approach taken at UWA to address the…

  3. Switch from neuroleptics to clozapine does not influence pituitary-gonadal axis hormone levels in male schizophrenic patients.

    Science.gov (United States)

    Markianos, M; Hatzimanolis, J; Lykouras, L

    1999-12-01

    Hypothalamic dopaminergic and serotonergic inputs participate in the regulation of pituitary hormones, and drugs that block central dopamine and serotonin receptors are expected to influence the hypothalamus-pituitary-gonadal (HPG) and -adrenal (HPA) axes. In schizophrenic patients, the switch from neuroleptics to clozapine influences prolactin and cortisol secretion, but there is no information on possible changes on HPG-axis hormones. We measured the plasma levels of testosterone (TST), LH, FSH, as well as of prolactin (PRL) and cortisol (CORT), in a group of male patients with schizophrenia during treatment with classical neuroleptics with no satisfactory therapeutic response (31 pts, age 30.3+/-8.5, range 18-50), and 6 weeks later, after switch to treatment with clozapine (CLZ) in doses from 100 to 600 mg daily (mean 328 mg). Psychopathology was assessed using the Brief Psychiatric Rating Scale. The hormone levels were also compared to those of a control group of 38 healthy males. Treatment with CLZ resulted in a reduction in the BPRS score by 30% in the mean. Plasma PRL was reduced from 39.9+/-26.1 to 8.3+/-5.0 ng/ml (PHPG-axis hormone plasma levels, although it reduces substantially the levels of prolactin and cortisol.

  4. Pentadecapeptide BPC 157 attenuates disturbances induced by neuroleptics: the effect on catalepsy and gastric ulcers in mice and rats.

    Science.gov (United States)

    Jelovac, N; Sikiric, P; Rucman, R; Petek, M; Marovic, A; Perovic, D; Seiwerth, S; Mise, S; Turkovic, B; Dodig, G; Miklic, P; Buljat, G; Prkacin, I

    1999-08-20

    A gastric pentadecapeptide, BPC 157, with the amino acid sequence, Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val, MW 1419, known to have a variety of protective effects in gastrointestinal tract and other organs, was recently shown to particularly affect dopamine systems. For instance, it blocks the stereotypy produced acutely by amphetamine in rats, and the development of haloperidol-induced supersensitivity to amphetamine in mice. Consequently, whether pentadecapeptide BPC 157, that by itself has no cataleptogenic effect in normal animals, may attenuate the immediate effects of neuroleptics application, particularly catalepsy, was the focus of the present report. Prominent catalepsy, otherwise consistently seen in the mice treated with haloperidol (0.625, 1.25, 2.5, 5.0 and 10.0 mg/kg b.w., i.p.) and fluphenazine (0.3125, 0.625, 1.25, 2.5 and 5.0 mg/kg b.w., i.p.) after 1.5, 3, 4.5, 6 and 7.5 h following administration, was markedly attenuated when pentadecapeptide BPC 157 (10 microg or 10 ng/kg b.w., i.p.) was coadministered with the neuroleptic. The number of cataleptic mice was markedly lower throughout most of the experimental period. Moreover, on challenge with lower doses of neuroleptics, catalepsy appearance was postponed and the mice, otherwise cataleptic since the earliest period, became cataleptic later, not before 3 or 4.5 h after neuroleptic administration, especially if protected with higher pentadecapeptide dose. Besides catalepsy, coadministration of the pentadecapeptide BPC 157, given in the above mentioned doses, reduced not only catalepsy but somatosensory disorientation (for 7.5 h after administration of a neuroleptic, assessed at intervals of 1.5 h, by a simple scoring system [0-5]) in haloperidol- or fluphenazine-challenged mice as it did in mice treated with sulpiride (20, 40, 80 and 160 mg/kg b.w., i.p.) or with clozapine (25, 50 and 100 mg/kg b.w., i.p.), in which case catalepsy was absent. In other experiments, considering

  5. Associations between the patient-centered medical home and preventive care and healthcare quality for non-elderly adults with mental illness: A surveillance study analysis.

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    Bowdoin, Jennifer J; Rodriguez-Monguio, Rosa; Puleo, Elaine; Keller, David; Roche, Joan

    2016-08-24

    Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness, but the extent to which PCMHs are associated with preventive care and healthcare quality for this population is largely unknown. Our study addresses this gap by assessing the associations between receipt of care consistent with the PCMH and preventive care and healthcare quality for non-elderly adults with mental illness. This surveillance study used self-reported data for 6,908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey. Preventive care and healthcare quality measures included: participant rating of all healthcare; cervical, breast, and colorectal cancer screening; current smoking; smoking cessation advice; flu shot; foot exam and eye exam for people with diabetes; and follow-up after emergency room visit for mental illness. Multiple logistic regression models were developed to compare the odds of meeting preventive care and healthcare quality measures for participants without a usual source of care, participants with a non-PCMH usual source of care, and participants who received care consistent with the PCMH. Compared to participants without a usual source of care, those with a non-PCMH usual source of care had better odds of meeting almost all measures examined, while those who received care consistent with the PCMH had better odds of meeting most measures. Participants who received care consistent with the PCMH had better odds of meeting only one measure compared to participants with a non-PCMH usual source of care. Compared with having a non-PCMH usual source of care, receipt of care consistent with the PCMH does not appear to be associated with most preventive care or healthcare quality measures. These findings raise concerns about the potential value of the PCMH for non-elderly adults with mental illness and suggest that alternative models of primary care are needed to improve outcomes and address

  6. [The most cited themes in the research in the field of Mental Health: analyses of six international nursing and medical journals].

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    Cunico, Laura; Fredo, Susanna; Bernini, Massimo

    2017-01-01

    The review aimed to identify and analyse the future development on the topic by analysing the main themes discussed in number of scientific journal focused on Mental Health both by nurses and physicians.. 4 international journals focused on Mental health and psychiatry International Journal of Mental Health Nursing, Archives of Psychiatric Nursing, American Journal of Psychiatry, Australian and New Zeland Journal of Psychiatry as well as two journal focused generically on health, Journal of Advanced Nursing and Lancet were scrutinized. We have analysed the papers of 2012-2015 for the specialised journals and last and first 6 months of 2012 and 2013 and 2014-2015 for the generic. Editorials, comments and contributions regarding theoretical models were exluded. From the analysis we identified 9 themes and for each theme the pertinent category. For the diagnostic grouping we used the International Statistical Classification of Diseases and Related Health Problems 10th Revision. A trend in research about mood disorders, schizophrenia and addictions and comorbidity emerged according to the 2099 abstracts analysed. Within medical research antidepressants were the most studied psychotropic medication and cognitive behaviour therapy was the most studied psychotherapy. Within nursing research: the nurse-patient relationship, adherence and monitoring of pharmacological therapy, the treatment planning and the working environment, the nursing training and its efficacy. The clinical research trials were twice as frequent in the medical versus nursing research where qualitative research prevails. The research challenge will be to find a new paradigm fit for the future psychiatry having at its disposition the patient's genoma, and needing to routinely use biomarkers for a personalised therapy. A further challenge might be the promotion of interprofessional research between doctors and nurses and the acquisition of new competences of health professionals needed to tackle the

  7. The Relationship between Wife Abuse and Mental Health in Women Experiencing Domestic Violence referred to the Forensic Medical Center of Shiraz

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    Arezoo Shayan

    2015-03-01

    Full Text Available Background and Objectives: Neglecting women's health and the domestic violence prevailing against them can cause a variety of mental and even physical diseases that threaten the health of the family. Disruptions in the life pattern of women and mothers have adverse health effects for both the family and the entire society. The present study was conducted to investigate the relationship between wife abuse and mental health in female victims of domestic violence referred to the Forensic Medical Center of Shiraz. Materials and Methods: The present cross-sectional, descriptive, analytical study was conducted over three months in 2013 on 197 women with abusive husbands referred to the Forensic Medical Center of Shiraz. The study data collection tools included a demographic information questionnaire, the General Health Questionnaire (GHQ-28 and a standard violence against women questionnaire. Cronbach's alpha was measured to assess the data collection tools' reliability. Data were analyzed in SPSS-18. Results: The mean age of the study subjects was reported as 30.42±6.72. More than 50 percent of the women had been victim to domestic violence and suffered from disorders in all the aspects of general health (P<0.05. There was a positive relationship between domestic violence and all the aspects of general health. In other words, violence of any kind was a predictor of general health disorders (P<0.05. Domestic violence was found to have the greatest effect on the incidence of depression and anxiety. Conclusion: The present study revealed the psychological consequences of wife abuse and violence against women and confirmed the damaging effect of violence on women's mental health. In addition to imposing heavy costs on the society for providing healthcare and medications, mental health disorders in women are also a burden for the family life and the children's upbringing.

  8. A Cross-Lingual Mobile Medical Communication System Prototype for Foreigners and Subjects with Speech, Hearing, and Mental Disabilities Based on Pictograms

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    Krzysztof Wołk

    2017-01-01

    Full Text Available People with speech, hearing, or mental impairment require special communication assistance, especially for medical purposes. Automatic solutions for speech recognition and voice synthesis from text are poor fits for communication in the medical domain because they are dependent on error-prone statistical models. Systems dependent on manual text input are insufficient. Recently introduced systems for automatic sign language recognition are dependent on statistical models as well as on image and gesture quality. Such systems remain in early development and are based mostly on minimal hand gestures unsuitable for medical purposes. Furthermore, solutions that rely on the Internet cannot be used after disasters that require humanitarian aid. We propose a high-speed, intuitive, Internet-free, voice-free, and text-free tool suited for emergency medical communication. Our solution is a pictogram-based application that provides easy communication for individuals who have speech or hearing impairment or mental health issues that impair communication, as well as foreigners who do not speak the local language. It provides support and clarification in communication by using intuitive icons and interactive symbols that are easy to use on a mobile device. Such pictogram-based communication can be quite effective and ultimately make people’s lives happier, easier, and safer.

  9. Smartphone Applications for Educating and Helping Non-motivating Patients Adhere to Medication That Treats Mental Health Conditions: Aims and Functioning.

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    Kassianos, Angelos P; Georgiou, Giorgos; Papaconstantinou, Electra P; Detzortzi, Angeliki; Horne, Rob

    2017-01-01

    Background: Patients prescribed with medication that treats mental health conditions benefit the most compared to those prescribed with other types of medication. However, they are also the most difficult to adhere. The development of mobile health (mHealth) applications ("apps") to help patients monitor their adherence is fast growing but with limited evidence on their efficacy. There is no evidence on the content of these apps for patients taking psychotropic medication. The aim of this study is to identify and evaluate the aims and functioning of available apps that are aiming to help and educate patients to adhere to medication that treats mental health conditions. Method: Three platform descriptions (Apple, Google, and Microsoft) were searched between October 2015 and February 2016. Included apps need to focus on adherence to medication that treats mental health conditions and use at least a reinforcement strategy. Descriptive information was extracted and apps evaluated on a number of assessment criteria using content analysis. Results: Sixteen apps were identified. All apps included self-monitoring properties like reminders and psycho-educational properties like mood logs. It was unclear how the latter were used or how adherence was measured. Major barriers to medication adherence like patients' illness and medication beliefs and attitudes were not considered nor where information to patients about mediation side effects. Very few apps were tailored and none was developed based on established theories explaining the processes for successful medication adherence like cognitions and beliefs. Reported information on app development and validation was poor. Discussion: A variety of apps with different properties that tackle both intentional and unintentional non-adherence from a different perspective are identified. An evidence-based approach and co-creation with patients is needed. This will ensure that the apps increase the possibility to impact on non

  10. Smartphone Applications for Educating and Helping Non-motivating Patients Adhere to Medication That Treats Mental Health Conditions: Aims and Functioning

    Directory of Open Access Journals (Sweden)

    Angelos P. Kassianos

    2017-10-01

    Full Text Available Background: Patients prescribed with medication that treats mental health conditions benefit the most compared to those prescribed with other types of medication. However, they are also the most difficult to adhere. The development of mobile health (mHealth applications (“apps” to help patients monitor their adherence is fast growing but with limited evidence on their efficacy. There is no evidence on the content of these apps for patients taking psychotropic medication. The aim of this study is to identify and evaluate the aims and functioning of available apps that are aiming to help and educate patients to adhere to medication that treats mental health conditions.Method: Three platform descriptions (Apple, Google, and Microsoft were searched between October 2015 and February 2016. Included apps need to focus on adherence to medication that treats mental health conditions and use at least a reinforcement strategy. Descriptive information was extracted and apps evaluated on a number of assessment criteria using content analysis.Results: Sixteen apps were identified. All apps included self-monitoring properties like reminders and psycho-educational properties like mood logs. It was unclear how the latter were used or how adherence was measured. Major barriers to medication adherence like patients' illness and medication beliefs and attitudes were not considered nor where information to patients about mediation side effects. Very few apps were tailored and none was developed based on established theories explaining the processes for successful medication adherence like cognitions and beliefs. Reported information on app development and validation was poor.Discussion: A variety of apps with different properties that tackle both intentional and unintentional non-adherence from a different perspective are identified. An evidence-based approach and co-creation with patients is needed. This will ensure that the apps increase the possibility to

  11. Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif).

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    Ayoughi, Sarah; Missmahl, Inge; Weierstall, Roland; Elbert, Thomas

    2012-02-29

    Psychosocial stress caused by war, ongoing conflict, lack of security, and restricted access to resources promotes mental suffering and diseases in many resource-poor countries. In an exemplary setting, the present study compares the efficacy of psychosocial counselling with routine pharmacological treatment in a randomised trial in Mazar-e-Sharif (Afghanistan). Help seeking Afghan women (N = 61), who were diagnosed with mental health symptoms by local physicians either received routine medical treatment(treatment as usual) or psychosocial counselling (5-8 sessions) following a specifically developed manualised treatment protocol. Primary outcome measures were symptoms of depression and anxiety assessed before treatment and at follow-up using the Hopkins Symptom Checklist and the Mini-International Neuropsychiatric Interview. Secondary outcome measures were psychosocial stressors and coping mechanisms. At 3-month follow-up, psychosocial counselling patients showed high improvements with respect to the severity of symptoms of depression and anxiety. In addition, they reported a reduction of psychosocial stressors and showed an enhancement of coping strategies. At the same time, the severity of symptoms, the quantity of psychosocial stressors and coping mechanisms did not improve in patients receiving routine medical treatment. These results indicate that psychosocial counselling can be an effective treatment for mental illnesses even for those living in ongoing unsafe environments.

  12. Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif

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    Ayoughi Sarah

    2012-02-01

    Full Text Available Abstract Background Psychosocial stress caused by war, ongoing conflict, lack of security, and restricted access to resources promotes mental suffering and diseases in many resource-poor countries. In an exemplary setting, the present study compares the efficacy of psychosocial counselling with routine pharmacological treatment in a randomised trial in Mazar-e-Sharif (Afghanistan. Methods Help seeking Afghan women (N = 61, who were diagnosed with mental health symptoms by local physicians either received routine medical treatment(treatment as usual or psychosocial counselling (5-8 sessions following a specifically developed manualised treatment protocol. Primary outcome measures were symptoms of depression and anxiety assessed before treatment and at follow-up using the Hopkins Symptom Checklist and the Mini-International Neuropsychiatric Interview. Secondary outcome measures were psychosocial stressors and coping mechanisms. Results At 3-month follow-up, psychosocial counselling patients showed high improvements with respect to the severity of symptoms of depression and anxiety. In addition, they reported a reduction of psychosocial stressors and showed an enhancement of coping strategies. At the same time, the severity of symptoms, the quantity of psychosocial stressors and coping mechanisms did not improve in patients receiving routine medical treatment. Conclusion These results indicate that psychosocial counselling can be an effective treatment for mental illnesses even for those living in ongoing unsafe environments. Trial registration NCT01155687

  13. The Only Constant Is Change: Next Generation Materials and Medical Device Design for Physical and Mental Health.

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    Knothe Tate, Melissa L; Fath, Thomas

    2016-08-01

    Cell health and cell network patency dictate human physical and mental health throughout life. Cutting edge multiscale imaging and mapping of cell to organ structure and function is unravelling the remarkable plasticity of cellular networks, from bone to brain. Insights from these studies will enable the development of next generation implants to replace, repair and reprogram cellular networks, for promotion of mental and physical health. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Cross-National Analysis of Beliefs and Attitude Toward Mental Illness Among Medical Professionals From Five Countries.

    Science.gov (United States)

    Stefanovics, Elina; He, Hongbo; Ofori-Atta, Angela; Cavalcanti, Maria Tavares; Rocha Neto, Helio; Makanjuola, Victor; Ighodaro, Adesuwa; Leddy, Meaghan; Rosenheck, Robert

    2016-03-01

    This quantitative study sought to compare beliefs about the manifestation, causes and treatment of mental illness and attitudes toward people with mental illness among health professionals from five countries: the United States, Brazil, Ghana, Nigeria, and China. A total of 902 health professionals from the five countries were surveyed using a questionnaire addressing attitudes towards people with mental illness and beliefs about the causes of mental illness. Chi-square and analysis of covariance (ANCOVA) were used to compare age and gender of the samples. Confirmatory factor analysis was employed to confirm the structure and fit of the hypothesized model based on data from a previous study that identified four factors: socializing with people with mental illness (socializing), belief that people with mental illness should have normal roles in society (normalizing), non-belief in supernatural causes (witchcraft or curses), and belief in bio-psycho-social causes of mental illness (bio-psycho-social). Analysis of Covariance was used to compare four factor scores across countries adjusting for differences in age and gender. Scores on all four factors were highest among U.S. professionals. The Chinese sample showed lowest score on socializing and normalizing while the Nigerian and Ghanaian samples were lowest on non-belief in supernatural causes of mental illness. Responses from Brazil fell between those of the U.S. and the other countries. Although based on convenience samples of health professional robust differences in attitudes among health professionals between these five countries appear to reflect underlying socio-cultural differences affecting attitudes of professionals with the greater evidence of stigmatized attitudes in developing countries.

  15. Oral risperidone plus oral lorazepam versus standard care with intramuscular conventional neuroleptics in the initial phase of treating individuals with acute psychosis.

    Science.gov (United States)

    Lejeune, Joseph; Larmo, Ilkka; Chrzanowski, Wlodzimierz; Witte, Roel; Karavatos, Athanasios; Schreiner, Andreas; Lex, Alice; Medori, Rossella

    2004-09-01

    Although atypical antipsychotics are now considered first line treatments for schizophrenia, intramuscular (i.m.) conventional neuroleptics are often still considered necessary in emergency treatment of acute psychoses. This European, multicentre, open-label, active-controlled trial compared oral risperidone plus oral lorazepam to standard care with i.m. conventional neuroleptics with or without lorazepam in the emergency treatment of acutely psychotic patients. Patients were allowed to choose either oral risperidone (a single dose of 2 mg and 2.0-2.5 mg lorazepam; 121 patients) or standard i.m. treatment (conventional neuroleptic with or without lorazepam; 105 patients). No additional treatment was allowed for 2 h. Primary outcome was the percentage of patients with treatment success (asleep or at least much improved on Clinical Global Impression-global improvement scale) 2 h after treatment initiation. Baseline characteristics were similar in both treatment groups. Oral risperidone plus oral lorazepam was more successful at 2 h (66.9%) and significantly non-inferior compared to standard i.m. care (54.3%; P=0.0003), and the incidence of extrapyramidal symptoms (EPS) was lower (1.7%) compared to standard i.m. care (9.5%). In acutely psychotic patients requiring emergency treatment, oral risperidone/oral lorazepam was at least as effective as i.m. conventional neuroleptic treatment with or without lorazepam. Oral risperidone plus lorazepam rapidly reduces symptoms, including aggression, and causes fewer EPS.

  16. Catatonia, neuroleptic malignant syndrome, and cotard syndrome in a 22-year-old woman: a case report.

    Science.gov (United States)

    Weiss, C; Santander, J; Torres, R

    2013-01-01

    The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as "I do not have a heart," "my heart is not beating," "I can not breathe," "I am breaking apart," "I have no head" (ideas of negation) and statements about the patient being responsible for the "death of the whole world" (ideas of enormity). Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  17. The effects of training mental health practitioners in medication management to address nonadherence: a systematic review of clinician-related outcomes

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    Bressington D

    2013-05-01

    Full Text Available Daniel Bressington,1 Esther Coren,1 Douglas MacInnes21Department of Health, Well-Being and Family, 2Centre for Health and Social Care Research, Canterbury Christ Church University, Canterbury, UKBackground: Nonadherence with medicine prescribed for mental health is a common problem that results in poor clinical outcomes for service users. Studies that provide medication management-related training for the mental health workforce have demonstrated that improvements in the knowledge, attitudes, and skills of staff can help to address nonadherence. This systematic review aims to establish the effectiveness of these training interventions in terms of clinician-related outcomes.Methods: Five electronic databases were systematically searched: PubMed, CINAHL, Medline, PsycInfo, and Google Scholar. Studies were included if they were qualitative or quantitative in nature and were primarily designed to provide mental health clinicians with knowledge and interventions in order to improve service users' experiences of taking psychotropic medications, and therefore potentially address nonadherence issues.Results: A total of five quantitative studies were included in the review. All studies reported improvements in clinicians' knowledge, attitudes, and skills immediately following training. The largest effect sizes related to improvements in clinicians' knowledge and attitudes towards nonadherence. Training interventions of longer duration resulted in the greatest knowledge- and skills-related effect sizes.Conclusion: The findings of this review indicate that training interventions are likely to improve clinician-related outcomes; however, due to the methodological limitations of the current evidence base, future research in this area should aim to conduct robust randomized controlled trials with follow-up and consider collecting qualitative data to explore clinicians' experiences of using the approaches in clinical practice.Keywords: staff training

  18. Nociceptive thermal threshold testing in horses – effect of neuroleptic sedation and neuroleptanalgesia at different stimulation sites

    Science.gov (United States)

    2013-01-01

    Background Aim of the study was to compare the effect of neuroleptic sedation with acepromazine and neuroleptanalgesia with acepromazine and buprenorphine on thermal thresholds (TT) obtained at the nostrils and at the withers. The study was carried out as a randomized, blinded, controlled trial with cross-over design. Thermal thresholds were determined by incremental contact heat applied to the skin above the nostril (N) or the withers (W). Eleven horses were treated with saline (S), acepromazine (0.05 mg/kg) (ACE) or acepromazine and buprenorphine (0.0075 mg/kg) (AB) intravenously (IV). Single stimulations were performed 15 minutes prior and 15, 45, 75, 105, 165, 225, 285, 405 and 525 minutes after treatment. Sedation score, gastrointestinal auscultation score and occurrence of skin lesions were recorded. Data were analysed with analysis of variance for repeated measurements. Results There were no significant differences in TT between N and W with all treatments. The TT remained constant after S and there was no difference in TT between S and ACE. After AB there was a significant increase above baseline in TT until 405 minutes after treatment. Restlessness occurred 30–90 minutes after AB in 7 horses. All horses had reduced to absent borborygmi after AB administration for 165 to 495 minutes. Conclusion Thermal stimulation at both described body areas gives comparable results in the assessment of cutaneous anti-nociception in horses. There is no differential influence of neuroleptic sedation or neuroleptanalgesia on TTs obtained at N or W. Buprenorphine combined with acepromazine has a long lasting anti-nociceptive effect associated with the typical opioid induced side effects in horses. PMID:23837730

  19. Nurses' genetic/genomics competencies when medication therapy is guided by pharmacogenetic testing: children with mental health disorders as an exemplar.

    Science.gov (United States)

    Prows, Cynthia A; Saldaña, Shannon N

    2009-06-01

    There is considerable variability in the effectiveness and toxicity of psychotropics used to treat mental health disorders in children and adolescents. Pharmacogenetic (PG) testing is beginning to be used to decrease the time it takes to reach therapeutic response and decrease the occurrence of adverse drug reactions in children and adolescents treated with psychotropics. This article reviews the pharmacogenetics literature and uses a clinical scenario to illustrate the essential genetic/genomics competencies pediatric nurses need to meet when providing care to patients whose medication therapy is being guided by PG testing.

  20. The economic burden of eating disorders and related mental health comorbidities: An exploratory analysis using the U.S. Medical Expenditures Panel Survey.

    Science.gov (United States)

    Samnaliev, Mihail; Noh, H LeAnn; Sonneville, Kendrin R; Austin, S Bryn

    2015-01-01

    Very little is known about the economic burden of eating disorders (ED) and related mental health comorbidities. Using 5 years of data from the U.S. Medical Expenditures Panel Survey, we estimated the difference in annual health care costs, employment status, and earned income (2011 US$) between individuals with current ED compared to those without ED. We further estimated the contribution of mental health comorbidities to these disparities in health care costs, employment and earnings. Individuals with ED had greater annual health care costs ($1869, p = 0.012), lower but borderline significant employment rates (OR = 0.67, 95% CIs [0.41, 1.09]), and lower but not statistically significant earnings among those who were employed ($2093, p = 0.48), compared to individuals without ED. Among individuals with ED, the presence of mental health comorbidities was associated with higher but not statistically significant health care costs ($1993, p = 0.17), lower borderline significant odds of employment (OR = 0.41, 95% CIs [0.14, 1.20]), and significantly lower earnings ($19,374, p eating disorders and comorbidities.

  1. Sociodemographic, perceived and objective need indicators of mental health treatment use and treatment-seeking intentions among primary care medical patients.

    Science.gov (United States)

    Elhai, Jon D; Voorhees, Summer; Ford, Julian D; Min, Kyeong Sam; Frueh, B Christopher

    2009-01-30

    We explored sociodemographic and illness/need associations with both recent mental healthcare utilization intensity and self-reported behavioral intentions to seek treatment. Data were examined from a community sample of 201 participants presenting for medical appointments at a Midwestern U.S. primary care clinic, in a cross-sectional survey study. Using non-linear regression analyses accounting for the excess of zero values in treatment visit counts, we found that both sociodemographic and illness/need models were significantly predictive of both recent treatment utilization intensity and intentions to seek treatment. Need models added substantial variance in prediction, above and beyond sociodemographic models. Variables with the greatest predictive role in explaining past treatment utilization intensity were greater depression severity, perceived need for treatment, older age, and lower income. Robust variables in predicting intentions to seek treatment were greater depression severity, perceived need for treatment, and more positive treatment attitudes. This study extends research findings on mental health treatment utilization, specifically addressing medical patients and using statistical methods appropriate to examining treatment visit counts, and demonstrates the importance of both objective and subjective illness/need variables in predicting recent service use intensity and intended future utilization.

  2. Monitoring and documentation of side effects from depot antipsychotic medication: an interdisciplinary audit of practice in a regional mental health service.

    Science.gov (United States)

    Cleary, A; Walsh, F; Connolly, H; Hays, V; Oluwole, B; Macken, E; Dowling, M

    2012-06-01

    This audit reviewed current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. A sample of 60 case files, care plans and prescriptions were audited, which is 31% of the total number of service users receiving depot injections in the mental health service region (n= 181). The sample audited had a range of diagnoses, including: schizophrenia, schizoaffective disorder, bipolar affective disorder, depression, alcoholic hallucinosis and autism. The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only five (8%) case notes examined had documentation recorded describing the condition of the injection site, and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded. In 57 (95%) of case notes, no documentation of recorded information on the depot and on side effects was given. The failure to monitor and record some blood tests was partly attributed to a lack of clarity regarding whose responsibility it was. A standardized checklist has been developed as a result of the audit and this will be introduced by all teams across the service. © 2011 Blackwell Publishing.

  3. Most common mental problems in the elderly as viewed by medical school students in Poland, Belarus and Greece

    Directory of Open Access Journals (Sweden)

    Mateusz Cybulski

    2015-10-01

    Full Text Available Aim: The aim of this study was to investigate the opinions of respondents on the most common mental and psychological problems of the elderly over 60 years of age. Material and methods: The study was conducted between January 2013 and November 2014 in three study groups: Polish, Belarusian and Greek students. A total of 600 (200 for each group respondents were tested with a questionnaire developed by the authors. Women dominated in study groups. Three quarters of the study population consisted of people between the ages of 21 and 25 years. An analysis of the education level of respondents showed that almost 60% of respondents studied nursing, 30% – physiotherapy and 10% – other courses of studies. Results: More than half of all respondents (50.8% were afraid of old age. The vast majority of students in each group (a total of 88.3% stated that it is better for the elderly not to be alone and to have a family. Loneliness (61.5%, the sense of helplessness (52.7% and depression (50.8% were mental problems of the elderly that were most often indicated by the respondents. Conclusions: There is a need to educate the younger generations on problems associated with aging and old age, including mental health problems. The study showed significant differences in the perception of mental health problems of elderly people, depending on respondents’ country. There is a need for a change in the functioning of the care systems for the elderly, which would involve perceiving a family as an institution able to provide care services for old people.

  4. FastStats: Mental Health

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Mental Health Recommend on Facebook Tweet Share Compartir Data are ... Health, United States trend tables with data on mental health National Hospital Ambulatory Medical Care Survey: 2011 Outpatient ...

  5. Air Pollution and Dispensed Medications for Asthma, and Possible Effect Modifiers Related to Mental Health and Socio-Economy: A Longitudinal Cohort Study of Swedish Children and Adolescents.

    Science.gov (United States)

    Oudin, Anna; Bråbäck, Lennart; Oudin Åström, Daniel; Forsberg, Bertil

    2017-11-16

    It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO₂ from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01-1.03) for asthma associated with a 10 µg·m -3 increase in NO₂. The association only seemed to be present in areas where NO₂ was higher than 15 µg·m -3 with an OR of 1.09 (95% CI: 1.07-1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02-1.09) and OR = 1.04 (95% CI: 1.01-1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma.

  6. Perception, knowledge, and attitude toward mental disorders and psychiatry among medical undergraduates in Karnataka: A cross-sectional study

    Science.gov (United States)

    Aruna, G.; Mittal, Shobhana; Yadiyal, Muralidhara B.; Acharya, Chandana; Acharya, Srilekha; Uppulari, Chinmay

    2016-01-01

    Context: Globally, psychiatry as a subject, psychiatrists as professionals, and patients with psychiatric disorders are subjected to cultural stereotypes and negative attitude by the general population. What is of alarming concern is that these prejudices exist within the medical community as well. Aims: This study aims at evaluating the perception, knowledge, and attitude toward psychiatric disorders, therapeutic modalities used in psychiatry, psychiatry as a subject and psychiatrists as professionals among undergraduate medical students in Karnataka. Settings and Design: This is a descriptive, cross-sectional type of study conducted in three medical colleges located in Karnataka. Materials and Methods: A sample of 500 students from all three professional phases of MBBS was selected using purposive sampling. A semistructured prevalidated questionnaire was used to assess the perception, knowledge, and attitude of undergraduate medical students toward psychiatric disorders and psychiatry. Statistical Analysis: Data were analyzed using Statistical Package for Social Sciences, version 16.0. Results: The undergraduate medical student population had significant shortcomings in knowledge and attitude pertaining to psychiatric disorders, more glaring in the initial years of education. A comparatively positive opinion was obtained regarding psychiatry as a subject and psychiatrists as professionals, which may reflect the changing trends and concepts, both in society and medical community. Conclusion: This study highlights the need for better educational measures at undergraduate level in order to shape a positive attitude of the health care providers towards psychiatry, which is essential for ensuring better care for patients as well as reduction of stigma surrounding psychiatric disorders. PMID:26985108

  7. Association between 5-HT2A, TPH1 and GNB3 genotypes and response to typical neuroleptics: a serotonergic approach

    Directory of Open Access Journals (Sweden)

    Kampman Olli

    2007-05-01

    Full Text Available Abstract Background Schizophrenia is a common psychiatric disease affecting about 1% of population. One major problem in the treatment is finding the right the drug for the right patients. However, pharmacogenetic results in psychiatry can seldom be replicated. Methods We selected three candidate genes associated with serotonergic neurotransmission for the study: serotonin 2A (5-HT2A receptor gene, tryptophan hydroxylase 1 (TPH1 gene, and G-protein beta-3 subunit (GNB3 gene. We recruited 94 schizophrenia patients representing extremes in treatment response to typical neuroleptics: 43 were good responders and 51 were poor responders. The control group consisted of 392 healthy blood donors. Results We do, in part, replicate the association between 5-HT2A T102C polymorphism and response to typical neuroleptics. In female patients, C/C genotype was significantly more common in non-responders than in responders [OR = 6.04 (95% Cl 1.67–21.93, p = 0.005] or in the control population [OR = 4.16 (95% CI 1.46–11.84, p = 0.005]. TPH1 A779C C/A genotype was inversely associated with good treatment response when compared with non-responders [OR = 0.59 (95% Cl 0.36–0.98, p = 0.030] or with the controls [OR = 0.44 (95% CI 0.23–0.86, p = 0.016], and GNB3 C825T C/T genotype showed a trend-like positive association among the male patients with a good response compared with non-responders [OR = 3.48 (95% Cl 0.92–13.25, p = 0.061], and a clearer association when compared with the controls [OR = 4.95 (95% CI 1.56–15.70, p = 0.004]. Conclusion More findings on the consequences of functional polymorphisms for the role of serotonin in the development of brain and serotonergic neurotransmission are needed before more detailed hypotheses regarding susceptibility and outcome in schizophrenia can be formulated. The present results may highlight some of the biological mechanisms in different courses of schizophrenia between men and women.

  8. The effect of life skills education on the mental health of First year student in Ilam university of medical science in 2013 year

    Directory of Open Access Journals (Sweden)

    L Naseri

    2015-12-01

    Full Text Available Introduction: The rapid socio-cultural changes, i.e. changing the structure of the family and human lifestyle can change the humans with various issues. The deals with these changes require psycho-social abilities. In the present paper it had been reviewed the effect of educating life skills on the mental health of students of Ilam University of medical sciences. Methods: This is a quasi-experimental research using post and pre tests. In this study, 61 freshmen were selected through stratified random sampling method in 2013. From this population, 34 ones were in the experimental group and 27 in the control group. For data collection, the general health questionnaire of Goldberg was used. The data were analyzed using SPSS20 software. The univariate analysis of covariance and multivariate analysis of covariance and paired T-test were analyzed. Results: The results showed that based on univariate analysis there was a significant correlation between the experimental and control groups in the scales of physical  symptoms (p = 0.002, social dysfunction symptoms (p = 0.001 and depression symptoms  (p = 0.048, but there was not a significant relationship in the scale of anxiety symptoms (p = 0.174. Multivariate analysis of covariance showed that there are significance deference between the subscales of mental health in experimental and control groups (P=.002. According to the analysis of paired t-test in the experimental group, life skill decreased the mean of scores in posttest compared to the pretest in the scales of the physical (p=0.001, anxiety (p=0.006, social dysfunction (0.017 and depression (p=0.001. Conclusion: Life skills training had an effect on reducing the impact of students' mental health scores. Training of these kinds of skills causes the progress among the freshmen.

  9. Integrating Client and Clinician Perspectives on Psychotropic Medication Decisions: Developing a Communication-Centered Epistemic Model of Shared Decision Making for Mental Health Contexts.

    Science.gov (United States)

    Mikesell, Lisa; Bromley, Elizabeth; Young, Alexander S; Vona, Pamela; Zima, Bonnie

    2016-01-01

    Shared decision making (SDM) interventions aim to improve client autonomy, information sharing, and collaborative decision making, yet implementation of these interventions has been variably perceived. Using interviews and focus groups with clients and clinicians from mental health clinics, we explored experiences with and perceptions about decision support strategies aimed to promote SDM around psychotropic medication treatment. Using thematic analysis, we identified themes regarding beliefs about participant involvement, information management, and participants' broader understanding of their epistemic expertise. Clients and clinicians highly valued client-centered priorities such as autonomy and empowerment when making decisions. However, two frequently discussed themes revealed complex beliefs about what that involvement should look like in practice: (a) the role of communication and information exchange and (b) the value and stability of clinician and client epistemic expertise. Complex beliefs regarding these two themes suggested a dynamic and reflexive approach to information management. Situating these findings within the Theory of Motivated Information Management, we discuss implications for conceptualizing SDM in mental health services and adapt Siminoff and Step's Communication Model of Shared Decision Making (CMSDM) to propose a Communication-centered Epistemic Model of Shared Decision Making (CEM-SDM).

  10. You're it! How to psychologically survive an internal investigation, disciplinary proceeding, or legal action in the police, fire, medical, mental health, legal, or emergency services professions.

    Science.gov (United States)

    Miller, Laurence

    2009-01-01

    Rightly or wrongly, law enforcement, public safety, medical, mental health, legal, and emergency services professionals may have to face internal investigation, disciplinary measures, license suspension, criminal prosecution, civil lawsuits, and/or personal life disruption related to actions taken in the course of their work. This article describes the main categories of misconduct--or simply mistakes--that can cause different types of professionals to be investigated, charged, prosecuted, and/or sued. It next discusses the kinds of psychological reactions commonly seen in workers who face these kinds of proceedings. Finally, the article offers a set of practical psychological coping strategies and procedural recommendations for dealing with the stresses of an investigation, administrative action, or litigation, and for mitigating their effects on one's life and career.

  11. Catatonia, Neuroleptic Malignant Syndrome, and Cotard Syndrome in a 22-Year-Old Woman: A Case Report

    Directory of Open Access Journals (Sweden)

    C. Weiss

    2013-01-01

    Full Text Available The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as “I do not have a heart,” “my heart is not beating,” “I can not breathe,” “I am breaking apart,” “I have no head” (ideas of negation and statements about the patient being responsible for the “death of the whole world” (ideas of enormity. Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  12. Prediction of Neurocognitive Deficits by Parkinsonian Motor Impairment in Schizophrenia: A Study in Neuroleptic-Naïve Subjects, Unaffected First-Degree Relatives and Healthy Controls From an Indigenous Population.

    Science.gov (United States)

    Molina, Juan L; González Alemán, Gabriela; Florenzano, Néstor; Padilla, Eduardo; Calvó, María; Guerrero, Gonzalo; Kamis, Danielle; Stratton, Lee; Toranzo, Juan; Molina Rangeon, Beatriz; Hernández Cuervo, Helena; Bourdieu, Mercedes; Sedó, Manuel; Strejilevich, Sergio; Cloninger, Claude Robert; Escobar, Javier I; de Erausquin, Gabriel A

    2016-11-01

    Neurocognitive deficits are among the most debilitating and pervasive symptoms of schizophrenia, and are present also in unaffected first-degree relatives. Also, multiple reports reveal parkisonian motor deficits in untreated subjects with schizophrenia and in first-degree relatives of affected subjects. Yet, the relation between motor and cognitive impairment and its value as a classifier of endophenotypes has not been studied. To test the efficacy of midbrain hyperechogenicity (MHE) and parkinsonian motor impairment (PKM) as predictors of neurocognitive impairment in subjects with or at risk for schizophrenia, that could be used to segregate them from first-degree relatives and healthy controls. Seventy-six subjects with chronic schizophrenia never exposed to antipsychotic medication, 106 unaffected first-degree relatives, and 62 healthy controls were blindly assessed for cognitive and motor function, and transcranial ultrasound. Executive function, fluid intelligence, motor planning, and hand coordination showed group differences. PKM and MHE were significantly higher in untreated schizophrenia and unaffected relatives. Unaffected relatives showed milder impairment, but were different from controls. PKM and MHE predict cognitive impairment in neuroleptic-naive patients with schizophrenia and their unaffected first-degree relatives and may be used to segregate them from first-degree relatives and healthy controls. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. Monitoring and documentation of side effects from depot antipsychotic medication: an interdisciplinary audit of practice in a regional mental health service.

    LENUS (Irish Health Repository)

    Cleary, A

    2012-01-01

    The aim of this audit was to review current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. Following a review of the literature on best practice internationally, an evidence based audit tool was adapted. A sample of 60 case files, care plans and prescriptions were audited between January and May 2010. This represented 31% of the total number of service users receiving depot injections in the mental health service region (n=181). The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only 5 (8%) case notes examined had documentation recorded describing the condition of the injection site and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded, and only 3 (5%) of case notes had documented that information on the depot injection and side effects was given. In 57 (95%) of case notes no documentation of recorded information on the depot and on side effects was given. Documentation of physical observations and tests revealed that 58% of cases had full blood count, liver function tests, thyroid function tests and fasting lipids recorded. All other tests (i.e. temperature, pulse, respirations, blood pressure, ECG) were recorded in less than 50% of cases. Prolactin levels were not recorded in any case. The lack of written consent was partly attributed to lack of recording of consent. The failure to monitor and record some\\r\

  14. [Comparison of lifestyle, mental stress, and medical check-up results between Tanshin-funin workers and workers living with their families].

    Science.gov (United States)

    Moriyama, Yoko; Toyokawa, Satoshi; Kobayashi, Yasuki; Inoue, Kazuo; Suyama, Yasuo; Sugimoto, Nanako; Miyoshi, Yuji

    2012-01-01

    We conducted a comparative analysis of lifestyle, mental stress, and medical check-up results between tanshin-funin workers and workers living with their families. Study participants were 3,026 married men, aged 40-59 yr, who worked at a large financial firm in Japan. Tanshin-funin was defined as married men separated from their families due to workplace assignments, as determined by a self-administered questionnaire in 2004. Participants' lifestyle factors, including exercise, alcohol and smoking consumption, and dietary habits, and mental stress, including lack of vigor, irritability, fatigue, anxiety, depressed mood, and physical complaints, were examined using a self-administered questionnaire. Medical check-ups conducted in 2004 included measurements of BMI, SBP, DBP, FBS, GOT, GPT, γ-GTP, TC, TG, HDL, RBC, and WBC. An analysis of lifestyle factors, using the χ(2) test, indicated that fewer tanshin-funin workers exercise, and that they had fewer regularly-scheduled meals. Tanshin-funin workers smoked more and consumed more alcohol, but ate fewer green and yellow vegetables. Tanshin-funin workers had fewer commuting hours and took fewer days off. Tanshin-funin workers also suffered more frequently from irritability and anxiety. A regression analysis, adjusted for age and smoking status, indicated that levels of TC, TG, and WBC for tanshin-funin workers were higher than workers living with their families. The lifestyle habits of tanshin-funin workers, such as dietary habits, were worse than those of workers living with their families, and tanshin-funin workers suffered from more irritability and anxiety. Clinical markers, such as dyslipidemia, were worse among tanshin-funin workers than among workers living with their families.

  15. Population Screening for Coronary Artery Calcification Does Not Increase Mental Distress and the Use of Psychoactive Medication

    DEFF Research Database (Denmark)

    Nielsen, Anders Daldorph; Videbech, Poul; Gerke, Oke

    2012-01-01

    as a result of the observations were at the discretion of the individual general practitioner. Before screening and at 6-month follow-up a depression test (Major Depression Inventory) was conducted, and the use of psychoactive medication was recorded. RESULTS:: A total of 1257 (69%) subjects agreed...

  16. Inpatient Mental Health Recapture

    Science.gov (United States)

    2009-08-07

    FINAL REPORT DATES COVERED (From - To) JULY 2008 TO AUG 2009 4. TITLE AND SUBTITLE lnpatient Mental Health Recapture 5a. CONTRACT NUMBER 5b...provides 28 Medical/Surgical inpatient beds, 6 ICU beds, and full spectrum outpatient clinical services (Table l). EACH maintained inpatient mental health...Global War on Terrorism (GWOT), EACH experienced a significant increase in the amount of inpatient mental health purchased in the Colorado Springs

  17. Electronic medical record analysis of emergency room visits and hospitalizations in individuals with epilepsy and mental illness comorbidity.

    Science.gov (United States)

    Sajatovic, Martha; Welter, Elisabeth; Tatsuoka, Curtis; Perzynski, Adam T; Einstadter, Douglas

    2015-09-01

    Epilepsy is a chronic neurological condition that significantly increases risk of injury and premature death. Rates of mental illness are also disproportionately high in those with epilepsy, which can be attributed in part to the stress and stigma associated with epilepsy. Psychiatric conditions generally complicate the management of epilepsy, and understanding how psychiatric comorbidity affects use of crisis-based health resources could inform care approaches that help improve epilepsy care. To better understand effects of psychiatric comorbidity on epilepsy burden, we conducted a 5-year retrospective analysis of data from a large safety-net healthcare network and compared the occurrence of negative health events (NHEs), defined as emergency department (ED) visits and hospitalizations, among individuals with epilepsy and mental illness (E-MI) vs. those with epilepsy alone (E). Electronic health record (EHR) data from a large Midwestern U.S. safety-net healthcare system were queried to identify a study population of adults ≥18years with a diagnosis of epilepsy, with or without mental illness. We assessed demographic and clinical characteristics for each of the 5years and compared NHEs between subgroups with E-MI vs. E. An additional analysis focused on those individuals who remained in the healthcare system over the entire 5-year study time frame (January, 2010 to December, 2014). Annual and cumulative NHE counts and hospital length of stay for individuals with E-MI and E were assessed, as were hospital discharge diagnoses. The number (approximately 2000) and demographic characteristics of individuals with epilepsy who received care each year of the study period was relatively consistent. In 2014, mean age of individuals with epilepsy was 48 (range: 18-95), 48.2% were women, 51.5% were White, 37.9% were African-American, and 8.6% were Hispanic. In 2014, there were 1616 (78.6%) individuals in the subgroup with E and 439 (21.4%) in the subgroup with E-MI. Most

  18. The Relationship Between Religious Beliefs and Mental Health in Students of Alborz University of Medical Sciences and Health Services and Karaj Islamic Azad University in 92-93

    Directory of Open Access Journals (Sweden)

    M. Darvishi

    2017-06-01

    Full Text Available Introduction and Goal: We as a society in transition countries grapple with issues. Including the issues of youth unemployment, the economic, social, cultural and others. The increasing tendency of students to imitate the western culture And the duplication of a part of western culture and identity today emptiness of the west And moral collapse brought and glamor that can be said for our youth no entertainment, sports and leisure programs for their healthy catchy and their needs and the vacuum created in imitation of the vulgar aspects of western culture that quickly spread in our society to our young people away from having ideas is healthy and know the distance of this group of noble and religious values. students based on academic and social issues specific pressure groups are at risk. According to Islamic texts adherence to religious beliefs can be a deterrent lot of mental illness. increased attention to this issue across the world, the importance of religion and represents a return to religion and spirituality. According to the study on health and religion is still in its infancy and mental health in ensuring the dynamics of this segment of society that is dependent on medical students is important, It seems that the implementation of such researches to improve the level of social and religious knowledge students have an important role. Methods: This cross-sectional study (descriptive - analysis, the population of all students studying medical sciences universities in Tehran and Karaj Islamic Azad form. of the population. According to the study, the sample of 377 randomly selected subjects and to prevent the loss of samples, ten percent was added to the sample (415 people and of these 404 people filled out the questionnaire responded. Three demographic information, general health and religious beliefs to collect data in order to achieve the objectives of the study were analyzed using descriptive statistics. After data collection, data

  19. Transtornos mentais comuns entre os estudantes do curso de medicina: prevalência e fatores associados Common mental disorders in medical students: prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Karoline Pedroti Fiorotti

    2010-01-01

    Full Text Available Objetivo: O objetivo do estudo foi estimar a prevalência de transtornos mentais comuns (TMC entre os estudantes do curso de medicina da UFES e avaliar possíveis correlações entre TMC e fatores de risco. Métodos: Estudo transversal realizado de setembro a novembro de 2007 envolvendo 229 alunos do curso de medicina. O questionário utilizado foi autoaplicável e anônimo. Foram coletados dados socioeconômicos, informações sobre o curso, o processo de ensino-aprendizagem e a rede de apoio social. Para o rastreamento de TMC, utilizou-se o Self-Reporting Questionnaire (SRQ-20. Resultados: A prevalência total de TMC encontrada foi de 37,1% (IC 95%, 30,8%-43,4%, que esteve independentemente associada a não receber o apoio emocional necessário (OR = 7,4, IC 95%, 3,1-17,9 e relatar "dificuldade para tirar dúvidas em sala de aula por timidez" durante a infância ou adolescência (OR = 2,5, IC 95%, 1,0-6,1. Conclusão: Os dados demonstram elevada prevalência de TMC nessa população e a importância em subsidiar ações para prevenção e cuidado com a saúde mental dos estudantes, melhorando a qualidade de vida deles.Objective: The goal of this study was to estimate the prevalence of Common Mental Disorders (CMD in medical students from Universidade Federal do Espírito Santo and evaluate possible correlation among CMD and risk factors. Methods: A cross-sectional study performed from September to November 2007 enrolled 229 medical students. A self-applicable and anonymous questionnaire was used. Information on socioeconomic characteristics, about the course, teaching-learning process and support assistance were collected. CMD was screened by SRQ-20 questionnaire. Results: Global prevalence was 37.1% (IC 95%, 30.8%-43.4% and it was independent correlated to not receiving sufficient emotional support (OR = 7.4, IC 95%, 3.1-17.9 and report "difficulties for asking questions during classes, by shyness" during childhood and adolescence (OR = 2

  20. Prevalência e fatores de risco para transtornos mentais comuns entre estudantes de medicina Prevalence and risk factors of common mental disorders among medical students

    Directory of Open Access Journals (Sweden)

    Maria Cristina Pereira Lima

    2006-12-01

    Full Text Available OBJETIVO: Estimar a prevalência de transtornos mentais comuns entre estudantes de medicina e respectivos fatores de risco. MÉTODOS: Estudo transversal realizado com 551 universitários de um curso de medicina de Botucatu, SP. Utilizou-se questionário auto-aplicável investigando aspectos sócio demográficos, relacionados ao curso e o Self Reporting Questionnaire. Para análise dos dados empregaram-se os testes de qui-quadrado e regressão logística. RESULTADOS: Participaram 82,6% dos alunos matriculados no curso, predominando mulheres (61%, jovens (60% 20-23 anos, procedentes de outros municípios (99%. A prevalência de transtornos mentais comuns foi de 44,7% associando-se independentemente a: dificuldade para fazer amigos (RC=2,0, avaliação ruim sobre desempenho escolar (RC=1,7, pensar em abandonar o curso (RC=5,0, não receber o apoio emocional de que necessita (RC=4,6. Embora na primeira análise a prevalência tenha se mostrado associada ao ano do curso, esta associação não se manteve na análise multivariada. CONCLUSÕES: A prevalência de transtornos mentais comuns mostrou-se elevada entre os estudantes de medicina, associando-se a variáveis relacionadas à rede de apoio. As experiências emocionalmente tensas como o contato com pacientes graves, formação de grupos, entre outras, vividas nos últimos anos do curso, são provavelmente potentes estressores, especialmente para sujeitos com uma rede de apoio considerada deficiente. Sugere-se que instituições formadoras estejam atentas a esse fato, estabelecendo intervenções voltadas ao acolhimento e ao cuidado com o sofrimento dos estudantes.OBJECTIVE: To estimate the prevalence and assess risk factors of common mental disorders among medical students. METHODS: A cross-sectional study was carried out comprising 551 university medical students in the state of São Paulo, Southeastern Brazil. A self-administered questionnaire to collect sociodemographic and course-related data

  1. Behavioral and Mental Healthcare: Total Warrior Care Commitment. U.S. Army Medical Department Journal, July-September 2008

    Science.gov (United States)

    2008-09-01

    Finkelhor D, Kendall-Tackett KA. Developmental perspective on the childhood impact of crime , abuse and violent victimization. In: Cicchetti D, Toth S...and organizations , and other members of the medical community worldwide. Perspective Major General Russell J. Czerw From the beginning of the...recorded history of campaigns and combat between organized armies, wars and battles were usually characterized in terms of glory and pride, focused on

  2. [Narratives in the study of mental health care practices: contributions of the perspectives of Paul Ricoeur, Walter Benjamin and of medical anthropology].

    Science.gov (United States)

    Onocko-Campos, Rosana Teresa; Palombini, Analice de Lima; Leal, Erotildes; de Serpa, Octavio Domont; Baccari, Ivana Oliveira Preto; Ferrer, Ana Luiza; Diaz, Alberto Giovanello; Xavier, Maria Angélica Zamora

    2013-10-01

    Narratives are ever more frequent in qualitative studies seeking to interpret experiences and the different viewpoints of individuals in a given context. Starting from this concept, the tradition that addresses narrative is reexamined, including the philosophy of Paul Ricoeur, the historical perspective of Walter Benjamin and the field of medical anthropology grounded in phenomenology. In Ricoeur, with hermeneutics as a variation derived from phenomenology, narrative is linked to temporality. In Benjamin, narrative comprised of bits and pieces, always inconclusive, emerges in spite of the official stories. If Ricoeur retrieves tradition from Gadamer as a fundamental component for the construction of the world of a text that makes imitation of life possible, Benjamin, faced with the collapse of tradition, suggests the invention of narrative forms outside the traditional canons, making it possible to hark to the past in order to change the present. Assumptions of medical anthropology are also presented, as they consider narrative a dimension of life and not its abstraction, namely an embodied and situated narrative. Lastly, three distinct research projects in mental health that use narrative linked to the theoretical concepts cited with their differences and similarities are presented.

  3. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

    Full Text Available Abstract Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home, or days spent in the same care home (if admitted from a care home. Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of

  4. Defining Medically Necessary Services To Protect Children. Protecting Consumer Rights in Public Systems: Managed Mental Health Care Policy. A Series of Issue Papers on Contracting for Managed Behavioral Health Care, #5.

    Science.gov (United States)

    Bazelon Center for Mental Health Law, Washington, DC.

    This issue paper is designed to help families, advocates and policymakers ensure that "medically necessary" standards in public-sector contracts for managed mental health care protect children's rights, particularly the rights of children who have serious emotional disturbance. Fundamental principles for developing sound contracts for…

  5. Context-dependent efficacy of a counter-conditioning strategy with atypical neuroleptic drugs in mice previously sensitized to cocaine.

    Science.gov (United States)

    Oliveira-Lima, A J; Marinho, Eav; Santos-Baldaia, R; Hollais, A W; Baldaia, M A; Talhati, F; Ribeiro, L T; Wuo-Silva, R; Berro, L F; Frussa-Filho, R

    2017-02-06

    We have previously demonstrated that treatment with ziprasidone and aripiprazole selectively inhibit the development of behavioral sensitization to cocaine in mice. We now investigate their effects on a counter-conditioning strategy in mice and the importance of the treatment environment for this phenomenon. Evaluate the context-specificity of ziprasidone and aripiprazole on conditioned locomotion to cocaine and cocaine-induced hyperlocomotion and behavioral sensitization in a counter-conditioning strategy in mice. Animals were sensitized with saline or cocaine injections in the open-field apparatus in a 15-day intermittent treatment and subsequently treated with vehicle, 5mg/kg ziprasidone or 0.1mg/kg aripiprazole paired to the open-field or the home-cage for 4 alternate days. Mice were then challenged with saline and cocaine in the open-field apparatus on subsequent days. While treatment with ziprasidone decreased spontaneous locomotion and conditioned locomotion alike, treatment with aripiprazole specifically attenuated the expression of conditioned hyperlocomotion to cocaine. Ziprasidone and aripiprazole had no effects on cocaine-induced conditioned hyperlocomotion observed during saline challenge after drug withdrawal. Treatment with either ziprasidone or aripiprazole when previously given in the cocaine-paired environment attenuated the subsequent expression of behavioral sensitization to cocaine. Animals treated with aripiprazole in the open-field, but not in the home-cage, showed a blunted response to cocaine when receiving a cocaine challenge for the first time. Both neuroleptic drugs showed a context-dependent effectiveness in attenuating long-term expression of cocaine-induced behavioral sensitization when administered in the cocaine-associated environment, with aripiprazole also showing effectiveness in blocking the expression of acute cocaine effects. Copyright © 2016. Published by Elsevier Inc.

  6. Receptor imaging of schizophrenic patients under treatment with typical and atypical neuroleptics; Nuklearmedizinische Rezeptordiagnostik bei schizophrenen Patienten unter Therapie mit typischen und atypischen Neuroleptika

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin der Ludwig-Maximilians-Univ. Muenchen (Germany); Meisenzahl, E. [Psychiatrische Klinik der Ludwig-Maximilians-Univ. Muenchen (Germany); Scherer, J. [Bezirkskrankenhaus Haar (Germany)

    2002-09-01

    Schizophrenic psychosis is typically treated by typical and atypical neuroleptics. Both groups of drugs differ with regard to induction of extrapyramidal side effects. The occupancy of postsynaptic dopaminergic D2 receptors is considered to be an essential aspect of their antipsychotic properties. The dopamine D2 receptor status can be assessed by means of [I-123]IBZM SPECT. Studies on the typical neuroleptic haloperidol revealed an exponential dose response relationship measured by IBZM. Extrapyramidal side effects were presented by all patients below a threshold of the specific binding of IBZM below 0.4 (with one exception, norm value: >0.95). Also under treatment with the atypical neuroleptic clozapine an exponential dose response relationship was found. However, none of these patients showed extrapyramidal side effects. Recently introduced, new atypical neuroleptics such as risperidone and olanzapine again presented with an exponential relationship between daily dose and IBZM binding. The curves of the latter were in between the curves of haloperidol and clozapine. Extrapyramidal side effects were documented in a less number of patients treated with risperidone as compared to haloperidol, for olanzapine only one patient revealed these findings in our own patient group. The pharmacological profile of atypical neuroleptics shows - in addition to their binding to dopamine receptors - also high affinities to the receptors of other neurotransmitter systems, particularly the serotonergic system. Therefore, the lower incidence of extrapyramidal side effects seen by atypical in comparison to typical neuroleptics is at least in part most likely due to a complex interaction on a variety of neurotransmitter systems. (orig.) [German] Die pharmakologische Therapie von Erkrankungen aus dem schizophrenen Formenkreis erfolgt durch typische und atypische Neuroleptika. Beide Gruppen unterscheiden sich klinsich im Wesentlichen durch die Eigenschaft, extrapyramidal

  7. [Effects of Mental Disorders on the Academic Outcomes of University Students--A Retrospective Study Using Medical Records from a Health Services Center].

    Science.gov (United States)

    Ishii, Terumi; Tachikawa, Hirokazu; Hori, Takafumi; Ishikawa, Masanori; Hatanaka, Kimitaka; Aiba, Miyuki; Asada, Takashi

    2015-01-01

    Falling behind in class is a serious problem for university students as it can lead to social problems and increase the risk of suicide. Although it is common for students suffering from mental disorders to fall behind academically, there have been few studies investigating the difficulties these students face in order to graduate from university. Therefore, we investigated factors associated with dropping out of school with the purpose of creating a strategy to improve the academic outcomes of students who regularly seek psychiatric consultation. We investigated undergraduate students who received consultation at Tsukuba University's Health Services Center Psychiatry Department and whose academic outcomes between the 2004 and 2013 academic years were known. Academic outcomes were obtained from Tsukuba University's grade management system by permission of the authority. The students were divided into either a graduate or dropout group depending on their academic outcomes. The medical records for both groups were retrospectively investigated, and factors that were predicted to affect academic outcomes were assessed using statistical methods. The dropout group was younger in grade and had a greater severity of illness at initial consultation. Moreover, this group had a greater number of consultation visits, showed less cooperation with the instructor in charge, had a significantly longer duration of social with drawal and temporary leave of absence from school, and had a significantly greater number of students with grade retention. When a time factor was incorporated in the analysis, the presence of grade retention/temporary leave of absence from school and social withdrawal was significantly correlated with dropping out of school. It was revealed that not only the mental disorder itself, but also psychosocial severity and the maladjusted state that occur secondary to such mental disorder influence academic outcomes. These results indicated that in order to improve

  8. Mental health parity legislation.

    Science.gov (United States)

    Smaldone, Arlene; Cullen-Drill, Mary

    2010-09-01

    Although recognition and treatment of mental health disorders have become integrated into routine medical care, inequities remain regarding limits on mental health outpatient visits and higher copayments and deductibles required for mental health services when accessed. Two federal laws were passed by Congress in 2008: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and the Medicare Improvements for Patients and Providers Act. Both laws became effective on January 1, 2010. The purpose of this article is to discuss provisions of each act and provide clinical examples describing how patients are affected by lack of parity and may potentially benefit from implementation of these new laws. Using available evidence, we examine the potential strengths and limitations of mental health parity legislation from the health policy perspectives of health care access, cost, and quality and identify the important role of nurses as patient and mental health parity advocates. Copyright 2010, SLACK Incorporated.

  9. Chronic diseases and mental disorder.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Heijmans, M.J.W.M.; Peters, L.; Rijken, M.

    2005-01-01

    The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease

  10. The primary health care version of ICD-11: the detection of common mental disorders in general medical settings.

    Science.gov (United States)

    Goldberg, David P; Prisciandaro, James J; Williams, Paul

    2012-01-01

    The primary health care version of the ICD-11 is currently being revised. To test two brief sets of symptoms for depression and anxiety in primary care settings, and validate them against diagnoses of major depression and current generalised anxiety made by the CIDI. The study took place in general medical or primary care clinics in 14 different countries, using the Composite International Diagnostic Interview adapted for primary care (CIDI-PC) in 5,438 patients. The latent structure of common symptoms was explored, and two symptom scales were derived from item response theory (IRT), these were then investigated against research diagnoses. Correlations between dimensions of anxious, depressive and somatic symptoms were found to be high. For major depression the 5 item depression scale has marked superiority over the usual 2 item scales used by both the ICD and DSM systems, and for anxiety there is some superiority. If the questions are used with patients that the clinician suspects may have a psychological disorder, the positive predictive value of the scale is between 78 and 90%. The two scales allow clinicians to make diagnostic assessments of depression and anxiety with a high positive predictive value, provided they use them only when they suspect that a psychological disorder is present. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Hydrotherapy in state mental hospitals in the mid-twentieth century.

    Science.gov (United States)

    Harmon, Rebecca Bouterie

    2009-08-01

    This research describes nurses' experiences in administering "the water cure," hot or cold wet sheet packs, and continuous tub baths in state mental hospitals during the early twentieth century. Student and graduate nurses were required to demonstrate competence in hydrotherapy treatments used to calm agitated or manic patients in the era before neuroleptics. The nurses interviewed for this study indicated that, although labor intensive, hydrotherapy worked, at least temporarily. Although no longer used in state hospitals, hydrotherapy is regaining popularity with the general public and may serve as an adjunct to pharmacological treatments to calm hospitalized patients in the future.

  12. World Trade Center-related physical and mental health burden among New York City Fire Department emergency medical service workers.

    Science.gov (United States)

    Yip, Jennifer; Zeig-Owens, Rachel; Webber, Mayris P; Kablanian, Andrea; Hall, Charles B; Vossbrinck, Madeline; Liu, Xiaoxue; Weakley, Jessica; Schwartz, Theresa; Kelly, Kerry J; Prezant, David J

    2016-01-01

    To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Somali Refugees' Perceptions of Mental Illness.

    Science.gov (United States)

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  14. Neurolépticos en el tratamiento de la esquizofrenia paranoide del paciente hospitalizado Neuroleptic drugs for the treatment of paranoid squizophrenia in the hospitalizad patient

    Directory of Open Access Journals (Sweden)

    Ismary González Hernánde

    2008-12-01

    Full Text Available Se realizó un estudio de utilización de medicamentos: indicación-prescripción, con elementos de consumo y consecuencias prácticas en el Hospital Psiquiátrico de Santa Clara durante el año 2006. Se elaboró un formulario con datos como: edad, sexo, tiempo de evolución, neurolépticos usados, estadía hospitalaria y precio de los medicamentos por unidad. Se propuso describir el uso de neurolépticos en el manejo de la esquizofrenia paranoide del paciente hospitalizado, contrastar el número de neurolépticos utilizados según estadía hospitalaria y tiempo de evolución, así como los costos del tratamiento en estos pacientes. El análisis se realizó mediante pruebas paramétricas y no paramétricas, con un nivel de significación de 0,01 ó 0,05. Como resultados relevantes se observaron que los fármacos usados con mayor frecuencia fueron flufenacina y clorpromacina. La combinación más empleada resultó ser la flufenacina y clorpromacina. El grupo de pacientes con más de 63 días de estadía hospitalaria, mostró el más alto gasto promedio en medicamentos. Se concluyó que los neurolépticos más utilizados fueron la flufenacina, la clorpromacina y el levomepromacina. Existe asociación entre el número de neurolépticos utilizados y el tiempo de evolución de la enfermedad. La estadía hospitalaria constituye el indicador que más encareció la terapéutica del paciente esquizofrénico.A drug use evaluation study that considered prescription, consumption elements and practical consequences was carried out in the Psychiatric Hospital of Santa Clara city in Villa Clara province during 2006. A form to collect data such as age, sex, time of evolution, neuroleptic drugs used, stay at hospital and price of drug per unit was made. The objective was to describe the use of neuroleptic drugs in the management of paranoid squizophrenia of the hospitalized patient, to compare the number of neuroleptic drugs that was used according to stay at

  15. What inhibits working women with mental disorders from returning to their workplace?-A study of systematic re-employment support in a medical institution.

    Science.gov (United States)

    Hayashi, Karin; Taira, Yoichi; Maeda, Takamitsu; Matsuda, Yumie; Kato, Yuki; Hashi, Kozue; Kuroki, Nobuo; Katsuragawa, Shuichi

    2016-01-01

    It has been customary for working women in Japan to retire when they marry and to devote themselves to household work as well as having children. However, according to a report published by the Ministry of Internal Affairs and Communications in 2013, the number of working women has increased consistently. As more women are advancing into society, they have more options with respect to lifestyle but may encounter new psychological burdens. Therefore, we reviewed trends among participants in a re-work day care program (hereinafter referred to as "re-work program") to clarify various problems encountered by working women and the prevalence of mental disorders. A total of 454 participants (352 males, mean age 46.5 ± 9.4 years; 102 females, mean age 39.8 ± 9.4 years) who participated in our re-work program were included in this study. We reviewed their basic characteristics: life background, clinical diagnoses, outcomes after use of the re-work program, and reasons for failing to return to the workplace or start working where applicable. The number of female participants was small and accounted for less than one fourth of all participants. As many as 67.3 % of the males succeeded in returning to the workplace, but only 48.0 % of the females were successful. The most common reason for failing to return to the workplace in both sexes was the exacerbation of symptoms; among females, other reasons, such as pregnancy, marriage, and family circumstances, were observed occasionally, but these reasons were not reported by the males. We found that female-specific problems were not the only issue, but rather work-life balance, relationships in the workplace, and gender differences in work roles could also trigger psychiatric disorders. A deeper understanding of the problems encountered by women in the workforce is important for the treatment of their psychiatric disorders. Therefore, it is considered essential for family members, co-workers, medical staff, and

  16. Neuroleptic Malignant Syndrome

    Science.gov (United States)

    ... Skeletal Syndrome (COFS) Information Page Charcot-Marie-Tooth Disease Information Page Chorea Information Page Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Information Page Coffin Lowry Syndrome Information ...

  17. Educational, developmental and psychological outcomes of resettled refugee children in Western Australia: a review of School of Special Educational Needs: Medical and Mental Health input.

    Science.gov (United States)

    Mace, Ariel Olivia; Mulheron, Shani; Jones, Caleb; Cherian, Sarah

    2014-12-01

    There are limited data regarding the educational backgrounds and associated psychological and developmental outcomes of refugee children resettling in Western Australia (WA). The WA paediatric Refugee Health Service (RHS) revised its first consult questionnaire (August 2011) to increase educational and psychosocial documentation, concurrent with engagement of a School of Special Educational Needs: Medical and Mental Health (SSEN: MMH) liaison teacher. This study aims to utilise these data to increase understanding of this cohort's educational, developmental and psychological needs and to describe SSEN: MMH's role within the RHS. Retrospective audit and analyses were performed on all initial standardised questionnaires for school-aged refugee children (4-18 years) and SSEN: MMH referrals between August 2011 and December 2012. Demographic data from 332 refugees are described (mean age 9.58 ± standard deviation 3.43 years). Detailed educational information was available for 205 children. Prior education was limited (median 2 years), 64.9% experienced likely schooling interruption and 55.8% received education in their primary language. Language development concerns were significantly associated with previous education in a second language (odds ratio (OR) 4.55, P education. In contrast, several migration factors, including family separation and mandatory detention, were significantly associated with psychological comorbidities such as post-traumatic stress disorder (OR 5.60, P educational, developmental and psychological concerns. Refugee children have varied migration, trauma and educational backgrounds, impacting on health and psychological outcomes. In-depth multidisciplinary history including prior education and psychosocial issues is recommended. Partnering with education services appears to play an effective, multifaceted role in aiding resettlement; however, longitudinal studies are required. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014

  18. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data

    NARCIS (Netherlands)

    van Melle, M.A.; Lamkaddem, M.; Stuiver, M.M.; Gerritsen, A.A.M.; Devillé, W.L.J.M.; Essink-Bot, M.-L.

    2014-01-01

    Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we

  19. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

    NARCIS (Netherlands)

    Melle, M.A. van; Lamkaddem, M.; Stuiver, M.M.; Gerritsen, A.A.M.; Devillé, W.L.J.M.; Essink-Bot, M.L.

    2014-01-01

    Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we

  20. Psychometric properties of the Subjective Well-Being Under Neuroleptics Scale and the Subjective Deficit Syndrome Scale

    NARCIS (Netherlands)

    de Haan, L.; Weisfelt, M.; Dingemans, P. M. A. J.; Linszen, D. H.; Wouters, L.

    2002-01-01

    Rationale: Subjective experience of antipsychotic drugs is relevant for medication compliance and quality of life. There is, however, sparse knowledge about the assessment of subjective experience. Objectives: To examine the internal consistency, test-retest reliability, sensitivity to medication

  1. De la ética médica a la legislación en salud mental: tendencias actuales y realidad cubana From Medical Ethics up to Mental Health legislation. Current trends and Cuban actuality

    Directory of Open Access Journals (Sweden)

    Jorge Tomas Balseiro Estevez

    2007-08-01

    Full Text Available Se presentan algunas consideraciones sobre algunos aspectos éticos en salud mental, los enfermos y la enfermedad mental, las frecuentes violaciones de los códigos y normas internacionales, entre las tendencias actuales del mundo contemporáneo en esta importante temática, al tiempo que se reflexiona en los principales aspectos que según la OMS constituyen recomendaciones a tener en cuenta en la confección y diseño de la legislación en salud mental, por la importancia que ello tiene en la materialización de los planes y políticas en este sentido. Se presenta el contraste de la realidad cubana actual, a tono con la cultura profesional y social alcanzada en nuestro país en estos años de Revolución en relación con la Salud Mental, los contundentes logros que hoy se exhiben con resultados palpables reconocidos a nivel mundial, aun cuando se señalan algunas insuficiencias en la legislación existente, aludiendo a las imperfecciones, brechas, y algunos aspectos susceptibles de nuevos enfoques, los que tienen que ver con los problemas que dominan el cuadro actual de la salud mental, sugiriendo su revisión. Motivar que reflexionemos en el orden ético con una mirada diferente acorde a las circunstancias que hoy enfrentamos, propiciará que nuevas ideas iluminen el camino para mejorar el bienestar, los derechos y la calidad de vida de los enfermos mentales en nuestras sociedadesSome considerations are presented on some ethical aspects in mental health, the sick persons and the mental illness, the frequent violations of the codes and international norms, among the current tendencies of the contemporary world in this important one thematic, at the time that is meditated in the main aspects that constitute recommendations to keep in mind in the making and design of the legislation in mental health according to the OMS, by the importance that has it in the materialization of the plans and political in this sense. The contrast of the current

  2. Medical image of the week: prozac eyes

    Directory of Open Access Journals (Sweden)

    Shetty S

    2015-12-01

    Full Text Available A 59-year-old man with a past medical history significant for hypertension, obesity and depression underwent an overnight polysomnogram for high clinical suspicion for obstructive sleep apnea. His current medications include doxepin, fluoxetine, bupropion, ambien and amlodipine. A snapshot during NREM sleep is shown (Figure 1. Fluoxetine (Prozac® is a potent selective serotonin reuptake inhibitor (SSRI.“Omnipause” neurons in the brainstem inhibit saccadic eye movements. NREM eye movements result from the potentiation of serotonergic neurons that inhibit these neurons (1. These eye movements occur during all stages of NREM sleep. These atypical eye movements have been reported to be present with a lower incidence with use of other antidepressants, benzodiazepines and neuroleptics and they tend to persist even after discontinuation of the medication (2. The clinical significance of these eye movements is unknown.

  3. Mental Illness

    Science.gov (United States)

    ... leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: Unhappiness and decreased enjoyment of life ...

  4. Mental Health

    Science.gov (United States)

    Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel and act as ... stress, relate to others, and make choices. Mental health is important at every stage of life, from ...

  5. Mental Disorders

    Science.gov (United States)

    Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play ...

  6. Revisiting the 'self-medication' hypothesis in light of the new data linking low striatal dopamine to comorbid addictive behavior.

    Science.gov (United States)

    Awad, A George; Voruganti, Lakshmi L N P

    2015-06-01

    Persons with schizophrenia are at a high risk, almost 4.6 times more likely, of having drug abuse problems than persons without psychiatric illness. Among the influential proposals to explain such a high comorbidity rate, the 'self-medication hypothesis' proposed that persons with schizophrenia take to drugs in an effort to cope with the illness and medication side effects. In support of the self-medication hypothesis, data from our earlier clinical study confirmed the strong association between neuroleptic dysphoria and negative subjective responses and comorbid drug abuse. Though dopamine has been consistently suspected as one of the major culprits for the development of neuroleptic dysphoria, it is only recently our neuroimaging studies correlated the emergence of neuroleptic dysphoria to the low level of striatal dopamine functioning. Similarly, more evidence has recently emerged linking low striatal dopamine with the development of vulnerability for drug addictive states in schizophrenia. The convergence of evidence from both the dysphoria and comorbidity research, implicating the role of low striatal dopamine in both conditions, has led us to propose that the person with schizophrenia who develops dysphoria and comorbid addictive disorder is likely to be one and the same.

  7. Mental Retardation: Construction Program.

    Science.gov (United States)

    Department of Health, Education, and Welfare, Washington, DC. Secretary's Committee on Mental Retardation.

    Federally funded construction programs for the retarded included are the following: 12 research centers in which biological, medical, social, and behavioral research is conducted to investigate the causes and prevention of mental retardation; 18 university-affiliated facilities for inter-disciplinary training of professional and technical…

  8. Mapa Mental

    OpenAIRE

    do Couto, Hildo Honório

    2017-01-01

    O objetivo principal deste artigo é mostrar que no interior do ecossistema mental da língua, e do nosso ecossistema cognitivo geral, existe uma parte que se pode chamar de mapa mental, intimamente associado ao mapa cognitivo. Após caracterizar o conceito de mapa mental e de associá-lo a conceitos assemelhados, comento o mapa mental que eu tinha de Brasília, por ter vivido lá por mais de 30 anos. Como me mudei para Goiânia, comecei a perder partes do mapa mental de Brasília. Por outro lado, es...

  9. Uso de olanzapina e eletroconvulsoterapia em um paciente com esquizofrenia catatônica refratária e antecedentes de síndrome neuroléptica maligna Olanzapina y ECT en un enfermo con esquizofrenia catatónica refractaria y alto riesgo de síndrome neuroléptico maligno Olanzapine and ECT combined therapy in a refractory catatonic subtype schizophrenia patient with previous neuroleptic malignant syndrome episodes

    Directory of Open Access Journals (Sweden)

    Pedro Gomes de Alvarenga

    2005-12-01

    Full Text Available Este artigo descreve a história clínica e o manejo de um paciente masculino adulto com esquizofrenia catatônica refratária a dois neurolépticos típicos (haloperidol e clorpromazina e a outro agente atípico (risperidona, e com antecedente de dois episódios de síndrome neuroléptica maligna em vigência de neurolépticos típicos. Os autores optaram pela associação de eletroconvulsoterapia (ECT e olanzapina (7,5 mg. Foram obtidos consideráveis benefícios para o paciente.Presentamos un relato clínico referente a la historia precedente y al desarrollo de un enfermo varón con esquizofrenia catatónica refractaria a los neurolépticos convencionales (clorpromazina y haloperidol y a otro agente de nueva generación (risperidona. El enfermo presentó, en dos ocasiones, síndrome neuroléptico maligno, provocado por el uso de los neurolépticos convencionales. Los autores emplearon ECT y olanzapina (7,5 mg obteniendo considerable éxito clínico.This article describes the clinical history and management of an adult male patient with refractory catatonic schizophrenia to two typically used neurolpetic medications (haloperidol and chlorpromazine and to another atypical agent (risperidone.The patient had also presented two neuroleptic malignant syndrome episodes due to typical neuroleptic agents. The authors combined ECT and olanzapine (7.5 mg as treatment, and a considerable clinical improvement was obtained.

  10. Learn About Mental Health

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Learn About Mental Health Recommend on Facebook Tweet Share Compartir Mental Health Basics Types of Mental Illness Fast Facts Mental Health Basics What is mental illness? Mental illnesses are ...

  11. Mental models

    OpenAIRE

    Marco Antonio Moreira

    1996-01-01

    The mental models subject is presented particularly in the light of Johnson-Laird’s theory. Views from different authors are also presented but the emphasis lies in Johson-Laird’s approach, proposing mental models as a third path in the images x propositions debate. In this perspective, the nature, content, and typology of mental models are discussed, as well as the issue of conciousness and computability. In addition, the methodology of research studies are provided. Essentially, the aim of ...

  12. Mental models

    Directory of Open Access Journals (Sweden)

    Marco Antonio Moreira

    1996-12-01

    Full Text Available The mental models subject is presented particularly in the light of Johnson-Laird’s theory. Views from different authors are also presented but the emphasis lies in Johson-Laird’s approach, proposing mental models as a third path in the images x propositions debate. In this perspective, the nature, content, and typology of mental models are discussed, as well as the issue of conciousness and computability. In addition, the methodology of research studies are provided. Essentially, the aim of the paper is to provide an introduction to the mental models topic, having science education research in mind.

  13. Saúde mental em um hospital público: o olhar de profissionais médicos do município do Rio de Janeiro Mental health in a public hospital: the perspective of medical professionals of the city of Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Heloisa dos Reis Malheiro Máximo

    2006-01-01

    Full Text Available Este estudo teve por objetivo compreender percepções de médicos de um hospital público acerca do papel dos profissionais de Saúde Mental nesse espaço institucional, explorando interfaces estabelecidas entre as duas categorias no cotidiano da assistência, tal como percebidas pelos informantes. Para tanto, desenvolveu-se um estudo qualitativo fundamentado na tradição crítico-interpretativa como caminho metodológico, elegendo-se como técnica a entrevista não-diretiva. A amostra foi composta por médicos de diferentes setores que, no momento do estudo, haviam encaminhado pacientes para os profissionais de Saúde Mental e integravam a equipe do hospital por um período mínimo de dois anos. Com base nas categorias que emergiram no campo, a análise identificou diferentes temas, configurando uma rede interpretativa que representou a base do exercício hermenêutico. Os resultados do estudo apontam uma heterogeneidade no que se refere às concepções dos informantes acerca do papel da Saúde Mental no espaço hospitalar. No que tange à organização do trabalho, a variável tempo é fator fundamental no cotidiano do atendimento. Percebe-se uma nítida diferenciação entre o paradigma "psi", referente aos profissionais da Psicologia e da Psiquiatria, e o paradigma médico, revelando obstáculos para uma efetiva integração entre esses dois modelos.This study aims to understand the perceptions of the medical professionals at a public hospital, concerning the role of the Mental Health professionals, identifying simultaneously, the interfaces established between these two categories in the assistance enviroment. Therefore, we begin with the study on demand that characterizes the client assisted by mental health professionals, discussing the main demands required by the medical doctors in the different areas of the hospital unit. At the same time, we highlight the reasons of these indications. Based on this data, we have developed this

  14. Mental health informatics

    CERN Document Server

    Song, Insu; Yellowlees, Peter; Diederich, Joachim

    2014-01-01

    This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).

  15. Doing Mental?

    Science.gov (United States)

    Hobbs, Sandy; And Others

    1980-01-01

    "Mental work" recorded in primary mathematics classes as part of the Classroom Interaction Process is not a simple, single activity of drill or quiz but a set of overlapping activities with different functions. A more analytical approach to mental work is advocated to enhance its usefulness as a classroom activity. (Author/SJL)

  16. Mental health in the United States. Prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder--United States, 2003.

    Science.gov (United States)

    2005-09-02

    Attention-deficit/hyperactivity disorder (ADHD), previously known as attention deficit disorder, is a neurobehavioral disorder characterized by pervasive inattention and hyperactivity-impulsivity that often results in substantial functional impairment. Prevalence estimates of ADHD in school-aged children have ranged from 2% to 18% in community samples. Although stimulant medications are an effective first-line treatment for ADHD , concern persists regarding the possible side effects and long-term health outcomes associated with stimulant consumption. Estimating the number of children who have had ADHD diagnosed and are currently taking medication for the disorder is an important step toward understanding the overall burden of ADHD in the United States. Previously, population-based estimates of medication treatment for ADHD were not available or were limited by their lack of generalizability. To estimate rates of parent-reported ADHD diagnosis and medication treatment for ADHD, CDC analyzed data from the 2003 National Survey of Children's Health (NSCH). This report describes the results of that analysis, which indicated that, in 2003, approximately 4.4 million children aged 4-17 years were reported to have a history of ADHD diagnosis; of these, 2.5 million (56%) were reported to be taking medication for the disorder. Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.

  17. Does the Cultural Formulation Interview for the fifth revision of the diagnostic and statistical manual of mental disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site.

    Science.gov (United States)

    Aggarwal, Neil K; Desilva, Ravi; Nicasio, Andel V; Boiler, Marit; Lewis-Fernández, Roberto

    2015-01-01

    Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n = 64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Despite racial, ethnical, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient's perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but two codes fell under the implementation outcome of clinical utility, two fell under acceptability, and none fell under feasibility. Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence

  18. Does the Cultural Formulation Interview (CFI) for the Fifth Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site

    Science.gov (United States)

    Aggarwal, Neil K.; DeSilva, Ravi; Nicasio, Andel V.; Boiler, Marit; Lewis-Fernández, Roberto

    2014-01-01

    Objectives Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. Design We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n=64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Results Despite racial, ethnic, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient’s perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but 2 codes fell under the implementation outcome of clinical utility, 2 fell under acceptability, and none fell under feasibility. Conclusion Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes

  19. Growing Use of Mental and General Health Care Services Among Older Veterans With Mental Illness.

    Science.gov (United States)

    Wiechers, Ilse R; Karel, Michele J; Hoff, Rani; Karlin, Bradley E

    2015-11-01

    National data from Veterans Health Administration (VHA) electronic medical records were used to examine rates of mental illness and service use among older veterans since mental health care transformation efforts were implemented in 2005. Data were extracted from VHA electronic medical records for each fiscal year from 2005 through 2013 for veterans ages 65 and older. Among those receiving any health care services, the number and proportion treated for a confirmed mental illness and the utilization of non-mental health care services were identified. In 2013, 2.6 million older veterans utilized services in VHA, 14% of whom had a confirmed mental illness, which was a 57% increase from 2005. Older veterans with confirmed mental illness accounted for a sizable and growing proportion of non-mental health service utilization. Preparing the workforce to address the mental health needs of older veterans and nonveterans is essential.

  20. [From freshmanship to the first "Staatsexamen"--increase of depression and decline in sense of coherence and mental quality of life in advanced medical students].

    Science.gov (United States)

    Burger, Pascal H M; Tektas, Ozan Y; Paulsen, Friedrich; Scholz, Michael

    2014-08-01

    Psychiatric disorders (Burnout, depression, anxiety disorders) are common among medical students with a distinctly higher prevalence compared to the general public. Although medi-cal students show a normal health status at the beginning of their university study period, a deterioration of these aspects in higher semesters is evident and continues when they become residents. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters (1st-4th) before their first "Staatsexamen" with validated psychological questionnaires for depression, anxiety, quality of life and sense of coherence. Students in their 1st semester show normal values like the general public. During the 4 semesters a slow and continuous rise of depressive symptoms and anxiety was detected. Quality of life and sense of coherence constantly deteriorated. An increase of physical symptoms was not detected. In the 4th semester the number of depressive students had already doubled. The development of worsening psychological problems and resulting psychiatric disorders seems to be a continuous process, starting with the beginning of the medical studies and growing continuously during the preclinical semesters. Effect-ive strategies for coping with distress should be integrated in the medical curriculum at universities from the very first semester on. Relaxation techniques could thus be an opportunity. © Georg Thieme Verlag KG Stuttgart · New York.

  1. What Is Mental Health?

    Science.gov (United States)

    ... Myths and Facts Recovery Is Possible What Is Mental Health? Mental health includes our emotional, psychological, and social ... mental health problems and where to find help . Mental Health and Wellness Positive mental health allows people to: ...

  2. Impact and Amount of Academic Self-efficacy and Stress on the Mental and Physical Well-Being of Students Competing in the 4th Olympiad of Iranian Universities of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Leila Vahedi

    2014-12-01

    Full Text Available Introduction: Studying mental and physical health and their determinants is an important issue, especially among future health providers.Methods: This is a sectional-analytical study whose target population was students who had participated in the 4th National Olympiad of Medical Sciences Universities in Tabriz, Iran, held in February 4-7 2013.Web-based designed questionnaires were sent to all 328 participating students’ emails containing our questionnaires that were designed as web-based through Google Drive was sent to all available email addresses of our target population. Questionnaires consisted of student life stress inventory (SLSI, SF-36 (Short Form Health Survey, and College Self-Efficacy Inventory (CSEI, which were translated to Persian and revalidated. The data were analyzed using SPSS ver.19 software.Results: 59 students completely filled the questionnaires and enrolled in the study. In the area of student life stress inventory, the total score of the participants ranged from 79(13.73% to 168(63.73% with a mean of 130.74(40.05% and SD of 21.51(10.84%. On the college self-efficacy scale, participants’ scores ranged from 62(40.79% to 152(100% with a mean of 114.29(77.10% and SD of 22.82(14.20%. On the Sf-36 form, participants scored 72.28±14.09% on average (Min=44.03%, Max=98.75%. The Spearman correlation coefficient test indicated that all correlations between variables were statistically significant (p<0.001. Conclusion: It can be concluded that adopting additional methods to increase self-efficacy and decrease stress amongst medical students in the academic population will lead to improved mental and physical health, which can help national improvement of science.

  3. Electronic medical records: recommendations for routine. Report of the eHID (Electronic Health Indicator Data Project). International comparisons of epidemiological outcomes: diabetes, health disease and mental illness.

    NARCIS (Netherlands)

    Pringle, M.; Schellevis, F.G.; Elliott, C.; Verheij, R.A.; Fleming, D.M.

    2007-01-01

    Aim: It is believed that electronic medical records generated in a routine and disciplined manner by primary care doctors can potentially provide a very cost effective approach to disease monitoring. Part of the eHID project was concerned with a comparison of the actual epidemiological data that

  4. Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study.

    Science.gov (United States)

    Baygin, Ozgul; Tuzuner, Tamer; Kusgoz, Adem; Yahyaoglu, Gorkem; Yilmaz, Nagehan; Aksoy, Simge

    2017-02-01

    This study evaluated the differences in dental conditions and treatment modalities between disabled and non-cooperative healthy children under general anaesthesia. The data were collected from paediatric patients between 3 and 15 years of age who received dental treatment under general anaesthesia. Patients with at least one mental/physical disturbance (group 1) and other healthy non-cooperative patients (group 2) were compared with regard to gender, age, weight, and treatment time-type. The statistical analyses were performed using Fisher's exact and Mann-Whitney U tests. No significant differences were observed between the groups with regard to gender, weight and treatment-time (p>0.05). The numbers of treated teeth (pgeneral condition of the patients may alter the type of treatment provided and confirms the necessity of performing preventive procedures.

  5. The new mission of forensic mental health systems: managing violence as a medical syndrome in an environment that balances treatment and safety.

    Science.gov (United States)

    Warburton, Katherine

    2014-10-01

    The association between violence and mental illness is well-studied, yet remains highly controversial. Currently, there appears to be a trend of increasing violence in state hospital settings, including both civilly and forensically committed populations. In fact, physical aggression is the primary reason for admission to many state hospitals. Given that violence is now often both a reason for admission and a barrier to discharge, there is a case to be made for psychiatric violence to be re-conceptualized dimensionally, as a primary syndrome, not as the byproduct of one. Furthermore, treatment settings need to be enhanced to address the new types of violence exhibited in inpatient environments, and this modification needs to be geared toward balancing safety with treatment.

  6. [Temporary Disability Pension from the Perspective of the Individual: Self-Reported Physical and Mental Health, Medical Rehabilitation, and Return to Work Plans].

    Science.gov (United States)

    Zschucke, E; Hessel, A; Lippke, S

    2016-08-01

    To assess health and psychosocial variables as well as return-to-work (RTW) plans in people with long-term illness-related absence from work in Germany. Structured telephone interviews with N=452 persons receiving a temporary disability pension (53.3% female, mean age 50.3 years). Participants reported high levels of multimorbidity and physical and mental complaints. The majority however stated to intend or even to have prepared their RTW. This intention was correlated with age and the duration of the temporary disability pension, but not with gender, number or type of diseases, or current subjective health status. Our results indicate a large intention-behavior gap which needs to be addressed in studies, but also in rehabilitation and return-to-work interventions. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Teaching recovery to medical students.

    LENUS (Irish Health Repository)

    Feeney, Larkin

    2013-03-01

    Community mental health services are evolving toward more holistic, patient-centered, recovery-based practices. This change necessitates an attitudinal shift from mental health workers, and training in recovery principles is helpful in achieving this change. Medical students often have narrow, doctor-centered concepts of mental health care. Traditional clinical placements in psychiatry do little to address this. We evaluated a recovery-focused teaching program for medical students in psychiatry.

  8. Mental Health First Aid: A Useful Tool for School Nurses.

    Science.gov (United States)

    Atkins, Joy

    2017-11-01

    School nurses address mental health issues of youth on a daily basis. These mental health issues include substance abuse, anxiety, depression, and even suicidal ideation. Mental health first aid is a process that seeks to help medical professionals and laypeople recognize and address someone that is having a mental health or substance abuse crisis. This article will describe an experience with a student having suicidal ideations and how the mental health action plan was used.

  9. Mental Byomdannelse

    DEFF Research Database (Denmark)

    Olsen, Tina Vestermann; Boye, Anne Mette; Borchmann, Inger Haarup

    Formålet med publikationen er at præsentere metoden "Mental byomdannelse". Metoden viser, hvordan man via midlertidig brug af grunde kan undersøge et steds potentialer, tage et område i brug tidligt i en byomdannelsesproces og derved bidrage til at opbygge en ny identitet for området. Mental...... byomdannelse går ud på at skabe bevidsthed om et byudviklingsområde overfor byens borgere, kommende beboere og fremtidige brugere af området allerede mens den fysiske omdannelse er i gang. I publikationen præsenteres en værktøjskasse, som giver redskaber og ideer til, hvordan man kan sætte en mental...... byomdannelsesproces i gang i byens rum. Publikationen udgør en afrapportering fra et støttet forsøgsprojekt hvor metoden ”Mental byomdannelse” er udviklet ved at afprøve ideerne om mental byomdannelse i to cases i Ålborg Kommune, hhv. i Østre Havn og Nibe by. Formålet med at anvende metoden i de to cases har været...

  10. Prevalência e fatores associados aos transtornos mentais comuns em residentes médicos e da área multiprofissional Prevalence and factors associated with commom mental disorders in medical and multiprofessional health residents

    Directory of Open Access Journals (Sweden)

    Carla Novaes Carvalho

    2013-01-01

    Full Text Available OBJETIVO: Determinar a prevalência de transtornos mentais comuns (TMC e sua associação a fatores sociodemográficos e profissionais em residentes de medicina, enfermagem, nutrição e saúde coletiva da cidade do Recife (PE. MÉTODOS: Estudo transversal foi conduzido, em 2007, envolvendo uma amostra aleatória de 178 residentes que responderam a questões sociodemográficas e sobre a formação profissional e ao Self-Reporting Questionnaire (SRQ-20. Calcularam-se as prevalências de TMC e estimaram-se as razões de prevalência (RP e os intervalos de confiança. RESULTADOS: A prevalência total dos TMC foi de 51,1% e não se observou associação aos fatores sociodemográficos. A prevalência do evento foi 39% maior nos médicos que nos não médicos (p = 0,049 e 46% maior em residentes médicos das especialidades cirúrgicas que entre os de enfermagem, nutrição e saúde coletiva (p = 0,048. Cinco das queixas do SRQ-20 foram mais frequentes no sexo feminino (p OBJECTIVE: To determine the prevalence of common mental disorders (CMD and its association with sociodemographics and professionals resident in medicine, nursing, nutrition and public health from the city of Recife (PE. METHODS: A survey was conducted in 2007, involving a random sample of 178 residents, who responded to question about sociodemographics and professional training and the Self-Reporting Questionnaire (SRQ-20. The prevalence of CMD were calculated, also prevalence ratios (PR and confidence intervals were estimated. RESULTS: The overall prevalence of CMD was 51.1%, and there was no association with sociodemographics factors. The prevalence of the event was 39% higher among the physicians than in the non-medical (p = 0,049 and 46% greater in the surgical specialties medical residents than among nursing, nutrition and public health (p = 0,048. Five of the SRQ-20 items were more frequent in female (p < 0,05. CONCLUSION: These findings indicate the high magnitude of CMD in

  11. Clinical and demographic profile of users of a mental health system for medical residents and other health professionals undergoing training at the Universidade Federal de São Paulo

    Directory of Open Access Journals (Sweden)

    Rafael Fagnani Neto

    Full Text Available CONTEXT: A postgraduate and resident trainee mental health assistance center was created in September 1996 within our university. OBJECTIVE: To describe the clinical and demographic profile of its users. TYPE OF STUDY: Retrospective. SETTING: Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM. METHODS: The study was carried between September 1996 and November 2002, when 233 semi-structured registration forms were filled out either by the psychologist or the psychiatrist during their first contact with the trainees, who were medical and nursing residents, and postgraduate students at specialization, master or doctoral levels. The registration forms included demographic, occupational and clinical data. RESULTS: The trainees were predominantly young (mean of 27 years old, single (82.0% of cases, women (79.4%, seeking help especially during the first year of training (63.1%. In 70.8% of the cases, they came to the service spontaneously. Such individuals showed greater adherence to the treatment than those who were referred by supervisors (p < 0.05. In 30% of the cases, the trainee sought psychological guidance or support at the service due to specific situational conflicts. Depression and anxiety disorders were the most frequent diagnoses; 22.3% of the trainees followed up mentioned a tendency towards suicidal thoughts. In comparison with other trainees, there was a higher prevalence of males among the medical residents (p < 0.01, with more cases of sleep disorders (p < 0.05, a smaller number of individuals refraining from the use of alcohol (p < 0.05 and a higher number of trainees requiring leave of absence (p < 0.001. DISCUSSION: The first year of training in health sciences is the most stressful, especially for women. Depression and anxiety symptoms are common, reflecting transitory self-limited deadaptation. However, the severity of the cases can also be evaluated in view of the large number of trainees who mentioned

  12. Meta-analysis of the impact of 9 medication classes on falls in elderly persons.

    Science.gov (United States)

    Woolcott, John C; Richardson, Kathryn J; Wiens, Matthew O; Patel, Bhavini; Marin, Judith; Khan, Karim M; Marra, Carlo A

    2009-11-23

    There is increasing recognition that the use of certain medications contributes to falls in seniors. Our objective was to update a previously completed meta-analysis looking at the association of medication use and falling to include relevant drug classes and new studies that have been completed since a previous meta-analysis. Studies were identified through a systematic search of English-language articles published from 1996 to 2007. We identified studies that were completed on patients older than 60 years, looking at the association between medication use and falling. Bayesian methods allowed us to combine the results of a previous meta-analysis with new information to estimate updated Bayesian odds ratios (ORs) and 95% credible intervals (95% CrIs) Of 11 118 identified articles, 22 met our inclusion criteria. Meta-analyses were completed on 9 unique drug classes, including 79 081 participants, with the following Bayesian unadjusted OR estimates: antihypertensive agents, OR, 1.24 (95% CrI, 1.01-1.50); diuretics, OR, 1.07 (95% CrI, 1.01-1.14); beta-blockers, OR, 1.01 (95% CrI, 0.86-1.17); sedatives and hypnotics, OR, 1.47 (95% CrI, 1.35-1.62); neuroleptics and antipsychotics, OR, 1.59 (95% CrI, 1.37-1.83); antidepressants, OR, 1.68 (95% CrI, 1.47-1.91); benzodiazepines, OR, 1.57 (95% CrI, 1.43-1.72); narcotics, OR, 0.96 (95% CrI, 0.78-1.18); and nonsteroidal anti-inflammatory drugs, OR, 1.21 (95% CrI, 1.01-1.44). The updated Bayesian adjusted OR estimates for diuretics, neuroleptics and antipsychotics, antidepressants, and benzodiazepines were 0.99 (95% CrI, 0.78-1.25), 1.39 (95% CrI, 0.94-2.00), 1.36 (95% CrI, 1.13-1.76), and 1.41 (95% CrI, 1.20-1.71), respectively. Stratification of studies had little effect on Bayesian OR estimates, with only small differences in the stratified ORs observed across population (for beta-blockers and neuroleptics and antipsychotics) and study type (for sedatives and hypnotics, benzodiazepines, and narcotics). An increased

  13. Support from the Internet for Individuals with Mental Disorders: Advantages and Disadvantages of e-Mental Health Service Delivery.

    Science.gov (United States)

    Moock, Jörn

    2014-01-01

    Mental disorders are common in almost all industrialized countries and many emerging economies. While several trials have shown that effective treatments exist for mental disorders, such as pharmacotherapy, psychological interventions, and self-help programs, the treatment gap in mental health care remains pervasive. Unrestricted access to adequate medical care for people with mental disorders will be one of the pressing public mental health tasks in the near future. In addition, scarcity of financial resources across the public mental health sector is a powerful argument for investigating innovative alternatives of delivering mental health care. Thus, one challenge that arises in modern mental health care is the development of innovative treatment concepts. One possibility for improving mental health care services is to deliver them via the Internet. Online-based mental health services have the potential to address the unmet need for mental health care.

  14. Support from the Internet for individuals with mental disorders: advantages and disadvantages of e-mental health service delivery

    Directory of Open Access Journals (Sweden)

    Jörn eMoock

    2014-06-01

    Full Text Available Mental disorders are common in almost all industrialized countries and many emerging economies. While several trials have shown that effective treatments exist for mental disorders, such as pharmacotherapy, psychological interventions, and self-help programs, the treatment gap in mental health care remains pervasive. Unrestricted access to adequate medical care for people with mental disorders will be one of the pressing public mental health tasks in the near future. In addition, scarcity of financial resources across the public mental health sector is a powerful argument for investigating innovative alternatives of delivering mental health care. Thus, one challenge that arises in modern mental health care is the development of innovative treatment concepts. One possibility for improving mental health care services is to deliver them via the Internet. Online-based mental health services have the potential to address the unmet need for mental health care.

  15. 76 FR 78824 - Copayments for Medications in 2012

    Science.gov (United States)

    2011-12-20

    ... and dental schools; Medical devices; Medical research; Mental health programs; Nursing homes... Affairs. ACTION: Interim final rule. SUMMARY: The Department of Veterans Affairs (VA) amends its medical regulations concerning the copayment required for certain medications. Under current regulations, beginning on...

  16. Mental health literacy: focus on developing countries

    African Journals Online (AJOL)

    superstitions or cultural and personal beliefs. For example, a .... countries such as Kenya, the Philippines, Papua New Guinea ..... barriers to their provision of mental healthcare: a report on Mental. Health and General Practice Investigation (MaGPIe). The New. Zealand Medical Journal 2005 vol 118 No 1222. 41. Rahman A ...

  17. The effect of regular medication on the outcome of paracetamol poisoning

    DEFF Research Database (Denmark)

    Schmidt, L E; Dalhoff, K

    2002-01-01

    BACKGROUND: Patients admitted with paracetamol overdose frequently receive one or more types of regular medication that may affect the outcome of the paracetamol intoxication. AIM: To describe the use of regular medication in patients with paracetamol poisoning and to evaluate its effects...... on morbidity and mortality. METHODS: Seven hundred and thirty-seven consecutive patients admitted with paracetamol poisoning were studied and the use of regular medication was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, severe hepatic dysfunction and severe...... hepatocellular injury was evaluated by multivariate analysis. RESULTS: Regular medication was received by 332 patients (45%). Medication with benzodiazepines (105 cases), antidepressants (100 cases), neuroleptics (75 cases), paracetamol (58 cases), oral contraceptives (51 cases), beta-agonists (40 cases), opioid...

  18. Mental Toughness

    Science.gov (United States)

    Quinn, Tori; Cavanaugh, Lauren

    2017-01-01

    Mental toughness (MT) is defined as a set of attributes that allow an individual to persevere through difficult circumstances that ultimately can lead to successful outcomes. It is also a critical component of maximizing the performance of an athlete. These attributes assist with and promote a state of mind that enhances performance. A negative…

  19. Mental Illness

    Science.gov (United States)

    ... to situations and to people Alcohol or drug abuse Major changes in eating habits Sex drive changes Excessive anger, hostility or violence Suicidal thinking Sometimes symptoms of a mental health disorder appear as physical ... on Drug Abuse. http://www.drugabuse.gov/publications/principles-drug-addiction- ...

  20. Mental health aspects of disasters.

    Science.gov (United States)

    Oldham, Robert L

    2013-01-01

    Disaster preparations and responses are incomplete without addressing the mental health aspects of disasters. Unpleasant mental states can be a natural and even adaptive human response following a disaster; however, disasters also can contribute to the development of mental illnesses and substance use disorders or exacerbate existing disorders for disaster survivors, response personnel, and even families and close contacts of survivors and responders. Disaster-related psychopathology can mimic or negatively affect other disaster-related illnesses and can impair health professionals and others who must respond to catastrophic events; however, disasters also can encourage tremendous human coping, perseverance, and resilience and can even enhance personal and collective feelings of purpose, connection, and meaning. Integrating mental health promotion and care into disaster planning and response has the potential to mitigate psychiatric and medical consequences of a disaster and may preserve the mission readiness of disaster response personnel and promote healing among communities traumatized by disaster.

  1. Lithuania mental health country profile.

    Science.gov (United States)

    Puras, Dainius; Germanavicius, Arunas; Povilaitis, Robertas; Veniute, Marija; Jasilionis, Domantas

    2004-01-01

    As a part of international mental health policy, programmes and services project, the 'country profile' instrument was used for assessment of mental health policy and services in the Republic of Lithuania. Analysis of contextual factors revealed high levels of social pathology (including violence, suicide and other self-destructive behaviour) with stigmatizing approaches by the general population to mentally disturbed persons and other vulnerable groups. Analysis of existing data about resources invested in the mental health care system raises questions for policymakers about the effectiveness of this traditional way of investment. The largest proportion of physical and human capital is concentrated in psychiatric institutions, with large numbers of beds, psychiatrists and increasing funding for medications, while other components of care--such as housing, psychosocial and vocational rehabilitation, community-based child mental health services--are not being developed. Statistical accounts keep the tradition of presenting processes as outcomes, while modern assessment of outcomes of services, programmes and policies are lacking. The findings from this country profile may be very useful in the development of modern mental health policies in the countries of Eastern and Central Europe, which have been deprived for decades from the opportunity to introduce evidence-based mental health policies and services.

  2. Disaster Management: Mental Health Perspective

    Science.gov (United States)

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C.

    2015-01-01

    Disaster mental health is based on the principles of ‘preventive medicine’ This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six ‘R’s such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health. PMID:26664073

  3. The influence of selective serotonin reuptake inhibitors on the plasma and brain pharmacokinetics of the simplest phenothiazine neuroleptic promazine in the rat.

    Science.gov (United States)

    Daniel, W A; Syrek, M; Wójcikowski, J

    1999-06-01

    , metabolic pathway of promazine, e.g. hydroxylation. In conclusion, all the three SSRIs administered chronically in pharmacological doses, increase the concentrations of promazine in the blood plasma and brain of rats by inhibiting different metabolic pathways of the neuroleptic. Assuming that similar interactions occur in humans, reduced doses of phenotiazines should be considered when one of the above antidepressants is to be given jointly.

  4. Stigmatization and mental health

    Directory of Open Access Journals (Sweden)

    Gulsum Ozge Doganavsargil Baysal

    2013-04-01

    Full Text Available Stigmatizasyon represent a chronic negative interaction with the environment that most of people with a of diagnosis mental disorders. Different types of stigma may have harmful effects. Poor psychological well being, poor quality of life and poor self esteem are related stigmatization. In this article, definition and mechanism of stigmatization, influenced factors and consequences of stigmatization are reviewed. Stigmatization is a modifiable environmental risk factor. Integrating approaches against stigma in treatment may represent cost-effective way to reduce the risk of relapse and poor outcome occasioned by chronic exposure to stigma. [Archives Medical Review Journal 2013; 22(2.000: 239-251

  5. Fleet leaders' attitudes about subordinates' use of mental health services.

    Science.gov (United States)

    Westphal, Richard J

    2007-11-01

    Mental disorders are a significant source of medical and occupational morbidity for sailors. Stigma, fear of negative career impact, and subordinates concern about leaders' attitudes are significant barriers to the use of mental health services. Semistructured interviews and military policies were data sources used to analyze the language, knowledge, and attitudes of Navy surface fleet leaders about mental illness and mental health treatment using Foucault's concept of discourse analysis. A discourse is a system of knowledge that influences language, perceptions, values, and social practices. The results showed that leaders' concerns about sailors' mental combat readiness, not mental illness stigma, was the dominant discourse about mental illness and mental health services use. In particular, organizational differences between the surface warfare and the mental health communities may influence leaders' attitudes more than stigma. This study provides an elaborated view of mental health knowledge and power within a Navy community.

  6. Perceived training needs of nurses working with mentally ill patients.

    Science.gov (United States)

    Oranye, Nelson Ositadimma; Arumugam, Utharas; Ahmad, Nora; Arumugam, Marian E

    2016-10-01

    Introductio n: In Malaysia, nurses form a significant part of the clinical mental health team, but the current level of training in mental health results in suboptimal nursing care delivery. For this study 220 registered nurses and medical assistants working with the mentally ill completed a structured questionnaire. The purpose of this study was to explore perceived competence in mental healthcare and the training needs of nurses working with mentally ill patients in inpatient mental healthcare facilities. The skills perceived as important for practicing in mental health varied among the nurse participants. Post basic training in mental health was significantly related to perceived competence in patient mental state assessment (p=0.036), risk assessment for suicide (p=0.024), violence (p=0.044) and self-harm (p=0.013). There is little emphasis on psychosocial skills in current post basic mental health training in Malaysia.

  7. Mental Health under National Health Care Reform: The Empirical Foundations.

    Science.gov (United States)

    Hudson, Christopher G.; DeVito, Jo Anne

    1994-01-01

    Reviews research pertinent to mental health services under health care reform proposals. Examines redistributional impact of inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. Argues that extending minimalist model of time-limited benefits to national…

  8. Lithium‐induced Confusional States: Nonconvulsive Status Epilepticus or Triphasic Encephalopathy?

    National Research Council Canada - National Science Library

    Kaplan, Peter W; Birbeck, Gretchen

    2006-01-01

    Lithium therapy can cause a confusional state by direct toxicity, precipitation of nonconvulsive status epilepticus, or by interplay with other neuroleptic medications to produce neuroleptic malignant...

  9. Perceptions of Mental Retardation and Mental Illness.

    Science.gov (United States)

    Caruso, David R.; Hodapp, Robert M.

    1988-01-01

    Open-ended questions of college students (N=60) indicated students clearly differentiated between the mentally retarded and mentally ill. Mental retardation was characterized by physical stigmata, brain damage, developmental delays, and cognitive deficits; mental illness by emotional lability due to environmental, hereditary, or mixed factors.…

  10. Experiências com a gestão autônoma da medicação: narrativa de usuários de saúde mental no encontro dos grupos focais em centros de atenção psicossocial Experiments with autonomous management of medication: narrative of mental health users in focus group meeting in psychosocial care centers

    Directory of Open Access Journals (Sweden)

    Maria Salete Bessa Jorge

    2012-01-01

    Full Text Available Objetiva-se analisar as experiências vivenciadas pelos usuários do Centro de Atenção Psicossocial no desenvolvimento do grupo para Gestão Autônoma da Medicação (GAM. Opta-se pela pesquisa qualitativa, dentro de uma perspectiva crítica que protagoniza a vivência dos participantes do grupo operativo GAM. Realizado nos Centros de Atenção Psicossocial (CAPS Geral e Álcool e outras Drogas (AD do município de Maracanaú-CE. Os participantes foram 13 usuários de CAPS Geral e Ad do referido município. Técnica de coleta das narrativas foi constituída por três grupos narrativos e a análise pautada na hermenêutica. Segundo as narrativas desvelaram, em todo o processo de discussão sobre a medicação, fica evidente a importância da escuta e do acompanhamento individual. A abordagem singular dos usuários possibilitou melhoria significativa no estado de saúde mental e na compreensão do adoecimento. Assim, é possível ressignificar a utilização precípua do medicamento e interagir com inovações terapêuticas mais voltadas para hábitos de vida saudável.The study aimed to analyze the feelings experienced by users of the Center for Psychosocial Care in developing the group for Autonomous Management of Medication (AMM. It uses qualitative research within a critical perspective that carries the experience of participating in the operative AMM group. It was conducted at the General Center for Psychosocial Care (CAPS and Alcohol and other Drugs (AD in the city of Maracanau, state of Ceara, Brazil. The participants were 13 users of General and Ad CAPS of that city. The technique of narratives' collection consisted of three groups based in the narrative analysis and hermeneutics. According to the narratives, throughout the discussion process on the medication, it is evident the importance of listening and coaching. The unique approach of users allowed significant improvement in health status and understanding of mental illness. Thus, it

  11. Use of interactive teaching techniques to introduce mental health ...

    African Journals Online (AJOL)

    Objective: There are currently no practising psychiatrists in Somaliland. In 2007 the first medical students graduated from universities in Somaliland without mental health training. We aimed to pilot an intensive but flexible package of mental health training to all senior medical students and interns using interactive training ...

  12. Facilitating Soldier Receipt of Needed Mental Health Treatment

    Science.gov (United States)

    2013-11-01

    Beliefs About Medications 1. The medications prescribed by mental health providers are usually addictive . (.705) 2. Ifl were to receive mental...deploymenL He ... wasn’t able to cope, but his outlet was the use of marijuana , primarily. It was one of those things that he just

  13. Knowledge, attitude and practice (KAP) of mental illness among staff ...

    African Journals Online (AJOL)

    Knowledge, attitude and practice (KAP) of mental illness among staff in general medical facilities in Kenya: practice and policy implications. ... illness which could be constructively filled with Continued Medical Education (CME). Key words: Hospital, General; Health Knowledge, Attitudes, Practice; Mental disorders; Kenya ...

  14. Mental depression and kundalini yoga.

    Science.gov (United States)

    Devi, S K; Chansauria, J P; Udupa, K N

    1986-10-01

    In cases of mental depression, the plasma serotonin, melatonin and glutamate levels are increased along with the lowering of urinary - 5 - hydroxyindole acetic acid, plasma monoamine oxidase and cortisol levels following three and six months Practice of Kundalini Yoga. The pulse rate and blood pressure in these patients are also lowered after Kundalini Yoga practice. Thus, the practice of Kundalini Yoga helps to maintain a perfect homeostasis by bringing an equilibrium between the sympathetic and parasympathetic activities and it can be used as a non - medical measure in treating patients with mental depression.

  15. Higiene mental

    Directory of Open Access Journals (Sweden)

    Francisco Gomez Pinzón

    1940-08-01

    Full Text Available El número cada día mayor de enfermos mentales, que hace “contraste con  la evidente disminución de enfermedades infecto-contagiosas, -lograda a favor de los modernos métodos de curación y profilaxis- es un hecho que está siendo comprobado “en todos los países civilizados y que constituye motivo de justificada alarma para cuantos se preocupan por cuestiones del orden biológico y social”

  16. Study on the attitude of “Tomorrow's Doctors” towards mental illness ...

    African Journals Online (AJOL)

    Different studies show different attitudes towards mental illness among medical students. This study was initiated to explore the attitude towards mental illness among medical students in a medical college of Manipur. A cross-sectional selfadministered questionnaire-based study was conducted among medical students in ...

  17. 42 CFR 34.4 - Medical notifications.

    Science.gov (United States)

    2010-10-01

    ... abuse or addition. Provided, however, That a Class A medical notification of a physical or mental... have: (i) A communicable disease of public health significance; (ii)(A) A physical or mental disorder..., safety, or welfare of the alien or others; or (B) A history of a physical or mental disorder and behavior...

  18. Good Mental Health

    Science.gov (United States)

    ... Mental Health This information in Spanish ( en español ) Good mental health Nutrition and mental health Exercise and mental health ... a friend. Return to top More information on Good mental health Read more from womenshealth.gov Action Steps for ...

  19. Mental health and welfare in Australian anaesthetists.

    Science.gov (United States)

    McDonnell, N J; Kaye, R M; Hood, S; Shrivastava, P; Khursandi, D C S

    2013-09-01

    This survey was designed to evaluate the factors affecting mental health and welfare in Australian anaesthetists and to investigate current sources of support. An electronic survey was sent to 500 randomly selected Fellows and trainees of the Australian and New Zealand College of Anaesthetists. Questions were related to: anxiety, stress, depression, substance misuse, self-medication, suicide, reporting illness, and help-seeking. Current psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10). A total of 191 completed surveys were received (a response rate of 38%): 26% had attended their general practitioner for mental health issues, of whom half had been diagnosed with a mental illness; 7% of all respondents were currently prescribed medication for this; 25% had previously self-prescribed psychoactive medication; 17% admitted to using alcohol to deal with stress, anxiety or depression; and 8% responded that mental illness had at some point impaired clinical care. Sixteen percent of all respondents reported previous suicidal ideation. Despite a low response rate, and the possibility of responder bias, the mental health of Australian anaesthetists would appear to be subject to common and persistent risk factors, many of which are well described in previous studies. We identify general practitioners as particularly valuable in targeting initiatives for improvements in mental health and welfare. The significant prevalence of suicidal ideation and reluctance to approach senior colleagues with concerns about mental health or welfare issues are specific causes for concern and suggest that further investigation, education and a potential review of support networks is required.

  20. Lay Judgments of Mental Health Treatment Options

    Directory of Open Access Journals (Sweden)

    Jessecae K. Marsh PhD

    2016-09-01

    Full Text Available Background: Past research shows that people believe psychologically caused mental disorders are helped by different treatments than biologically caused mental disorders. However, it is unknown how people think about treatment when limited information is known to identify the disorder. Objective: Our objective was to explore how laypeople judged the helpfulness of treatments when a limited set of mental health symptoms is presented. Method: Across four experiments, Mechanical Turk and college undergraduate participants (N = 331 read descriptions displaying sets of three mental health symptoms and rated how helpful pharmaceuticals, counseling, or alternative medicine would be on a 0 (not at all helpful to 100 (completely helpful scale. We measured judgments for perceived mental and medical symptoms (Experiment 1 and how judgments were influenced by symptom severity (Experiment 2, duration (Experiment 3, and if alternative medicine and conventional treatments were used in conjunction (Experiment 4. Results: Perceived mental symptoms were rated as helped by counseling, while perceived medical symptoms were rated as helped by medication. Alternative medicine was never rated as extremely helpful. For example, in Experiment 1, counseling (mean [M] = 80.1 was rated more helpful than pharmaceuticals (M = 50.5; P < 0.001 or alternative medicine (M = 45.1; P < 0.001 for mental symptoms, and pharmaceuticals (M = 62.6 was rated more helpful than counseling (M = 36.1; P < 0.001 or alternative medicine (M = 47.5; P < 0.001 for medical symptoms. This pattern held regardless of severity, duration, or the adjunct use of alternative medicine. Limitations: We employed a general population sample and measured hypothetical treatment judgments. Conclusions: Mental