WorldWideScience

Sample records for psychiatric association practice

  1. Psychotherapy in Contemporary Psychiatric Practice

    Science.gov (United States)

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2015-01-01

    Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

  2. Psychiatric conditions associated with bullying.

    Science.gov (United States)

    Kumpulainen, Kirsti

    2008-01-01

    Bullying is a complex phenomenon moderated not only by the personal characteristics and behavioral traits of the individual but also by family rearing practices, as well as by situational factors such as the frequency and type of bullying. The phenomenon is also affected by group processes among the individuals present during the event. Bullying is a distressing experience that is often continuous over years and predicts both concurrent and future psychiatric symptoms and disorders, even in adulthood. At young ages, attention-deficit hyperactivity disorder and depression, as well as anxiety, are prevalent concurrently with bullying among the children involved. Later in young adulthood, male victims are at risk for anxiety, male bullies for personality disorders, and male bully-victims for both personality disorders and anxiety, and the risk is especially increased if the child is disturbed when involved in bullying at school age. Rarely does any single behavior predict future problems as clearly as bullying does, and additional assessment of psychiatric problems is always warranted, if the child is involved in bullying as a bully, victim or bully-victim. Based on our current knowledge, school-based interventions regulating the behavior of the child, increasing pro-social skills and promoting peer relationships are recommended for those without concurrent psychiatric disturbance, but those displaying psychiatric symptoms and disorders should be referred for psychiatric consultation and intervention.

  3. An interprofessional psychiatric advanced pharmacy practice experience.

    Science.gov (United States)

    Goldstone, Lisa W; Cooley, Janet

    2013-08-12

    To create an interprofessional psychiatry advanced pharmacy practice experience (APPE) and assess the initial outcomes. An elective psychiatry APPE was developed in a setting of interdisciplinary practice. Preceptor responsibilities were shared between a psychiatric pharmacist and an attending psychiatrist or psychiatric nurse practitioner. Students were also given the opportunity to shadow and work with other health care professionals such as nurses, social workers, therapists, family nurse practitioners, and utilization review staff members. Midpoint and final evaluations demonstrated student advancement throughout the experience as well as the development of communication skills with patients and an increased ability to work collaboratively with other health care providers. Students rated this practice experience highly and their comments reflected achievement of the established learning objectives. An interdisciplinary elective practice experience in psychiatry at a local teaching hospital was effective in teaching psychiatric care and interprofessional interaction. This teaching model can be adapted for use in other practice settings or specialty areas.

  4. Physician assisted death in psychiatric practice

    NARCIS (Netherlands)

    Groenewoud, J.H.; van der Maas, P.J.; van der Wal, G.; Hengeveld, M.W.; Tholen, A.J.; Schudel, W.J.; van der Heide, A.

    1997-01-01

    Background: In 1994 the Dutch Supreme Court ruled that in exceptional instances, physician-assisted suicide might be justifiable for patients with unbearable mental suffering but no physical illness. We studied physician- assisted suicide and euthanasia in psychiatric practice in the Netherlands.

  5. A qualitative study of factors influencing psychiatric nursing practice in Australian prisons.

    Science.gov (United States)

    Doyle, J

    1999-01-01

    Factors influencing the practice of psychiatric nursing in Australian prisons. A qualitative study of psychiatric nurses (N = 30) working in a prison. The psychiatric nurses identified the following factors as influencing their work: challenging patients, threats to personal survival of patients, the technology and artifice of confinement, conflicting values of nurses and corrections staff, stigma by association, and prisoner identification of the nurses with prison administration. Psychiatric nurses who work in forensic settings must adapt to less than optimal practice conditions.

  6. Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association.

    Science.gov (United States)

    Hoagwood, Kimberly E; Kelleher, Kelly; Murray, Laura K; Jensen, Peter S

    2006-03-01

    The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.

  7. Towards a systems definition of psychiatric practice.

    Science.gov (United States)

    Rashkis, H A; Yanovski, A

    1976-04-01

    Assessment of psychiatric practice has been difficult largely because of the apparent diversity of psychiatrists' theories, procedures, and goals. Searching for a unifying principle, we propose system identification failure (SIF), a defect in data-processing, as the unit of psychopathology underlying all psychiatric disorder (and other behavioral error). Definitive treatment must not only identify and correct the data-processing defect, but also eliminate the secondary symptoms. Emphasis is not on method of treatment but on goal or intent. Preparatory treatment includes supportive psychological and environmental measures and somatic therapies (regardless of type, duration, or intensity) which make definitive treatment possible. Palliative treatment must be frequently reviewed. Preventive treatment should prevent SIF-formation. We consider our proposal a distillate of the aims and implicit intent of experienced psychiatrists regardless of their training or theoretical orientation. The search for a functional definition of the practice of psychiatry was perhaps at one time an academic or lexicographic exercise, but, with the advent of peer review, it has become a pragmatic matter deserving of earnest attention. What is psychiatric practice? In a universe criss-crossed by psychiatrists "riding madly off in all directions." not only are the descendants of Anna O. and Dora analyzed in vivo and those of Little Hans at one remove, but also are distant figures and cultures subjected, often iv vitro, to critical scrutiny, while the "talking treatment" is applied to couples, families, groups, "networks" and communities. When one adds to this the diversity of biological therapies and institutional, environmental, and behavioral manipulations, the task of finding a common theme, much less procedure, becomes a worthy problem in hermeneutics, general semantics, or system analysis. Thus we must ask not only the operational question, "What do psychiatrists do?" BUt also, "What did

  8. Teaching safe sex practices to psychiatric patients.

    Science.gov (United States)

    Sladyk, K

    1990-03-01

    An occupational therapist presented her 45-minute program called AIDS Education and Safe Sex 5 times to female mental patients in the locked ward of Cedarcrest Regional Hospital in Newington, Connecticut, to inform them about safe-sex practices and AIDS. She first administered a pretest then spoke briefly about AIDS and safe-sex practices. The lecture emphasized various important points such as no cure for AIDS exist, casual contact (e.g., kiss on the cheek, handshake) cannot transmit HIV, and effectiveness of using latex condoms. The occupational therapist spent much of her time addressing myths about AIDS and what safe-sex practices are. The patients discussed sexual abuse and dishonest partners. She administered a posttest which was the same as the pretest. Some sessions attracted more people than did other sessions. Test scores increased for every patient and for every session. They ranged from a 5% (68-73%) increase for the 3rd session to a 24% (67-91%) increase for the last session. She was not able to determine, however, whether the increased knowledge would translate into positive behavioral changes. Patients' psychiatric symptoms may have interfered with learning resulting in less than ideal improvements in knowledge. These symptoms were hypomanic behavior, restlessness, and distractibility. Perhaps other sessions with experiential techniques (e.g., putting condoms on dummies) would increase their understanding. This program helps fill the information gap not provided by the mass media which avoid mentioning safe-sex practices.

  9. Psychiatric consultations and the management of associated ...

    African Journals Online (AJOL)

    Consultation-liaison psychiatry (CLP) was conceptualised as far back as the late 1800s when. Benjamin Rush promoted interest in the integration of medicine: 'the psychosomatic unity of the body and soul'.[1] Others have described CLP as the practical application of all psychiatric knowledge, ideas and techniques to.

  10. Epigenetics: An Emerging Framework for Advanced Practice Psychiatric Nursing.

    Science.gov (United States)

    DeSocio, Janiece E

    2016-07-01

    The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.

  11. Asperger Syndrome: Associated Psychiatric and Medical Conditions.

    Science.gov (United States)

    Ghaziuddin, Mohammad

    2002-01-01

    This article explores the association of medical and psychiatric conditions with Asperger syndrome, based mainly on publications from the last two decades. It examines comorbidity of Asperger syndrome with mood disorders, schizophrenia, obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, violence and aggression,…

  12. Stability of psychiatric diagnoses in clinical practice.

    Science.gov (United States)

    Daradkeh, T K

    1996-01-01

    This is a retrospective study that aimed at studying the diagnostic stability of psychiatric diagnoses over a 4-year period. Three-hundred and twelve patients (n = 312) admitted more than once to Al Ain in-patient unit from January 1, 1990 to December 31, 1993, were the subjects for this study. The sample included patients with the following index diagnoses: acute psychoses (n = 37), alcohol abuse (n = 15), bipolar disorder (n = 27), depressive disorders (n = 63), drug abuse (n = 21), hysteria (n = 23), neurotic disorders (n = 50) and schizophrenia (n = 76). Diagnoses on discharge for first admissions were considered the index diagnoses. The shift from index diagnoses to subsequent diagnoses was counted. Diagnostic stability was calculated as the percentages of index diagnoses that did not change over time. In nearly half of the patients the index diagnoses changed over the 4-year period. Highest diagnostic stability was found in patients with index diagnoses of alcohol abuse, schizophrenia and drug abuse (92%, 74% and 71% respectively), while the lowest stability was found in patients with neurotic, hysterical, depressive disorders, acute psychoses and bipolar disorders (38%, 48% and 45%, 42%, 52% respectively). Two distinct patterns of shifts were noted. First shift occurred between functional psychoses and second shift between depressive and neurotic disorders. This study provides further support to the notion that diagnostic stability in clinical practice is still far from being satisfactory.

  13. Religion and spirituality in psychiatric practice.

    Science.gov (United States)

    Camp, Mary E

    2011-11-01

    The role of religion and spirituality in psychiatric practice has long been a topic of discussion among mental health providers, patients, and faith communities. This review examines the recent findings in the literature that shape current dialogues on this topic and provide implications for patient care. An increasing body of evidence correlates certain aspects of religion/spirituality with mental and physical health outcomes, and researchers continue to explore how and when psychiatrists should intervene in matters of faith. As this topic is inherently multidisciplinary, many encourage approaches that incorporate neurobiology, faith, and psychology for enhanced understanding of patient experience. Many also stress the importance of effective interpersonal communication between providers and patients, using a person-centered framework. In all of these dialogues, implications for patient care are highlighted. The proper role of religion and spirituality in psychiatry continues as a matter of debate. However, current publications attempt to clarify issues that may lead to more evidence-based and empathic care in this area.

  14. Association between bullying and pediatric psychiatric hospitalizations

    Science.gov (United States)

    Leader, Hadassa; Singh, Jasmine; Ghaffar, Ayesha; de Silva, Cheryl

    2018-01-01

    Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3–12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department. Patients completed the validated Olweus Bully/Victim Questionnaire (OBQ) was analyzed to formulate a report of bullying in our sample as well as a sub-score measurement of bullying victimization. Pediatric residents simultaneously documented whether the subject was a medical versus an in-patient psychiatry admission. Statistical analysis was performed to look for an association between the victimization sub-score and a psychiatric indication for admission. Results: A total of 185 surveys were analyzed. Peak bullying occurred in 7th and 8th grades. Demographics and types of bullying in our sample were described. A strong association between bullying victimization and hospitalization for in-patient psychiatry was demonstrated. Association between bullying victimization and suicidal ideation, psychiatry, and social work consults was also shown. Concern for an association between hospitalization for psychogenic illness and bullying victimization was also raised. Conclusions: There is a significant association between bullying victimization and psychiatric hospital admissions. This raises the specter of the serious consequences of bullying as it is the first study to prospectively link hospital admissions to bullying. Studies using a valid measure of psychogenic illness to look for an association with bullying victimization are needed. PMID:29326819

  15. Psychobiotics: An emerging probiotic in psychiatric practice

    Directory of Open Access Journals (Sweden)

    Arunava Kali

    2016-06-01

    Full Text Available Intestinal microbial flora plays critical role in maintenance of health. Probiotic organisms have been recognized as an essential therapeutic component in the treatment of intestinal dysbiosis. Current research suggests their health benefits extends beyond intestinal disorders. The neuroactive molecules produced by the gut microbiota has been found to modulate neural signals which affect neurological and psychiatric parameters like sleep, appetite, mood and cognition. Use of these novel probiotics opens up the possibility of restructuring of intestinal microbiota for effective management of various psychiatric disorders.

  16. Psychiatric Nurses' Attitude and Practice toward Physical Restraint.

    Science.gov (United States)

    Mahmoud, Amal Sobhy

    2017-02-01

    This study was to assess psychiatric nurses' attitude and practice toward physical restraint among mentally ill patients. A descriptive research design was used to achieve the study objective. The present study was carried out in three specialized governmental mental hospitals and two psychiatric wards in general hospital. A convenient purposive sample of 96 nurses who were working in the previously mentioned setting was included. The tool used for data collection was the Self-Administered Structured Questionnaire; it included three parts: The first comprised items concerned with demographic characteristics of the nurses, the second comprised 10 item measuring nurses' attitudes toward physical restraint, and the third was used to assess nurses' practices regarding use of physical restraint. There were insignificant differences between attitudes and practices in relation to nurses' sex, level of education, years of experience and work place. Moreover, a positive significant correlation was found between nurses' total attitude scores, and practices regarding use of physical restraint. Psychiatric nurses have positive attitude and adequate practice toward using physical restraints as an alternative management for psychiatric patients. It is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. The study recommended that it is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. About the practice of psychiatric euthanasia: a commentary.

    Science.gov (United States)

    Lopez-Castroman, Jorge

    2017-06-27

    Euthanasia motivated by mental disorders is legal in only a few countries and has a short history. In a recent report of all psychiatric euthanasia cases in Belgium between 2002 and 2013, Dierickx and colleagues suggest that the number of these cases is increasing, and provide a profile of the applicants. To date, knowledge of the practice of psychiatric euthanasia is limited, but rising public awareness might increase the number of requests. The authors reveal several shortcomings in cases of psychiatric euthanasia and open avenues for future research.Please see related article: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1369-0.

  18. The Psychiatric Family Nurse Practitioner: A Collaborator in Family Practice

    OpenAIRE

    Cunningham, Patricia D.

    1999-01-01

    The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of ...

  19. Physician-assisted death in psychiatric practice in the Netherlands

    NARCIS (Netherlands)

    Groenewoud, JH; van der Maas, PJ; vanderWal, G; Hengeveld, MW; Tholen, AJ; Schudel, WJ; vanderHeide, A

    1997-01-01

    Background In 1994 the Dutch Supreme Court ruled that in exceptional instances, physician-assist ed suicide might be justifiable for patients with unbearable mental suffering but no physical illness. We studied physician-assisted suicide and euthanasia in psychiatric practice in the Netherlands.

  20. Respect in forensic psychiatric nurse-patient relationships: a practical compromise.

    Science.gov (United States)

    Rose, Donald N; Peter, Elizabeth; Gallop, Ruth; Angus, Jan E; Liaschenko, Joan

    2011-03-01

    The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients. © 2011 International Association of Forensic Nurses.

  1. Understanding the domestic rupture in forensic psychiatric nursing practice.

    Science.gov (United States)

    Jacob, Jean Daniel

    2014-01-01

    The objective of this article is to examine the tensions that exist between care and custody in correctional environments by presenting the (im)possibilities of psychiatric nursing practice within this context. The analysis will be guided by empirical data obtained from a qualitative research conducted in a correctional setting. Semistructured interviews with nurses were conducted and used as the primary source of data for analysis. This article will explore the contextual characteristics of psychiatric nursing practice in correctional settings, describe the alienating effects of this context on nursing practice, theorize nurses' experience using Festinger's theory on cognitive dissonance, and, finally, explore how some nurses engage in the reconstruction of their care to counter the effects of working in correctional settings.

  2. Fear of future terrorism: Associated psychiatric burden.

    Science.gov (United States)

    Abiola, T; Udofia, O; Sheikh, T L; Yusuf, D A

    2017-02-04

    The mental health burden from fear of future terrorism has not been given much research attention compared to the immediate mental distress such as post-traumatic stress disorder (PTSD). Such neglected ongoing mental health morbidity associated with threats of terrorism had been described as pre-traumatic stress syndrome (PTSS). The study highlighted this phenomenon (PTSS) in Nigeria by examining the catastrophic burden of the fear of future terrorism and associated psychiatric burden among adult population in Kaduna city. Participants were students and staff of Kaduna State University (KASU), Kaduna Polytechnic, and students awaiting admission into Kaduna State University. They responded to the following instruments after obtaining their informed consents: a sociodemographic questionnaire, the Terrorism Catastrophising Scale (TCS), and the depression and Generalised Anxiety Disorder (GAD) portion of Mini International Neuropsychiatric Interview (MINI). The TCS showed that 78.8% of the participants had from moderate to severe clinical distress on fear of terrorism. The TCS has a Cronbach's alpha of 0.721 and also had significant moderate correlation with depression (r=0.278; pterrorism was high and this was relatively related to depression and GAD. This highlighted the need for ongoing monitoring and called for their effective prevention from the identified underlying cognitive mechanisms. Copyright © 2017. Published by Elsevier B.V.

  3. Are social theories still relevant in current psychiatric practice?

    Directory of Open Access Journals (Sweden)

    Ajit Avasthi

    2016-01-01

    Full Text Available Current psychiatric practice is being influenced by advances in the field of molecular biology, genetic studies, neuroimaging, and psychopharmacology and the approach has become "biological." Social theories of mental illness had once revolutionized the field of psychiatry and are currently being somewhat ignored under the dazzle of biological sciences. Main social theories are functionalism, interpersonal theory, attachment theory, stress theory, and labeling theory. Each of these theories had tried to explain the genesis of psychiatric disorders in their own way. However, each theory has its own limitations and critique. Still, for a holistic approach to treat persons with mental illness, it is essential to take a biopsychosocial approach which can only be done if one understands the contribution and relevance of social theories. Nonpharmacological management has been the cornerstone of treatment of any psychiatric disorder and social theories also form the basis of various nonpharmacological modes of treatment. Overall, social theories are still very relevant in current psychiatric practice and should not be neglected. Efforts should be made to integrate social theories with other theories of mental illness for better understanding and treatment.

  4. Physician-assisted death in psychiatric practice in the Netherlands.

    Science.gov (United States)

    Groenewoud, J H; van der Maas, P J; van der Wal, G; Hengeveld, M W; Tholen, A J; Schudel, W J; van der Heide, A

    1997-06-19

    In 1994 the Dutch Supreme Court ruled that in exceptional instances, physician-assisted suicide might be justifiable for patients with unbearable mental suffering but no physical illness. We studied physician-assisted suicide and euthanasia in psychiatric practice in the Netherlands. In 1996, we sent questionnaires to 673 Dutch psychiatrists - about half of all such specialists in the country - and received 552 responses from the 667 who met the study criteria (response rate, 83 percent). We estimated the annual frequencies of requests for physician-assisted suicide by psychiatrists and actual instances of assistance. Of the respondents, 205 (37 percent) had at least once received an explicit, persistent request for physician-assisted suicide and 12 had complied. We estimate there are 320 requests a year in psychiatric practice and 2 to 5 assisted suicides. Excluding those who had ever assisted, 345 of the respondents (64 percent) thought physician-assisted suicide because of a mental disorder could be acceptable, including 241 who said they could conceive of instances in which they themselves would be willing to assist. The most frequent reasons for refusing were the belief that the patient had a treatable mental disorder, opposition to assisted suicide in principle, and doubt that the suffering was unbearable or hopeless. Most, but not all, patients who had been assisted by their psychiatrists in suicide had both a mental disorder and a serious physical illness, often in a terminal phase. Thirty percent of the respondents had been consulted at least once by a physician in another specialty about a patient's request for assisted death. The annual number of such consultations was estimated at 310, about 3 percent of the estimated 9700 requests for euthanasia or physician-assisted suicide in medical practice. Explicit requests for physician-assisted suicide are not uncommon in psychiatric practice in the Netherlands, but these requests are rarely granted

  5. Physician-assisted death in psychiatric practice in the Netherlands

    OpenAIRE

    Groenewoud, Hanny; Maas,Paul; van der Wal, Gerrit; Hengeveld, Michiel; Tholen, A.J.; Schudel, Willem; van der Heide, Agnes

    1997-01-01

    textabstractBACKGROUND: In 1994 the Dutch Supreme Court ruled that in exceptional instances, physician-assisted suicide might be justifiable for patients with unbearable mental suffering but no physical illness. We studied physician-assisted suicide and euthanasia in psychiatric practice in the Netherlands. METHODS: In 1996, we sent questionnaires to 673 Dutch psychiatrists - about half of all such specialists in the country - and received 552 responses from the 667 who met the study criteria...

  6. Different Places, Different Ideas: Reimagining Practice in American Psychiatric Nursing After World War II.

    Science.gov (United States)

    Smith, Kylie M

    2018-01-01

    In 1952, Hildegard Peplau published her textbook Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. This was the same year the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (1st ed.; DSM-I; APA). These events occurred in the context of a rapidly changing policy and practice environment in the United States after World War II, where the passing of the National Mental Health Act in 1946 released vast amounts of funding for the establishment of the National Institute of Mental Health and the development of advanced educational programs for the mental health professions including nursing. This article explores the work of two nurse leaders, Hildegard Peplau and Dorothy Mereness, as they developed their respective graduate psychiatric nursing programs and sought to create new knowledge for psychiatric nursing that would facilitate the development of advanced nursing practice. Both nurses had strong ideas about what they felt this practice should look like and developed distinct and particular approaches to their respective programs. This reflected a common belief that it was only through nurse-led education that psychiatric nursing could shape its own practice and control its own future. At the same time, there are similarities in the thinking of Peplau and Mereness that demonstrate the link between the specific social context of mental health immediately after World War II and the development of modern psychiatric nursing. Psychiatric nurses were able to gain significant control of their own education and practice after the war, but this was not without a struggle and some limitations, which continue to impact on the profession today.

  7. Use of empathy in psychiatric practice: constructivist grounded theory study.

    Science.gov (United States)

    Ross, James; Watling, Chris

    2017-01-01

    Psychiatry has faced significant criticism for overreliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and medications with purported disregard for empathetic, humanistic interventions. To develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches. This study used constructivist grounded theory methodology to ask (a) 'How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?' and (b) 'How do psychiatrists learn and teach the skills of empathetic engagement?' The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data. This constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional. Participants were described by empathy-based interventions which are presented in a theory of 'empathetic engagement'. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

  8. Treatment of anxiety disorders by psychiatrists from the American Psychiatric Practice Research Network

    Directory of Open Access Journals (Sweden)

    Katherine Sorsdahl

    2013-06-01

    Full Text Available Objective: Anxiety disorders are highly prevalent in the United States, and if untreated, result in a number of negative outcomes. This study aimed to investigate psychiatrists' current treatment practices for patients with anxiety disorders in the United States. Methods: Psychiatrist-reported data from the 1997 and 1999 American Psychiatric Institute for Research and Education Practice Research Network (PRN Study of Psychiatric Patients and Treatments (SPPT were examined, focusing on patients diagnosed with anxiety disorders. Information related to diagnostic and clinical features and treatments provided were obtained. Results: Anxiety disorders remain underdiagnosed and undertreated, since only 11.4% of the sample received a principal diagnosis of an anxiety disorder in a real world setting. Posttraumatic stress disorder was associated with particularly high comorbidity and disability, and social anxiety disorder was relatively rarely diagnosed and treated. Although combined pharmacotherapy and psychotherapy was commonly used to treat anxiety disorders, anxiolytics were more commonly prescribed than selective serotonin reuptake inhibitors (SSRIs. Conclusions: These data provide a picture of diagnosis and practice patterns across a range of psychiatric settings and suggest that anxiety disorders, despite being among the most prevalent of psychiatric disorders remain underdiagnosed and undertreated particularly in respect of the use of psychotherapeutic interventions.

  9. Use of empathy in psychiatric practice: constructivist grounded theory study

    Science.gov (United States)

    Watling, Chris

    2017-01-01

    Background Psychiatry has faced significant criticism for overreliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and medications with purported disregard for empathetic, humanistic interventions. Aims To develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches. Method This study used constructivist grounded theory methodology to ask (a) ‘How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?’ and (b) ‘How do psychiatrists learn and teach the skills of empathetic engagement?’ The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data. Results This constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional. Conclusions Participants were described by empathy-based interventions which are presented in a theory of ’empathetic engagement’. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28243463

  10. Factors associated with problematic drug use among psychiatric outpatients

    Directory of Open Access Journals (Sweden)

    Clarissa Mendonça Corradi-Webster

    Full Text Available ABSTRACT Objective: to examine the factors associated with problematic drug use among psychiatric outpatients. Method: a cross-sectional study was carried out in two mental health services. Eligible individuals were patients of these mental health services, who used them within the data collection period. Instruments: standardized questionnaire with sociodemographic, social network, social harm, and clinical information; Alcohol, Smoking and Substance Involvement Screening Test; Barratt Impulsiveness Scale; Holmes and Rahe Stress Scale. Statistical analysis was performed using parametric statistics considering a significance level of p ≤ 0.05. Study participants were 243 patients, with 53.9% of these presenting problematic drug use. Results: the most important independent predictors of problematic drug use were marital status (OR = 0.491, religious practice (OR = 0.449, satisfaction with financial situation (OR = 0.469, having suffered discrimination (OR = 3.821 and practicing sports activities in previous 12 months (OR = 2.25. Conclusion: the variables found to be predictors were those related to the social context of the patient, there, it is recommended that mental health services valorize psychosocial actions, seeking to know the social support network of patients, their modes of socialization, their financial needs, and their experiences of life and suffering.

  11. Age at fatherhood: heritability and associations with psychiatric disorders.

    Science.gov (United States)

    Frans, E M; Lichtenstein, P; Hultman, C M; Kuja-Halkola, R

    2016-10-01

    Advancing paternal age has been linked to psychiatric disorders. These associations might be caused by the increased number of de novo mutations transmitted to offspring of older men. It has also been suggested that the associations are confounded by a genetic liability for psychiatric disorders in parents. The aim of this study was to indirectly test the confounding hypotheses by examining if there is a genetic component to advancing paternal age and if men with a genetic liability for psychiatric disorders have children at older ages. We examined the genetic component to advancing paternal age by utilizing the twin model in a cohort of male twins (N = 14 679). We also studied ages at childbirth in men with or without schizophrenia, bipolar disorder and/or autism spectrum disorder. Ages were examined in: (1) healthy men, (2) affected men, (3) healthy men with an affected sibling, (4) men with healthy spouses, (5) men with affected spouses, and (6) men with healthy spouses with an affected sibling. The twin analyses showed that late fatherhood is under genetic influence (heritability = 0.33). However, affected men or men with affected spouses did not have children at older ages. The same was found for healthy individuals with affected siblings. Instead, these men were generally having children at younger ages. Although there is a genetic component influencing late fatherhood, our data suggest that the associations are not explained by psychiatric disorders or a genetic liability for psychiatric disorders in the parent.

  12. Genomewide association studies: history, rationale, and prospects for psychiatric disorders.

    NARCIS (Netherlands)

    Franke, B.; Buitelaar, J.K.; Cichon, S.; Craddock, N.; Daly, M.; Faraone, S.V.; Gejman, P.V.; Kelsoe, J.; Lehner, T.; Levinson, D.F.; Moran, A.; Sklar, P.; Sullivan, P.F.

    2009-01-01

    OBJECTIVE: The authors conducted a review of the history and empirical basis of genomewide association studies (GWAS), the rationale for GWAS of psychiatric disorders, results to date, limitations, and plans for GWAS meta-analyses. METHOD: A literature review was carried out, power and other issues

  13. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  14. Psychiatric consultations and the management of associated ...

    African Journals Online (AJOL)

    This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP) service at the Helen Joseph Hospital (HJH) in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a ...

  15. Associations between Polygenic Risk for Psychiatric Disorders and Substance Involvement

    Directory of Open Access Journals (Sweden)

    Caitlin E Carey

    2016-08-01

    Full Text Available Despite evidence of substantial comorbidity between psychiatric disorders and substance involvement, the extent to which common genetic factors contribute to their co-occurrence remains understudied. In the current study, we tested for associations between polygenic risk for psychiatric disorders and substance involvement (i.e., ranging from ever-use to severe dependence among 2573 non-Hispanic European-American participants from the Study of Addiction: Genetics and Environment. Polygenic risk scores (PRS for cross-disorder psychopathology (CROSS were generated based on the Psychiatric Genomics Consortium’s Cross-Disorder meta-analysis and then tested for associations with a factor representing general liability to alcohol, cannabis, cocaine, nicotine, and opioid involvement (GENSUB. Follow-up analyses evaluated specific associations between each of the 5 psychiatric disorders which comprised CROSS—attention deficit hyperactivity disorder (ADHD, autism spectrum disorder (AUT, bipolar disorder (BIP, major depressive disorder (MDD, and schizophrenia (SCZ—and involvement with each component substance included in GENSUB. CROSS PRS explained 1.10% of variance in GENSUB in our sample (p<0.001. After correction for multiple testing in our follow-up analyses of polygenic risk for each individual disorder predicting involvement with each component substance, associations remained between: A MDD PRS and non-problem cannabis use, B MDD PRS and severe cocaine dependence, C SCZ PRS and non-problem cannabis use and severe cannabis dependence, and D SCZ PRS and severe cocaine dependence. These results suggest that shared covariance from common genetic variation contributes to psychiatric and substance involvement comorbidity.

  16. Interventions for posttraumatic stress disorder in psychiatric practice across Europe: a trainees’ perspective

    Directory of Open Access Journals (Sweden)

    Katja Koelkebeck

    2015-09-01

    Full Text Available Background: With an annual prevalence of 0.9–2.6%, posttraumatic stress disorder (PTSD is very common in clinical practice across Europe. Despite the fact that evidence-based interventions have been developed, there is no evidence on their implementation in clinical practice and in national psychiatric training programmes. Objective and method: The Early Career Psychiatrists Committee of the European Psychiatric Association conducted a survey in 23 European countries to explore implementation of evidence-based interventions for PTSD and training options. Results: The findings indicate that pharmacotherapy was available in the majority of the participating countries (n=19, 82.8%. However, psychological interventions were much less widespread. For example, psychoeducation was widely available in 52% of the countries (n=12, cognitive-behavioural therapy in 26.2% (n=6, and specific trauma-focused techniques were rarely available. Training on PTSD was part of the official training in 13 countries (56.5%, predominantly in the form of theoretical seminars. Conclusions: Overall, this survey indicates that the treatment for PTSD is largely focused on pharmacotherapy, with psychological evidence-based interventions poorly available, especially outside specialized centres. Poor implementation is linked to the lack of official training in evidence-based interventions for psychiatric trainees across Europe.

  17. Gender and Psychiatric Morbidity at First Contact in General Practice ...

    African Journals Online (AJOL)

    Background: Gender is a predictor of prevalence of psychiatric morbidity. The present study was to examine gender difference, prevalence and pattern of psychiatric morbidity among attendees of a general outpatient clinic in a tertiary hospital in sokoto, Nigeria. Methods: A total of 267,000 patients attended the general ...

  18. Psychiatric disorders and obesity: A review of association studies

    Directory of Open Access Journals (Sweden)

    T M Rajan

    2017-01-01

    Full Text Available Background: Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. Aim: This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Materials and Methods: Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle–Ottawa checklist tool. Results: From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15, obesity and anxiety (four and one each on obesity and personality disorders, eating disorder (ED, attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs were similar for developing depression in obesity (OR: 1.21–5.8 and vice versa (OR: 1.18–3.76 with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27–1.40. Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5. Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84. Conclusion: Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric

  19. Psychiatric disorders and obesity: A review of association studies

    Science.gov (United States)

    Rajan, TM; Menon, V

    2017-01-01

    Background: Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. Aim: This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Materials and Methods: Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle–Ottawa checklist tool. Results: From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15), obesity and anxiety (four) and one each on obesity and personality disorders, eating disorder (ED), attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs) were similar for developing depression in obesity (OR: 1.21–5.8) and vice versa (OR: 1.18–3.76) with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27–1.40). Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5). Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84). Conclusion: Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric conditions

  20. Genomewide association studies: history, rationale, and prospects for psychiatric disorders.

    Science.gov (United States)

    Cichon, Sven; Craddock, Nick; Daly, Mark; Faraone, Stephen V; Gejman, Pablo V; Kelsoe, John; Lehner, Thomas; Levinson, Douglas F; Moran, Audra; Sklar, Pamela; Sullivan, Patrick F

    2009-05-01

    The authors conducted a review of the history and empirical basis of genomewide association studies (GWAS), the rationale for GWAS of psychiatric disorders, results to date, limitations, and plans for GWAS meta-analyses. A literature review was carried out, power and other issues discussed, and planned studies assessed. Most of the genomic DNA sequence differences between any two people are common (frequency >5%) single nucleotide polymorphisms (SNPs). Because of localized patterns of correlation (linkage disequilibrium), 500,000 to 1,000,000 of these SNPs can test the hypothesis that one or more common variants explain part of the genetic risk for a disease. GWAS technologies can also detect some of the copy number variants (deletions and duplications) in the genome. Systematic study of rare variants will require large-scale resequencing analyses. GWAS methods have detected a remarkable number of robust genetic associations for dozens of common diseases and traits, leading to new pathophysiological hypotheses, although only small proportions of genetic variance have been explained thus far and therapeutic applications will require substantial further effort. Study design issues, power, and limitations are discussed. For psychiatric disorders, there are initial significant findings for common SNPs and for rare copy number variants, and many other studies are in progress. GWAS of large samples have detected associations of common SNPs and of rare copy number variants with psychiatric disorders. More findings are likely, since larger GWAS samples detect larger numbers of common susceptibility variants, with smaller effects. The Psychiatric GWAS Consortium is conducting GWAS meta-analyses for schizophrenia, bipolar disorder, major depressive disorder, autism, and attention deficit hyperactivity disorder. Based on results for other diseases, larger samples will be required. The contribution of GWAS will depend on the true genetic architecture of each disorder.

  1. Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

    Science.gov (United States)

    Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

    2014-04-07

    Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

  2. Advanced psychiatric nurse practitioners’ ideas and needs for supervision in private practice in South Africa

    Directory of Open Access Journals (Sweden)

    Annie M. Temane

    2014-02-01

    Full Text Available Background: Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field.Objectives: The aim of this study was to explore and describe advanced psychiatric nursepractitioners’ ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa.Method: A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch’s method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature.Results: The data analysis generated the following themes – that the supervisor should have or possess: (a professional competencies, (b personal competencies and (c specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa.Conclusion: This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

  3. We are different: the voices of psychiatric advanced practice nurses on the performance of their roles.

    Science.gov (United States)

    Fung, Yuen-Ling; Chan, Zenobia C Y; Chien, Wai-Tong

    2016-02-01

    Many studies have affirmed that psychiatric advanced practice nurses (APNs) perform multifaceted roles. However, only a limited amount of research has been conducted on their perceptions of the performance of their roles. To explore the lived experiences of psychiatric APNs concerning the performance of their roles. Data were collected from individual semi-structured interviews and analysed using the interpretative phenomenological analysis method. The study was conducted in a hospital cluster in Hong Kong. Thirteen psychiatric APNs were purposively recruited. Three themes were discerned, namely, 'We are different', 'Who am I?', and 'I am who I am'. The findings can help psychiatric APNs and nurse administrators to better understand the needs of the role-bearers (APNs) and to develop strategies to support the development of advanced psychiatric nursing practices in Hong Kong and worldwide.

  4. Difficult encounters with psychiatric patients: a South Texas Psychiatry practice-based research network (PBRN) study.

    Science.gov (United States)

    Sellers, Randall V; Salazar, Ricardo; Martinez, Cervando; Gelfond, Stephen D; Deuter, Melissa; Hayes, Holly G; Ketchum, Norma; Pollock, Brad H

    2012-01-01

    To examine the prevalence of difficult psychiatrist-patient interactions of 20 psychiatrists in the South Texas Psychiatric practice-based research network, determine what characteristics were associated with "difficult" patients, and compare findings with previous studies in primary care. During a 2-month observational study, psychiatrists collected patient information on setting, demographics, diagnoses, and medications and rated the patients using the Difficult Doctor-Patient Relationship Questionnaire, which had previously been used and validated in the primary care setting. A total of 905 valid data cards were collected. Difficult patients were identified in 15% of the sample. Diagnoses of schizophrenia, alcohol/substance abuse, and personality disorder were associated with difficulty. Psychiatrists least burdened by difficult patients were older and in a solo practice and worked 51 to 55 hours per week. This cross-sectional study demonstrates that psychiatrists encounter difficult patients at a rate (15%) similar to that of primary care physicians. Mentoring programs and structured treatment interventions for the most difficult patient groups may assist all physicians who treat psychiatric patients, whether in specialty, family medicine, or other primary care settings.

  5. Exposure to violence: associations with psychiatric disorders in Brazilian youth.

    Science.gov (United States)

    Fidalgo, Thiago M; Sanchez, Zila M; Caetano, Sheila C; Andreoni, Solange; Sanudo, Adriana; Chen, Qixuan; Martins, Sílvia S

    2018-02-15

    The effects of exposure to violent events in adolescence have not been sufficiently studied in middle-income countries such as Brazil. The aims of this study are to investigate the prevalence of psychiatric disorders among 12-year-olds in two neighborhoods with different socioeconomic status (SES) levels in São Paulo and to examine the influence of previous violent events and SES on the prevalence of psychiatric disorders. Students from nine public schools in two neighborhoods of São Paulo were recruited. Students and parents answered questions about demographic characteristics, SES, urbanicity and violent experiences. All participants completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to obtain DSM-IV diagnoses. The data were analyzed using weighted logistic regression with neighborhood stratification after adjusting for neighborhood characteristics, gender, SES and previous traumatic events. The sample included 180 individuals, of whom 61.3% were from low SES and 39.3% had experienced a traumatic event. The weighted prevalence of psychiatric disorders was 21.7%. Having experienced a traumatic event and having low SES were associated with having an internalizing (adjusted OR = 5.46; 2.17-13.74) or externalizing disorder (adjusted OR = 4.33; 1.85-10.15). Investment in reducing SES inequalities and preventing violent events during childhood may improve the mental health of youths from low SES backgrounds.

  6. The Competencies, Roles and Scope of Practice of Advanced Psychiatric Nursing in Indonesia

    Directory of Open Access Journals (Sweden)

    Yulia Wardani

    2014-01-01

    Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.

  7. Abuse Characteristics and Psychiatric Consequences Associated with Online Sexual Abuse.

    Science.gov (United States)

    Say, Gökçe Nur; Babadağı, Zehra; Karabekiroğlu, Koray; Yüce, Murat; Akbaş, Seher

    2015-06-01

    The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.

  8. Role performance of psychiatric nurses in advanced practice: a systematic review of the literature.

    Science.gov (United States)

    Fung, Y L; Chan, Z; Chien, W T

    2014-10-01

    This paper discusses findings from a systematic review of literature pertaining to the role performance of psychiatric nurses in advanced practice. A search of 11 electronic databases was conducted to identify research involving interventions by psychiatric (or mental health) nurses in advanced practice. A total of 14 studies were identified. In this review, the role performance of psychiatric nurses in advanced practice was categorized into three themes: (1) the provision of psychosocial interventions; (2) the provision of nurse-directed services in health-care contexts; and (3) the provision of psychiatric nursing consultation services. Our results document that psychiatric nurses in advanced practice perform multifaceted roles and provide mental health-care services in various contexts. This systematic review reveals that the nurses obtain significant results in managing clients with depression and psychological stress, and demonstrates their value when developing partnerships with non-mental health service providers. One study, however, showed that the nurses had insignificant results in performing transitional care for pre-discharged mental health service users. © 2013 John Wiley & Sons Ltd.

  9. Association between cigarette smoking and suicide in psychiatric inpatients

    Directory of Open Access Journals (Sweden)

    Hooman Sharifi

    2013-02-01

    Full Text Available Introduction Cigarette smoking is the single largest preventable cause of death and disability in the industrialized world and it causes at least 85% of lung cancers, chronic bronchitis and emphysema. In addition smokers are at a higher risk from psychiatric co-morbid illness such as depression and completed suicide. Methods We conducted a cross-sectional survey in which we targeted all patients with serious mental illness (SMI who were admitted in Razi mental health Hospital in Tehran, Iran. We recruited 984 participants, who were receiving services from Razi mental health Hospital and hospitalized for at least two days between 21 July to 21 September, 2010. Nine hundred and fifty patients out of this figure were able to participate in our study. Results The final study sample (n = 950 consisted of 73.2% males and 26.8% females. The mean age was 45.31 (SD=13.7. A majority of participants (70% was smoker. A history of never smoking was present for 25.2% of the study sample; while 4.8% qualified as former smokers and 70.0% as occasional or current smokers. Two hundred and nineteen participants had attempted suicide amongst them 102 (46.6% once, 37 (16.9% twice, and 80 (36.5% attempted more than two times in their life time. In regression model, gender, age, and cigarette consumption were associated with previous suicide attempts and entered the model in this order as significant predictors. Conclusion There is an association of cigarette smoking and suicide attempt in psychiatric inpatients. Current smoking, a simple clinical assessment, should trigger greater attention by clinicians to potential suicidality and become part of a comprehensive assessment of suicide risk.

  10. Irish psychiatric nurses' self-reported sources of knowledge for practice.

    LENUS (Irish Health Repository)

    Yadav, B L

    2012-02-01

    Evidence-based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence-Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.

  11. Associations between Pathological Gambling and Psychiatric Comorbidity among Help-Seeking Populations in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N=201 who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.

  12. Psychiatric behaviors associated with cytoskeletal defects in radial neuronal migration.

    Science.gov (United States)

    Fukuda, Toshifumi; Yanagi, Shigeru

    2017-10-01

    Normal development of the cerebral cortex is an important process for higher brain functions, such as language, and cognitive and social functions. Psychiatric disorders, such as schizophrenia and autism, are thought to develop owing to various dysfunctions occurring during the development of the cerebral cortex. Radial neuronal migration in the embryonic cerebral cortex is a complex process, which is achieved by strict control of cytoskeletal dynamics, and impairments in this process are suggested to cause various psychiatric disorders. Our recent findings indicate that radial neuronal migration as well as psychiatric behaviors is rescued by controlling microtubule stability during the embryonic stage. In this review, we outline the relationship between psychiatric disorders, such as schizophrenia and autism, and radial neuronal migration in the cerebral cortex by focusing on the cytoskeleton and centrosomes. New treatment strategies for psychiatric disorders will be discussed.

  13. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    LENUS (Irish Health Repository)

    Yadav, B L

    2012-03-01

    Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

  14. Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

    Science.gov (United States)

    Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

    2017-05-01

    To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. HIV-associated neurocognitive disorder: rate of referral for neurorehabilitation and psychiatric co-morbidity.

    LENUS (Irish Health Repository)

    Herlihy, D

    2012-04-01

    Despite advances in antiretroviral therapy, HIV-infected patients continue to present with HIV-associated neurocognitive disorder (HAND) which may be associated with significant psychiatric co-morbidity. We audited our patients with HAND referred for psychiatric assessment against the National Service Framework guidelines that they should receive neurorehabilitation. We found that despite these patients posing a risk to themselves and others due to poor insight and medication adherence, high rates of psychiatric co-morbidity and severely challenging behaviour, few were referred for neurorehabilitation. We recommend that clear referral pathways for psychiatric intervention and neurorehabilitation are established in HIV treatment centres.

  16. Recent trends in the use of psychosocial interventions in foreign forensic psychiatric practice (Part I

    Directory of Open Access Journals (Sweden)

    Bulygina V.G.

    2014-09-01

    Full Text Available This article examines contemporary paradigm of rehabilitation of the mentally ill persons. We describe the specific features and efficiency factors of psychosocial interventions used in compulsory treatment. We highlight the key strategies of psychosocial interventions used in foreign forensic psychiatric practice.

  17. Implementation of information technology in nursing practice - challenge for management in psychiatric nursing.

    Science.gov (United States)

    Koivunen, Marita; Hätönen, Heli; Välimäki, Maritta

    2009-01-01

    The implementation of information technology (IT) applications in nursing practice requires systematic investments and guidance. A collaborative organisational culture, and systematic and close clinical and administrative cooperation during the implementation process support the acceptance of IT among users in organisation. Although knowledge of IT projects management exists, there is a lack of knowledge about nursing management in IT implementation processes in psychiatric nursing.

  18. Factors associated with problematic drug use among psychiatric outpatients.

    Science.gov (United States)

    Corradi-Webster, Clarissa Mendonça; Gherardi-Donato, Edilaine Cristina da Silva

    2016-11-28

    to examine the factors associated with problematic drug use among psychiatric outpatients. a cross-sectional study was carried out in two mental health services. Eligible individuals were patients of these mental health services, who used them within the data collection period. Instruments: standardized questionnaire with sociodemographic, social network, social harm, and clinical information; Alcohol, Smoking and Substance Involvement Screening Test; Barratt Impulsiveness Scale; Holmes and Rahe Stress Scale. Statistical analysis was performed using parametric statistics considering a significance level of p ≤ 0.05. Study participants were 243 patients, with 53.9% of these presenting problematic drug use. the most important independent predictors of problematic drug use were marital status (OR = 0.491), religious practice (OR = 0.449), satisfaction with financial situation (OR = 0.469), having suffered discrimination (OR = 3.821) and practicing sports activities in previous 12 months (OR = 2.25). the variables found to be predictors were those related to the social context of the patient, there, it is recommended that mental health services valorize psychosocial actions, seeking to know the social support network of patients, their modes of socialization, their financial needs, and their experiences of life and suffering. analisar os fatores associados ao consumo problemático de droga entre pacientes psiquiátricos ambulatoriais. estudo transversal em dois serviços de saúde mental. Foram considerados indivíduos elegíveis os usuários desses serviços de saúde mental, que os utilizaram dentro do período de coleta de dados. Instrumentos: Questionário padronizado sobre dados sociodemográficos, redes sociais, prejuízos sociais e informações clínicas; Teste de Triagem do Envolvimento com Álcool, Cigarro e outras Substâncias (ASSIST); Escala de Impulsividade de Barratt; e Escala de Avaliação de Reajustamento Social de Holmes e Rahe. A análise estat

  19. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products

    Directory of Open Access Journals (Sweden)

    F. Saverio Bersani

    2015-01-01

    Full Text Available Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications.

  20. Polypharmacy in psychiatric out- patient practice in northern Nigeria

    African Journals Online (AJOL)

    Introduction. Polypharmacy in psychiatry refers to the concurrent use of two or more psychotropic medications in a patient. It is an old practice that is increasingly becoming the norm rather than the exception. In the. 1960s and 70s, a limited understanding of therapeutics resulted in psychotropic polypharmacy that was ...

  1. The cultural formulation: A model to combine nosology and patients' life context in psychiatric diagnostic practice.

    Science.gov (United States)

    Bäärnhielm, Sofie; Scarpinati Rosso, Marco

    2009-09-01

    This article discusses the experience of adapting and applying the Outline for a Cultural Formulation in DSM-IV to the Swedish context. Findings from a research project on the Cultural Formulation highlight the value of combining psychiatric nosological categorization with an understanding of patients' cultural life context in order to increase the validity of categorization and to formulate individualized treatment plans. In clinical care practitioners need models and tools that help them take into account patients' cultural backgrounds, needs, and resources in psychiatric diagnostic practice. We present a summary of a Swedish manual for conducting a Cultural Formulation interview. The need for further development of the Cultural Formulation is also discussed.

  2. Alzheimer´s Disease associated with Psychiatric Comorbidities

    Directory of Open Access Journals (Sweden)

    Michelle L. Garcez

    2015-08-01

    Full Text Available Alzheimer's disease (AD is the most common cause of dementia and has become a severe public health issue. It is estimated that globally, 35.6% of people have some form of dementia. This number is expected to double by 2030, and possibly even triple by 2050. The disease is associated with deficits in cognition/memory and a reduced ability in coping with everyday life. Moreover, patients can experience behavioral alterations such as mood swings, depression and hallucinations. Therefore, it is common to find the presence of neuropsychiatric comorbidities such as depression, schizophrenia and bipolar disorder during the course or development of AD. These disorders can become severe enough to interfere with the patients daily functioning, and can worsen the course of the disease. However, little is known about the causal relationship between psychiatric comorbidities and AD, or the reasons for the predisposition of some individuals to such disorders. Therefore, the purpose of this review is to clarify the causal relationship between depression, schizophrenia and bipolar disorder with AD.

  3. The detrimental impact of maladaptive personality on public mental health: a challenge for psychiatric practice

    Directory of Open Access Journals (Sweden)

    Michael Pascal Hengartner

    2015-06-01

    Full Text Available Experts in personality psychology and personality disorders have long emphasised the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment and disability pensioning; second, relate to the prevalence, incidence and co-occurrence of common mental disorders; third, impair functioning, symptom remission and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders, but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice.

  4. The Detrimental Impact of Maladaptive Personality on Public Mental Health: A Challenge for Psychiatric Practice

    Science.gov (United States)

    Hengartner, Michael Pascal

    2015-01-01

    Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment, and disability pensioning; second, relate to the prevalence, incidence, and co-occurrence of common mental disorders; third, impair functioning, symptom remission, and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice. PMID:26106335

  5. [Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

    Science.gov (United States)

    Paslakis, G; Schredl, M; Alm, B; Sobanski, E

    2013-08-01

    Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Tattoos as a window to the psyche: How talking about skin art can inform psychiatric practice.

    Science.gov (United States)

    Roggenkamp, Hannah; Nicholls, Andrew; Pierre, Joseph M

    2017-09-22

    Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

  7. The Psychiatric Cultural Formulation: Applying Medical Anthropology in Clinical Practice

    Science.gov (United States)

    Aggarwal, Neil Krishan

    2014-01-01

    This paper considers revisions to the DSM-IV Outline for Cultural Formulation from the perspective of clinical practice. First, the paper explores the theoretical development of the Cultural Formulation. Next, a case presentation demonstrates challenges in its actual implementation. Finally, the paper recommends a set of questions for the clinician on barriers to care and countertransference. The development of a standardized, user-friendly format can increase the Cultural Formulation’s utilization among all psychiatrists beyond those specializing in cultural psychiatry. PMID:22418398

  8. [Practicals in a psychiatric clinic for occupational orientation in pupils].

    Science.gov (United States)

    Schaub, Annette; Mueser, Kim; Schmidt, Ann-Kathrin; Koller, Gabriele; Falkai, Peter

    2017-09-01

    This pilot study investigates the implementation of a practical program for pupils including psychoeducation aimed to educate them about professions in psychiatry. 29 persons aged between 16-21 years were included in the program for vocational orientation at the Department of Psychiatry and Psychotherapy, University of Munich, from 2013-2016. The 1-2-week program provides information about job descriptions of psychologists and physicians. On average the pupils performed at M=2.75, SD=0.64 and they were motivated. At the end of their practical course, they reported that their fear of contact with inpatients decreased. Their knowledge in psychiatry and psychotherapy increased. 59 % of the participants reported that they plan to study medicine or psychology. All young adolescents reported that they satisfied with the program. Enhancing contact with patients and their caretakers may serve to decrease anxiety and prejudices as well as to increase interest and knowledge in this area. Georg Thieme Verlag KG Stuttgart · New York.

  9. Crack and Cocaine Use among Adolescents in Psychiatric Treatment: Associations with HIV Risk

    Science.gov (United States)

    Tolou-Shams, Marina; Feldstein Ewing, Sarah W. Tarantino, Nicholas; Brown, Larry K.

    2010-01-01

    Crack and cocaine use among adults has been associated with co-occurring psychiatric disorders as well as other drug use and unprotected sex. However, this issue is relatively unstudied in adolescents. This study collected data from 282 adolescents (mean age = 14.9 years) treated in intensive psychiatric treatment settings to understand the…

  10. Knowledge and practices of general practitioners regarding psychiatric problems

    Directory of Open Access Journals (Sweden)

    R K Chaudhary

    2009-01-01

    Full Text Available Background: Mental health problems account for 12% of global disease burden and non-psychiatrist medical practitioners deal with a large proportion of this burden. This study was planned to assess the knowledge, attitude and treatment practices of non-psychiatrist medical practitioners regarding mental health problems. Materials and Methods: One hundred Allopathic and 25 each of Homeopathic and Ayurvedic medical practitioners were interviewed and assessed using a semi-structured performa. Results: Majority (95% of them were aware regarding etiology, increasing incidence and treatment facilities available for mental health problems. Treatment modalities include counseling and medication but 69.9% of them had not received any formal training in administering them. Conclusions: 98.5% practitioners providing mental health services at the primary level feel the need to be properly trained and oriented in the management of these patients to improve quality of healthcare.

  11. 7. Bipolar disorder in child psychiatric practice.cdr

    African Journals Online (AJOL)

    ESEM

    children, despite its potentially debilitating effects on growth and development. It may be comorbid with ... and mental disorders associated with the abuse of alcohol and cannabinol. The mother is HIV-positive (since ... old Memory's sister diagnosed with bipolar I disorder and generalized anxiety disorder. The parents are ...

  12. Psychiatric disorders in Ehlers-Danlos syndrome are frequent, diverse and strongly associated with pain.

    Science.gov (United States)

    Hershenfeld, Samantha Aliza; Wasim, Syed; McNiven, Vanda; Parikh, Manasi; Majewski, Paula; Faghfoury, Hanna; So, Joyce

    2016-03-01

    Ehlers-Danlos syndromes (EDS) are a heterogeneous group of hereditary connective tissue disorders characterized by joint hypermobility, widespread musculoskeletal pain and tissue fragility. Psychiatric disorders and psychosocial impairment are common, yet poorly characterized, findings in EDS patients. We investigated the frequency and types of psychiatric disorders and their relationship to systemic manifestations in a cohort of 106 classic and hypermobility type EDS patients. In this retrospective study, extensive medical chart review was performed for patients referred at two genetics clinics who were diagnosed with EDS. Statistical analysis was undertaken to determine the frequency of psychiatric disorders and association with systemic findings. Psychiatric disorders were found in 42.5% of the EDS cohort, with 22.7% of patients affected with 2 or more psychiatric diagnoses. Anxiety and depression were most commonly reported, with frequencies of 23.6 and 25.5%, respectively. A variety of other psychiatric diagnoses were also identified. Abdominal pain [odds ratio (OR) 7.38], neuropathic pain (OR 4.07), migraines (OR 5.21), joint pain (OR 2.85) and fatigue (OR 5.55) were significantly associated with the presence of a psychiatric disorder. The presence of any pain symptom was significantly associated with having a psychiatric disorder (OR 9.68). Muscle pain (OR 2.79), abdominal pain (OR 5.78), neuropathic pain (OR 3.91), migraines (OR 2.63) and fatigue (OR 3.78) were significantly associated with having an anxiety or mood disorder. Joint hypermobility and the classic dermatological features of EDS showed no significant association with having a psychiatric disorder. Our findings demonstrate a high frequency of psychiatric disorders and an association with pain symptoms in EDS.

  13. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice.

    Science.gov (United States)

    Slemon, Allie; Jenkins, Emily; Bungay, Vicky

    2017-10-01

    The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

  14. Psychiatric Morbidity and Its Associated Factors, amongst Third Year ...

    African Journals Online (AJOL)

    Background: The problem of psychiatric morbidity among university students is important because subsequent impairment of the student's capacity for study may invariably lead to the termination of their studies(various works, as reviewed in the literature, have confirmed this). Aim/Objective: The aim of this study was to ...

  15. Competence to consent to voluntary psychiatric hospitalization: a test of a standard proposed by APA. American Psychiatric Association.

    Science.gov (United States)

    Appelbaum, B C; Appelbaum, P S; Grisso, T

    1998-09-01

    In the wake of the U.S. Supreme Court's 1990 decision in Zinermon v. Burch, renewed attention has been given to capacities patients must have to be considered competent to consent to voluntary hospitalization. An American Psychiatric Association (APA) task force suggested that strong policy interests support the establishment of a low threshold for competence in this situation. The study examined whether, as previous research suggested, patients would have difficulty meeting even this lenient standard. One hundred voluntarily hospitalized psychiatric patients were read two brief paragraphs, one explaining the purposes of psychiatric hospitalization and and the other explaining policies for discharge. The paragraphs' readability measured about eighth-grade level. After each paragraph, participants were read two sets of questions, one testing recall of the presented information and the other testing recognition of the information in a true-false format. The scores of patients grouped by selected demographic and clinical variables were compared. The vast majority of patients were able to comprehend the information that the APA task force suggested was relevant to their decision. However, a subgroup of patients who were initially admitted involuntarily had significantly poorer performance and may constitute a group who need special educational efforts focused on the consequences of voluntary admission.

  16. Association between income trajectories in childhood and psychiatric disorder: a Swedish population-based study.

    Science.gov (United States)

    Björkenstam, Emma; Cheng, Siwei; Burström, Bo; Pebley, Anne R; Björkenstam, Charlotte; Kosidou, Kyriaki

    2017-07-01

    Childhood family income variation is an understudied aspect of households' economic context that may have distinct consequences for children. We identified trajectories of childhood family income over a 12-year period, and examined associations between these trajectories and later psychiatric disorders, among individuals born in Sweden between 1987 and 1991 (n=534 294). We used annual income data between the ages of 3-14 years and identified 5 trajectories (2 high-income upward, 1 downward and 2 low-income upward trajectories). Psychiatric disorders in the follow-up period after age 15 were defined from International Classification of Disease (ICD)-codes in a nationwide patient register. Multiadjusted risks for all psychiatric disorders, as well as for specific psychiatric diagnoses, were calculated as HRs with 95% CIs. Of the 5 identified income trajectories, the constant low and the downward trajectories were particularly associated with later psychiatric disorder. Children with these trajectories had increased risks for psychiatric disorder, including mood, anxiety, psychotic disorders and attention deficit/hyperactivity disorder. The association remained, even after adjusting for important variables including parental psychiatric disorder. In contrast, the relationship was reversed for eating disorders, for which children in higher income trajectories had elevated risks. Findings show that children growing up in a household characterised by low or decreasing family income have an increased risk for psychiatric disorder. Continued work is needed to reduce socioeconomic inequalities in psychiatric disorders. Policies and interventions for psychiatric disorders should consider the socioeconomic background of the family as an important risk or protective factor. 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/.

  17. Exploring the influence of gestalt therapy training on psychiatric nursing practice: stories from the field.

    Science.gov (United States)

    Kelly, Teresa; Howie, Linsey

    2011-08-01

    Psychiatric nurses interested in extending their interpersonal and psychotherapeutic skills sometimes undertake postgraduate training in gestalt therapy. Little is known about how this new knowledge and psychotherapeutic skill base informs their practice. This paper presents the findings of a qualitative study that aimed to explore the influence of gestalt therapy training on psychiatric nursing practice. Within a framework of narrative inquiry, four psychiatric nurses trained in gestalt therapy were invited to tell their stories of training in a gestalt approach to therapy, and recount their experiences of how it influenced their practice. In keeping with narrative analysis methods, the research findings were presented as a collection of four stories. Eight themes were derived from a thematic analysis conducted within and across the four stories. The discussion of the themes encapsulates the similarities and differences across the storied collection, providing a community and cultural context for understanding the individual stories. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  18. Association between moral distress and job satisfaction of Japanese psychiatric nurses

    Directory of Open Access Journals (Sweden)

    Michiyo Ando

    2016-08-01

    Full Text Available Moral distress of psychiatric nurses may affect their job satisfaction or quality of nursing care, thus examination of their moral distress is a significant issue for practice. The purpose of this study was to investigate the level of moral distress and job satisfaction, and association between moral distress and job satisfaction. One hundred and thirty nurses who worked in psychiatric wards in a hospital in Japan completed the Moral Distress Scale for psychiatric nurses (MDS-P and the Job Satisfaction scale (JS. The MDS-P consisted of subdomains such as “unethical conduct by caregivers,” “low staffing,” and “acquiescence to violations of patients’ rights” in intensity and frequency; the JS consisted of seven subcategories. An institutional review board in the researcher’s college approved this study. Results showed that the “acquiescence to violations of patients’ rights” was the highest of the subdomains of MDS-P, and the “interactions among nurses” was the highest of the subdomains of the JS. The unethical conduct by caregivers (MDS-P score was negatively correlated with administration (JS for intensity (r = -.40, p < .001 and frequency (r = .37, p < .001. Moreover “acquiescence to violations of patients’ rights (MDS-P” was also negatively correlated with the “task requirement (JS” score for intensity (r = -0.49, p < .001 and for frequency (r = -0.50, p < .001. These results suggest that reduction of moral distress increases job satisfaction particularly for administration and task requirement in nursing care.

  19. Association between childhood abuse and psychiatric morbidities among hospitalized patients

    Directory of Open Access Journals (Sweden)

    Kshirod Kumar Mishra

    2016-01-01

    Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

  20. Prevalence of substance use and association with psychiatric illness ...

    African Journals Online (AJOL)

    A lifetime prevalence rate of 48.4% use of substances was found. The prevalence rate of current use of alcohol was 36.3%; cannabis 28.3%; cigarette 14.5%; Cocaine 0.8%; snuff/fumes 2.4%; Pain killers and kola nuts 1.6%. About 51.7% of the subjects used two or more substances. Substance use preceded first psychiatric ...

  1. The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates.

    Science.gov (United States)

    Kane, Catherine F

    2015-01-31

    The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice. Implications for nursing education and a companion resource are discussed.

  2. Therapist Adherence to Good Psychiatric Practice in a Short-Term Treatment for Borderline Personality Disorder.

    Science.gov (United States)

    Kolly, Stéphane; Despland, Jean-Nicolas; de Roten, Yves; Marquet, Pierre; Kramer, Ueli

    2016-07-01

    Therapist adherence describes the quality of interventions according to the imperatives of a treatment model. We examined the relationship between therapist adherence and symptom change in the context of a short-term treatment with respect good psychiatric management (GPM) principles. Based on a parent trial, borderline personality disorder patients (N = 40) benefited from a 10-session intervention. Adherence to GPM was assessed using a GPM Adherence Scale (GPMAS). The psychometric properties of the GPMAS were excellent, and the adherence to GPM explained 16% of the general symptom improvement (t(1) = 2.38, β = 0.40, p = 0.02) and 23% of the borderline symptom improvement (t(1) = 2.46, β = 0.48, p = 0.02). Because GPM adherence predicts the outcome after only 10 sessions, GPMAS is a valuable measure early on in psychiatric practice as part of an initial step to longer-term treatment, to quickly detect problems and correct them.

  3. Use of psychiatric inpatient capacities and diagnostic practice in Tashkent/Uzbekistan as compared to Berlin/Germany.

    Science.gov (United States)

    Mundt, Adrian P; Fakhriddinov, Sardor; Fayzirahmanova, Maria; Aichberger, Marion C; Ivens, Sebastian; Schouler-Ocak, Meryam; Grohmann, Renate; Magzumova, Shakhnoza; Heinz, Andreas; Sartorius, Norman; Ströhle, Andreas

    2011-12-01

    The present study shows a comparison of diagnoses used for the treatment of urban psychiatric inpatients in Tashkent/Uzbekistan and Berlin/Germany. Differential diagnostic practices related to different traditions in psychopathology between the two settings are analysed to explain part of the difference in relative frequencies of the diagnoses. We conducted a cross-sectional survey of diagnoses used for the treatment of 845 inpatients including 17 out of 18 wards of the Tashkent psychiatric hospital and of all 2,260 psychiatric and psychotherapeutic inpatients in Berlin in October 2008. Relative frequencies of diagnostic categories were calculated for each setting and compared between the two settings using the Chi-square test. A descriptive analysis of differential diagnostic practice is used to explain differences in relative frequencies. Patients diagnosed with schizophrenia (59.3 vs. 21.0%), with organic mental disorders (20.5 vs. 8.3%), with mental retardation (6.9 vs. 0.2%) and with neurasthenia (1.4 vs. 0.0%) had larger relative frequencies of the psychiatric inpatient population in Tashkent than in Berlin. Patients diagnosed with unipolar depression (24.1 vs. 0.9%), substance use disorder (17.4 vs. 6.4%), adjustment disorder (6.0 vs. 0.4%), schizoaffective disorder (4.9 vs. 0.0%), mania and bipolar disorder (5.3 vs. 0.4%), personality disorder (3.2 vs. 2.0%) and anxiety disorder (3.1 vs. 0.1%) had larger relative frequencies in Berlin than in Tashkent. The diagnostic concept of schizophrenia in Tashkent includes patients with affective psychoses, schizoaffective psychoses and delusional disorders. In Tashkent, mental disorders are more readily associated with organic brain disease such as head trauma or vascular disease than in Berlin. In Tashkent, most of the psychiatric inpatient capacities are used for the treatment of schizophrenia and organic mental disorders, whereas in Berlin patients with affective disorders, schizophrenia and substance use

  4. The Low Proportion and Associated Factors of Involuntary Admission in the Psychiatric Emergency Service in Taiwan

    Science.gov (United States)

    Wang, Jen-Pang; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Wu, Chia-Yi; Chou, Pesus

    2015-01-01

    Background The involuntary admission regulated under the Mental Health Act has become an increasingly important issue in the developed countries in recent years. Most studies about the distribution and associated factors of involuntary admission were carried out in the western countries; however, the results may vary in different areas with different legal and socio-cultural backgrounds. Aims The aim of this study was to investigate the proportion and associated factors of involuntary admission in a psychiatric emergency service in Taiwan. Methods The study cohort included patients admitted from a psychiatric emergency service over a two-year period. Demographic, psychiatric emergency service utilization, and clinical variables were compared between those who were voluntarily and involuntarily admitted to explore the associated factors of involuntary admission. Results Among 2,777 admitted patients, 110 (4.0%) were involuntarily admitted. Police referrals and presenting problems as violence assessed by psychiatric nurses were found to be associated with involuntary admission. These patients were more likely to be involuntarily admitted during the night shift and stayed longer in the psychiatric emergency service. Conclusions The proportion of involuntary admissions in Taiwan was in the lower range when compared to Western countries. Dangerous conditions evaluated by the psychiatric nurses and police rather than diagnosis made by the psychiatrists were related factors of involuntary admission. As it spent more time to admit involuntary patients, it was suggested that multidisciplinary professionals should be included in and educated for during the process of involuntary admission. PMID:26046529

  5. A statistical perspective on association studies of psychiatric disorders

    DEFF Research Database (Denmark)

    Foldager, Leslie

    2014-01-01

    Gene-gene (GxG) and gene-environment (GxE) interactions likely play an important role in the aetiology of complex diseases like psychiatric disorders. Thus, we aim at investigating methodological aspects of and apply methods from statistical genetics taking interactions into account. In addition we...... genes and maternal infection by virus. Paper 3 presents the initial steps (mainly data construction) of an ongoing simulation study aiming at guiding decisions by comparing methods for GxE interaction analysis including both traditional two-step logistic regression, exhaustive searches using efficient...

  6. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    Science.gov (United States)

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples.

    Science.gov (United States)

    Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W

    2016-10-01

    The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Mood changes after indoor tanning among college women: associations with psychiatric/addictive symptoms

    Directory of Open Access Journals (Sweden)

    Carolyn Heckman

    2016-06-01

    Full Text Available Indoor tanning (IT has been linked with psychiatric and addictive symptoms, and frequent tanning may indicate tanning dependence (addiction. The current study evaluated the effects of an IT episode on mood states and the association of these effects with psychiatric and addictive symptoms among young adult female indoor tanners. One-hundred thirty-nine female university students aged 18-25 years who had indoor tanned completed an online survey including the Positive and Negative Affects Scales and a standardized psychiatric interview (the MINI International Neuropsychiatric Interview via telephone. Psychiatric and addictive symptoms were relatively common among these young adult female indoor tanners. Overall, participants reported significant decreases in both negative (upset, scared, irritable, nervous, jittery, afraid and positive (feeling interested mood states after their most recent tanning episode. Multivariable linear regression analyses showed that more frequent indoor tanning in the past month and symptoms of illicit drug use disorders were associated with decreases in negative mood, and symptoms of generalized anxiety disorder were associated with a decrease in feeling interested. In summary, indoor tanners report relatively high rates of psychiatric and substance use symptoms, including symptoms of tanning dependence, and indoor tanning appears to alter mood. Women with certain substance use and psychiatric characteristics may be more vulnerable to such mood changes after tanning indoors. Further research is needed to clarify the relationships among these variables.

  9. [An exploratory study of psychiatric patients' needs and nurses' current practices related to sexual counseling].

    Science.gov (United States)

    Sung, Su-Ching; Lin, Yen-Chin; Hong, Chi-Mei; Cho, Pei-Pei

    2007-02-01

    The purpose of this study was to explore psychiatric patient needs and current nursing practice with regard to sexual counseling and to understand differences in individual patient characteristics. A total of 182 psychiatric patients and 44 psychiatric nurses were purposively selected from a mental hospital in northern Taiwan. Results revealed that 63.2% of subjects had not been given sexuality information and 81.9% had not been approached by nurses to discuss such issues. While 35.2% of study patients treated sexual issues as psychological or private issues that should only be discussed with psychologists, 33.5% expressed a desire to discuss issues related to sexuality with nurses. Even so, most subjects preferred to discuss sexual issues in a private way, and asked for assistance from same-gender professionals. Also, patients with higher education levels placed greater attention on the counseling topics of how to express sexual needs and the impacts of mental illness on sexuality. With regard to nurses participating in the study, female nurses had a generally more conservative attitude toward sexual values than males. Those who were married, older, or had received continuing sexuality education were more comfortable with conducting sexual counseling. Those with clinical experience and continuing sexuality education were able to take more responsibility and a more professional role in sexual counseling. Data collected on the specific subject groups in order to provide effective comparisons can be employed to refine current sexual counseling training programs for nurses in order to improve patient care.

  10. Factors associated with psychiatric symptoms and psychiatric disorders in ethnic minority youth

    NARCIS (Netherlands)

    Adriaanse, Marcia; Doreleijers, Theo; van Domburgh, Lieke; Veling, Wim

    2016-01-01

    While ethnic diversity is increasing in many countries, ethnic minority youth is less likely to be reached, effectively treated and retained by youth mental health care compared to majority youth. Improving understanding of factors associated with mental health problems within socially disadvantaged

  11. Inquiry-based learning and critical thinking in an advanced practice psychiatric nursing program.

    Science.gov (United States)

    Flannelly, L; Inouye, J

    1998-06-01

    The advanced practice psychiatric nurse must be prepared to meet the changing demands being placed on the nursing profession. Some changes are the product of health care reforms, especially managed care. Others are more fundamental, because continuing scientific advances drive rapid changes in the knowledge base required of mental health nurses. Curricular reforms initiated earlier this decade were intended to equip nurses with the problem-solving and critical-thinking skills required to deal with novel and complex situations in a rapidly changing healthcare system. This article describes how the Inquiry-Based Learning tutorial method attends to the mental processes of graduate students and fosters critical-thinking skills.

  12. The psychiatric patient as a health resource consumer: costs associated with electroconvulsive therapy

    Directory of Open Access Journals (Sweden)

    Carmen Selva- Sevilla

    2016-05-01

    Full Text Available Background: Clinical practice protocols should consider both the psychological criteria related to a patient’s satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the electroconvulsive therapy sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving electroconvulsive therapy.Methods: A descriptive analysis of the direct health costs related to electroconvulsive therapy from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011 and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Results: Seventy-six patients received 853 sessions of electroconvulsive therapy. The cumulative cost of these sessions was € 1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of € 420732.57 (29.8% was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty.Conclusions: The efficiency of electroconvulsive therapy in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed.

  13. European Psychiatric Association (EPA) guidance on post-graduate psychiatric training in Europe.

    Science.gov (United States)

    Mayer, S; van der Gaag, R J; Dom, G; Wassermann, D; Gaebel, W; Falkai, P; Schüle, C

    2014-02-01

    The European Union Free Movement Directive gives professionals the opportunity to work and live within the European Union, but does not give specific requirements regarding how the specialists in medicine have to be trained, with the exception of a required minimum of 4 years of education. Efforts have been undertaken to harmonize post-graduate training in psychiatry in Europe since the Treaty of Rome 1957, with the founding of the European Union of Medical Specialists (UEMS) and establishment of a charter outlining how psychiatrists should be trained. However, the different curricula for post-graduate training were only compared by surveys, never through a systematic review of the official national requirements. The published survey data still shows great differences between European countries and unlike other UEMS Boards, the Board of Psychiatry did not introduce a certification for specialists willing to practice in a foreign country within Europe. Such a European certification could help to keep a high qualification level for post-graduate training in psychiatry all over Europe. Moreover, it would make it easier for employers to assess the educational level of European psychiatrists applying for a job in their field. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Association of child maltreatment and psychiatric diagnosis in Brazilian children and adolescents

    Directory of Open Access Journals (Sweden)

    Luciana Burim Scomparini

    2013-01-01

    Full Text Available OBJECTIVES: The objective of this study was to evaluate the association between different types of child maltreatment and the presence of psychiatric disorders in highly vulnerable children and adolescents served by a multidisciplinary program. METHODS: In total, 351 patients with a mean age of 12.47, of whom 68.7% were male and 82.1% lived in shelters, underwent psychiatric evaluations based on the Kiddie-Sads-Present and Lifetime Version. Two different methods were used to evaluate maltreatment: medical records were reviewed to identify previous diagnoses related to socioeconomic and psychosocial circumstances, and the Childhood Trauma Questionnaire was used to obtain a structured history of trauma. Bivariate associations were evaluated between psychiatric disorders and evidence of each type and the frequency of abuse. RESULTS: The most frequent psychiatric diagnoses were substance use disorders, affective disorders and specific disorders of early childhood, whereas 13.67% of the sample had no psychiatric diagnosis. All patients suffered neglect, and 58.4% experienced physical or sexual abuse. The presence of a history of multiple traumas was only associated with a diagnosis of substance use disorder. Mental retardation showed a strong positive association with reported physical abuse and emotional neglect. However, a negative correlation was found when we analyzed the presence of a history of multiple traumas and mental retardation. CONCLUSION: All children living in adverse conditions deserve careful assistance, but we found that physical abuse and emotional neglect were most strongly associated with mental retardation and multiple traumas with substance abuse.

  15. Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients.

    Science.gov (United States)

    Compen, F R; Adang, E M M; Bisseling, E M; Van der Lee, M L; Speckens, A E M

    2017-12-04

    The mental burden of cancer might elicit additional health care utilization. However, it is unclear how psychiatric disorder and psychological distress relate to health care utilization. Therefore, this study explores associations between psychiatric disorder, psychological distress, and health care utilization. It was hypothesized that presence of psychiatric disorder and psychological distress was associated with increased health care utilization and costs. The current study consisted of secondary analyses of baseline data of a larger randomized controlled trial. Two hundred forty-five mixed-cancer patients with at least mild symptoms of psychological distress (Hospital Anxiety and Depression Scale-T ≥ 11) were mainly recruited via online media, participating centers and patient associations. Patients were assessed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) for depressive, anxiety, and/or adjustment disorder. Psychological distress was measured by the Hospital Anxiety and Depression Scale. Retrospective self-reported health care utilization in the past 3 months was collected. Associations between predictors and health care utilization in terms of incidence rate ratios (IRR) and costs per category (mental, primary, somatic, and complementary) were assessed by negative binomial, logistic, and gamma regression. Eighty-nine (36.3%) patients suffered from psychiatric disorder, which was associated with mental health care utilization (IRR = 1.63) and costs (OR = 3.11). We observed a nonsignificant trend of somatic health care utilization in patients with psychiatric disorder. Psychological distress was associated with mental health care utilization (IRR = 1.09) and costs (OR = 1.09). Psychological distress was also associated with complementary health care utilization (IRR = 1.03). Psychiatric disorder and psychological distress were associated with mental health care use and costs. Psychological distress was associated

  16. Difficult encounters with psychiatric patients: a South Texas Psychiatry Practice-based Re search Network (PBRN) study

    Science.gov (United States)

    Sellers, Randall V.; Salazar, Ricardo; Martinez, Cervando; Gelfond, Stephen D.; Deuter, Melissa; Hayes, Holly G.; Ketchum, Norma; Pollock, Brad H.

    2012-01-01

    Purpose To examine the prevalence of difficult psychiatrist-patient interactions of 20 psychiatrists in the South Texas Psychiatric PBRN, determine what characteristics were associated with “difficult” patients, and compare findings with previous studies in primary care. Methods During a 2-month observational study, psychiatrists collected patient information on setting, demographics, diagnoses, medications and rated the patients using a Difficult Doctor Patient Relationship Questionnaire (DDPRQ-10) which had previously been used and validated in the primary care setting. Results A total of 905 valid data cards were collected. Difficult patients were identified in 15% of the sample. Diagnoses of schizophrenia, alcohol/substance abuse, and personality disorder were associated with difficulty. Psychiatrists least burdened by difficult patients were older, in solo practice, and worked 51-55 hours per week. Conclusions This cross-sectional study demonstrates that psychiatrists encounter difficult patients at a similar rate (15%) as do primary care physicians. Mentoring programs and structured treatment interventions for the most difficult patient groups may assist all physicians who treat psychiatric patients whether in specialty, family medicine, or other primary care settings. PMID:22956702

  17. Genome-wide association study of behavioural and psychiatric features in human prion disease.

    Science.gov (United States)

    Thompson, A G B; Uphill, J; Lowe, J; Porter, M-C; Lukic, A; Carswell, C; Rudge, P; MacKay, A; Collinge, J; Mead, S

    2015-04-21

    Prion diseases are rare neurodegenerative conditions causing highly variable clinical syndromes, which often include prominent neuropsychiatric symptoms. We have recently carried out a clinical study of behavioural and psychiatric symptoms in a large prospective cohort of patients with prion disease in the United Kingdom, allowing us to operationalise specific behavioural/psychiatric phenotypes as traits in human prion disease. Here, we report exploratory genome-wide association analysis on 170 of these patients and 5200 UK controls, looking for single-nucleotide polymorphisms (SNPs) associated with three behavioural/psychiatric phenotypes in the context of prion disease. We also specifically examined a selection of candidate SNPs that have shown genome-wide association with psychiatric conditions in previously published studies, and the codon 129 polymorphism of the prion protein gene, which is known to modify various aspects of the phenotype of prion disease. No SNPs reached genome-wide significance, and there was no evidence of altered burden of known psychiatric risk alleles in relevant prion cases. SNPs showing suggestive evidence of association (Panalysis that may shed clearer light on the biological basis of these complex disease manifestations, and the diseases themselves.

  18. Tensions between policy and practice: A qualitative analysis of decisions regarding compulsory admission to psychiatric hospital.

    Science.gov (United States)

    Fistein, Elizabeth C; Clare, Isabel C H; Redley, Marcus; Holland, Anthony J

    2016-01-01

    The use of detention for psychiatric treatment is widespread and sometimes necessary. International human rights law requires a legal framework to safeguard the rights to liberty and personal integrity by preventing arbitrary detention. However, research suggests that extra-legal factors may influence decisions to detain. This article presents observational and interview data to describe how decisions to detain are made in practice in one jurisdiction (England and Wales) where a tension between policy and practice has been described. The analysis shows that practitioners mould the law into 'practical criteria' that appear to form a set of operational criteria for identifying cases to which the principle of soft paternalism may be applied. Most practitioners also appear willing, albeit often reluctantly, to depart from their usual reliance on the principle of soft paternalism and authorise detention of people with the capacity to refuse treatment, in order to prevent serious harm. We propose a potential resolution for the tension between policy and practice: two separate legal frameworks to authorise detention, one with a suitable test of capacity, used to enact soft paternalism, and the other to provide legal justification for detention for psychiatric treatment of the small number of people who retain decision-making capacity but nonetheless choose to place others at risk by refusing treatment. This separation of detention powers into two systems, according to the principle that justifies the use of detention would be intellectually coherent, consistent with human rights instruments and, being consistent with the apparent moral sentiments of practitioners, less prone to idiosyncratic interpretations in practice. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. [Psychiatric disorders and associated factors in patients with epilepsy in Fez, Morocco].

    Science.gov (United States)

    Elghazouani, F; Aarab, C; Faiz, F; Midaoui, A; Barrimi, M; Elrhazi, K; Berraho, A; Belahssen, M F; Rammouz, I; Aalouane, R

    2015-12-01

    The prevalence of psychiatric disorders in epileptic patients remains unclear. This study was conducted in order to determine the prevalence and nature of the psychiatric disorders and the associated factors in patients with idiopathic epilepsy. A cross-sectional study was conducted over a period of eighteen months in the psychiatric unit of the University Hospital Hassan II of Fez (Morocco). A questionnaire was completed by the included patients, which specified: the socio-demographic data, personal and family history, and the clinical features of epilepsy and its management. Psychiatric disorders were identified by the Mini International Neuropsychiatric Interview test (MINI). The severity of the depression and anxiety symptoms was investigated using the Beck Depression Inventory (BDI) and the Hamilton Rating Scale. Eighty-nine patients met the inclusion criteria. The average age of patients was 29.7±10.8years. Mood disorders were the leading psychiatric comorbidity: 32.6% among which 25.8% of major depressive episodes, 15.7% of dysthymia and 2.2% of hypomanic episodes. Anxiety disorders came second: 28.1% (among which 19.1% panic disorder, 13.5% agoraphobia, 12.4% generalized anxiety disorder, 10.1% social phobia and 4.5% post-traumatic stress disorder). Female gender, unemployment and poor compliance to antiepileptic drugs are all risk factors for the occurrence of psychiatric disorders in this population. Copyright © 2015. Published by Elsevier Masson SAS.

  20. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Directory of Open Access Journals (Sweden)

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  1. Psychiatric advanced practice nurses contributions to supporting survivors and caregivers affected by the Boston marathon bombings.

    Science.gov (United States)

    Lakatos, Barbara E; Delisle, Leslie; Mitchell, Monique; Etheredge, Mary Lou

    2014-01-01

    The role of the psychiatric advanced practice nurse in promoting psychological health and resiliency for patients, their families and staff following the Boston Marathon bombings is reviewed. On April 15, 2013, 2 bombs exploded near the finish line at the Boston Marathon. Within minutes, 39 patients suffering from multiple injuries presented at a level I trauma center. The magnitude of this event and its effect on our hospital required a comprehensive response that would promote resiliency and healing. Lessons shared from responders to other tragedies were helpful in guiding our interprofessional efforts. The multiple layers of our response are reviewed to offer learnings that may inform others as they work to promote resiliency and healing following traumatic events. In response to this event, we utilized a trauma-informed care framework emphasizing physical, psychological, and emotional safety to assist staff, survivors, and families on their journey of healing. Emotional reactions were dramatic but were eased by the psychological care and education that our patients, their families, and staff received in the first days to weeks after the bombings. The psychiatric advanced practice nurse can influence positive outcomes by utilizing a trauma-informed care framework.

  2. Designer drugs in psychiatric practice - a review of the literature and the recent situation in Hungary.

    Science.gov (United States)

    Szily, Erika; Bitter, István

    2013-12-01

    In recent years service providers experienced a new phenomenon in the drug markets of Hungary: the dramatically increasing sale and use of designer drugs. In psychiatric practice, the first sign of this new trend was the increasing number of hospitalized patients with acute psychosis using a new type of designer drug: MDPV (3,4-Methylenedioxypyrovalerone). The range of designer drugs available is wider than ever before. They are inexpensive and many times are known to be legal, undetectable, safe or natural to the consumers. In fact, the compounds and their biological effects are many times unknown to the consumers and to the physicians as well, while a recently emerging body of data suggests that the somatic and mental consequences of their consumption are frequent, severe, and sometimes even life-threatening. The aims of this paper are to summarize the most important general information about some widely used designer drugs (synthetic cathinones and cannabinoids); to draw attention to present and upcoming trends of substance abuse patterns; and to highlight the importance and consequences of these trends in every day clinical practice, considering the most important and challenging somatic and psychiatric consequences of designer drug abuse.

  3. Pregnancy is associated with psychiatric symptoms in a low-income countryside community of Brazil.

    Science.gov (United States)

    Dias, Fernando Mv; Junior, Claudio Sd; Franco, Glaura C; Teixeira, Antônio L; Ribeiro, Angela M

    2011-01-01

    Psychiatric symptoms during pregnancy induce an increase in morbidity and also in the mortality levels among women and children. However, the real association between pregnancy and psychiatric disorders and the peculiarities of the phenomenology of symptoms in underprivileged countryside communities remain uncertain. To verify the association between psychiatric disorder, symptoms, and pregnancy among women from a low-income countryside community and to determine the specific cutoff points for major depression diagnosis according to Beck Depression Inventory for the different trimesters of pregnancy in this population. Ninety-four pregnant women and 38 healthy women from the Conceição do Mato Dentro health service, a rural low-income community in Brazil, participated in the present study. Psychiatric examination included a structured clinical interview for psychiatric disorders according to Mini International Neuropsychiatric Interview and psychometric scales such as the Yale-Brown Obsessive Scale, the Beck Depression Inventory, and the Hamilton Anxiety Scale. The cutoff points for Beck Depression Inventory were determined through the application of receiver operating characteristic curves considering the diagnosis of major depression according to Mini International Neuropsychiatric Interview. The pregnant women had a higher frequency of psychiatric disorders and depression and anxiety symptoms. All cutoff points of Beck Depression Inventory were equal or higher than 12 with high sensitivity and specificity. Although the modified cutoff was selected based on both high sensitivity and high specificity, they were lower than when the cutoff was applied to nonpregnant women. Pregnancy was associated with the occurrence of psychiatric disorders and depressive and anxiety symptoms. In comparison to the literature, the present results indicate that there are different cutoff points in the Beck Depression Inventory for pregnant women from different cultures and in

  4. Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways

    DEFF Research Database (Denmark)

    O'Dushlaine, Colm; Rossin, Lizzy; Lee, Phil H.

    2015-01-01

    Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from ...

  5. Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways

    NARCIS (Netherlands)

    O'Dushlaine, Colm; Rossin, Lizzy; Lee, Phil H.; Duncan, Laramie; Parikshak, Neelroop N.; Newhouse, Stephen; Ripke, Stephan; Neale, Benjamin M.; Purcell, Shaun M.; Posthuma, Danielle; Nurnberger, John I.; Lee, S. Hong; Faraone, Stephen V.; Perlis, Roy H.; Mowry, Bryan J.; Thapar, Anita; Goddard, Michael E.; Witte, John S.; Absher, Devin; Agartz, Ingrid; Akil, Huda; Amin, Farooq; Andreassen, Ole A.; Anjorin, Adebayo; Anney, Richard; Anttila, Verneri; Arking, Dan E.; Asherson, Philip; Azevedo, Maria H.; Backlund, Lena; Badner, Judith A.; Bailey, Anthony J.; Banaschewski, Tobias; Barchas, Jack D.; Barnes, Michael R.; Barrett, Thomas B.; Bass, Nicholas; Battaglia, Agatino; Bauer, Michael; Bayés, Mònica; Bellivier, Frank; Bergen, Sarah E.; Berrettini, Wade; Betancur, Catalina; Bettecken, Thomas; Biederman, Joseph; Binder, Elisabeth B.; Black, Donald W.; Blackwood, Douglas H. R.; Bloss, Cinnamon S.; Boehnke, Michael; Boomsma, Dorret I.; Breuer, René; Bruggeman, Richard; Cormican, Paul; Buccola, Nancy G.; Buitelaar, Jan K.; Bunney, William E.; Buxbaum, Joseph D.; Byerley, William F.; Byrne, Enda M.; Caesar, Sian; Cahn, Wiepke; Cantor, Rita M.; Casas, Miguel; Chakravarti, Aravinda; Chambert, Kimberly; Choudhury, Khalid; Cichon, Sven; Mattheisen, Manuel; Cloninger, C. Robert; Collier, David A.; Cook, Edwin H.; Coon, Hilary; Cormand, Bru; Corvin, Aiden; Coryell, William H.; Craig, David W.; Craig, Ian W.; Crosbie, Jennifer; Cuccaro, Michael L.; Curtis, David; Czamara, Darina; Datta, Susmita; Dawson, Geraldine; Day, Richard; de Geus, Eco J.; Degenhardt, Franziska; Djurovic, Srdjan; Donohoe, Gary J.; Doyle, Alysa E.; Duan, Jubao; Dudbridge, Frank; Duketis, Eftichia; Ebstein, Richard P.; Edenberg, Howard J.; Elia, Josephine; Ennis, Sean; Etain, Bruno; Fanous, Ayman; Farmer, Anne E.; Ferrier, I. Nicol; Flickinger, Matthew; Fombonne, Eric; Foroud, Tatiana; Frank, Josef; Franke, Barbara; Fraser, Christine; Freedman, Robert; Freimer, Nelson B.; Freitag, Christine M.; Friedl, Marion; Frisén, Louise; Gallagher, Louise; Gejman, Pablo V.; Georgieva, Lyudmila; Gershon, Elliot S.; Giegling, Ina; Gill, Michael; Gordon, Scott D.; Gordon-Smith, Katherine; Green, Elaine K.; Greenwood, Tiffany A.; Grice, Dorothy E.; Gross, Magdalena; Grozeva, Detelina; Guan, Weihua; Gurling, Hugh; de Haan, Lieuwe; Haines, Jonathan L.; Hakonarson, Hakon; Hallmayer, Joachim; Hamilton, Steven P.; Hamshere, Marian L.; Hansen, Thomas F.; Hartmann, Annette M.; Hautzinger, Martin; Heath, Andrew C.; Henders, Anjali K.; Herms, Stefan; Hickie, Ian B.; Hipolito, Maria; Hoefels, Susanne; Holsboer, Florian; Hoogendijk, Witte J.; Hottenga, Jouke-Jan; Hultman, Christina M.; Hus, Vanessa; Ingason, Andrés; Ising, Marcus; Jamain, Stéphane; Jones, Edward G.; Jones, Ian; Jones, Lisa; Tzeng, Jung-Ying; Kähler, Anna K.; Kahn, René S.; Kandaswamy, Radhika; Keller, Matthew C.; Kennedy, James L.; Kenny, Elaine; Kent, Lindsey; Kim, Yunjung; Kirov, George K.; Klauck, Sabine M.; Klei, Lambertus; Knowles, James A.; Kohli, Martin A.; Koller, Daniel L.; Konte, Bettina; Korszun, Ania; Krabbendam, Lydia; Krasucki, Robert; Kuntsi, Jonna; Kwan, Phoenix; Landén, Mikael; Längström, Niklas; Lathrop, Mark; Lawrence, Jacob; Lawson, William B.; Leboyer, Marion; Ledbetter, David H.; Lencz, Todd; Lesch, Klaus-Peter; Levinson, Douglas F.; Lewis, Cathryn M.; Li, Jun; Lichtenstein, Paul; Lieberman, Jeffrey A.; Lin, Dan-Yu; Linszen, Don H.; Liu, Chunyu; Lohoff, Falk W.; Loo, Sandra K.; Lord, Catherine; Lowe, Jennifer K.; Lucae, Susanne; MacIntyre, Donald J.; Madden, Pamela A. F.; Maestrini, Elena; Magnusson, Patrik K. E.; Mahon, Pamela B.; Maier, Wolfgang; Malhotra, Anil K.; Mane, Shrikant M.; Martin, Christa L.; Martin, Nicholas G.; Matthews, Keith; Mattingsdal, Morten; McCarroll, Steven A.; McGhee, Kevin A.; McGough, James J.; McGrath, Patrick J.; McGuffin, Peter; McInnis, Melvin G.; McIntosh, Andrew; McKinney, Rebecca; McLean, Alan W.; McMahon, Francis J.; McMahon, William M.; McQuillin, Andrew; Medeiros, Helena; Medland, Sarah E.; Meier, Sandra; Melle, Ingrid; Meyer, Jobst; Middeldorp, Christel M.; Middleton, Lefkos; Milanova, Vihra; Miranda, Ana; Monaco, Anthony P.; Montgomery, Grant W.; Moran, Jennifer L.; Moreno-de-Luca, Daniel; Morken, Gunnar; Morris, Derek W.; Morrow, Eric M.; Moskvina, Valentina; Muglia, Pierandrea; Mühleisen, Thomas W.; Muir, Walter J.; Müller-Myhsok, Bertram; Murtha, Michael; Myers, Richard M.; Myin-Germeys, Inez; Neale, Michael C.; Nelson, Stan F.; Nievergelt, Caroline M.; Nikolov, Ivan; Nimgaonkar, Vishwajit; Nolen, Willem A.; Nöthen, Markus M.; Nwulia, Evaristus A.; Nyholt, Dale R.; Oades, Robert D.; Olincy, Ann; Oliveira, Guiomar; Olsen, Line; Ophoff, Roel A.; Osby, Urban; Owen, Michael J.; Palotie, Aarno; Parr, Jeremy R.; Paterson, Andrew D.; Pato, Carlos N.; Pato, Michele T.; Penninx, Brenda W.; Pergadia, Michele L.; Pericak-Vance, Margaret A.; Pickard, Benjamin S.; Pimm, Jonathan; Piven, Joseph; Potash, James B.; Poustka, Fritz; Propping, Peter; Puri, Vinay; Quested, Digby J.; Quinn, Emma M.; Ramos-Quiroga, Josep Antoni; Rasmussen, Henrik B.; Raychaudhuri, Soumya; Rehnström, Karola; Reif, Andreas; Ribasés, Marta; Rice, John P.; Rietschel, Marcella; Roeder, Kathryn; Roeyers, Herbert; Rothenberger, Aribert; Rouleau, Guy; Ruderfer, Douglas; Rujescu, Dan; Sanders, Alan R.; Sanders, Stephan J.; Santangelo, Susan L.; Sergeant, Joseph A.; Schachar, Russell; Schalling, Martin; Schatzberg, Alan F.; Scheftner, William A.; Schellenberg, Gerard D.; Scherer, Stephen W.; Schork, Nicholas J.; Schulze, Thomas G.; Schumacher, Johannes; Schwarz, Markus; Scolnick, Edward; Scott, Laura J.; Shi, Jianxin; Shilling, Paul D.; Shyn, Stanley I.; Silverman, Jeremy M.; Slager, Susan L.; Smalley, Susan L.; Smit, Johannes H.; Smith, Erin N.; Sonuga-Barke, Edmund J. S.; St Clair, David; State, Matthew; Steffens, Michael; Steinhausen, Hans-Christoph; Strauss, John S.; Strohmaier, Jana; Stroup, T. Scott; Sutcliffe, James S.; Szatmari, Peter; Szelinger, Szabocls; Thirumalai, Srinivasa; Thompson, Robert C.; Todorov, Alexandre A.; Tozzi, Federica; Treutlein, Jens; Uhr, Manfred; van den Oord, J. C. G.; van Grootheest, Gerard; van Os, Jim; Vicente, Astrid M.; Vieland, Veronica J.; Vincent, John B.; Visscher, Peter M.; Walsh, Christopher A.; Wassink, Thomas H.; Watson, Stanley J.; Weissman, Myrna M.; Werge, Thomas; Wienker, Thomas F.; Wijsman, Ellen M.; Willemsen, Gonneke; Williams, Nigel; Willsey, A. Jeremy; Witt, Stephanie H.; Xu, Wei; Young, Allan H.; Yu, Timothy W.; Zammit, Stanley; Zandi, Peter P.; Zhang, Peng; Zitman, Frans G.; Zöllner, Sebastian; Devlin, Bernie; Kelsoe, John R.; Sklar, Pamela; Daly, Mark J.; O'Donovan, Michael C.; Craddock, Nicholas; Kendler, Kenneth S.; Weiss, Lauren A.; Wray, Naomi R.; Zhao, Zhaoming; Geschwind, Daniel H.; Sullivan, Patrick F.; Smoller, Jordan W.; Holmans, Peter A.; Breen, Gerome

    2015-01-01

    Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from

  6. Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways

    NARCIS (Netherlands)

    O'Dushlaine, Colm; Rossin, Lizzy; Lee, Phil H.; Duncan, Laramie; Parikshak, Neelroop N.; Newhouse, Stephen; Ripke, Stephan; Neale, Benjamin M.; Purcell, Shaun M.; Posthuma, Danielle; Nurnberger, John I.; Lee, S. Hong; Faraone, Stephen V.; Perlis, Roy H.; Mowry, Bryan J.; Thapar, Anita; Goddard, Michael E.; Witte, John S.; Absher, Devin; Agartz, Ingrid; Akil, Huda; Amin, Farooq; Andreassen, Ole A.; Anjorin, Adebayo; Anney, Richard; Anttila, Verneri; Arking, Dan E.; Asherson, Philip; Azevedo, Maria H.; Backlund, Lena; Badner, Judith A.; Bailey, Anthony J.; Banaschewski, Tobias; Barchas, Jack D.; Barnes, Michael R.; Barrett, Thomas B.; Bass, Nicholas; Battaglia, Agatino; Bauer, Michael; Bayes, Monica; Bellivier, Frank; Bergen, Sarah E.; Berrettini, Wade; Betancur, Catalina; Bettecken, Thomas; Biederman, Joseph; Binder, Elisabeth B.; Black, Donald W.; Blackwood, Douglas H. R.; Bloss, Cinnamon S.; Boehnke, Michael; Boomsma, Dorret I.; Breuer, Rene; Bruggeman, Richard; Cormican, Paul; Buccola, Nancy G.; Buitelaar, Jan K.; Bunney, William E.; Buxbaum, Joseph D.; Byerley, William F.; Byrne, Enda M.; Caesar, Sian; Cahn, Wiepke; Cantor, Rita M.; Casas, Miguel; Chakravarti, Aravinda; Chambert, Kimberly; Choudhury, Khalid; Cichon, Sven; Mattheisen, Manuel; Cloninger, C. Robert; Collier, David A.; Cook, Edwin H.; Coon, Hilary; Cormand, Bru; Corvin, Aiden; Coryell, William H.; Craig, David W.; Craig, Ian W.; Crosbie, Jennifer; Cuccaro, Michael L.; Curtis, David; Czamara, Darina; Datta, Susmita; Dawson, Geraldine; Day, Richard; De Geus, Eco J.; Degenhardt, Franziska; Djurovic, Srdjan; Donohoe, Gary J.; Doyle, Alysa E.; Duan, Jubao; Dudbridge, Frank; Duketis, Eftichia; Ebstein, Richard P.; Edenberg, Howard J.; Elia, Josephine; Ennis, Sean; Etain, Bruno; Fanous, Ayman; Farmer, Anne E.; Ferrier, I. Nicol; Flicldnger, Matthew; Fombonne, Eric; Foroud, Tatiana; Frank, Josef; Franke, Barbara; Fraser, Christine; Freedman, Robert; Freimer, Nelson B.; Freitag, Christine M.; Friedl, Marion; Frisen, Louise; Gailagher, Louise; Gejman, Pablo V.; Georgieva, Lyudmila; Gershon, Elliot S.; Giegling, Ina; Gill, Michael; Gordon, Scott D.; Gordon-Smith, Katherine; Green, Elaine K.; Greenwood, Tiffany A.; Grice, Dorothy E.; Gross, Magdalena; Grozeva, Detelina; Guan, Weihua; Gurling, Hugh; De Haan, Lieuwe; Haines, Jonathan L.; Hakonarson, Hakon; Hallmayer, Joachim; Hamilton, Steven P.; Hamshere, Marian L.; Hansen, Thomas F.; Hartmann, Annette M.; Hautzinger, Martin; Heath, Andrew C.; Henders, Anjali K.; Herms, Stefan; Hickie, Ian B.; Hipolito, Maria; Hoefels, Susanne; Holsboer, Florian; Hoogendijk, Witte J.; Hottenga, Jouke-Jan; Hultman, Christina M.; Hus, Vanessa; Ingason, Andres; Ising, Marcus; Jamain, Stephane; Jones, Edward G.; Jones, Ian; Jones, Lisa; Tzeng, Jung-Ying; Kaehler, Anna K.; Kahn, Rene S.; Kandaswamy, Radhika; Keller, Matthew C.; Kennedy, James L.; Kenny, Elaine; Kent, Lindsey; Kim, Yunjung; Kirov, George K.; Klauck, Sabine M.; Klei, Lambertus; Knowles, James A.; Kohli, Martin A.; Koller, Daniel L.; Konte, Bettina; Korszun, Ania; Krabbendam, Lydia; Krasucki, Robert; Kuntsi, Jonna; Kwan, Phoenix; Landen, Mikael; Laengstroem, Niklas; Lathrop, Mark; Lawrence, Jacob; Lawson, William B.; Leboyer, Marion; Ledbetter, David H.; Lencz, Todd; Lesch, Klaus-Peter; Levinson, Douglas F.; Lewis, Cathryn M.; Li, Jun; Lichtenstein, Paul; Lieberman, Jeffrey A.; Lin, Dan-Yu; Linszen, Don H.; Liu, Chunyu; Lohoff, Falk W.; Loo, Sandra K.; Lord, Catherine; Lowe, Jennifer K.; Lucae, Susanne; MacIntyre, Donald J.; Madden, Pamela A. F.; Maestrini, Elena; Magnusson, Patrik K. E.; Mahon, Pamela B.; Maier, Wolfgang; Malhotra, Anil K.; Mane, Shrikant M.; Martin, Christa L.; Martin, Nicholas G.; Matthews, Keith; Mattingsdal, Morten; McCarroll, Steven A.; McGhee, Kevin A.; McGough, James J.; McGrath, Patrick J.; McGuffin, Peter; McInnis, Melvin G.; McIntosh, Andrew; McKinney, Rebecca; McLean, Alan W.; McMahon, Francis J.; McMahon, William M.; McQuillin, Andrew; Medeiros, Helena; Medland, Sarah E.; Meier, Sandra; Melle, Ingrid; Meng, Fan; Meyer, Jobst; Middeldorp, Christel M.; Middleton, Lefkos; Milanova, Vihra; Miranda, Ana; Monaco, Anthony P.; Montgomery, Grant W.; Moran, Jennifer L.; Moreno-De-Luca, Daniel; Morken, Gunnar; Morris, Derek W.; Morrow, Eric M.; Moskvina, Valentina; Muglia, Pierandrea; Muehleisen, Thomas W.; Muir, Walter J.; Mueller-Myhsok, Bertram; Murtha, Michael; Myers, Richard M.; Myin-Germeys, Inez; Neale, Michael C.; Nelson, Stan F.; Nievergelt, Caroline M.; Nikolov, Ivan; Nimgaonkar, Vishwajit; Nolen, Willem A.; Noethen, Markus M.; Nwulia, Evaristus A.; Nyholt, Dale R.; Oades, Robert D.; Olincy, Ann; Oliveira, Guiomar; Olsen, Line; Ophoff, Roel A.; Osby, Urban; Owen, Michael J.; Palotie, Aarno; Parr, Jeremy R.; Paterson, Andrew D.; Pato, Carlos N.; Pato, Michele T.; Penninx, Brenda W.; Pergadia, Michele L.; Pericak-Vance, Margaret A.; Pickard, Benjamin S.; Pimm, Jonathan; Piven, Joseph; Potash, James B.; Poustka, Fritz; Propping, Peter; Puri, Vinay; Quested, Digby J.; Quinn, Emma M.; Ramos-Quiroga, Josep Antoni; Rasmussen, Henrik B.; Raychaudhuri, Soumya; Rehnstroem, Karola; Reif, Andreas; Ribases, Marta; Rice, John P.; Rietschel, Marcella; Roeder, Kathryn; Roeyers, Herbert; Rothenberger, Aribert; Rouleau, Guy; Ruderfer, Douglas; Rujescu, Dan; Sanders, Alan R.; Sanders, Stephan J.; Santangelo, Susan L.; Sergeant, Joseph A.; Schachar, Russell; Schalling, Martin; Schatzberg, Alan F.; Scheftner, William A.; Schellenberg, Gerard D.; Scherer, Stephen W.; Schork, Nicholas J.; Schulze, Thomas G.; Schumacher, Johannes; Schwarz, Markus; Scolnick, Edward; Scott, Laura J.; Shi, Jianxin; Shilling, Paul D.; Shyn, Stanley I.; Silverman, Jeremy M.; Slager, Susan L.; Smalley, Susan L.; Smit, Johannes H.; Smith, Erin N.; Sonuga-Barke, Edmund J. S.; Cair, David St.; State, Matthew; Steffens, Michael; Steinhausen, Hans-Christoph; Strauss, John S.; Strohmaier, Jana; Stroup, T. Scott; Sutdiffe, James S.; Szatmari, Peter; Szelinger, Szabocls; Thirumalai, Srinivasa; Thompson, Robert C.; Todorov, Alexandre A.; Tozzi, Federica; Treutlein, Jens; Uhr, Manfred; Van den Oord, Edwin J. C. G.; Van Grootheest, Gerard; Van Os, Jim; Vicente, Astrid M.; Vieland, Veronica J.; Vincent, John B.; Visscher, Peter M.; Walsh, Christopher A.; Wassink, Thomas H.; Watson, Stanley J.; Weissman, Myrna M.; Werge, Thomas; Wienker, Thomas F.; Wijsman, Ellen M.; Willemsen, Gonneke; Williams, Nigel; Willsey, A. Jeremy; Witt, Stephanie H.; Xu, Wei; Young, Allan H.; Yu, Timothy W.; Zammit, Stanley; Zandi, Peter P.; Zhang, Peng; Zitman, Frans G.; Zoellner, Sebastian; Devlin, Bernie; Kelsoe, John R.; Sklar, Pamela; Daly, Mark J.; O'Donovan, Michael C.; Craddock, Nicholas; Kendler, Kenneth S.; Weiss, Lauren A.; Wray, Naomi R.; Zhao, Zhaoming; Geschwind, Daniel H.; Sullivan, Patrick F.; Smoller, Jordan W.; Holmans, Peter A.; Breen, Gerome

    Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from

  7. Walking on the sunny side: what positive psychology can contribute to psychiatric rehabilitation concepts and practice.

    Science.gov (United States)

    Moran, Galia S; Nemec, Patricia B

    2013-09-01

    This article suggests a positive psychology framework to strengthen and broaden psychiatric rehabilitation and recovery thought and practice. We inform about positive psychology concepts and measures that can be used to further knowledge, enhance practice, and guide research. Foundational concepts are drawn from the published literature. Specific positive psychology concepts and measures are highlighted: complete mental health, well being, flourishing, positive emotions, flow, self-determination, posttraumatic growth, and resilience. Employing a positive psychology framework can advance research on recovery phenomena and be used to assess rehabilitation outcomes. In addition we advocate positive psychology interventions in education and training of service providers that will enhance a positive focus and the culture of recovery. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  8. Psychiatric readmissions and their association with physical comorbidity: a systematic literature review.

    Science.gov (United States)

    Šprah, Lilijana; Dernovšek, Mojca Zvezdana; Wahlbeck, Kristian; Haaramo, Peija

    2017-01-03

    Comorbidity between mental and physical disorder conditions is the rule rather than the exception. It is estimated that 25% of adult population have mental health condition and 68% of them suffer from comorbid medical condition. Readmission rates in psychiatric patients are high and we still lack understanding potential predictors of recidivism. Physical comorbidity could be one of important risk factors for psychiatric readmission. The aim of the present study was to review the impact of physical comorbidity variables on readmission after discharge from psychiatric or general inpatient care among patients with co-occurring psychiatric and medical conditions. A comprehensive database search from January 1990 to June 2014 was performed in the following bibliographic databases: Ovid Medline, PsycINFO, ProQuest Health Management, OpenGrey and Google Scholar. An integrative research review was conducted on 23 observational studies. Six studies documented physical comorbidity variables only at admission/discharge and 17 also at readmission. The main body of studies supported the hypothesis that patients with mental disorders are at increased risk of readmission if they had co-occurring medical condition. The impact of physical comorbidity variables on psychiatric readmission was most frequently studied in in patients with affective and substance use disorders (SUD). Most common physical comorbidity variables with higher probability for psychiatric readmission were associated with certain category of psychiatric diagnoses. Chronic lung conditions, hepatitis C virus infection, hypertension and number of medical diagnoses were associated with increased risk of readmission in SUD; Charlson Comorbidity Index, somatic complaints, physical health problems with serious mental illnesses (schizophrenia, schizoaffective disorder, personality disorders); not specified medical illness, somatic complaints, number of medical diagnoses, hyperthyroidism with affective disorders

  9. Association of family background with adolescent smoking and regular use of illicit substances among underage psychiatric in-patients.

    Science.gov (United States)

    Laukkanen, Matti; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko

    2008-01-01

    This study investigated whether adolescent's family type was associated with regular smoking or the use of illicit substances (cannabis or hard drugs) among underage adolescent psychiatric in-patients. The sample consisted of 471 adolescents aged 12-17 years admitted to psychiatric hospital between April 2001 and March 2006 at Oulu University Hospital, Finland. The information on family factors and substance use was based on the Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime interview and the European modification of the Addiction Severity Index questionnaire. Compared to adolescent boys from two-parent families, those from child welfare placement were more likely to regularly use both cannabis (odds ratio [OR]=4.4; 95%confidence interval [CI]=1.4-13.7; P=.012) and hard drugs (OR=8.4; 95% CI=1.7-42.1; P=.01).Among girls, no association was found between family type and the use of illicit substances. Two-parent or foster family units may protect adolescents from involvement with illicit substances. In clinical adolescent psychiatric practice more attention should be paid to family interventions and parental support.

  10. Psychiatric outcomes associated with chronic illness in adolescence: A systematic review.

    Science.gov (United States)

    Brady, Ann Marie; Deighton, Jessica; Stansfeld, Stephen

    2017-08-01

    Recent years have seen an increased focus on the high rates of psychiatric comorbidities in adults with chronic illness. This systematic review explored whether chronic illness in adolescents was similarly associated with poor psychiatric outcomes. The literature search identified 129 articles, only 5 of which were indicated to be at a low risk of methodological bias. Four of these articles found a strong relationship between asthma in adolescence and an increase in the prevalence of anxiety and depressive disorders, while the remaining article, which focused on diabetes mellitus, indicated similarly increased rates of psychiatric illness. Trends among the remaining studies suggested that many illnesses were not associated with poor adolescent mental health. Please note that chronic conditions with a neurological aetiology were excluded from the main review due to indications of qualitative differences in comorbidities. Findings highlight that the well-being of adolescents with chronic illness warrants a specific research focus. Copyright © 2017. Published by Elsevier Ltd.

  11. Recovery-oriented practices of psychiatric-mental health nursing staff in an acute hospital setting.

    Science.gov (United States)

    McLoughlin, Kris A; Du Wick, Amanda; Collazzi, Charlene M; Puntil, Cheryl

    2013-01-01

    There is a national initiative to integrate recovery-oriented practices into the delivery of mental health services. Few empirical studies have been conducted to measure these practices in psychiatric-mental health (PMH) nursing, particularly in short-term acute hospital settings. This study examined the reliability of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) and explored recovery practices of PMH nurses and nursing staff in an acute treatment setting. A descriptive one-group design with convenience sampling was employed. One hundred and five participants completed the RSA-RN and the demographic data form. The RSA-RN full-scale instrument demonstrated excellent internal consistency, and the five subscales demonstrated acceptable internal consistency. Significant, favorable relationships were found between RSA-RN scores and nursing staff who (a) had formal education in mental health recovery, (b) considered themselves knowledgeable about recovery, and (c) considered their place of work to be "recovery-oriented." The RSA-RN is a useful tool in measuring recovery-oriented practice. Formal education should be considered as an intervention to increase recovery-oriented practices in PMH nursing.

  12. Associations between Familial Rates of Psychiatric Disorders and De Novo Genetic Mutations in Autism

    Directory of Open Access Journals (Sweden)

    Kyleen Luhrs

    2017-01-01

    Full Text Available The purpose of this study was to examine the confluence of genetic and familial risk factors in children with Autism Spectrum Disorder (ASD with distinct de novo genetic events. We hypothesized that gene-disrupting mutations would be associated with reduced rates of familial psychiatric disorders relative to structural mutations. Participants included families of children with ASD in four groups: de novo duplication copy number variations (DUP, n=62, de novo deletion copy number variations (DEL, n=74, de novo likely gene-disrupting mutations (LGDM, n=267, and children without a known genetic etiology (NON, n=2111. Familial rates of psychiatric disorders were calculated from semistructured interviews. Results indicated overall increased rates of psychiatric disorders in DUP families compared to DEL and LGDM families, specific to paternal psychiatric histories, and particularly evident for depressive disorders. Higher rates of depressive disorders in maternal psychiatric histories were observed overall compared to paternal histories and higher rates of anxiety disorders were observed in paternal histories for LGDM families compared to DUP families. These findings support the notion of an additive contribution of genetic etiology and familial factors are associated with ASD risk and highlight critical need for continued work targeting these relationships.

  13. Impulse control disorders are associated with multiple psychiatric symptoms in Parkinson's disease.

    Science.gov (United States)

    Jaakkola, Elina; Kaasinen, Valtteri; Siri, Chiara; Martikainen, Kirsti; Cilia, Roberto; Niemelä, Solja; Joutsa, Juho

    2014-01-01

    Impulse control disorders can have serious adverse consequences to the life of a patient with Parkinson's disease. Although impulse control disorders are common, a possible psychiatric comorbidity has not been fully characterized. The aim of this study was to investigate the psychiatric symptoms exhibited by Parkinson's disease patients with impulse control disorders. The study was conducted as a postal survey to patients in the registry of the Finnish Parkinson Association. A total of 290 Parkinson's disease patients were evaluated for impulse control disorders using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. Psychiatric symptoms were systematically screened using the Symptom Checklist 90. We found that 108 of the evaluated patients had one or more impulse control disorders. Patients with impulse control disorders had markedly higher scores for symptoms of psychoticism (Bonferroni corrected p disorder (p disorders. Impulse control disorders were shown to be independently associated with these symptoms. Patients with multiple impulse control disorders had higher scores for depression and obsessive-compulsive symptoms when compared with patients that exhibited only one impulse control disorder. COUNCLUSIONS: Our results confirm the previous observations that impulse control disorders in Parkinson's disease are linked with multiple psychiatric symptoms, including psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms and depression. Clinicians treating these patients should acknowledge the concomitant psychiatric symptoms.

  14. Psychiatric disturbances associated with Erhard Seminars Training: II. additional cases and theoretical considerations.

    Science.gov (United States)

    Kirsch, M A; Glass, L L

    1977-11-01

    In a previous article, the authors reported on 5 individuals who developed psychoses after participation in Erhard Seminars Training (est). Two additional cases are reported, and the combined case material is discussed in terms of group and psychodynamic theories. The authoritarian est leadership style may mobilize in trainees an overdetermined and pathological reliance on identification with the aggressor. Such a mechanism may be central to the production of psychiatric casualties, particularly in individuals with defective ego boundaries. Future controlled research is necessary to ascertain the rate of occurrence of psychiatric disturbances associated with est and to test the authors' hypotheses.

  15. Introduction To The Special Section: The American Psychiatric Association's Research Agenda For The DSM-V

    DEFF Research Database (Denmark)

    Widiger, Thomas A; Simonsen, Erik

    2005-01-01

    of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders. This article provides the historical background for and a brief description of the first conference, which was concerned with the research that would help move the field toward a dimensional classification...... of personality disorder. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (from the journal abstract)...

  16. Mothers' Resolution of Their Young Children's Psychiatric Diagnoses: Associations with Child, Parent, and Relationship Characteristics

    Science.gov (United States)

    Kearney, Joan A.; Britner, Preston A.; Farrell, Anne F.; Robinson, JoAnn L.

    2011-01-01

    Maternal resolution of a child's diagnosis relates to sensitive caregiving and healthy attachment. Failure to resolve is associated with maternal distress, high caregiving burden, and the quality of marital and social support. This study examined maternal resolution of diagnosis in a child psychiatric population utilizing the Reaction to Diagnosis…

  17. Forensic Psychiatric Perspective on Criminality Associated with Intellectual Disability: A Nationwide Register-Based Study

    Science.gov (United States)

    Mannynsalo, L.; Putkonen, H.; Lindberg, N.; Kotilainen, I.

    2009-01-01

    Background: Contrasting views exist over the association of intellectual disability (ID) and criminal offending. This nationwide study attempts to shed further light to expand understanding to substantiate the relation between socio-demographic characteristics, psychiatric co-morbidity and criminal behaviour among the Finnish forensic population…

  18. Associations between Relational Aggression, Depression, and Suicidal Ideation in a Child Psychiatric Inpatient Sample

    Science.gov (United States)

    Fite, Paula J.; Stoppelbein, Laura; Greening, Leilani; Preddy, Teresa M.

    2011-01-01

    The current study examined relations between relational aggression, depressive symptoms, and suicidal ideation in a child clinical population. Participants included 276 children (M age = 9.55 years; 69% Male) who were admitted to a child psychiatric inpatient facility. Findings suggested that relational aggression was associated with depressive…

  19. Tobacco industry influence on the definition of tobacco related disorders by the American Psychiatric Association

    OpenAIRE

    Neuman, M; Bitton, A.; Glantz, S.

    2005-01-01

    Objective: The Diagnostic and statistical manual of mental disorders, third edition (DSM-III), published by the American Psychiatric Association (APA) in 1980, included the first official definitions by the APA of tobacco dependence and tobacco withdrawal. Tobacco industry efforts to influence the DSM-III were investigated.

  20. The association between depressive symptoms and non-psychiatric hospitalisation in older adults

    NARCIS (Netherlands)

    Prina, A.M.; Deeg, D.; Brayne, C.; Beekman, A.; Huisman, M.

    2012-01-01

    Background: It is known that people who suffer from depression are more likely to have other physical illnesses, but the extent of the association between depression and non-psychiatric hospitalisation episodes has never been researched in great depth. We therefore aimed to investigate whether

  1. Associations Between Psychiatric Impairment and Sexual Risk Behavior Among Teens in Mental Health Treatment.

    Science.gov (United States)

    Hadley, Wendy; Barker, David H; Lescano, Celia M; Stewart, Angela J; Affleck, Katelyn; Donenberg, Geri; DiClemente, Ralph; Brown, Larry K

    2014-04-01

    To assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. Adolescents (N=893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy and condom use intentions. Two structural equation models were used to test the study hypotheses; one for sexually active youth and one for non-active youth. For non-active youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes, but depend on previous sexual experience.

  2. Patients with a psychiatric disorder in general practice: determinants of general practitioners' psychological diagnosis.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Schellevis, F.G.; Nuijen, J.; Volkers, A.

    2006-01-01

    BACKGROUND: Although psychiatric disorders are highly prevalent in the community, many patients with a psychiatric morbidity remain unidentified as such in primary care. OBJECTIVE: The aim of this study was to analyze which clinical and sociodemographic characteristics of patients with psychiatric

  3. Subjectivity in clinical practice: on the origins of psychiatric semiology in early French alienism.

    Science.gov (United States)

    Huertas, Rafael

    2014-12-01

    The aim of this article is to contribute to the analysis of the origins of psychiatric semiology, which by emphasizing subjectivity in clinical practice, gave birth to psychopathology as the scientific and intellectual enterprise of alienism. In other words, beyond simple anatomical and clinical observation, there was an effort to 'listen to' and 'read' the patient's delirium. In essence, the basic thesis which this short paper seeks to defend is that, despite a growing anatomical and clinical mind-set and a clear interest in physically locating mental illness within the body, during the Romantic period, psychiatry was able to construct a semiology largely based on the experience of the ego, on the inner world of the individual. This makes it possible to establish, from a clinical perspective, that the birth of alienism - of psychiatry - must be situated within the framework of a modernity in which the culture of subjectivity was one of its most characteristic features. © The Author(s) 2014.

  4. Supported education for individuals with psychiatric disabilities: State of the practice and policy implications.

    Science.gov (United States)

    Ringeisen, Heather; Langer Ellison, Marsha; Ryder-Burge, Amy; Biebel, Kathleen; Alikhan, Shums; Jones, Emily

    2017-06-01

    Supported education (SEd) is a promising practice that supports and encourages educational goals and attainment among individuals with psychiatric disabilities. This paper provides insights into how SEd objectives are pursued in different settings, assesses the evidence base, and discusses policy implications. Insights from 3 data sources were synthesized: published literature, an environmental scan, and 3 site visits to programs that support the education goals of individuals with psychiatric disabilities. While setting, target populations, level of coordination with supported employment, and financing strategies varied, common SEd components emerged: specialized and dedicated staffing, one-on-one and group skill-building activities, assistance with navigating the academic setting and coordinating different services, and linkages with mental health counseling. The evidence base is growing; however, many published studies to date do not employ rigorous methodology. Conclusions and Implications for Policy and Practice: Continued specification, operationalization, and testing of SEd core components are needed. The components of the evolving SEd model would benefit from rigorous testing to evaluate impact on degree completion and other key impacts such as employment; health, mental health, or recovery; and community participation. In addition to funding streams from special education and Medicaid, new opportunities for increasing the availability of SEd include the Workforce Innovation and Opportunities Act (WIOA) reauthorization, which requires state vocational rehabilitation agencies to fund preemployment services for transition-age individuals. New "set-aside" requirements for the Mental Health Services Block Grant will increase funding for early intervention services for individuals with serious mental illness, potentially including SEd. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder.

    Science.gov (United States)

    Byne, William; Bradley, Susan J; Coleman, Eli; Eyler, A Evan; Green, Richard; Menvielle, Edgardo J; Meyer-Bahlburg, Heino F L; Pleak, Richard R; Tompkins, D Andrew

    2012-08-01

    Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.

  6. Exposure to non-ionizing electromagnetic radiation from mobile telephony and the association with psychiatric symptoms.

    Science.gov (United States)

    Silva, Denize Francisca da; Barros, Warley Rocha; Almeida, Maria da Conceição Chagas de; Rêgo, Marco Antônio Vasconcelos

    2015-10-01

    The aim of this study was to investigate the association between exposure to non-ionizing electromagnetic radiation from mobile phone base stations and psychiatric symptoms. In a cross-sectional study in Salvador, Bahia State, Brazil, 440 individuals were interviewed. Psychiatric complaints and diagnoses were the dependent variables and distance from the individual's residence to the base station was considered the main independent variable. Hierarchical logistic regression analysis was conducted to assess confounding. An association was observed between psychiatric symptoms and residential proximity to the base station and different forms of mobile phone use (making calls with weak signal coverage, keeping the mobile phone close to the body, having two or more chips, and never turning off the phone while sleeping), and with the use of other electronic devices. The study concluded that exposure to electromagnetic radiation from mobile phone base stations and other electronic devices was associated with psychiatric symptoms, independently of gender, schooling, and smoking status. The adoption of precautionary measures to reduce such exposure is recommended.

  7. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Directory of Open Access Journals (Sweden)

    Nkokone S Z Tema

    2015-05-01

    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  8. Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice

    Directory of Open Access Journals (Sweden)

    Dell’Osso B

    2015-07-01

    Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, University of Cagliari, Cagliari, 18Department of Clinical and Experimental Medicine, Psychiatric Division, University of Insubria, Varese, 19Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, 20Department of Medical and Surgical Sciences, Bologna University, Bologna, 21Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy *These authors contributed equally as first authors Abstract: More than half a century after their discovery, benzodiazepines (BDZs still represent one of the largest and most widely prescribed groups of psychotropic compounds, not only in clinical psychiatry but also in the entire medical field. Over the last two decades, however, there has been an increased focus on the development of antidepressants and antipsychotics on the part of the pharmaceutical industry, clinicians, and researchers, with a reduced interest in BDZs, in spite of their widespread clinical use. As a consequence, many psychiatric residents, medical students, nurses, and other mental health professionals might receive poor academic teaching and training regarding these agents, and have the false impression that BDZs represent an outdated chapter in clinical psychopharmacology. However, recent advances in the field, including findings concerning epidemiology, addiction risk, and drug interactions, as well as the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with related diagnostic changes, strongly encourage an updated appraisal of the use of BDZs in clinical practice. During a recent thematic event convened with the aim of approaching this topic in a critical manner, a group of young Italian psychiatrists attempted to highlight possible flaws in current teaching pathways, identify the main clinical pros and cons

  9. Special observations in forensic psychiatric practice: gender issues of the watchers and the watched.

    Science.gov (United States)

    Mason, T; Mason-Whitehead, E; Thomas, M

    2009-12-01

    Special observations in psychiatric practice may create tensions for both the patient under surveillance and the staff undertaking the procedure. This study reports on special observations undertaken in forensic settings focusing specifically on the gender-sensitive issues. The aim of the study was to investigate the specific gender issues relating to special observations in relation to those under the procedure and those engaged in observing. Three medium secure units in the UK formed the sampling frame, and the population studied was eight female and seven male clinical Registered nurses. Semi-structured interviews were conducted, audio-tape-recorded and transcribed for analysis. The analysis involved a Grounded Theory approach to explicate categories and formulate two overarching themes: (1) the psychosocial fusion; and (2) the private as spectacle. There are implications for practice in relation to policy formulation and the implementation of special observations following risk assessment and individual skill identification. It is concluded that gender issues are extremely important for all concerned in this intrusive practice.

  10. Associations of specific psychiatric disorders with isolated focal dystonia, and monogenic and idiopathic Parkinson's disease.

    Science.gov (United States)

    Steinlechner, Susanne; Hagenah, Johann; Rumpf, Hans-Jürgen; Meyer, Christian; John, Ulrich; Bäumer, Tobias; Brüggemann, Norbert; Kasten, Meike; Münchau, Alexander; Klein, Christine; Lencer, Rebekka

    2017-06-01

    Comorbidity of psychiatric disorders in patients with movement disorders is common. Often, psychiatric symptoms manifest before the onset of the movement disorder, thus not representing a mere reaction to its burden. How the disease mechanisms of psychiatric and movement disorders are related is still poorly understood. The aim of the present study was to compare prevalence rates of specific psychiatric disorders between different movement disorders including isolated focal dystonia (IFD, N = 91), monogenic Parkinson's disease (PD, N = 41), idiopathic PD (N = 45), and a sample from a Northern Germany general population (TACOS Study; N = 4075). Our results indicate an odds ratio (OR) of 2.6 [confidence interval (CI) 1.7-4.0] for general axis I disorders in IFD, an OR of 2.5 (CI 1.4-4.7) in monogenic PD, and an OR of 1.4 (CI 0.8-2.6) in idiopathic PD. More specifically, the monogenic PD group showed the highest ORs for affective disorders including depression (OR = 4.9), bipolar disorder (OR = 17.4), and hypomanic episodes (OR = 17.0), whereas IFD expressed the highest rates of anxiety disorders (OR = 3.3). Psychotic symptoms were only observed in the PD groups but not in IFD. Our findings underline the notion that psychiatric disorders are part of the phenotypic spectrum of movement disorders. Moreover, they suggest that IFD, monogenic PD, and idiopathic PD are associated with specific psychiatric disorders indicating disturbances in a different neural circuitry for sensorimotor control.

  11. Sexual attitudes and associated psychiatric features among youths in a community sample.

    Science.gov (United States)

    Feldman, M J; Bird, H R; Hoven, C; Moore, R E; Bin, F

    2000-08-01

    Using an epidemiological sample of adolescents, this study examined associations between the acceptability of potential sex partners and psychiatric status. Subjects aged 14 to 17 years (N = 161) from the Columbia site of the National Institute of Mental Health (NIMH) Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study were grouped according to their responses about the acceptability of youths their age having sex with partners of (1) the opposite sex, (2) neither sex, and (3) either sex. Youths endorsing either sex were compared with youths endorsing the other two types of partners according to psychiatric indicators obtained from the Diagnostic Interview Schedule for Children Version 2.3. Higher-than-expected proportions of male and female youths endorsed sex partners of either sex as potentially acceptable for peers. Youths who did so abused substances and used mental health services more than peers but did not differ in rates of suicidal ideation or attempts. Males endorsing either sex also had higher rates of mood disorders and, compared with males endorsing only the opposite sex, a higher intelligence level. Attitudes about the potential acceptability of sex partners for peers are associated with psychiatric morbidity and mental health service use in the respondent as well as with intelligence level in males. Youths who endorsed potential sex partners of either sex, especially males, appear to be at higher risk for multiple psychiatric problems.

  12. The Practice of Seclusion and Time-out on English Acute Psychiatric Wards: The City-128 Study

    NARCIS (Netherlands)

    Bowers, L.; Merwe, M. van der; Nijman, H.L.I.; Hamilton, B.; Noorthoorn, E.O.; Stewart, D.; Muir-Cochrane, E.

    2010-01-01

    Background - Seclusion is widely used internationally to manage disturbed behavior by psychiatric patients, although many countries are seeking to reduce or eliminate this practice. Time-out has been little described and almost completely unstudied. Aim and method - To assess the relationship of

  13. Utility and adoption of CYP2D6 and CYP2C19 genotyping and its translation into psychiatric clinical practice

    DEFF Research Database (Denmark)

    Jürgens, G; Jacobsen, C B; Rasmussen, H B

    2012-01-01

    To describe clinical utility and adoption of routinely offered CYP2D6 and CYP2C19 genotyping (CYP test) in daily clinical practice of a psychiatric centre.......To describe clinical utility and adoption of routinely offered CYP2D6 and CYP2C19 genotyping (CYP test) in daily clinical practice of a psychiatric centre....

  14. Measuring Limit-Setting Practices Used by Family Members Towards Relatives with Psychiatric Disorders.

    Science.gov (United States)

    Labrum, Travis; Walk, Marlene; Solomon, Phyllis L

    2016-09-01

    Family members often set limits with relatives with psychiatric disorders (PD), however, no scale currently exists measuring the use of such limit-setting practices. The present article describes the development and results of a new measure, the Family Limit-Setting Scale (FLSS). Via a national online survey, the FLSS was completed by 573 adults residing in the U.S. who report having an adult relative with PD. We conducted exploratory and confirmatory factor analyses, examined internal consistencies and other indicators of construct validity, and performed invariance analyses assessing the generality of the optimal factor model to men, women, Caucasian respondents, and non-Caucasian respondents. Results indicate that the FLSS has an acceptable two factor structure (routine limit-setting and crisis prevention limit-setting) with both factors being highly generalizable to all groups of respondents examined. Internal consistencies and other indicators provide additional evidence of the FLSS' construct validity. Use of the FLSS will enable the conduction of quantitative research in this area. In addition, this measure may be employed in education/support organizations for families with a member with mental illness in an effort to identify persons using high levels of limit-setting practices who may benefit from extra support and/or guidance.

  15. Mental health legislation in Lebanon: Nonconformity to international standards and clinical dilemmas in psychiatric practice.

    Science.gov (United States)

    Kerbage, Hala; El Chammay, Rabih; Richa, Sami

    2016-01-01

    Mental health legislation represents an important mean of protecting the rights of persons with mental disabilities by preventing human rights violations and discrimination and by legally reinforcing the objectives of a mental health policy. The last decade has seen significant changes in the laws relating to psychiatric practice all over the world, especially with the implementation of the Convention for the Rights of People with Disabilities (CRPD). In this paper, we review the existing legislation in Lebanon concerning the following areas in mental health: treatment and legal protection of persons with mental disabilities, criminal laws in relation to offenders with mental disorders, and laws regulating incapacity. We will discuss these texts in comparison with international recommendations and standards on the rights of persons with disabilities, showing the recurrent contradiction between them. Throughout our article, we will address the clinical dilemmas that Lebanese psychiatrists encounter in practice, in the absence of a clear legislation that can orient their decisions and protect their patients from abuse. Copyright © 2015. Published by Elsevier Ltd.

  16. Pedagogy, power and practice ethics: clinical teaching in psychiatric/mental health settings.

    Science.gov (United States)

    Ewashen, Carol; Lane, Annette

    2007-09-01

    Often, baccalaureate nursing students initially approach a psychiatric mental health practicum with uncertainty, and even fear. They may feel unprepared for the myriad complex practice situations encountered. In addition, memories of personal painful life events may be vicariously evoked through learning about and listening to the experiences of those diagnosed with mental disorders. When faced with such challenging situations, nursing students often seek counsel from the clinical and/or classroom faculty. Pedagogic boundaries may begin to blur in the face of student distress. For the nurse educator, several questions arise: Should a nurse educator provide counseling to students? How does one best negotiate the boundaries between 'counselor', and 'caring educator'? What are the limits of a caring and professional pedagogic relation? What different knowledges provide guidance and to what differential consequences for ethical pedagogic relationships? This paper offers a comparative analysis of three philosophical stances to examine differences in key assumptions, pedagogic positioning, relationships of power/knowledge, and consequences for professional ethical pedagogic practices. While definitive answers are difficult, the authors pose several questions for consideration in discerning how best to proceed and under what particular conditions.

  17. Associations between the social organization of communities and psychiatric disorders in rural Asia.

    Science.gov (United States)

    Axinn, William G; Ghimire, Dirgha J; Williams, Nathalie E; Scott, Kate M

    2015-10-01

    We provide rare evidence of factors producing psychiatric variation in a general population sample from rural South Asia. The setting is particularly useful for demonstrating that variations in the social organization of communities, often difficult to observe in rich countries, are associated with important variations in mental health. Clinically validated survey measures are used to document variation in psychiatric disorders among 401 adults. This sample is chosen from a systematic sample of the general population of rural Nepal, in a community-level-controlled comparison design. Multilevel logistic regression is used to estimate multivariate models of the association between community-level nonfamily social organization and individual-level psychiatric disorders. Schools, markets, health services and social support groups each substantially reduce the odds of depression, post-traumatic stress disorder (PTSD), intermittent explosive disorder and anxiety disorders. Associations between schools, health services and social support groups and depression are statistically significant and independent of each other. The association between access to markets and PTSD is statistically significant and independent of other social organization and support groups. Community integration of some nonfamily social organizations promotes mental health in ways that may go unobserved in settings with many such organizations. More research on the mechanisms producing these associations is likely to reveal potential avenues for public policy and programs to improve mental health in the general population.

  18. Chronic widespread pain in patients with occupational spinal disorders: prevalence, psychiatric comorbidity, and association with outcomes.

    Science.gov (United States)

    Mayer, Tom G; Towns, Benjamin L; Neblett, Randy; Theodore, Brian R; Gatchel, Robert J

    2008-08-01

    A prospective study assessing chronic widespread pain (CWP) and psychiatric comorbidities in patients with chronic disabling occupational spinal disorders (CDOSDs). To assess the prevalence of CWP, demographic characteristics, and associated psychiatric comorbidity among CDOSD patients, as well as determine if CWP is a risk factor for less successful one-year postrehabilitation socioeconomic outcomes. CWP is an essential criterion for diagnosing fibromyalgia. CWP is estimated to affect between 4.1% to 13.5% of the general population and it is associated with higher rates of psychiatric disorders and growing rates of disability. The prevalence of CWP, or its associations as a comorbidity, in patients with CDOSDs are unknown. The socioeconomic outcomes, demographic characteristics, and psychiatric comorbidity of CDOSD patients with CWP were compared to non-CWP patients within a cohort of consecutive CDOSD patients (n = 2730), treated in an interdisciplinary functional restoration program. CWP was determined according to American College of Rheumatology criteria. Psychiatric comorbidity was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-fourth Edition at the beginning of the rehabilitation program. RESULTS.: In the CDOSD cohort, 32% of the patients (N = 878) met American College of Rheumatology criteria for CWP, relative to 4.1% to 13.5% within the general population. CWP patients (82%) were much more likely than non-CWP patients (16%) to have multisite pain complaints, leading to the finding that CDOSD patients with multisite pain showed a CWP prevalence of 70%. CWP patients were 1.5 times more likely to be female, more likely to have multiple compensable injuries, and had slightly elevated rates of pre- and postinjury Axis I psychopathology. Nevertheless, CWP was not associated with less successful 1-year socioeconomic outcomes. A surprisingly high frequency of CDOSD patients participating in

  19. Benzodiazepine use in the real world of psychiatric practice: low-dose, long-term drug taking and low rates of treatment discontinuation.

    Science.gov (United States)

    Veronese, Antonio; Garatti, Massimo; Cipriani, Andrea; Barbui, Corrado

    2007-09-01

    The present study was designed to (1) estimate the frequency of benzodiazepine use in psychiatric practice, (2) investigate factors associated with use, (3) establish whether a relationship exists between benzodiazepine dose and length of use, and (4) investigate factors associated with time to discontinuation. This study was conducted in South Verona, Italy. All individuals who were exposed to benzodiazepines during 2005 were extracted from the local Psychiatric Case Register, and the longitudinal history of benzodiazepine exposure was retrospectively described. In 2005, a total of 1,771 individuals were in contact with at least one of the psychiatric facilities of the South Verona catchment area. Of these, 535 were benzodiazepine users, yielding a frequency of use of 30.2% [95% confidence intervals (CI) 28.0, 32.4]. In multivariate logistic regression analysis, lower level of education, diagnosis of affective illness, longer length of illness and higher service use were significantly associated with benzodiazepine exposure. An increase in dosages over time to maintain the drug's effectiveness was not evident from the analysis of the relationship between daily dose and length of therapy. A total of 17.3% (93/535) of patients exposed to benzodiazepines discontinued treatment. Cox regression analysis revealed that age and length of illness were negatively associated with the probability of discontinuing therapy, while the concomitant use of antipsychotics and mood stabilisers was positively associated with discontinuing therapy. The finding that in the great majority of psychiatric patients, low doses of benzodiazepines are routinely prescribed on a long-term basis suggests that, in this specific setting of care, treatment recommendations stating that use should be short term may not be applicable.

  20. Disability status, disease parameters, defense styles, and ego strength associated with psychiatric complications of multiple sclerosis.

    Science.gov (United States)

    Hyphantis, Thomas N; Christou, Konstantinos; Kontoudaki, Stavroula; Mantas, Christos; Papamichael, George; Goulia, Panagiota; Konitsiotis, Spyros; Mavreas, Venetsanos

    2008-01-01

    The aim of the present study was to identify disease parameters, defensive styles and ego strength measurements associated with various forms of psychiatric complications in patients with multiple sclerosis (MS). Seventy-nine patients with MS participated in the study and 158 healthy subjects matched for age and sex served as controls. A wide range of clinical information was collected and the following self-report instruments were used: General Health Questionnaire, Symptom Distress Check List, Defense Style Questionnaire, MMPI Ego Strength Scale and Hostility and Direction of Hostility Questionnaire. The odds of being assessed with a psychiatric diagnosis upon interview were 6.7 times greater among patients compared to controls and 9.3 times greater among patients with recent-onset MS compared to patients with long-term disease. Psychiatric complications of MS were closely associated with age of the disease onset and the degree of disability due to MS. Additionally, higher rates of introverted hostility, adoption of maladaptive ego defenses and weakened ego strength were also closely associated with several forms of psychological distress, especially depressive symptoms. MS patients experience elevated symptoms of psychological distress, especially depressive symptoms, which are most closely associated with disease parameters. However, the crucial role of various personality traits such as ego defenses and hostility features in the psychiatric symptom formation also appear to contribute to the development of depressive symptoms. Clinicians involved in the clinical management of patients with MS should identify and modify treatment if these specific personality markers that indicate the exhaustion of the patient's resources to cope with the physical and psychological stress of the illness are present.

  1. Bullying Victimization (Being Bullied) Among Adolescents Referred for Urgent Psychiatric Consultation: Prevalence and Association With Suicidality

    Science.gov (United States)

    Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne

    2015-01-01

    Objective: To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. Method: A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen’s University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. Results: The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Conclusions: Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment. PMID:26720189

  2. Bullying Victimization (Being Bullied) Among Adolescents Referred for Urgent Psychiatric Consultation: Prevalence and Association With Suicidality.

    Science.gov (United States)

    Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne

    2015-10-01

    To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen's University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment.

  3. [Bullying and its association with psychiatric disorders in a Mexican students sample].

    Science.gov (United States)

    Albores-Gallo, Lilia; Sauceda-García, Juan Manuel; Ruiz-Velasco, Silvia; Roque-Santiago, Eduardo

    2011-01-01

    To study the relationship between bullying behavior and psychopathology. A total of 1 092 students identified their peers' bullying status based on the Bull-S questionnaire. Parents completed the Child Behavior Checklist (CBCL) to determine psychopathology levels. The bullying group had associations with anxiety, somatic symptoms, oppositionalism and behavior problems; the bully-victims group had associations with attention, oppositionalism and behavior problems; victims had higher anxiety scores.These differences were significant compared with the control group. Bullying is associated with psychopathology, which requires timely psychiatric attention.

  4. Association between stalking victimisation and psychiatric morbidity in a random community sample.

    Science.gov (United States)

    Purcell, Rosemary; Pathé, Michele; Mullen, Paul E

    2005-11-01

    No studies have assessed psychopathology among victims of stalking who have not sought specialist help. To examine the associations between stalking victimisation and psychiatric morbidity in a representative community sample. A random community sample (n=1844) completed surveys examining the experience of harassment and current mental health. The 28-item General Health Questionnaire (GHQ-28) and the Impact of Event Scale were used to assess symptomatology in those reporting brief harassment (n=196) or protracted stalking (n=236) and a matched control group reporting no harassment (n=432). Rates of caseness on the GHQ-28 were higher among stalking victims (36.4%) than among controls (19.3%) and victims of brief harassment (21.9%). Psychiatric morbidity did not differ according to the recency of victimisation, with 34.1% of victims meeting caseness criteria 1 year after stalking had ended. In a significant minority of victims, stalking victimisation is associated with psychiatric morbidity that may persist long after it has ceased. Recognition of the immediate and long-term impacts of stalking is necessary to assist victims and help alleviate distress and long-term disability.

  5. Association of Psychiatric History and Type D Personality with Symptoms of Anxiety, Depression, and Health Status Prior to ICD Implantation

    NARCIS (Netherlands)

    Starrenburg, Annemieke H.; Kraaier, Karin; Pedersen, Susanne S.; Hout, Moniek; Scholten, Marcoen; van der Palen, Jacobus Adrianus Maria

    2013-01-01

    BACKGROUND: Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD). PURPOSE: We examined associations between previous anxiety and depressive

  6. Association of Fluid Intelligence and Psychiatric Disorders in a Population-Representative Sample of US Adolescents.

    Science.gov (United States)

    Keyes, Katherine M; Platt, Jonathan; Kaufman, Alan S; McLaughlin, Katie A

    2017-02-01

    Despite long-standing interest in the association of psychiatric disorders with intelligence, few population-based studies of psychiatric disorders have assessed intelligence. To investigate the association of fluid intelligence with past-year and lifetime psychiatric disorders, disorder age at onset, and disorder severity in a nationally representative sample of US adolescents. National sample of adolescents ascertained from schools and households from the National Comorbidity Survey Replication-Adolescent Supplement, collected 2001 through 2004. Face-to-face household interviews with adolescents and questionnaires from parents were obtained. The data were analyzed from February to December 2016. DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview, and included a broad range of fear, distress, behavior, substance use, and other disorders. Disorder severity was measured with the Sheehan Disability Scale. Fluid IQ measured with the Kaufman Brief Intelligence Test, normed within the sample by 6-month age groups. The sample included 10 073 adolescents (mean [SD] age, 15.2 [1.50] years; 49.0% female) with valid data on fluid intelligence. Lower mean (SE) IQ was observed among adolescents with past-year bipolar disorder (94.2 [1.69]; P = .004), attention-deficit/hyperactivity disorder (96.3 [0.91]; P = .002), oppositional defiant disorder (97.3 [0.66]; P = .007), conduct disorder (97.1 [0.82]; P = .02), substance use disorders (alcohol abuse, 96.5 [0.67]; P Intelligence was not associated with posttraumatic stress disorder, eating disorders, and anxiety disorders other than specific phobia, and was positively associated with past-year major depression (mean [SE], 100 [0.5]; P = .01). Associations of fluid intelligence with lifetime disorders that had remitted were attenuated compared with past-year disorders, with the exception of separation anxiety disorder. Multiple past

  7. Correlation between brain damage, associated biomarkers, and medication in psychiatric inpatients: A cross-sectional study.

    Science.gov (United States)

    Yoshida, Madoka; Kanzaki, Tetsuto; Mizoi, Mutsumi; Nakamura, Mizuho; Uemura, Takeshi; Mimori, Seisuke; Uju, Yoriyasu; Sekine, Keisuke; Ishii, Yukihiro; Yoshimi, Taro; Yasui, Reiko; Yasukawa, Asuka; Sato, Mamoru; Okamoto, Seiko; Hisaoka, Tetsuya; Miura, Masafumi; Kusanishi, Shun; Murakami, Kanako; Nakano, Chieko; Mizuta, Yasuhiko; Mishima, Shunichi; Hayakawa, Tatsuro; Tsukada, Kazumi; Kashiwagi, Keiko; Igarashi, Kazuei

    2017-01-01

    We clarified the correlation between brain damage, associated biomarkers and medication in psychiatric patients, because patients with schizophrenia have an increased risk of stroke. The cross-sectional study was performed from January 2013 to December 2015. Study participants were 96 hospitalized patients (41 men and 55 women) in the Department of Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Chiba, Japan. Patients were classified into schizophrenia (n=70) and mood disorders (n=26) by psychiatric diagnoses with DSM-IV-TR criteria. The incidence of brain damage [symptomatic and silent brain infarctions (SBIs) and white matter hyperintensity (WMH)] was correlated more with mood disorders than with schizophrenia. It has been previously shown that the concentrations of protein-conjugated acrolein (PC-Acro) and interleukin-6 (IL-6) increased in plasma of brain infarction patients together with C-reactive protein (CRP). The concentration of PC-Acro was significantly higher in patients with mood disorders than in those with schizophrenia. The concentration of IL-6 in both groups was nearly equal to that in the control group, but that of CRP in both groups, especially in mood disorders, was higher than that in the control group. Accordingly, the relative risk value for brain infarction was higher in patients with mood disorders than with schizophrenia. Medication with atypical antipsychotics reduced PC-Acro significantly in all psychiatric patients and reduced IL-6 in mood disorder patients. Measurement of 3 biomarkers (CRP, PC-Acro and IL-6) are probably useful for judgement of severity of brain damage and effectiveness of medication in psychiatric patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Culture, salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application.

    Science.gov (United States)

    Rashed, Mohammed Abouelleil

    2013-07-16

    Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence construct including impoverished definitions of culture as religious, national or ethnic group and of congruence as validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct. The article distinguishes symbolic from phenomenological conceptions of culture, the latter expanded upon through two sources: Husserl's phenomenological analysis of background intentionality and neuropsychological literature on salience. It is argued that culture is not limited to symbolic presuppositions and shapes subjects' experiential dispositions. This conception is deployed to re-examine the meaning of (in)congruence. The main argument is that a significant, since foundational, deviation from culture is not from a value or belief but from culturally-instilled experiential dispositions, in what is salient to an individual in a particular context. Applying the concept of cultural congruence must not be limited to assessing violations of the symbolic order and must consider alignment with or deviations from culturally-instilled experiential dispositions. By virtue of being foundational to a shared experience of the world, such dispositions are more accurate indicators of potential vulnerability. Notwithstanding problems of access and expertise, clinical practice should aim to accommodate this richer meaning of cultural congruence.

  9. The Prevalence of Psychiatric Distress and Associated Risk Factors among College Students Using GHQ-28 Questionnaire.

    Science.gov (United States)

    Poorolajal, Jalal; Ghaleiha, Ali; Darvishi, Nahid; Daryaei, Shahla; Panahi, Soheila

    2017-07-01

    Adolescent and young adults are at increased risk of psychiatric distress and serious disability. We estimated the prevalence and associated risk factors of psychiatric distress among the college students of Hamadan University of Medical Sciences, Iran. We performed this cross-sectional study, from Jan to May 2016 at Hamadan University of Medical Sciences, Hamadan, Iran. Students filled out voluntarily an anonymous self-administered questionnaire, including demographic characteristics, personal information, behavioral risk factors, and a validated Persian version of the GHQ-28 questionnaire, including somatic symptoms (items 1-7), anxiety/insomnia (items 8-14), social dysfunctions (items 15-21), and severe depression (items 22-28). Of 1259 participants, 518 (41.1%) had psychiatric distress, 166 (13.2%) had heterosexual intercourse, 100 (8.0%) had homosexual intercourse, 204 (16.2%) were smokers (31.6% in males and 6.3% in females), 124 (9.9%) reported a history of using opium/psychedelic substances, 204 (16.2%) reported suicide thought, and 103 (8.2%) had attempted suicide at least once in the past. After adjusting odds ratio (95% CI) for age and sex, psychiatric distress were significantly associated with emotional breakdown 2.67 (2.09, 3.40), heterosexual intercourse 2.56 (1.82, 3.62), homosexual intercourse 2.42 (1.57, 3.71), smoking 3.19 (2.29, 4.45), substance abuse 5.03 (3.26, 7.76), suicide thought 7.81 (5.42, 11.27), suicide attempt 5.64 (3.49, 9.12), uninterested in the discipline 2.29 (1.70, 3.07), and non-optimistic about future 2.16 (1.63, 2.86). A majority of college students had psychiatric distress and a substantial number of them reported one or more high-risk behaviors that if neglected, may severely impair the students' function and influence their subsequent development and productive lives.

  10. Ringleader bullying: association with psychopathic narcissism and theory of mind among child psychiatric inpatients.

    Science.gov (United States)

    Stellwagen, Kurt K; Kerig, Patricia K

    2013-10-01

    This study examined the association of ringleader bullying with psychopathic traits and theory of mind among 100 youth aged 10-15 (62 boys and 38 girls) receiving inpatient psychiatric services at a state facility. Results of hierarchical multiple regression analyses indicated a positive association between ringleader bullying and psychopathic narcissism, and a significant interaction effect between narcissism and theory of mind. More specifically, narcissism moderated the relationship between theory of mind and ringleader bullying such that theory of mind was positively associated with ringleader bullying when levels of narcissism were high, and theory of mind was negatively associated ringleader bullying when levels of narcissism were low. The discussion of these results focuses on the importance of developing effective treatment techniques for youth whose bullying behavior is associated with narcissistic features and social acuity.

  11. Limiting Patients as a Nursing Practice in Psychiatric Intensive Care Units to Ensure Safety and Gain Control.

    Science.gov (United States)

    Salzmann-Erikson, Martin

    2015-10-01

    The aim of this study was to describe how the limitation of patients is being practiced in psychiatric intensive care units. A focused ethnographic methodology was applied. To gather data, the author conducted fieldwork involving participant observation. The results of the study are presented in two categories, which describe the limited access patients had to items and in the ward environments. It is advisable for practitioners to critically reflect upon local regulations and policies related to the practice of limiting patients during the worst phase of their mental illness. © 2014 Wiley Periodicals, Inc.

  12. Psychiatric Genomics

    DEFF Research Database (Denmark)

    Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M

    2018-01-01

    into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...

  13. Achieving Full Scope of Practice Readiness Using Evidence for Psychotherapy Teaching in Web and Hybrid Approaches in Psychiatric Mental Health Advanced Practice Nursing Education.

    Science.gov (United States)

    McCoy, Kathleen T

    2018-01-01

    Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur. This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms. With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training? By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path. In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort. © 2017 Wiley Periodicals, Inc.

  14. Identifying key factors associated with aggression on acute inpatient psychiatric wards.

    Science.gov (United States)

    Bowers, Len; Allan, Teresa; Simpson, Alan; Jones, Julia; Van Der Merwe, Marie; Jeffery, Debra

    2009-04-01

    Aggressive behaviour is a critical issue for modern acute psychiatric services, not just because of the adverse impact it has on patients and staff, but also because it puts a financial strain on service providers. The aim of this study was to assess the relationship of patient violence to other variables: patient characteristics, features of the service and physical environment, patient routines, staff factors, the use of containment methods, and other patient behaviours. A multivariate cross sectional design was utilised. Data were collected for a six month period on 136 acute psychiatric wards in 26 NHS Trusts in England. Multilevel modelling was conducted to ascertain those factors most strongly associated with verbal aggression, aggression toward objects, and physical aggression against others. High levels of aggression were associated with a high proportion of patients formally detained under mental health legislation, high patient turnover, alcohol use by patients, ward doors being locked, and higher staffing numbers (especially qualified nurses). The findings suggest that the imposition of restrictions on patients exacerbates the problem of violence, and that alcohol management strategies may be a productive intervention. Insufficient evidence is available to draw conclusions about the nature of the link between staffing numbers and violence.

  15. Cardiovascular and psychiatric characteristics associated with oxidative stress markers among adolescents with bipolar disorder.

    Science.gov (United States)

    Hatch, Jessica; Andreazza, Ana; Olowoyeye, Omodele; Rezin, Gislane Tezza; Moody, Alan; Goldstein, Benjamin I

    2015-09-01

    In the field of bipolar disorder (BD) research there is an absence of validated biomarkers and limited understanding of the biology underlying excessive and premature cardiovascular disease (CVD). Oxidative stress is a potential biomarker in both BD and CVD. To examine psychiatric and cardiovascular characteristics associated with peripheral oxidative stress markers among adolescents with BD, who are at high risk for CVD. Participants were 30 adolescents, 13-19years old, with BD and without CVD. Ultrasonography was used to evaluate vascular function and structure. Traditional CVD risk factors were also measured. Psychiatric assessments were conducted via semi-structured interview. Serum levels of oxidative stress (lipid hydroperoxides (LPH) and protein carbonylation (PC)) were assayed. Compared to published data on adults with BD, adolescents had significantly lower levels of LPH and PC (t52(11.34), ptheories for BD. Oxidative stress is robustly associated with a proxy measure of atherosclerosis and may explain in part the increased risk of CVD in BD. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Psychosocial and Psychiatric Factors Associated with Adolescent Suicide: A Case-Control Psychological Autopsy Study

    Science.gov (United States)

    Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees

    2009-01-01

    This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…

  17. The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery-orientated policy in practice.

    Science.gov (United States)

    Cusack, E; Killoury, F; Nugent, L E

    2017-03-01

    WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally. Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical

  18. Increased oxytocin levels among abstinent heroin addicts: Association with aggressiveness, psychiatric symptoms and perceived childhood neglect.

    Science.gov (United States)

    Gerra, Lidia M; Gerra, Gilberto; Mercolini, Laura; Manfredini, Matteo; Somaini, Lorenzo; Pieri, Chiara M; Antonioni, Maina; Protti, Michele; Ossola, Paolo; Marchesi, Carlo

    2017-04-03

    A disruption of the oxytocin system seems to affect a variety of brain functions including emotions, mood and social behavior possibly underlying severe social deficits and susceptibility for substance use and mental health disorders. Early life adversity, such as insecure attachment in childhood, has been suggested to influence oxytocin tone contributing to a condition of neurobiological vulnerability. Aim of the present study was to investigate oxytocin serum levels in abstinent heroin addicted patients, in comparison with healthy controls, and the possible correlation with co-occurring psychiatric symptoms, aggressiveness and perception of parental neglect. Eighteen (18) abstinent patients, affected by heroin use disorders, and 18 control subjects, who never used drugs or abused alcohol, were included in the study and submitted to 1) collection of a blood sample for oxytocin assay, 2) Symptoms Check List 90 for psychiatric symptoms evaluation 3) Buss Durkee Hostility Inventory to measure aggressiveness 4) Child Experience of Care and Abuse-Questionnaire to retrospectively test the perception of parental neglect. Heroin exposure extent and heroin dosages were also recorded. Oxytocin serum levels were unexpectedly significantly higher among abstinent patients affected by heroin use disorders and positively correlated with psychiatric symptoms, aggressiveness and mother neglect scores. No correlation was evidenced between oxytocin and heroin exposure extent or dosages. Our findings appear to contradict the simplistic view of oxytocin as a pro-social hormone and confirm previous evidence concerning the peptide levels direct association with aggressive behavior and mood disorders. Considering a more complex mechanism, oxytocin would increase the sensitivity to social salience cues related to contextual or inter-individual factors, promoting pro-sociality in "safe" conditions and, in contrast, inducing more defensive and "anti-social" emotions and behaviors when the

  19. Headache complaints associated with psychiatric comorbidity in a population-based sample

    Directory of Open Access Journals (Sweden)

    Benseñor I.M.

    2003-01-01

    Full Text Available The objective of the present study was to determine the frequency at which people complain of any type of headache, and its relationship with sociodemographic characteristics and psychiatric comorbidity in São Paulo, Brazil. A three-step cluster sampling method was used to select 1,464 subjects aged 18 years or older. They were mainly from families of middle and upper socioeconomic levels living in the catchment area of Instituto de Psiquiatria. However, this area also contains some slums and shantytowns. The subjects were interviewed using the Brazilian version of the Composite International Diagnostic Interview version 1.1. (CIDI 1.1 by a lay trained interviewer. Answers to CIDI 1.1 questions allowed us to classify people according to their psychiatric condition and their headaches based on their own ideas about the nature of their illness. The lifetime prevalence of "a lot of problems with" headache was 37.4% (76.2% of which were attributed to use of medicines, drugs/alcohol, physical illness or trauma, and 23.8% attributed to nervousness, tension or mental illness. The odds ratio (OR for headache among participants with "nervousness, tension or mental illness" was elevated for depressive episodes (OR, 2.1; 95%CI, 1.4-3.4, dysthymia (OR, 3.4; 95%CI, 1.6-7.4 and generalized anxiety disorder (OR, 4.3; 95%CI, 2.1-8.6, when compared with patients without headache. For "a lot of problems with" headaches attributed to medicines, drugs/alcohol, physical illness or trauma, the risk was also increased for dysthymia but not for generalized anxiety disorder. These data show a high association between headache and chronic psychiatric disorders in this Brazilian population sample.

  20. Headache complaints associated with psychiatric comorbidity in a population-based sample.

    Science.gov (United States)

    Benseñor, I M; Tófoli, L F; Andrade, L

    2003-10-01

    The objective of the present study was to determine the frequency at which people complain of any type of headache, and its relationship with sociodemographic characteristics and psychiatric comorbidity in S o Paulo, Brazil. A three-step cluster sampling method was used to select 1,464 subjects aged 18 years or older. They were mainly from families of middle and upper socioeconomic levels living in the catchment area of Instituto de Psiquiatria. However, this area also contains some slums and shantytowns. The subjects were interviewed using the Brazilian version of the Composite International Diagnostic Interview version 1.1. (CIDI 1.1) by a lay trained interviewer. Answers to CIDI 1.1 questions allowed us to classify people according to their psychiatric condition and their headaches based on their own ideas about the nature of their illness. The lifetime prevalence of "a lot of problems with" headache was 37.4% (76.2% of which were attributed to use of medicines, drugs/alcohol, physical illness or trauma, and 23.8% attributed to nervousness, tension or mental illness). The odds ratio (OR) for headache among participants with "nervousness, tension or mental illness" was elevated for depressive episodes (OR, 2.1; 95%CI, 1.4-3.4), dysthymia (OR, 3.4; 95%CI, 1.6-7.4) and generalized anxiety disorder (OR, 4.3; 95%CI, 2.1-8.6), when compared with patients without headache. For "a lot of problems with" headaches attributed to medicines, drugs/alcohol, physical illness or trauma, the risk was also increased for dysthymia but not for generalized anxiety disorder. These data show a high association between headache and chronic psychiatric disorders in this Brazilian population sample.

  1. Associations between psychiatric comorbidities and sleep disturbances in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Accardo, Jennifer A; Marcus, Carole L; Leonard, Mary B; Shults, Justine; Meltzer, Lisa J; Elia, Josephine

    2012-02-01

    Children with attention-deficit/hyperactivity disorder (ADHD) often have sleep complaints and also higher rates of psychiatric comorbidities such as mood and anxiety disorders that may affect sleep. The authors hypothesized that children with ADHD and psychiatric comorbidities would have higher overall sleep disturbance scores as measured by a sleep questionnaire than children with ADHD without comorbidities. This cross-sectional analysis in an academic center studied 317 children with ADHD; 195 subjects had no comorbid conditions, 60 were anxious and 62 were depressed. Participants completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present State, 4th Revised Edition and the Children's Sleep Habits Questionnaire. Median age (range) was 8.9 (6-18.7) years; 78% were male. Median (interquartile range) Total Sleep Disturbance Score (TSDS) on Children's Sleep Habits Questionnaire for subjects with no comorbidities was 44 (40-49); anxiety, 48 (43-54); and depression, 46 (41-52). Compared with subjects without comorbidities, TSDS in anxious subjects was greater (p = .008). TSDS in depressed subjects was not significantly different. Compared with subjects without comorbidities, anxious subjects had higher Bedtime Resistance, Sleep Onset Delay, and Night Wakings subscales (p = .03, .007, and .007, respectively); depressed subjects had higher Sleep Onset Delay and Sleep Duration subscales (p = .003 and .01, respectively). Anxiety in children with ADHD contributed to higher overall sleep disturbance scores, compared with children with ADHD alone. Both comorbidities were associated with higher Sleep Onset Latency subscale scores. Further study of the impact of psychiatric comorbidities on sleep in children with ADHD is warranted.

  2. The diagnostic stability of ICD-10 psychiatric diagnoses in clinical practice.

    Science.gov (United States)

    Daradkeh, T; El-Rufaie, O; Younis, Y; Ghubash, R

    1997-01-01

    This study examines the stability of ICD-10 diagnoses of patients admitted to Al Ain (United Arab Emirates) inpatients psychiatric unit during the period from November 1993 to August 1995. Diagnostic stability is a measure of the degree to which diagnoses remained unchanged at a later hospital admission. One hundred and seven patients were admitted more than once during this period, accounting for 168 readmissions. High levels of diagnostic stability were found for ICD-10 Fl-psychiatric disorders (100%), F2-schizophrenia (87%), F3-bipolar disorders (87%) and F3-depressive disorders (73%). A poor level of stability was found for patients with neurotic, stress related and adjustment disorders (F4), ranging from zero for somatoform disorders to 50% for generalized anxiety and panic disorders. Poor levels of stability were also found for other psychoses (excluding schizophrenia and affective psychoses) and personality disorders. We conclude that the introduction of ICD-10 as a formal diagnostic system has greatly improved the temporal stability of the most commonly encountered psychiatric disorders (ICD-10 Fl to F3 disorders), confirming the construct validity of those psychiatric disorders. Further investigations are required to evaluate the diagnostic stability of neurotic and other psychotic disorders.

  3. Work and Psychiatric Illness in Aotearoa/New Zealand: Implications for Career Practice

    Science.gov (United States)

    Southern, Annie; Miller, Judi

    2012-01-01

    This paper aims to examine the influence of Maori culture upon psychiatric service provision in Aotearoa/New Zealand and the implications of this for career counselling of people with experience of mental illness in Aotearoa/New Zealand. The research explored the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with…

  4. Trends in suicide risk associated with hospitalized psychiatric illness: a case-control study based on danish longitudinal registers

    DEFF Research Database (Denmark)

    Qin, Ping; Nordentoft, Merete; Hansen Høyer, Eyd

    2006-01-01

    is mainly accounted for by the reduction among patients who had been discharged from psychiatric hospitals for more than 1 year. For patients who had been discharged from hospitals within 1 year, the reduction is similar to that of the general population; while for patients hospitalized for treatment...... at the time of suicide or the index date, the reduction in suicide rate is relatively slower. Such trends hold for all diagnostic groups. Further analyses stratified by age indicate that the faster reduction in suicide rate associated with history of hospitalized psychiatric illness is more pronounced among...... patients aged 36 years and older. CONCLUSION: The reduction in suicide rate is substantial for patients who have been discharged from psychiatric hospitals for more than 1 year and for middle-aged and older patients. Recent improvement in psychiatric care and treatment and promotion of new generation...

  5. Rare Variants of the Serotonin Transporter Are Associated With Psychiatric Comorbidity in Irritable Bowel Syndrome.

    Science.gov (United States)

    Kohen, Ruth; Tracy, Julia H; Haugen, Eric; Cain, Kevin C; Jarrett, Monica E; Heitkemper, Margaret M

    2016-07-01

    Alterations in serotonin signaling are suspected in the pathophysiology of irritable bowel syndrome (IBS). By modulating the extracellular reuptake of serotonin, the serotonin transporter (SERT) acts as a key regulator of the bioavailability of serotonin. This study is the first to investigate the impact of rare SERT variants (i.e., those with a minor allele frequency of < 1%) on the risk for IBS, gastrointestinal (GI) symptom level, response to cognitive-behavioral treatment, and psychiatric comorbidity. We sequenced a 0.19 megabase chromosomal stretch containing the SERT gene and surrounding regions in a community sample of 304 IBS patients and 83 controls. We found no significant associations between rare variants in and around the SERT gene and IBS risk, GI symptom profile, or response to treatment. We found preliminary evidence, however, that IBS subjects with a history of either depression or anxiety were significantly more likely to carry multiple rare likely functional variant alleles than IBS patients without psychiatric comorbidity. © The Author(s) 2016.

  6. Monitoring of Metabolic Adverse Effects Associated With Atypical Antipsychotics Use in an Outpatient Psychiatric Clinic.

    Science.gov (United States)

    Pereira, Luis; Budovich, Aliaksandr; Claudio-Saez, Maria

    2018-01-01

    Atypical antipsychotics are associated with metabolic complications that contribute to a higher risk of cardiovascular disease. Current evidence reveal suboptimal adherence to the complex and variable official recommendations on metabolic monitoring in the corresponding patient population. A study evaluating metabolic monitoring at guideline-recommended intervals may help identify areas for intervention. Describe the frequency of monitoring metabolic adverse effects in patients receiving atypical antipsychotics in an outpatient psychiatric clinic with respect to the specific guideline-recommended intervals. A retrospective chart review was conducted in the outpatient psychiatric clinic. The primary outcome measure was the percentage of patients monitored for metabolic parameters at the current guideline-recommended intervals. The secondary end points were the percentage of patients with documented primary care physician, untreated metabolic comorbidities, and treated metabolic comorbidities by disease state. The most assessed parameters were family history (98%), blood pressure (81%), and body mass index/body weight (83%) at the baseline interval. The least assessed parameters were lipids (14%) at the 12-week interval and waist circumference (0%) at any interval. Interventions are needed to encourage higher compliance with current recommendations. The complexity of the recommendations is the most likely reason for the suboptimal compliance.

  7. Traumatic events in childhood and their association with psychiatric illness in the adult.

    Science.gov (United States)

    Verdolini, Norma; Attademo, Luigi; Agius, Mark; Ferranti, Laura; Moretti, Patrizia; Quartesan, Roberto

    2015-09-01

    Child maltreatment is a well-known condition that is currently considered to be associated with the development of severe psychiatric conditions. Consequently, the authors decided to review the current literature in order to give a complete scenario of the situation in the world and to give recommendations about prevention and treatment as well as research goals. An electronic search was conducted through the means of MEDLINE database in order to find the most up to date peer-reviewed papers, including only those papers published in 2015. 15 papers were included and analyzed the current situation in different countries: US (n.3), Australia (n.2), Ireland (n.2), Israel (n.2), China (n.2), Indonesia (n.1), Pakistan (n.1) and Norway (n.1). Even though sexual abuse has been studied extensively, both physical and emotional abuse and neglect appear to be more represented within the population of patients that had suffered from abuse. Psychiatric disorders (mainly personality disorders, depression and anxiety), interpersonal, social and legal outcomes are important consequences of child maltreatment. Interventions and strategies are needed at different levels, from prevention to treatment and further research is important in order to better understand the phenomenon.

  8. Association among serum cortisol, dehydroepiandrosterone-sulfate levels and psychiatric symptoms in men with chronic schizophrenia.

    Science.gov (United States)

    Peng, Rui; Li, Yan

    2017-07-01

    The purpose of this study was to examine possible associations of serum levels of cortisol and dehydroepiandrosterone-sulfate (DHEA-S) with psychiatric symptoms in men with chronic schizophrenia. This retrospective study involved 162 men with schizophrenia and 138 age-matched healthy controls, for whom data were collected on demographic characteristics, age at disease onset, disease duration, positive and negative syndrome scale (PANSS) scores, and history of atypical antipsychotic treatment. Serum levels of cortisol and DHEA-S were calculated, as well as the ratios of the two levels. Possible correlations were explored between these levels and psychiatric symptoms before and after antipsychotic treatment. Serum levels of cortisol and DHEA-S levels as well as the ratios of cortisol to DHEA-S levels were higher in patients than in controls (p cortisol and DHEA-S were significantly lower after treatment than before (p cortisol to DHEA-S levels remained similar. Serum levels of cortisol, DHEA-S and the ratios of the two levels were positively correlated with the negative symptoms score on the PANSS. The pathophysiology of schizophrenia may involve in the spread levels of cortisol and DHEA-S. These levels may serve as biomarkers for diagnosing schizophrenia and monitoring treatment efficacy. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Prevalence and associated factors of hypnotics dependence among Japanese outpatients with psychiatric disorders.

    Science.gov (United States)

    Murakoshi, Akiko; Takaesu, Yoshikazu; Komada, Yoko; Ishikawa, Jun; Inoue, Yuichi

    2015-12-30

    This study aimed to investigate the prevalence of the dependence for benzodiazepine or their agonist (BZDs) hypnotics, as well as factors associated with this dependence among Japanese psychiatric outpatients. One thousand and forty-three patients in the psychiatric outpatient clinic of Tokyo Medical University Hospital receiving treatment with BZDs hypnotics were analyzed. The subjects answered questionnaires including demographic variables, subjective sleep difficulty assessed by the Pittsburg Sleep Quality Index (PSQI), duration of hypnotics medication, dose of diazepam equivalent BZDs hypnotics, the presence or absence of subjective side effects due to BZDs hypnotics (dizziness, fatigue, daytime sleepiness, amnesia, and headache), and dependency assessed by the Dependency 2-A (D 2-A) score. Subjects with a D 2-A score ≥10 were considered as having BZDs hypnotics dependence, and the variables associated with the presence of dependence were examined using logistic regression analyses. Eighty-two out of the 1043 subjects (7.9%) were determined to have BZDs hypnotics dependence. Compared with the non-dependence group, the dependence group had a significantly higher proportion of positive respondents for all the side effects. Multiple logistic regression analyses showed that the dependence was significantly associated with younger age, higher total PSQI score, and higher daily dose of BZDs hypnotics. Younger age, higher total PSQI score, and higher dose may be associated with BZDs hypnotics dependence. The finding that patients with BZDs hypnotics dependence frequently suffered from subjective side effects and had greater sleep difficulty encourages the establishment of alternative treatments for patients with insomnia symptoms refractory to BZDs hypnotics treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. The Association between Intelligence Scores and Family History of Psychiatric Disorder in Schizophrenia Patients, Their Siblings and Healthy Controls

    Science.gov (United States)

    Verweij, Kim H. W.; Derks, Eske M.

    2013-01-01

    Background The degree of intellectual impairment in schizophrenia patients and their relatives has been suggested to be associated with the degree of familial loading for schizophrenia. Since other psychiatric disorders are also more present in relatives of schizophrenia patients, the definition of family history should be broadened. The association between family history for psychiatric disorder and intelligence scores was investigated in patients with non-affective psychosis, their unaffected siblings and controls. Methods A sample of 712 schizophrenia proband families (696 patients and 766 siblings) and 427 healthy control families (517 subjects) participated in this study. Family history of psychiatric disorder was determined while excluding the data of the participating schizophrenia patient. A dichotomous division was made between families with no first- or second degree relative with psychiatric disorder and families with one or more affected relatives. Total intelligence scores were estimated by admission of the short form of the Wechsler Adult Intelligence Scale III. Results A significant interaction was found between family history of psychiatric disorder and clinical status (F(2,1086.87)= 4.17; p=.016). Patients with a positive family history of psychiatric disorder obtained higher intelligence scores compared to patients with no family history (mean IQ scores are 95.52 and 92.72) with an opposite effect in controls (mean IQ scores are 108.71 and 111.19). No significant difference was found between siblings of schizophrenia patients with or without a positive family history (mean IQ scores are 102.98 and 103.24). Conclusion In patients with schizophrenia, a negative family history of psychiatric disorder was associated with relatively low IQ suggesting that the etiology in these patients may involve environmental or genetic factors which are unique to the patient and are not observed in other relatives. Possible factors include severe environmental

  11. Psychiatric Disorders in Children with Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors in a Population-Derived Sample

    Science.gov (United States)

    Simonoff, Emily; Pickles, Andrew; Charman, Tony; Chandler, Susie; Loucas, Tom; Baird, Gillian

    2008-01-01

    A study on autism spectrum disorders is conducted because its early onset, lifelong persistence, and high levels of associated impairment is turning it into a major public health concern. Results show that psychiatric disorders are common in children with autism spectrum disorders but there were few associations between putative risk factors and…

  12. Acculturation styles and their associations with psychiatric symptoms and quality of life in ethnic minorities with schizophrenia.

    Science.gov (United States)

    Weisman de Mamani, Amy; Weintraub, Marc J; Maura, Jessica; Martinez de Andino, Ana; Brown, Caitlin A; Gurak, Kayla

    2017-09-01

    This study examined whether Berry's model of acculturative stress would predict psychiatric symptom severity and quality of life (QoL) in ethnic minorities with schizophrenia. Tested extensively in non-psychiatric populations, Berry's framework generally suggests that integration, or engagement with both the host and minority culture, is most adaptive. Using the Abbreviated Multidimensional Acculturation Scale (AMAS), we tested the hypothesis that individuals with schizophrenia who employed an integrative acculturation strategy would have the highest QoL and lowest symptom severity, followed by the assimilation and enculturation groups, then the marginalized group. Psychiatric symptoms and QoL were regressed on AMAS assimilation scores, enculturation scores, and the interaction term in a sample of 128 Hispanic and Blacks with schizophrenia (M age = 41.28; 70% male). Acculturation strategy was not found to relate to psychiatric symptoms (measured from the Brief Psychiatric Rating Scale). However, acculturation strategy did predict QoL (measured from the Quality of Life Inventory), and results were in line with Berry's model. Marginalization may exacerbate issues surrounding social identity in schizophrenia, including low self-concept clarity and internalized stigma. Encouraging bicultural individuals with schizophrenia to interact with the host culture while also practicing traditions from their minority culture may help improve their quality of life. Copyright © 2017. Published by Elsevier B.V.

  13. Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers.

    Science.gov (United States)

    Brandt, Laura; Fischer, Gabriele

    2017-02-01

    The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale- deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems ( p = .009, d = 1.03) and a higher number of psychiatric comorbidities ( p gamblers.

  14. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study.

    Science.gov (United States)

    Nishinaka, Hirofumi; Nakane, Jun; Nagata, Takako; Imai, Atsushi; Kuroki, Noriomi; Sakikawa, Noriko; Omori, Mayu; Kuroda, Osamu; Hirabayashi, Naotsugu; Igarashi, Yoshito; Hashimoto, Kenji

    2016-01-01

    In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk. Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education) were enrolled. The CogState Battery (CSB) consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used. Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts. Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.

  15. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Hirofumi Nishinaka

    Full Text Available In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk.Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education were enrolled. The CogState Battery (CSB consisting of eight cognitive domains, the Iowa Gambling Task (IGT to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used.Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts.Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.

  16. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study

    Science.gov (United States)

    Nishinaka, Hirofumi; Nakane, Jun; Nagata, Takako; Imai, Atsushi; Kuroki, Noriomi; Sakikawa, Noriko; Omori, Mayu; Kuroda, Osamu; Hirabayashi, Naotsugu; Igarashi, Yoshito; Hashimoto, Kenji

    2016-01-01

    Background In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk. Methods Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education) were enrolled. The CogState Battery (CSB) consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used. Results Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts. Conclusion Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence. PMID:26824701

  17. A systematic review of music therapy practice and outcomes with acute adult psychiatric in-patients.

    Directory of Open Access Journals (Sweden)

    Catherine Carr

    Full Text Available There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported.A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis.98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions.No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to develop specific music therapy models for this

  18. A systematic review of music therapy practice and outcomes with acute adult psychiatric in-patients.

    Science.gov (United States)

    Carr, Catherine; Odell-Miller, Helen; Priebe, Stefan

    2013-01-01

    There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported. A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis. 98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions. No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to develop specific music therapy models for this patient group that

  19. A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients

    Science.gov (United States)

    Carr, Catherine; Odell-Miller, Helen; Priebe, Stefan

    2013-01-01

    Background and Objectives There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported. Review Methods A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis. Results 98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions. Conclusions No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to

  20. The frequency of rehospitalization and associated factors in Colombian psychiatric patients: a cohort study.

    Science.gov (United States)

    Jaramillo-Gonzalez, Luis Eduardo; Sanchez-Pedraza, Ricardo; Herazo, Maria Isabel

    2014-06-02

    The rehospitalization of patients with mental disorders is common, with rehospitalization rates of up to 80% observed in these patients. This phenomenon negatively impacts families, patients, and the health care system. Several factors have been associated with an increased likelihood of rehospitalization. This study was aimed at determining the frequency and the factors associated with rehospitalization in a psychiatric clinic. We performed a prospective cohort study with 361 patients who were hospitalized at the Clinic of Our Lady of Peace in Bogota, Colombia from August-December 2009. We calculated the incidence rates of rehospitalization and the risk factors using Cox regression. Overall, 60% of the patients in this cohort were rehospitalized during the year that followed the index event. The variables associated with rehospitalization were separated, divorced, or single status; higher socio-economic strata; a longer duration of index hospitalization; and a diagnosis of substance abuse, schizophrenia, bipolar disorder, or depression. The rehospitalization rate in our study was as high as reported in other studies. The associated factors with it in this group, may contribute to the design of programs that will reduce the frequency of rehospitalization among patients with mental disorders, in countries like Colombia. Additionally, these results may be useful in interventions, such as coping skills training, psycho-education, and community care strategies, which have been demonstrated to reduce the frequency of rehospitalization.

  1. [Psychocognitive and psychiatric disorders associated with developmental dyslexia: A clinical and scientific issue].

    Science.gov (United States)

    Huc-Chabrolle, M; Barthez, M-A; Tripi, G; Barthélémy, C; Bonnet-Brilhault, F

    2010-04-01

    Dyslexia is a complex neurodevelopemental disorder that affects 5 to 10% of school-age children. This condition consists in a specific learning disability with a neurological origin. These learning difficulties are unexpected in relation to other cognitive abilities and the provision of efficient classroom instruction. A range of neurobiological investigations suggests that disruption of the parieto-temporo-occipital systems underlies a failure of skilled reading to develop. The observation that dyslexia is both a familial and heritable problem was made early on and was confirmed by twin studies. They also suggested that both genetic and environmental factors are involved. Several loci have been implicated in dyslexia, notably on chromosomes 2, 3, 6, 15 and 18 and some candidate genes have been proposed, but no functional mutation has yet been identified. Dyslexia seldom appears isolated and dyslexic people are very likely to present other kinds of learning disabilities or psychiatric disorders. Specific language impairment, often with a mild outcome, is the most frequently associated with dyslexia. Indeed, late language development is often reported by dyslexic patients and also occurs more frequently among their siblings. Genetic linkage studies suggest some common genetic factor underlying this comorbidity. Dyscalculia is associated with dyslexia in 25% of cases, but most people with dyscalculia do not have any sign of dyslexia. The question of whether dyscalculia associated with dyslexia and dyscalculia itself rely on the same cognitive impairment is still controversial. Impaired motor development is also a common feature that affects nearly 50% of dyslexics and dyslexia is frequent among dyspraxic patients. This association raises the discussion on the role of motor impairment in dyslexia's physiopathology and the cerebellar theory of dyslexia. Beyond its link with other learning disorders, the study of dyslexia's comorbidity highlights psychopathological

  2. Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age.

    Science.gov (United States)

    Sourander, Andre; Gyllenberg, David; Brunstein Klomek, Anat; Sillanmäki, Lauri; Ilola, Anna-Marja; Kumpulainen, Kirsti

    2016-02-01

    Bullying and being exposed to bullying among children is prevalent, especially among children with psychiatric symptoms, and constitutes a major concern worldwide. Whether childhood bullying or exposure to bullying in the absence of childhood psychiatric symptoms is associated with psychiatric outcomes in adulthood remains unclear. To study the associations between bullying behavior at 8 years of age and adult psychiatric outcomes by 29 years of age. Nationwide birth cohort study of 5034 Finnish children with complete information about childhood bullying behavior was followed up from 8 to 29 years of age. Follow-up was completed on December 31, 2009, and data were analyzed from January 15, 2013, to February 15, 2015. Information about bullying, exposure to bullying, and psychiatric symptoms were obtained from parents, teachers, and child self-reports when children were 8 years of age. Use of specialized services for psychiatric disorders from 16 to 29 years of age was obtained from a nationwide hospital register, including outpatient and inpatient treatment. Among the 5034 study participants, 4540 (90.2%) did not engage in bullying behavior; of these, 520 (11.5%) had received a psychiatric diagnosis at follow-up; 33 of 166 (19.9%) who engaged in frequent bullying, 58 of 251 (23.1%) frequently exposed to bullying, and 24 of 77 (31.2%) who both frequently engaged in and were frequently exposed to bullying had received psychiatric diagnoses at follow-up. When analyses were adjusted by sex, family factors, and child psychiatric symptoms at 8 years of age, we found independent associations of treatment of any psychiatric disorder with frequent exposure to bullying (hazard ratio [HR], 1.9; 95% CI, 1.4-2.5) and being a bully and exposed to bullying (HR, 2.1; 95% CI, 1.3-3.4). Exposure to bullying was specifically associated with depression (HR, 1.9; 95% CI, 1.2-2.9). Bullying was associated with psychiatric outcomes only in the presence of psychiatric problems at 8 years

  3. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem.

    Science.gov (United States)

    Picco, Louisa; Pang, Shirlene; Lau, Ying Wen; Jeyagurunathan, Anitha; Satghare, Pratika; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Lim, Susan; Poh, Chee Lien; Chong, Siow Ann; Subramaniam, Mythily

    2016-12-30

    This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. Associations and Costs of Parental Symptoms of Psychiatric Distress in a Multi-Diagnosis Group of Children with Special Needs

    Science.gov (United States)

    Thurston, S.; Paul, L.; Loney, P.; Ye, C.; Wong, M.; Browne, G.

    2011-01-01

    Background: Families supporting children with complex needs are significantly more distressed and economically disadvantaged than families of children without disability and delay. What is not known is the associations and costs of parental psychiatric distress within a multi-diagnosis group of special needs children. Methods: In this…

  5. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population

    Directory of Open Access Journals (Sweden)

    Ajai Kumar Singh

    2013-01-01

    Full Text Available Objective: To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity. Materials and Methods: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI scale at the time of enrolment and at 3 months. Results: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM accounted for 59 patients, chronic tension type headache (CTTH 22 patients, new daily persistent headache (NDPH 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7% as compared to CTTH (36.4%. Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. Conclusion: Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

  6. Beyond trauma-focused psychiatric epidemiology: bridging research and practice with war-affected populations.

    Science.gov (United States)

    Miller, Kenneth E; Kulkarni, Madhur; Kushner, Hallie

    2006-10-01

    This article examines the centrality of trauma-focused psychiatric epidemiology (TFPE) in research with war-affected populations. The authors question the utility of the dominant focus on posttraumatic stress disorder and other disorders of Western psychiatry, and they identify a set of critical research foci related to mental health work with communities affected by political violence. Core assumptions of TFPE and its roots in logical positivism and the biomedical model of contemporary psychiatry are explored. The authors suggest that an alternative framework--social constructivism--can serve as a bridge between researchers and practitioners by helping to refocus research efforts in ways that are conceptually and methodologically more attuned to the needs of war-affected communities and those working to address their mental health needs. (c) 2007 APA, all rights reserved

  7. Demographic and clinical factors associated with benzodiazepine prescription at discharge from psychiatric inpatient treatment.

    Science.gov (United States)

    Peters, Shannon M; Knauf, Kendra Quincy; Derbidge, Christina M; Kimmel, Ryan; Vannoy, Steven

    2015-01-01

    We sought to characterize diagnostic and treatment factors associated with receiving a prescription for benzodiazepines at discharge from a psychiatric inpatient unit. We hypothesized that engaging in individual behavioral interventions while on the unit would decrease the likelihood of receiving a benzodiazepine prescription at discharge. This is an observational study utilizing medical chart review (n=1007) over 37 months (2008-2011). Descriptive statistics characterized patient demographics and diagnostic/prescription frequency. Multivariate regression was used to assess factors associated with receiving a benzodiazepine prescription at discharge. The sample was 61% female with mean age=40.5 (S.D.=13.6). Most frequent diagnoses were depression (54.7%) and bipolar disorder (18.6%). Thirty-eight percent of participants engaged in an individual behavioral intervention. Benzodiazepines were prescribed in 36% of discharges. Contrary to our hypothesis, individual behavioral interventions did not influence discharge benzodiazepine prescriptions. However, several other factors did, including having a substance use disorder [odds ratio (OR)=0.40]. Male sex (OR=0.56), Black race (OR=0.40) and age (OR=1.03) were nonclinical factors with strong prescribing influence. Benzodiazepines are frequently prescribed at discharge. Our results indicate strong racial and sex biases when prescribing benzodiazepines, even after controlling for diagnosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The Association between Psychiatric Disorders and Quality of Life of Patient with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Olusegun Baiyewu

    2007-05-01

    Full Text Available Objective: Quality of life (QOL assessment has been employed increasingly to evaluate outcome among patients with chronic medical conditions. Such assessment could be adversely affected by psychiatric disorders, co existing with such a medical condition. Method: A cross sectional study of 251 out-patients with diabetes mellitus was done at a Nigerian University Teaching Hospital using the Composite Diagnostic Interview (CIDI for psychiatric assessment and the World Health Organisation Quality of Life brief version (WHOQOL-BREF to evaluate the QOL. Results: Fifty (20% of the 251 respondents met the ICD-10 criteria for definite psychiatric diagnosis. Depression accounted for 9.6% while twenty-six (10.4% had anxiety disorder. Of the 35 respondents who performed poorly on the overall quality of life, 17(48.57% had psychiatric diagnosis; 9 were depressed and 8 had anxiety disorder. 39 (15.5% scored poor on the physical health domain. 21(53.8% of the 39 respondents with poor score had psychiatric diagnosis: 13 had depression while 8 had anxiety disorder. On domain 1 (physical health, 51 (20.3% scored poor. Twenty-eight (54.9% of the poor scorers had psychiatric diagnosis, 20 were depressed while 8 had anxiety. 51 (20.3% scored poor on psychological domain (domain 2 twenty-eight (54.9% of the poor scorers had psychiatric diagnosis, 20 of which were depressed while 8 had anxiety. 34 (13.5% scored poor on social relations (domain 3. 19 (55.9% of those who scored poor had psychiatric disorder and the diagnosis was depression. Conclusions: Physicians need to increase their surveillance of psychiatric co-morbidity in diabetes mellitus and collaborate with psychiatrists for a more effective liaison to improve the quality of life of patients with diabetes.

  9. Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001

    Science.gov (United States)

    Dedert, Eric A.; Green, Kimberly T.; Calhoun, Patrick S.; Yoash-Gantz, Ruth; Taber, Katherine H.; Mumford, Marinell Miller; Tupler, Larry A.; Morey, Rajendra A.; Marx, Christine E.; Weiner, Richard D.; Beckham, Jean C.

    2009-01-01

    Objective This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01. Method Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demo-graphic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress. Results Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology. Conclusions Particular categories of trauma were differentially associated with the risk of psychiatric diagnosis and current symptom severity. These findings underscore the importance of conducting thorough assessment of multiple trauma exposures when evaluating recently post-deployed veterans. PMID:19232639

  10. The Academy of Psychosomatic Medicine practice guidelines for psychiatric consultation in the general medical setting. The Academy of Psychosomatic Medicine.

    Science.gov (United States)

    Bronheim, H E; Fulop, G; Kunkel, E J; Muskin, P R; Schindler, B A; Yates, W R; Shaw, R; Steiner, H; Stern, T A; Stoudemire, A

    1998-01-01

    This practice guideline seeks to provide guidance to psychiatrists who regularly evaluate and manage patients with medical illnesses. The guideline is intended to delineate the knowledge base, professional expertise, and integrated clinical approach necessary to effectively manage this complex and diverse patient population. This guideline was drafted by a work group consisting of psychiatrists with clinical and research expertise in the field, who undertook a comprehensive review of the literature. The guideline was reviewed by the executive council of the Academy of Psychosomatic Medicine and revised prior to final approval. Some of the topics discussed include qualifications of C-L consultants, patient assessment, psychiatric interventions (e.g., psychotherapy, pharmacotherapy), medicolegal issues, and child and adolescent consultations.

  11. An investigation of factors associated with psychiatric hospital admission despite the presence of crisis resolution teams

    Directory of Open Access Journals (Sweden)

    Nolan Fiona

    2007-10-01

    Full Text Available Abstract Background Crisis resolution teams (CRTs provide a community alternative to psychiatric hospital admission for patients presenting in crisis. Little is known about the characteristics of patients admitted despite the availability of such teams. Methods Data were drawn from three investigations of the outcomes of CRTs in inner London. A literature review was used to identify candidate explanatory variables that may be associated with admission despite the availability of intensive home treatment. The main outcome variable was admission to hospital within 8 weeks of the initial crisis. Associations between this outcome and the candidate explanatory variables were tested using first univariate and then multivariate analysis. Results Patients who were uncooperative with initial assessment (OR 10.25 95% CI-4.20–24.97, at risk of self-neglect (OR 2.93 1.42–6.05, had a history of compulsory admission (OR 2.64 1.07–6.55, assessed outside usual office hours (OR 2.34 1.11–4.94 and/or were assessed in hospital casualty departments (OR 3.12 1.55–6.26, were more likely to be admitted. Other than age, no socio-demographic features or diagnostic variables were significantly associated with risk of admission. Conclusion With the introduction of CRTs, inpatient wards face a significant challenge, as patients who cooperate little with treatment, neglect themselves, or have previously been compulsorily detained are especially likely to be admitted. The increased risk of admission associated with casualty department assessment may be remediable.

  12. Smoking cessation care in state-operated or state-supported psychiatric hospitals: from policy to practice.

    Science.gov (United States)

    Ortiz, Glorimar; Schacht, Lucille; Lane, G Michael

    2013-07-01

    The aims of this study were to identify changes in smoking policies and their implementation and to determine the level of smoking cessation care provided at state-operated or state-supported psychiatric inpatient hospitals. Hospitals were surveyed in 2008 (N=219) and 2011 (N=206) about their smoking policies and practices, and changes in specific policies and practices, such as staff specialty training about smoking cessation care, assessment at intake, provision of smoking cessation treatment and education, and aftercare planning, were examined. Smoking cessation care was categorized as best, good, average, or poor. The survey was completed in both 2008 and 2011 by 108 hospitals. The number of hospitals prohibiting smoking rose by 73%, from 48% in 2008 to 83% in 2011. The provision of specialty training to staff did not significantly improve. Nearly all hospitals assessed smoking status at admission, and nicotine replacement therapy was provided by more hospitals than any other treatment in both 2008 and 2011. The number of hospitals providing no follow-up of smoking cessation care after discharge dropped significantly, from 64% to 41%, and significantly more provided good versus average smoking cessation care. Analysis of smoking policies at state-operated or state-supported psychiatric inpatient hospitals found significant movement in adopting nonsmoking policies and some increase in active treatment, notably wellness counseling. Educational resources have not reached full penetration, and continuum of care activities are also lagging behind. Additional resources and staff training may be needed to continue to address smoking cessation both during and after hospitalization.

  13. The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study.

    Science.gov (United States)

    Oudin, Anna; Åström, Daniel Oudin; Asplund, Peter; Steingrimsson, Steinn; Szabo, Zoltan; Carlsen, Hanne Krage

    2018-01-10

    Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit. Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM 10 ), ozone(O 3 ), nitrogen dioxides(NO 2 ) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season. Visits increased with increasing PM 10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM 10 adjusted for NO 2 . In the three-pollutant models (adjusting for NO 2 and O 3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO 2 , O 3 , or PM 10 during the colder season (October to March). Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of

  14. Psychiatric factors associated with normal coronary angiography among angina like chest pain patients

    Directory of Open Access Journals (Sweden)

    Ebru Altintas

    2016-03-01

    Conclusion: The present study revealed that prevalence of psychiatric co morbidities is high and impairment in quality of life is notable in the patients with NCA patients [Cukurova Med J 2016; 41(1.000: 129-135

  15. Neurofeedback Training for Psychiatric Disorders Associated with Criminal Offending: A Review

    Directory of Open Access Journals (Sweden)

    Sandra Fielenbach

    2018-01-01

    Full Text Available BackgroundEffective treatment interventions for criminal offenders are necessary to reduce risk of criminal recidivism. Evidence about deviant electroencephalographic (EEG-frequencies underlying disorders found in criminal offenders is accumulating. Yet, treatment modalities, such as neurofeedback, are rarely applied in the forensic psychiatric domain. Since offenders usually have multiple disorders, difficulties adhering to long-term treatment modalities, and are highly vulnerable for psychiatric decompensation, more information about neurofeedback training protocols, number of sessions, and expected symptom reduction is necessary before it can be successfully used in offender populations.MethodStudies were analyzed that used neurofeedback in adult criminal offenders, and in disorders these patients present with. Specifically aggression, violence, recidivism, offending, psychopathy, schizophrenia, attention-deficit hyperactivity disorder (ADHD, substance-use disorder (SUD, and cluster B personality disorders were included. Only studies that reported changes in EEG-frequencies posttreatment (increase/decrease/no change in EEG amplitude/power were included.ResultsDatabases Psychinfo and Pubmed were searched in the period 1990–2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resulting in a total of 10 studies. Studies in which neurofeedback was applied in ADHD (N = 3, SUD (N = 3, schizophrenia (N = 3, and psychopathy (N = 1 could be identified. No studies could be identified for neurofeedback applied in cluster B personality disorders, aggression, violence, or recidivism in criminal offenders. For all treatment populations and neurofeedback protocols, number of sessions varied greatly. Changes in behavioral levels ranged from no improvements to significant symptom reduction after neurofeedback training. The results are also mixed concerning posttreatment changes in targeted EEG

  16. Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James Francis; Haas, Gretchen Louise

    2012-08-30

    This study assessed potential for suicidal behaviors associated with sociodemographic, predisposing physical and mental health factors and self-reported psychological problems among homeless veterans in a large northeastern region. Data were obtained from a demographic and clinical history interview conducted with 3595 homeless veterans. Odds-ratio (OR) statistics were used to assess potential for suicidal behavior. Statistically significant ratios were similar for ideation and attempts. The highest ratios were for self-report of depression and difficulty controlling violence, but statistically significant ratios were found for reporting sleeping in a treatment facility the night before the interview, receiving VA support for a psychiatric condition, and the diagnoses of Alcoholism, Mood Disorder and Post Traumatic Stress Disorder (PTSD). Low but statistically significant odds-ratios were obtained for most of the physical health items. A negative odds-ratio was obtained for African-American ethnicity. Logistic regression results indicated that for ideation and attempts items entered first involved subjective report of trouble controlling violent behavior and experiencing depression. High odds ratios for the interview items concerning experiencing serious depression and having difficulties controlling violence may have strong implications for treatment and management of homeless veterans. There may be up to 14-1 odds that an individual who reports being seriously depressed or having difficulty inhibiting aggression may have a serious potential for suicidal behaviors. Published by Elsevier Ireland Ltd.

  17. Perceptions of the worker role among people with psychiatric disabilities: description and investigation of associated factors.

    Science.gov (United States)

    Argentzell, Elisabeth; Eklund, Mona

    2013-01-01

    To investigate how subjective perceptions of everyday occupations, activity level, day centre attendance, social interaction, self-mastery and clinical factors were related to how unemployed people with psychiatric disabilities (PD) envision a future worker role, also controlling for socio-demographic variables. 175 people with PD; 93 attended a day centre and 82 did not. Of the 93 day centre attendees 39 visited meeting place-oriented day centres and 54 attended work-oriented ones. Self-ratings and interview-based instruments were used to assess the view of the worker role, social interaction, subjective perceptions of everyday occupations, activity level, self-mastery, and socio-demographic and clinical factors. Non-parametric statistics were used when analysing the data. A few aspects of the worker role seemed positively influenced by attending a day centre, in particular a work-oriented one. High levels of activity (p=0.009) and self-mastery (p=0.024), being younger (p=0.004) and having less depression (p=0.008) were also associated with a more positive view of the worker role. In order to enhance a future worker role the individual's feeling of control in the rehabilitation process should be highlighted and possibilities for general activity engagement be offered. Since the findings indicate that most aspects of the worker role were not enhanced by day centre attendance community-based care should further concentrate on promoting this future role for people with PD.

  18. A Successful Model for Clinical Training in Child/Adolescent Cognitive Behavior Therapy for Graduate Psychiatric Advanced Practice Nursing Students.

    Science.gov (United States)

    Lusk, Pamela; Hart Abney, Beverly G; Melnyk, Bernadette Mazurek

    2017-08-01

    Graduate faculty in advanced practice nursing programs seek to provide clinical training in psychotherapy for psychiatric mental health nurse practitioner (PMHNP) students and prepare them for practice with patients across the lifespan, including children and adolescents. To develop a clinical training model for child/adolescent cognitive behavior therapy (CBT) that is adaptable to all graduate nursing programs including online, classroom, and blended programs. Clinical training included a didactic 4-hour workshop and 7 small group practice sessions utilizing Creating Opportunities for Personal Empowerment (COPE), a manualized CBT program for teens. Students completed post-clinical training evaluations. Using qualitative design, responses to the open-ended questions were analyzed and common themes identified. One hundred seven PMHNP students completed evaluations. Four themes emerged from the data: (a) therapeutic understanding of adapting CBT for children and adolescents, (b) therapeutic skills and techniques for use with children/adolescents, (c) improved level of confidence through participation in the CBT program, and (d) therapeutic benefits of being in a group. Positive PMHNP student evaluations indicated that this clinical training model is feasible both online and face-to-face and acceptable for providing clinical training in CBT for children and adolescents.

  19. The relationship of functional pruritus with anger and associated psychiatric disorders

    Directory of Open Access Journals (Sweden)

    İlknur Kıvanç Altunay

    2015-12-01

    Full Text Available Background and Design: Functional itch disorder is assessed among somatization disorders. Suppressed anger may play a role in the development of somatization and, thus, functional itch disorder. Our aim was to evaluate the relationship of severity of itching with anger, expression of anger and psychiatric disorders in patients with functional itch disorder. Materials and Methods: Forty patients who were diagnosed with functional itch disorder were enrolled into the study. Functional itch disorder was diagnosed according to the suggested diagnostic criteria from the French psychodermatology group. Pruritus severity was evaluated using the five-point Likert scale. The State-Trait Anger Expression Index was used to assess state anger, trait anger and anger expression and the Mini International Neuropsychiatric Interview (M.I.N.I Plus 5.0.0 was used for determining psychiatric status. Results: A total of 40 patients (30 (75% females, 10 (25% males with a mean age 46.55±13.20 years were enrolled in the study. According to the results of the M.I.N.I., psychiatric comorbidities at the time of itching were existent in 29 (72.5% patients, whereas 13 (27.5% patients did not have any other psychiatric symptom. Pruritus duration was correlated with anger trait and anger-in subscale scores in all patients. (r=0.349, p=0.027, r=0.417, p=0.007, respectively. Trait anger and anger-out subscale scores were statistically higher in patients with psychiatric disorders (p<0.05. Anger control scores were also lower in this group. Pruritus duration was correlated with trait-anger and anger-in subscale scores in patients with psychiatric disorder. Conclusions: Functional pruritus (FP as a somatoform psychodermatologic disorder seems to be related with anger levels and anger management styles; and psychiatric disorders are frequently accompanied by functional pruritus

  20. Social networks, social support and psychiatric symptoms: social determinants and associations within a multicultural community population.

    Science.gov (United States)

    Smyth, Natasha; Siriwardhana, Chesmal; Hotopf, Matthew; Hatch, Stephani L

    2015-07-01

    Little is known about how social networks and social support are distributed within diverse communities and how different types of each are associated with a range of psychiatric symptoms. This study aims to address such shortcomings by: (1) describing the demographic and socioeconomic characteristics of social networks and social support in a multicultural population and (2) examining how each is associated with multiple mental health outcomes. Data is drawn from the South East London Community Health Study; a cross-sectional study of 1,698 adults conducted between 2008 and 2010. The findings demonstrate variation in social networks and social support by socio-demographic factors. Ethnic minority groups reported larger family networks but less perceived instrumental support. Older individuals and migrant groups reported lower levels of particular network and support types. Individuals from lower socioeconomic groups tended to report less social networks and support across the indicators measured. Perceived emotional and instrumental support, family and friend network size emerged as protective factors for common mental disorder, personality dysfunction and psychotic experiences. In contrast, both social networks and social support appear less relevant for hazardous alcohol use. The findings both confirm established knowledge that social networks and social support exert differential effects on mental health and furthermore suggest that the particular type of social support may be important. In contrast, different types of social network appear to impact upon poor mental health in a more uniform way. Future psychosocial strategies promoting mental health should consider which social groups are vulnerable to reduced social networks and poor social support and which diagnostic groups may benefit most.

  1. The association between psychiatric diagnosis and violent re-offending in adult offenders in the community

    Directory of Open Access Journals (Sweden)

    Danesh John

    2008-11-01

    Full Text Available Abstract Background High rates of repeat offending are common across nations that are socially and culturally different. Although psychiatric disorders are believed to be risk factors for violent reoffending, the available evidence is sparse and liable to bias. Method We conducted a historical cohort study in Sweden of a selected sample of 4828 offenders given community sentences who were assessed by a psychiatrist during 1988–2001, and followed up for an average of 5 years for first violent offence, death, or emigration, using information from national registers. Hazard ratios for violent offending were calculated by Cox regression models. Results Nearly a third of the sample (n = 1506 or 31.3% offended violently during follow-up (mean duration: 4.8 years. After adjustment for socio-demographic and criminal history variables, substance use disorders (hazard ratio 1.97, 95% CI, 1.40–2.77 and personality disorders (hazard ratio 1.71, 1.20–2.44 were significantly associated with an increased risk of violent offending. No other diagnoses were related to recidivism risk. Adding information on diagnoses of substance use and personality disorders to data recorded on age, sex, and criminal history improved only minimally the prediction of violent offending. Conclusion Diagnoses of substance use and personality disorders are associated with the risk of subsequent violent offending in community offenders about as strongly as are its better documented demographic and criminal history risk factors. Despite this, assessment of such disorders in addition to demographic and criminal history factors enhances only minimally the prediction of violent offending in the community.

  2. Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.

    Science.gov (United States)

    Tessier, Arnaud; Boyer, Laurent; Husky, Mathilde; Baylé, Franck; Llorca, Pierre-Michel; Misdrahi, David

    2017-11-01

    Medication non adherence in schizophrenia is a major cause of relapse and hospitalization and remains for clinicians an important challenge. This study investigates the associations between insight, therapeutic alliance, perceived trauma related to psychiatric treatment and medication adherence in patients with schizophrenia. In this multicenter study, 72 patients were assessed regarding symptomatology, self-reported adherence with medication, insight, medication side-effects, therapeutic alliance and perceived trauma related to psychiatric treatment. Structural Equation Modeling (SEM) was used to test predicted paths among these variables. The data fit a model in which medication adherence was directly predicted by insight, therapeutic alliance and perceived trauma related to psychiatric treatment. Perceived trauma moderates the role of insight on medication adherence. The final model showed good fit, based on four reliable indices. Greater adherence was correlated with higher insight, higher therapeutic alliance and lower perceived trauma. These three variables appear to be important determinants of patient's medication adherence. Medication adherence could be enhanced by reducing perceived trauma and by increasing insight. The need for mental health providers to acknowledge patients' potentially traumatic experience with psychiatric treatment and the need to encourage greater involvement in care are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. [Psychiatric care in South Tyrol -- an example of coordination].

    Science.gov (United States)

    Pycha, Roger; Conca, Andreas

    2006-02-01

    The Tyrol's division after the two World Wars cut the South Tyrol off from every relevant aspect of psychiatric care. First attempts towards a community psychiatric system weren't sufficiently sustained by politicians. Only in the 90 ty's was the association of relatives of mentally ill people able to sensitize public and politicians to the need for an adequate psychiatric care system. Since 1996 an excellent psychiatric plan has been in existence, 80 % of which has to date been able to be put into practice. Since 1997 mentally ill people have founded their own self-help-organization and influenced the planning process.

  4. Palliative Care Psychiatry: Update on an Emerging Dimension of Psychiatric Practice

    Science.gov (United States)

    Fairman, Nathan

    2013-01-01

    Palliative care psychiatry is an emerging subspecialty field at the intersection of Palliative Medicine and Psychiatry. The discipline brings expertise in understanding the psychosocial dimensions of human experience to the care of dying patients and support of their families. The goals of this review are (1) to briefly define palliative care and summarize the evidence for its benefits, (2) to describe the roles for psychiatry within palliative care, (3) to review recent advances in the research and practice of palliative care psychiatry, and (4) to delineate some steps ahead as this sub-field continues to develop, in terms of research, education, and systems-based practice. PMID:23794027

  5. Preparing Psychiatric Residents for the "Real World": A Practice Management Curriculum

    Science.gov (United States)

    Wichman, Christina L.; Netzel, Pamela J.; Menaker, Ronald

    2009-01-01

    Objective: The authors describe a course designed for residents to develop the knowledge and skills necessary to collaborate and successfully compete in today's complex health care environment and to achieve competency in systems-based practice. Methods: Postgraduation surveys demonstrated a need for improvement in preparing residents for practice…

  6. Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses.

    Science.gov (United States)

    Al-Zayyat, Abdulkarim Subhi; Al-Gamal, Ekhlas

    2014-08-01

    Clinical practice in the psychiatric/mental health nursing (PMHN) field is considered a highly-stressful experience for nursing students. The purpose of the present study was to identify the degrees of stress, the types of stressors, and coping strategies perceived by undergraduate nursing students during their clinical practice in PMHN courses. A descriptive, longitudinal design was used. Sixty-five students registered in PMHN clinical courses were recruited from five Jordanian universities using a systematic random-sampling method. Data collection was conducted in the second semester of the 2012-2013 academic year at two points of time: pre-PMHN clinical training and post-PMHN training. The Basic Information Questionnaire, Perceived Stress Scale, and Coping Behavior Inventory were administered. Students' ages ranged from 20 to 25 years. The findings illustrate that the highest reported types of stressors at both data-collection times were taking care of patients, stress related to teachers and nursing staff, and from assignments and workloads. The most utilized coping strategy at both data-collection times was problem solving. The findings of the present study are useful for clinical educators in identifying nursing students' stressors, easing their learning in the clinical setting, and establishing an efficient PMHN course programme. © 2013 Australian College of Mental Health Nurses Inc.

  7. Prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons and association with socio-demographic and personal factors.

    Science.gov (United States)

    Aida, S A; Aili, H H; Manveen, K S; Salwina, W I W; Subash, K P; Ng, C G; Muhsin, A Z M

    2014-01-01

    The number of juvenile offenders admitted to Malaysian prisons is alarming. The purpose of this paper is to determine the presence of any psychiatric disorders and their association with personal characteristics of juvenile detainees in prisons across Peninsular Malaysia. Detainees were recruited from five different prisons in Peninsular Malaysia and interviewed by a psychiatrist using the MINI-Kid and FACES-IV, relevant personal and family information was also collected. A total of 105 detainees participated in the study. Almost all of the offenders (93.3 per cent) had at least one diagnosable psychiatric disorder and more than half (76.2 per cent) had two or more psychiatric diagnoses. Conduct disorder (CD) was the commonest disorder (59.0 per cent), while substance use disorders (SUD) was the commonest co-morbidity. A significant correlation was found between presence of CD, education level and SUD. Almost all (61/62, 98.4 per cent) of the detainees with CD, had not completed schooling (OR 8.03, 95 per cent CI 1.01-71.35), and detainees with this disorder were more likely to use substances than detainees without CD (OR 4.35, 95 per cent CI 1.90-9.99). Detainees with any psychiatric diagnosis were more likely to have four or more siblings in their families (OR 5.5, 95 per cent CI 1.1-26.9). There is a high prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons, detection and intervention would be important.

  8. Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation.

    Science.gov (United States)

    Santavirta, Torsten; Santavirta, Nina; Gilman, Stephen E

    2018-01-01

    Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in

  9. Genetic variation in DNMT3B and increased global DNA methylation is associated with suicide attempts in psychiatric patients.

    Science.gov (United States)

    Murphy, T M; Mullins, N; Ryan, M; Foster, T; Kelly, C; McClelland, R; O'Grady, J; Corcoran, E; Brady, J; Reilly, M; Jeffers, A; Brown, K; Maher, A; Bannan, N; Casement, A; Lynch, D; Bolger, S; Buckley, A; Quinlivan, L; Daly, L; Kelleher, C; Malone, K M

    2013-02-01

    Recently, a significant epigenetic component in the pathology of suicide has been realized. Here we investigate candidate functional SNPs in epigenetic-regulatory genes, DNMT1 and DNMT3B, for association with suicide attempt (SA) among patients with co-existing psychiatric illness. In addition, global DNA methylation levels [5-methyl cytosine (5-mC%)] between SA and psychiatric controls were quantified using the Methylflash Methylated DNA Quantification Kit. DNA was obtained from blood of 79 suicide attempters and 80 non-attempters, assessed for DSM-IV Axis I disorders. Functional SNPs were selected for each gene (DNMT1; n = 7, DNMT3B; n = 10), and genotyped. A SNP (rs2424932) residing in the 3' UTR of the DNMT3B gene was associated with SA compared with a non-attempter control group (P = 0.001; Chi-squared test, Bonferroni adjusted P value = 0.02). Moreover, haplotype analysis identified a DNMT3B haplotype which differed between cases and controls, however this association did not hold after Bonferroni correction (P = 0.01, Bonferroni adjusted P value = 0.56). Global methylation analysis showed that psychiatric patients with a history of SA had significantly higher levels of global DNA methylation compared with controls (P = 0.018, Student's t-test). In conclusion, this is the first report investigating polymorphisms in DNMT genes and global DNA methylation quantification in SA risk. Preliminary findings suggest that allelic variability in DNMT3B may be relevant to the underlying diathesis for suicidal acts and our findings support the hypothesis that aberrant DNA methylation profiles may contribute to the biology of suicidal acts. Thus, analysis of global DNA hypermethylation in blood may represent a biomarker for increased SA risk in psychiatric patients. © 2012 The Authors. Genes, Brain and Behavior © 2012 Blackwell Publishing Ltd and International Behavioural and Neural Genetics Society.

  10. Association between pretransplant psychological assessments and posttransplant psychiatric disorders in living-related transplantation.

    Science.gov (United States)

    Fukunishi, Isao; Sugawara, Yasutoshi; Takayama, Tadatoshi; Makuuchi, Masatoshi; Kawarasaki, Hideo; Surman, Owen S

    2002-01-01

    The authors examined pretransplant assessment in order to predict posttransplant occurrence of psychiatric disorders in living-related transplantation (LRT). Before LRT, the authors administered the Integrated House-Tree-Person Drawing Test (I-HTP) and 20-item Toronto Alexithymia Scale (TAS-20) to 31 donor-recipient pairs undergoing living-related liver transplantation (LRLT) and 65 pairs undergoing living-related kidney transplantation (LRKT). After LRT, the authors examined the occurrence of psychiatric disorders for the recipients and donors. Pretransplant, two psychological indicators,-alexithymia, a lack of verbalized emotion and abnormal projective drawings such as truncated tree representation-were significantly related to the manifestation of paradoxical psychiatric syndrome (PPS) in LRLT and LRKT. The occurrence of PPS was significantly related to recipients' guilt feelings toward living donors, but these were strongly superseded by recipients' desires to escape from approaching death just before LRT. These results suggest that pretransplant psychological assessment is useful for predicting posttransplant occurrence of psychiatric disorders.

  11. Spouses of Discharged Psychiatric Patients: Factors Associated with Their Experience of Burden.

    Science.gov (United States)

    Noh, Samuel; Avison, William R.

    1988-01-01

    Examined variations in experience of burden among men and women married to formerly hospitalized psychiatric patients. Substantial proportion of individuals found living with previously hospitalized spouse burdensome. Experience of burden was not simply function of patient's behavioral problems as indexed by measure of symptomatology; psychosocial…

  12. Are Ataques de Nerviosa in Puerto Rican Children Associated with Psychiatric Disorder?

    Science.gov (United States)

    Guarnaccia, Peter J.; Martinez, Igda; Ramirez, Rafael; Canino, Glorisa

    2005-01-01

    Objective: To provide the first empirical analysis of a cultural syndrome in children by examining the prevalence and psychiatric correlates of ataques de nervios in an epidemiological study of the mental health of children in Puerto Rico. Method: Probability samples of caretakers of children 4-17 years old in the community (N = 1,892; response…

  13. The association of psychiatric comorbidity and use of the emergency department among persons with substance use disorders: an observational cohort study

    Directory of Open Access Journals (Sweden)

    Allee Elise

    2008-12-01

    Full Text Available Abstract Background Psychiatric and substance use problems are commonly found to be contributing factors to frequent Emergency Department (ED use, yet little research has focused on the association between substance use and psychiatric comorbidity. This study assesses the association of a psychiatric comorbidity on (ED use among patients with substance use disorders (SUDs. Methods The study focuses on 6,865 patients who were diagnosed with SUDs in the ED of a large urban hospital in the southern United States from January 1994 – June 1998. Patients were grouped by type of substance use disorder. After examining frequency of visits by diagnosis, the sample was assigned to the following groups–alcohol dependence (ICD9 = 303, alcohol abuse (ICD9 = 305.0, cocaine dependence/abuse (ICD9 = 304.2, 305.6, and polysubstance/mixed use (ICD9 = 305.9. A patient was classified with psychiatric comorbidity if a psychiatric diagnosis appeared during any of the patient's visits. The following psychiatric diagnoses were included–schizophrenia/psychoses, bipolar disorder, depression, anxiety, and dementia (ICD-9 codes available upon request. Results Patients with SUDs and psychiatric comorbidity had significantly higher mean number of ER visits (mean = 5.2 SD = 8.7 than SUD patients without psychiatric comorbidity (mean = 2.5, SD = 3.7. In logistic regressions predicting several categorizations of heavier use of the ED (either 4+, 8+, 12+, 16+, or 20+ visits over the span of the study SUD patients with psychiatric comorbidity had adjusted odds ratios of 3.0 to 5.6 (reference group = patients with SUDs but no psychiatric comorbidity. This association was found across all substance use diagnostic categories studied, with the strongest relationship observed among patients with cocaine disorders or alcohol dependence. Conclusion The results provide further support for the notion that the ED could and should serve as an important identification site for cost

  14. "Treat me with respect". A systematic review and thematic analysis of psychiatric patients' reported perceptions of the situations associated with the process of coercion.

    Science.gov (United States)

    Tingleff, E B; Bradley, S K; Gildberg, F A; Munksgaard, G; Hounsgaard, L

    2017-11-01

    WHAT IS KNOWN ON THE SUBJECT?: Psychiatric patients have generally negative experiences of being exposed to coercive measures. Existing research has generally not investigated coercion as a process; that is, it does not address issues that arise before, during and after exposure to coercion. A part of existing research within the area does not clarify and define the type of coercive measure(s) investigated. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients place great significance on the link between the positive and negative perceived impact of a coercive situation and the professionals' ability and willingness to interact and communicate respectfully. Psychiatric patients associate the use of seclusion, physical restraint/holding, mechanical restraint and forced medication with strong negative perceptions and wish to be treated with respect by professionals, rather than being subjected to the professionals' control. What patients perceive as moderating factors in regard to the use of coercive measures is currently under-researched. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Increased sensitivity to the patient's views of the situation at each point in the coercive process would help professionals to respond to the patients' individual needs. Professionals need to articulate concern and empathy towards patients and to improve communication skills before, during and after a coercive incident. Greater emphasis should be placed on de-escalation and the use of non-coercive strategies or coping skills before the initiation of coercive measures. Introduction There is a lack of research into psychiatric patients' perceptions of coercion that discriminates between different types of coercive measures, while also investigating patients' perceptions of undergoing coercion as a process. This knowledge is required to improve our understanding and provide a foundation for improving clinical practice. Aims To review existing research literature in order to investigate adult

  15. The association of psychiatric symptomatology with patterns of alcohol, tobacco, and marijuana use among Brazilian high school students.

    Science.gov (United States)

    Fidalgo, Thiago M; Sanchez, Zila M; Caetano, Sheila C; Maia, Lucas O; Carlini, Elisaldo A; Martins, Silvia S

    2016-08-01

    Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms. A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-economic status (SES). Regarding SDQ total score, 43.6% of students had no psychiatric symptoms, 7.9% had subclinical symptoms and 48.5% presented clinically significant symptoms. Respondents with a clinically significant SDQ score were more likely to be past month alcohol (aOR = 1.51; 95%CI 1.22-1.88), tobacco (aOR = 1.82; 95%CI 1.25-2.66), and marijuana (aOR = 1.79; 95%CI 1.21-2.64) users as compared to those with no symptomatology. Psychopathological symptoms were associated with alcohol, tobacco and marijuana use by 15-18-year-old adolescents. These associations should also be considered when planning public policies of mental health promotion. This study discusses the importance of the association between psychopathological symptoms and substance use in a middle-income country, with high level of social inequalities, in a state representative sample. (Am J Addict 2016;25:416-425). © 2016 American Academy of Addiction Psychiatry.

  16. Prevalence and factors associated with minor psychiatric disorders in hospital housekeeping workers.

    Science.gov (United States)

    Marconato, Cintia da Silva; Magnago, Ana Carolina de Souza; Magnago, Tânia Solange Bosi de Souza; Dalmolin, Graziele de Lima; Andolhe, Rafaela; Tavares, Juliana Petri

    2017-06-12

    Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education. Investigar a prevalência e os fatores associados aos Distúrbios Psíquicos Menores (DPMs) em trabalhadores do Serviço Hospitalar de Limpeza. Estudo transversal, realizado em 2013, com trabalhadores do serviço de limpeza de um hospital universitário público do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um formulário contendo variáveis sociodemográficas, laborais, hábitos e saúde. Para avaliação dos DPMs utilizou-se do Self-Reporting Questionnaire-20. A população do estudo foi composta pelos 161 trabalhadores. A prevalência global para suspeição de DPM foi de 29,3%. As chances de suspeição de DPMs foram maiores nos trabalhadores em Desequilíbrio Esforço-Recompensa, nos que não tinham ou às vezes tinham tempo para o lazer e naqueles que faziam uso de medicação. A prevalência de DPMs assemelhou-se à encontrada na literatura em trabalhadores da área saúde. Portanto, considera-se importante a inclusão desses trabalhadores em programas institucionais de educação permanente em saúde.

  17. Psychiatric services in Algeria.

    Science.gov (United States)

    Benmebarek, Zoubir

    2017-02-01

    The paper describes the current provision of psychiatric services in Algeria - in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

  18. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  19. A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice

    Directory of Open Access Journals (Sweden)

    Kawa Shadia

    2012-01-01

    Full Text Available Abstract The Diagnostic and Statistical Manual (DSM of the American Psychiatric Association, currently in its fourth edition and considered the reference for the characterization and diagnosis of mental disorders, has undergone various developments since its inception in the mid-twentieth century. With the fifth edition of the DSM presently in field trials for release in 2013, there is renewed discussion and debate over the extent of its relative successes - and shortcomings - at iteratively incorporating scientific evidence on the often ambiguous nature and etiology of mental illness. Given the power that the DSM has exerted both within psychiatry and society at large, this essay seeks to analyze variations in content and context of various editions of the DSM, address contributory influences and repercussion of such variations on the evolving landscape of psychiatry as discipline and practice over the past sixty years. Specifically, we document major modifications in the definition, characterization, and classification of mental disorders throughout successive editions of the DSM, in light of shifting trends in the conceptualization of psychopathology within evolving schools of thought in psychiatry, and in the context of progress in behavioral and psychopharmacological therapeutics over time. We touch upon the social, political, and financial environments in which these changes took places, address the significance of these changes with respect to the legitimacy (and legitimization of what constitutes mental illness and health, and examine the impact and implications of these changes on psychiatric practice, research, and teaching. We argue that problematic issues in psychiatry, arguably reflecting the large-scale adoption of the DSM, may be linked to difficulties in formulating a standardized nosology of psychopathology. In this light, we highlight 1 issues relating to attempts to align the DSM with the medical model, with regard to

  20. Factors influencing the choice of antidepressants: a study of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade.

    Science.gov (United States)

    Marić, Nadja P; Stojiljković, Dragan J; Pavlović, Zorana; Jasović-Gamsić, Miroslava

    2012-04-01

    Antidepressants are a widely used class of drugs. The aim of this study was to investigate different aspects of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. This cross-sectional study was carried out by retrospective analysis of the patient's medical charts. The study included all patients with antidepressant prescribed at discharge during 2009 (n = 296). The evaluation was focused on patient-related factors (socio-demographic and illness related), psychiatrist-related factors (sex and duration of working experience) and drug related factors (type of antidepressant, dose, polypharmacy and reimbursement by national health insurance). Antidepressants were prescribed for unipolar depression (F32-34, ICD X) either without comorbidity (46.2%) or with comorbidity (24.7%), mostly as a monotherapy (91% had one antidepressant), to the patients who were 65% female, aged 50.1 +/- 8.9, most of them with 12 years of education (52.6%), married (69.3%) and employed (55.9%). The majority of patients had a history of two hospitalizations (Med 2; 25th-75th perc. 1-4) during nine years (Med 9; 25th-75th perc. 2-15) after the first episode of depression. Among them, 19% were found to be suicidal in a lifetime. The single most prescribed antidepressant was sertraline (20.4%), followed by fluoxetine (13.3%) and maprotiline (11.7%). Utilization of antidepressants was positively correlated with the rate of reimbursement (p choice for episodes with moderate symptom severity (p = 0.01). Psychiatrists with longer working age (20-30 years) hesitated to prescribe new antidepressants in comparison to younger colleagues (p = 0.01). Economic issues in Serbia as developing country influence the choice of antidepressants, as well as a psychiatrist's working age and severity of depression. However, SSRI are the drugs of the first choice, as it was shown in most of the developed countries nowadays.

  1. Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China.

    Science.gov (United States)

    An, Feng-Rong; Sha, Sha; Zhang, Qing-E; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Wu, Ping-Ping; Jin, Xin; Zhou, Jian-Song; Tang, Yi-Lang; Xiang, Yu-Tao

    2016-07-30

    Physical restraint (PR) for patients is an ongoing controversial topic in psychiatry. This study examined the percentage of PR and its associations with clinical characteristics and the implementation of the National Mental Health Law (NMHL) in China. The study consecutively assessed a sample of 1364 psychiatric inpatients. Socio-demographic and clinical data including use of PR were collected from the medical records using a form designed for this study and confirmed via interview. Psychopathology and insight were measured using standardized instruments. The percentage of PR was 27.2% in the whole sample with 30.7% and 22.4% occurring respectively before and after the NMHL implementation (p=0.001). In multiple logistic regression analysis PR was positively associated with unemployment, lower income, aggression in the past month, being admitted before the NMHL implementation and poorer insight. The percentage of PR in Chinese psychiatric patients is associated with various clinical factors and appeared to decrease after the implementation of the NMHL. Focused and individualized care for patients who are unemployed, have low income, recent aggression and poor insight would be necessary at early stages of admission. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Detained Male Adolescent Offender's Emotional, Physical and Sexual Maltreatment Profiles and Their Associations to Psychiatric Disorders and Criminal Behaviors.

    Science.gov (United States)

    Aebi, Marcel; Linhart, Susanne; Thun-Hohenstein, Leonhard; Bessler, Cornelia; Steinhausen, Hans-Christoph; Plattner, Belinda

    2015-07-01

    The objective of the present study was to analyse patterns of emotional, physical and sexual maltreatment in detained male juvenile offenders using latent class analysis (LCA). The association of maltreatment related LCA profiles with psychopathology and criminal behaviors was also studied. LCA based on the items of the Child Trauma Questionnaire (CTQ) assessing childhood emotional, physical, and sexual abuse was performed in a sample of 260 male adolescent offenders (mean age = 16.5 years, SD = 1.29 years). Chi square tests and general linear models were performed to assess the associations of CTQ profiles with categorical interview-based psychiatric disorders, dimensional Youth Self-Report problem scales, and officially registered offenses. LCA suggested a three class solution: (1) a no/mild trauma (NM; 76 %) (2) emotional and physical trauma (EP; 18 %) and (3) emotional, physical, and sexual trauma (EPS; 8 %). The classes EP and EPS were related to a variety of psychiatric disorders and self-reported mental health problems. Furthermore, EPS showed higher presence of a subsequent re-incarceration compared to NM. A majority of sexually abused juveniles also experienced emotional and physical abuse reflecting gravely disturbed family systems. Multiple abuse in childhood was associated with a broad variety of disorders including externalizing disorders and repeated criminal offending. Such findings indicate that trauma assessment is also relevant in externalizing youth. A comprehensive treatment approach for detained boys with multiple abuse experiences is required targeting both mental health needs and the reduction of criminal behaviors.

  3. [Discharge curve among psychiatric patients after admission and risk factors associated with long stay based on "patient survey"].

    Science.gov (United States)

    Fujita, Toshiharu; Takeshima, Tadashi

    2006-01-01

    The "Reform Vision of Mental Health Services" (2004) announced the basic policy for the transition from hospital based to community based care, and set up numerical objectives, such as the average proportion remaining hospitalized in the first year after admission and the incidence rate of discharge among psychiatric patients hospitalized for more than one year. Using data from the "Patient Survey" performed in 2002 by the Ministry of Health, Labour and Welfare, we estimated discharge curves for each mental disorder during the first year after admission and assessed the effects of variables, i.e., diagnosis, sex, age, hospital type, and residential area, on remaining hospitalized after one year from admission and the incidence rate of discharge among psychiatric patients hospitalized for more than one year. The estimated number of discharged psychiatric patients was 27,974 in September, 2002, and 86% of them were discharged less than one year after admission. The incidence rate of discharge (per 100 person-year) in the first year was 314.8, but the rate after the second year sharply decreased to 19.9. Patients with dementia, mental retardation, and schizophrenia tended to stay for a long period in hospital, and proportions remaining hospitalized after one year from admission were 27.0%, 16.4%, and 14.6% respectively. Based on multivariate analysis using the weighted Poisson regression model, risk factors associated with an increased chance of remaining hospitalized after the first year included a long length of continuous hospitalization, diagnoses of dementia, mental retardation, and schizophrenia, male, older age, and being in a mental hospital. On the other hand, as to the incidence rate of discharge after one year, a long length of continuous hospitalization and being in a mental hospital were related with a long stay, but other variables were slightly different. Being female, patients aged 45-54 years old, and diagnoses of epilepsy and schizophrenia were

  4. [Event-related EEG potentials associated with error detection in psychiatric disorder: literature review].

    Science.gov (United States)

    Balogh, Lívia; Czobor, Pál

    2010-01-01

    Error-related bioelectric signals constitute a special subgroup of event-related potentials. Researchers have identified two evoked potential components to be closely related to error processing, namely error-related negativity (ERN) and error-positivity (Pe), and they linked these to specific cognitive functions. In our article first we give a brief description of these components, then based on the available literature, we review differences in error-related evoked potentials observed in patients across psychiatric disorders. The PubMed and Medline search engines were used in order to identify all relevant articles, published between 2000 and 2009. For the purpose of the current paper we reviewed publications summarizing results of clinical trials. Patients suffering from schizophrenia, anorexia nervosa or borderline personality disorder exhibited a decrease in the amplitude of error-negativity when compared with healthy controls, while in cases of depression and anxiety an increase in the amplitude has been observed. Some of the articles suggest specific personality variables, such as impulsivity, perfectionism, negative emotions or sensitivity to punishment to underlie these electrophysiological differences. Research in the field of error-related electric activity has come to the focus of psychiatry research only recently, thus the amount of available data is significantly limited. However, since this is a relatively new field of research, the results available at present are noteworthy and promising for future electrophysiological investigations in psychiatric disorders.

  5. Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers

    Directory of Open Access Journals (Sweden)

    E. Girela

    2014-01-01

    Full Text Available We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint in mentally ill inmates within two secure psychiatric hospitals (SPH and three regular prisons (RP in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP were studied. Isolation (41.35% was the most frequent coercive measure, followed by mechanical restraint (33.17% and forced medication (25.48%. The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.

  6. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    Science.gov (United States)

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  7. Psychiatric morbidity associated with caesarean section: a study from Wesley Guild Hospital, Ilesa, Nigeria.

    Science.gov (United States)

    Ukpong, D I; Owolabi, A T

    2004-11-01

    Fifty-five women who presented at Wesley Guild Hospital, Ilesa, Nigeria, for either elective or emergency caesarean section during a 5-month period (1 December 2003 - 30 April 2004) were recruited consecutively and assessed for psychiatric morbidity using the General Health Questionnaire (GHQ-30), the Beck Depression Inventory (BDI) and the State Version of the State-Trait Anxiety Inventory (STAI). Twenty-two women (40%), were cases on the GHQ, and the BDI was able to pick 11 women with depression in the study sample. The mean anxiety score for the entire study population was 41.7, which was higher than the usually accepted threshold of 40 for clinical disorder on the scale. Thirty-three women (60%) were initially reluctant to give consent for the operation and they had higher mean STAI scores than those who willingly consented to the procedure, and the difference in scores was statistically significant. The implications of these findings are discussed.

  8. Factors influencing the choice of antidepressants: A study of antidepressant prescribing practice at University psychiatric clinic in Belgrade

    Directory of Open Access Journals (Sweden)

    Marić Nađa P.

    2012-01-01

    Full Text Available Background/Aim. Antidepressants are a widely used class of drugs. The aim of this study was to investigate different aspects of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. Methods. This cross-sectional study was carried out by retrospective analysis of the patient's medical charts. The study included all patients with antidepressant prescribed at discharge during 2009 (n = 296. The evaluation was focused on patient- related factors (socio-demographic and illness related, psychiatrist-related factors (sex and duration of working experience and drug related factors (type of antidepressant, dose, polypharmacy and reimbursement by national health insurance. Results. Antidepressants were prescribed for unipolar depression (F32-34, ICD X either without comorbidity (46.2% or with comorbidity (24.7%, mostly as a monotherapy (91% had one antidepressant, to the patients who were 65% female, aged 50.1 ± 8.9, most of them with 12 years of education (52.6%, married (69.3% and employed (55.9%. The majority of patients had a history of two hospitalizations (Med 2; 25th-75th perc. 1-4 during nine years (Med 9; 25th-75th perc. 2-15 after the first episode of depression. Among them, 19% were found to be suicidal in a lifetime. The single most prescribed antidepressant was sertraline (20.4%, followed by fluoxetine (13.3% and maprotiline (11.7%. Utilization of antidepressants was positively correlated with the rate of reimbursement (p < 0.01. The most prescribed antidepressant group was selective serotonin reuptake inhibitors (SSRI (47.8%, followed by tricyclic antidepresants (TCA (25.3% and new antidepressants - venlafaxine, tianeptine, mirtazapine, bupropion, trazodone (15.1%. Most of the drugs were prescribed in doses which are at the lower end of the recommended dose-range. Regarding severity of the actual depressive episode, TCA were prescribed for severe depression with psychotic features, while SSRI were choice for

  9. Patterns of psychiatric and physical comorbidities associated with panic disorder in a nationwide population-based study in Taiwan.

    Science.gov (United States)

    Chen, Y-H; Lin, H-C

    2011-01-01

    This study aims to document a range of risk of psychiatric and physical comorbidities among PD patients using a nationwide population-based dataset in Taiwan. A total of 3672 patients with at least three consensus diagnoses with PD were included, together with 18 360 matched controls without PD. Logistic regression analyses were performed after adjusting for sociodemographic characteristics. After adjusting for the patients' sex, age and geographic region, patients with PD were more likely to have major depressive disorder (OR = 23.45), bipolar disorder (OR = 15.54), cardiac dysrhythmia (OR = 15.12), coronary heart disease (OR = 7.69), myocardial infarction (OR = 6.55), irritable bowel syndrome (OR = 4.82), peptic ulcers (OR = 4.30), cerebrovascular disease (OR = 3.61), hypertension (OR = 3.31), epilepsy (OR = 3.07), hepatitis (OR = 2.70), hyperlipidemia (OR = 2.20), asthma (OR = 2.17), schizophrenia (OR = 2.14), neoplasms (OR = 2.02), renal disease (OR = 1.89) and diabetes (OR = 1.26), compared to patients in the comparison cohort. We conclude that PD is associated with an array of psychiatric and physical illnesses. © 2010 John Wiley & Sons A/S.

  10. Severity of alprazolam dependence and associated features among long-term alprazolam users from psychiatric outpatient clinics in Taiwan.

    Science.gov (United States)

    Chen, Tzu-Ting; Ko, Chih-Hung; Chen, Shao-Tsu; Yen, Chia-Nan; Su, Po-Wen; Hwang, Tzung-Jeng; Lin, Jin-Jia; Yen, Cheng-Fang

    2015-11-01

    The aim of this study was to examine the correlations between the severity of alprazolam dependence and socio-demographic characteristics, the characteristics of alprazolam use, psychiatric comorbidity, and beliefs toward alprazolam use among long-term alprazolam users in Taiwan. A total of 148 long-term alprazolam users participated in this study. The Chinese version of the Severity of Dependence Scale was used to assess participants' severity of alprazolam dependence in the preceding month. Their socio-demographic characteristics, family function characteristics, dosage of prescribed alprazolam, duration of alprazolam use, alcohol use pattern, pain reliever and cigarette use pattern, severity of depressive symptoms, psychiatric diagnosis, and belief toward alprazolam use were investigated. The results of multiple regression analysis indicated that a longer duration of alprazolam use, severe depressive symptoms, a high level of belief in the necessity of alprazolam treatment, and a high level of concern about the potential adverse consequences of alprazolam use were significantly associated with more severe alprazolam dependence. Doctors should closely monitor the severity of alprazolam dependence among long-term users, especially patients' levels of depression, beliefs in the necessity of alprazolam treatment, and their concerns over the adverse consequences of continued treatment with alprazolam. Copyright © 2014. Published by Elsevier B.V.

  11. Toxocara seroprevalence among clinically healthy individuals, pregnant women and psychiatric patients and associated risk factors in Shandong Province, Eastern China.

    Directory of Open Access Journals (Sweden)

    Wei Cong

    2014-08-01

    Full Text Available Toxocarosis is a widespread zoonosis caused by the ascarid nematodes Toxocara canis and Toxocara cati, which primarily infect dogs and cats, respectively. Most human infections with Toxocara are asymptomatic; however, some infected individuals may develop a serious illness and even death. Nevertheless, epidemiological knowledge regarding the prevalence and risks associated with Toxocara infection is limited in China. Therefore, we performed a cross-sectional pilot study and estimated the seroprevalence of Toxocara infection in humans in Shandong Province, eastern China for the first time, from June 2011 to July 2013, involving clinically healthy individuals, pregnant women and psychiatric patients, aiming to attract public attention to Toxocara infection.Seroprevalence of Toxocara was determined using an enzyme-linked immunosorbent assay based on a cross-sectional study conducted in Qingdao and Weihai, Shandong Province, eastern China. Factors potentially associated with Toxocara infection were identified by logistic regression analysis. The overall Toxocara seroprevalence among the study population (n = 2866 was 12.25%, and a significantly higher seroprevalence in psychiatric patients (16.40%, 73/445 than that in clinically healthy individuals (13.07%, 187/1431 and pregnant women (9.19%, 91/990 was revealed. Univariate analyses suggested that keeping dogs at home (OR = 0.06, 95% CI 0.05-0.08, P<0.001, contact with cats and dogs (OR = 0.42, 95% CI 0.33-0.53, P<0.001 and exposure with soil (OR = 0.37, 95% CI 0.28-0.49, P<0.001 were risk factors associated with Toxocara infection.The present study revealed, for the first time, that human infection with Toxocara is common in eastern China, posing a significant public health concern. Increasing human and dog populations, population movements and climate change all will serve to increase the importance of this zoonosis. Further studies under controlled conditions are necessary to define potential

  12. The potential consequences of informal interpreting practices for assessment of patients in a South African psychiatric hospital.

    Science.gov (United States)

    Kilian, Sanja; Swartz, Leslie; Dowling, Tessa; Dlali, Mawande; Chiliza, Bonginkosi

    2014-04-01

    In South Africa health care practitioners are commonly professionals who speak only one, or at most two, of the languages spoken by their patients. This provides for language provision challenges, since many patients are not proficient in English or Afrikaans and ad hoc and haphazard arrangements are made for interpreting by untrained personnel. As part of a larger study (conducted in 2010) in a public psychiatric hospital, we report here on the potential consequences for diagnostic assessments of 13 psychiatric evaluations mediated by ad hoc interpreters who were employed as health care workers and household aides. The psychiatric evaluations were recorded and transcribed verbatim. The first author checked for accuracy of transcription and translations, and the two members of the author team who are both senior African language academics rechecked transcription and translation. We used the typology developed by Vasquez and Javier (1991) to study interpreter errors (i.e. omissions, additions and substitutions). All errors were independently rated by a senior psychiatrist and a senior clinical psychologist to determine whether the errors were likely to have a bearing on clinical decisions concerning the patient and to rate whether errors deemed clinically significant contributed to making the patient appear more ill psychiatrically, or less ill. Of the 57 errors recorded, 46% were rated as likely to have an impact on the goal of the clinical session. Raters concurred that the clinically significant errors contributed towards potentially making the patient look more psychiatrically ill. Detailed analyses of evaluations demonstrate the complexity of informal interpreter positioning regarding issues of diagnosis and cultural factors in illness. Evaluations conducted where clinicians and interpreters are not trained in language and interpreting issues may create a distorted picture of the patients' mental health conditions. Copyright © 2014. Published by Elsevier Ltd.

  13. A cross-sectional study about associations between personality characteristics and mental health service utilization in a Korean national community sample of adults with psychiatric disorders.

    Science.gov (United States)

    Park, Subin; Lee, Yeeun; Seong, Su Jeong; Chang, Sung Man; Lee, Jun Young; Hahm, Bong Jin; Hong, Jin Pyo

    2017-05-05

    Personality traits are not only associated with psychiatric symptoms, but also with treatment seeking behavior. Our purpose was to examine the relationship between mental health service utilization and personality characteristics in a nationwide community sample of Korean adults. Of the 6022 subjects aged 18-74 years who participated in the Korean Epidemiologic Catchment Area study, 1544 (25.6%) with a lifetime diagnosis of any DSM-IV psychiatric disorder were analyzed. Diagnostic assessments were based on the Composite International Diagnostic Interview and personality constructs were measured by Big Five Personality Inventory-10. Of the 1544 participants, 275 (17.8%) had used mental health services. Multivariate analyses revealed positive associations between mental health service utilization and both neuroticism and openness, and an inverse association between mental health service utilization and agreeableness. These findings suggest that specific personality traits may have a role in treatment-seeking behaviors for mental health problems independent of the psychiatric disorder.

  14. Animal Models of Speech and Vocal Communication Deficits Associated With Psychiatric Disorders.

    Science.gov (United States)

    Konopka, Genevieve; Roberts, Todd F

    2016-01-01

    Disruptions in speech, language, and vocal communication are hallmarks of several neuropsychiatric disorders, most notably autism spectrum disorders. Historically, the use of animal models to dissect molecular pathways and connect them to behavioral endophenotypes in cognitive disorders has proven to be an effective approach for developing and testing disease-relevant therapeutics. The unique aspects of human language compared with vocal behaviors in other animals make such an approach potentially more challenging. However, the study of vocal learning in species with analogous brain circuits to humans may provide entry points for understanding this human-specific phenotype and diseases. We review animal models of vocal learning and vocal communication and specifically link phenotypes of psychiatric disorders to relevant model systems. Evolutionary constraints in the organization of neural circuits and synaptic plasticity result in similarities in the brain mechanisms for vocal learning and vocal communication. Comparative approaches and careful consideration of the behavioral limitations among different animal models can provide critical avenues for dissecting the molecular pathways underlying cognitive disorders that disrupt speech, language, and vocal communication. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV

    Directory of Open Access Journals (Sweden)

    Nancy P. Hanrahan

    2011-01-01

    Full Text Available Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI were randomly assigned to an intervention group (n=128 or to a control group (n=110. Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012 and the physical component of health-related quality of life (P=.03 from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population.

  16. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people.

    LENUS (Irish Health Repository)

    Young, Robert

    2011-11-18

    Abstract Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact

  17. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people

    Directory of Open Access Journals (Sweden)

    Young Robert

    2011-11-01

    Full Text Available Abstract Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15 followed up in early adulthood (age 19. At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc. and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts and at ages 19 (self-harm, psychiatric service use. In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.. Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84 to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications on later psychiatric problems, or at least higher than

  18. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people.

    Science.gov (United States)

    Young, Robert; Riordan, Vincent; Stark, Cameron

    2011-11-18

    Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact with psychiatric service.

  19. Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

    Science.gov (United States)

    Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

    2015-02-01

    Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

  20. Cultural relativism and psychiatric illness.

    Science.gov (United States)

    Fabrega, H

    1989-07-01

    Psychiatry has had a long-standing association with sociology and, especially, cultural anthropology. These social sciences have been influential in developing the concept of cultural relativism and applying it to psychiatry, sometimes in a challenging way and with much detriment. The concept has been used by some antipsychiatrists in attempts to discredit psychiatric practice. Contemporary psychiatrists endorsing a form of biological determinism have tended to either disregard the concept or judge it as trivial if not nonsensical. This study describes the concept of cultural relativism, reviews its applications to illness, and analyzes its implications from a historical and theoretical point of view. Its varied aspects, power, and limitations are discussed.

  1. Managing sensitive phenotypic data and biomaterial in large-scale collaborative psychiatric genetic research projects: practical considerations.

    Science.gov (United States)

    Demiroglu, S Y; Skrowny, D; Quade, M; Schwanke, J; Budde, M; Gullatz, V; Reich-Erkelenz, D; Jakob, J J; Falkai, P; Rienhoff, O; Helbing, K; Heilbronner, U; Schulze, T G

    2012-12-01

    Large-scale collaborative research will be a hallmark of future psychiatric genetic research. Ideally, both academic and non-academic institutions should be able to participate in such collaborations to allow for the establishment of very large samples in a straightforward manner. Any such endeavor requires an easy-to-implement information technology (IT) framework. Here we present the requirements for a centralized framework and describe how they can be met through a modular IT toolbox.

  2. Correlates of Stress and Coping among Jordanian Nursing Students during Clinical Practice in Psychiatric/Mental Health Course.

    Science.gov (United States)

    Alzayyat, Abdulkarim; Al-Gamal, Ekhlas

    2016-10-01

    Training in psychiatric settings is stressful for nursing students. The purpose of this study was to examine the correlations between the students' characteristics, their stress degrees, stressors and types of coping strategies they experience during training in psychiatric course. A descriptive, correlational, longitudinal design was used. Sixty-five undergraduate nursing students were recruited randomly from five Jordanian universities. Self-report questionnaires were administered at the second semester of the 2012-2013 academic year. The findings showed that students who utilized avoidance or transference strategies reported high stress degrees. Moreover, the results showed that those students who were in the fourth year, with a low family income, who avoid extracurricular activities, with a low academic grade or who registered in other clinical course(s) reported high stress degrees. These findings present a worthy data for the clinical instructors that facilitate students training in psychiatric settings and promote their psychosocial well-being. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Optimal breastfeeding practice and associated factors amongst ...

    African Journals Online (AJOL)

    employed women. However, little is known about working mothers' views, experiences and barriers of breastfeeding practice from employment perspective. The objective of this study was to examine knowledge, attitude and practice about optimal ...

  4. Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association Implementação de práticas baseadas em evidências para o tratamento de crianças em quatro países: um projeto da Associação Mundial de Psiquiatria

    Directory of Open Access Journals (Sweden)

    Kimberly E Hoagwood

    2006-03-01

    Full Text Available OBJETIVE: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. METHOD: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. RESULTS: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1 early adoption and guidance by innovative leaders (i.e., the Directors; 2 attention to the "fit" between the intervention model and local practices; 3 attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues; 4 attention to back-end processes early in the project (e.g., sustainability; and 5 establishing strong relationships with multiple stakeholders within the program setting. CONCLUSIONS: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.OBJETIVO: Este estudo visa a examinar problemas na implementação de técnicas psicoterápicas cognitivo-comportamentais em ambientes clínicos de atendimento primário em quatro países que refletem diversas culturas, línguas, ambientes e tradições. MÉTODO: Uma pesquisa foi aplicada

  5. A review and meta-analysis of the patient factors associated with psychiatric in-patient aggression.

    Science.gov (United States)

    Dack, C; Ross, J; Papadopoulos, C; Stewart, D; Bowers, L

    2013-04-01

    To combine the results of earlier comparison studies of in-patient aggression to quantitatively assess the strength of the association between patient factors and i) aggressive behaviour,ii) repetitive aggressive behaviour. A systematic review and meta-analysis of empirical articles and reports of comparison studies of aggression and non-aggression within adult psychiatric in-patient settings. Factors that were significantly associated with in-patient aggression included being younger, male, involuntary admissions, not being married, a diagnosis of schizophrenia, a greater number of previous admissions, a history of violence, a history of self-destructive behaviour and a history of substance abuse. The only factors associated with repeated in-patient aggression were not being male, a history of violence and a history of substance abuse. By comparing aggressive with non-aggressive patients, important differences between the two populations may be highlighted. These differences may help staff improve predictions of which patients might become aggressive and enable steps to be taken to reduce an aggressive incident occurring using actuarial judgements. However, the associations found between these actuarial factors and aggression were small. It is therefore important for staff to consider dynamic factors such as a patient's current state and the context to reduce in-patient aggression. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  6. Quantitative comparison of cognitive behavioral therapy and music therapy research: a methodological best-practices analysis to guide future investigation for adult psychiatric patients.

    Science.gov (United States)

    Silverman, Michael J

    2008-01-01

    While the music therapy profession is relatively young and small in size, it can treat a variety of clinical populations and has established a diverse research base. However, although the profession originated working with persons diagnosed with mental illnesses, there is a considerable lack of quantitative research concerning the effects of music therapy with this population. Music therapy clinicians and researchers have reported on this lack of evidence and the difficulty in conducting psychosocial research on their interventions (Choi, 1997; Silverman, 2003a). While published studies have provided suggestions for future research, no studies have provided detailed propositions for the methodology and design of meticulous high quality randomized controlled psychiatric music therapy research. How do other psychotherapies accomplish their databases and could the music therapy field borrow from their rigorous "methodological best practices" to strengthen its own literature base? Therefore, as the National Institutes of Mental Health state the treatment of choice for evidence-based psychotherapy is cognitive behavioral therapy (CBT), aspects of this psychotherapy's literature base were analyzed. The purpose of this literature analysis was to (a) analyze and identify components of high-quality quantitative CBT research for adult psychiatric consumers, (b) analyze and identify the variables and other elements of existing quantitative psychiatric music therapy research for adult consumers, and (c) compare the two data sets to identify the best methodological designs and variables for future quantitative music therapy research with the mental health population. A table analyzing randomized and thoroughly controlled studies involving the use of CBT for persons with severe mental illnesses is included to determine chief components of high-quality experimental research designs and implementation of quantitative clinical research. The table also shows the same analyzed

  7. Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation

    DEFF Research Database (Denmark)

    Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S.

    2013-01-01

    Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD).......Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD)....

  8. Childhood ADHD Is Strongly Associated with a Broad Range of Psychiatric Disorders during Adolescence: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.

    2012-01-01

    Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we…

  9. Psychiatric treatment of persons with HIV/AIDS: an HIV-psychiatry consensus survey of current practices.

    Science.gov (United States)

    Freudenreich, Oliver; Goforth, Harold W; Cozza, Kelly L; Mimiaga, Matthew J; Safren, Steven A; Bachmann, Grace; Cohen, Mary Ann

    2010-01-01

    Only sparse evidence from controlled clinical trials is available to guide the psychiatric treatment of persons with HIV/AIDS. The authors assessed and determined current treatment trends in AIDS psychiatry. Members of the Organization of AIDS Psychiatry (OAP) participated in a web-based survey. Of 159 members, 62 (39%) responded to the survey. Consensus emerged regarding first-line treatment for depression (escitalopram/citalopram), for psychosis and secondary mania (quetiapine), and for anxiety (clonazepam). Consensus statements can serve as a preliminary step toward providing some standardization of care for persons with HIV/AIDS.

  10. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide

    OpenAIRE

    Gradus, Jaimie L.; Qin, Ping; Lincoln, Alisa K; Miller, Matthew; Lawler, Elizabeth; Lash, Timothy L

    2010-01-01

    Adjustment disorder is a diagnosis given following a significant psychosocial stressor from which an individual has difficulty recovering. The individual?s reaction to this event must exceed what would be observed among similar people experiencing the same stressor. Adjustment disorder is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control s...

  11. Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders: a protocol for a systematic review.

    Science.gov (United States)

    Semahegn, Agumasie; Torpey, Kwasi; Manu, Abubakar; Assefa, Nega; Tesfaye, Gezahegn; Ankomah, Augustine

    2018-01-22

    Evidence from the global burden of diseases show that psychiatric disorders are a growing public health concern. Maintaining adherence to medication is the most essential, but challenging course in the pharmacological treatment modality for major psychiatric disorders. Nevertheless, there is a paucity of abridged evidence on the level of psychotropic medication non-adherence and associated factors. Therefore, we aim to systematically summarize existing primary studies finding to estimate the level and identify associated factors of psychotropic medication non-adherence among adult patients with major psychiatric disorders. We will search studies using computerized search engines, main electronic databases and other relevant sources. PubMed (Medline), EMBASE, CINAHL, PsycINFO, Web of Science, WHO Global Health Library, and direct Google search will be searched to retrieve studies written in English language before December 2017. Observational studies (cross-sectional, case-control, cohort or longitudinal, survey and surveillance reports) on major psychiatric disorders (schizophrenia, major depressive and bipolar disorders) among adult patients will be eligible. Data will be extracted independently by two authors. Data synthesis and statistical analysis will be carried out. Pooled estimate will be done to quantify the level of psychotropic medication non-adherence using Comprehensive Meta-Analysis software. Psychiatric disorders remain a public health, social and economic concern worldwide. Management of major psychiatric disorders is highly affected by medication non-adherence. Thus, undertaking an integrated and multifaceted approach is necessary to reduce the burden of medication non-adherence, and enhance the quality of patients' life. Evidence is required to design appropriate intervention to prevent psychotropic medication non-adherence. PROSPERO: 2017: CRD42017067436 .

  12. [To cast a spell on reality. On actions of Soviet authorities in connection with the 6th Congress of the World Psychiatric Association at Honolulu].

    Science.gov (United States)

    Nasierowski, T

    1999-01-01

    At the 6th Congress of the World Psychiatric Association, held at Honolulu in August 1977, its participants accepted by acclamation a--so called--"Hawaiian Declaration" and a Resolution of the Royal College of Psychiatrists. The Declaration condemned all kinds of abuse in psychiatry, and the Resolution condemned the abuses in the Soviet psychiatry in particular. The Congress of Honolulu carried out, at last, the action initiated at the Congress of Mexico City six years earlier. But by then there was a lack of courage yet to take these measures, and the counter-action of the Soviet authorities proved to be effective. Aware of the fact that this time the pressure to condemn the misuses practiced in the Soviet psychiatry would be ever stronger, the KGB and the Ministry of Health of the USSR began their "preparations" for the next Congress as early as in 1976. This article describes the tactics of action promoted by the Soviet authorities in order to prevent the condemnation. The Author made a proper use of some documents that he had recovered at the Moscow "Centre for Storing the Contemporary Archives".

  13. Reducing transfers of psychiatric inpatients to emergency rooms of general hospitals in Singapore: a clinical practice improvement project.

    Science.gov (United States)

    Low, Tchern Kuang Lambert; Tay, Kai Hong; Fang, Tina; Fung, Daniel Shuen Sheng

    2017-03-01

    Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals. Thereafter changes were implemented with Plan-Do-Study-Act (PDSA) cycles to analyse their outcomes. During the 6-month study period, we achieved a 100% reduction in preventable referrals through strategies aimed at reducing pressure on our on-call physicians in the making of medical decisions, maximising usage of our medical resources, constant education and raising awareness of this issue. Reducing preventable transfer of inpatients from a psychiatric hospital to the emergency departments of general hospitals is a worthwhile endeavour. Such initiatives optimise use of healthcare resources, improve patient care and increase satisfaction.

  14. Stigma resistance and its association with internalised stigma and psychosocial outcomes among psychiatric outpatients.

    Science.gov (United States)

    Lau, Ying Wen; Picco, Louisa; Pang, Shirlene; Jeyagurunathan, Anitha; Satghare, Pratika; Chong, Siow Ann; Subramaniam, Mythily

    2017-11-01

    Studies have suggested that stigma resistance plays an important role in the recovery from mental illness. However, there has been limited research in Asian countries that has examined the benefits of stigma resistance among the mentally ill in Asian populations. Hence, this study aimed to assess the prevalence of stigma resistance and establish the socio-demographic correlates of stigma resistance, as well as its association with internalised stigma and psychosocial outcomes among a multi-ethnic population of 280 outpatients with obsessive compulsive disorder (OCD), schizophrenia, depressive disorders and anxiety disorders in Singapore. Prevalence of stigma resistance measured using the Stigma Resistance subscale of the Internalised Stigma of Mental Illness Scale was 82.9%. ANOVA and logistic regressions were conducted and results revealed that: (i) Stigma resistance was positively associated with being separated/divorced/widowed but negatively associated with depression diagnosis; (ii) Psychosocial outcomes such as self-esteem and psychological health were positively associated with stigma resistance; and (iii) Internalised stigma was negatively associated with stigma resistance. Moving forward, treatments could emphasize on improving the self-esteem and psychological health of patients to increase their stigma resistance for counteracting effects of public and internalised stigma. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample.

    Science.gov (United States)

    Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth

    2014-12-15

    Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. Published by Elsevier Ireland Ltd.

  16. Simple Measures of Hopelessness and Impulsivity are Associated with Acute Suicidal Ideation and Attempts in Patients in Psychiatric Crisis.

    Science.gov (United States)

    Mccullumsmith, Cheryl B; Williamson, David J; May, Roberta S; Bruer, Emily H; Sheehan, David V; Alphs, Larry D

    2014-09-01

    To explore the authors' predictions 1) that hopelessness would positively correlate with suicidal ideation and that impulsivity (either transient urges to self-harm or impulsive acting out) would positively correlate with suicidal behavior, and 2) that the recent or long-standing nature of the traits will have corresponding effects on reported histories of suicidal ideation and behavior. Questionnaire validation trial in which each subject received every measure in counterbalanced fashion. Inpatient and outpatient psychiatric settings associated with a medium-sized medical school in the southeastern United States. Forty-five subjects presenting with varying levels of suicidal ideation and behavior completed measures providing information about their histories of suicidal ideation and behavior, recent feelings of hopelessness, feelings of general hopelessness, recent feelings of difficulty controlling urges to self-harm, and feeling about general levels of impulsivity. The InterSePT Scale for Suicidal Thinking-Plus, the Sheehan-Suicidality Tracking Scale, the Columbia-Suicide Severity Rating Scale, and six additional questions to assess hopelessness and impulsivity. Recent and trait hopelessness correlated positively with suicidal ideation. Patients who reported any suicide attempt endorsed higher levels of general impulsivity than those who did not report a history of at least one suicide attempt. Those enrolled in the study secondary to a very recent suicide attempt reported more difficulties with recent suicidal impulses. Simple measures of hopelessness and impulsivity are associated with suicidal ideation and attempts and may add to determination of suicide risk.

  17. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide

    DEFF Research Database (Denmark)

    Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K

    2010-01-01

    is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control study examining this association in the population of Denmark aged 15 to 90 years. All suicides...... in Denmark from 1994 to 2006 were included, resulting in 9,612 cases. For each case, up to 30 controls were matched on gender, exact date of birth, and calendar time, yielding 199,306 controls. Adjustment disorder diagnosis was found in 7.6% of suicide cases and 0.52% of controls. Conditional logistic...... regression analyses revealed that those diagnosed with adjustment disorder had 12 times the rate of suicide as those without an adjustment disorder diagnosis, after controlling for history of depression diagnosis, marital status, income, and the matched factors....

  18. Motor, psychiatric and fatigue features associated with nutritional status and its effects on quality of life in Parkinson's disease patients.

    Directory of Open Access Journals (Sweden)

    Seyed-Mohammad Fereshtehnejad

    Full Text Available OBJECTIVES: Parkinson's disease (PD patients are more likely to develop impaired nutritional status because of the symptoms, medications and complications of the disease. However, little is known about the determinants and consequences of malnutrition in PD. This study aimed to investigate the association of motor, psychiatric and fatigue features with nutritional status as well as the effects of malnutrition on different aspects of quality of life (QoL in PD patients. METHODS: One hundred and fifty patients with idiopathic PD (IPD were recruited in this study. A demographic checklist, the Unified Parkinson's Disease Rating Scale (UPDRS, the Hospital Anxiety and Depression Scale (HADS and the Fatigue Severity Scale (FSS were completed through face-to-face interviews and clinical examinations. The health-related QoL (HRQoL was also evaluated by means of the Parkinson's Disease Questionnaire (PDQ-39. For evaluation of nutritional status, the Mini Nutritional Assessment (MNA questionnaire was applied together with anthropometric measurements. RESULTS: Thirty seven (25.3% patients were at risk of malnutrition and another 3 (2.1% were malnourished. The total score of the UPDRS scale (r =  -0.613, P<0.001 and PD duration (r =  -0.284, P = 0.002 had a significant inverse correlation with the total MNA score. The median score of the Hoehn and Yahr stage was significantly higher in PD patients with abnormal nutritional status [2.5 vs. 2.0; P<0.001]. More severe anxiety [8.8 vs. 5.9; P = 0.002], depression [9.0 vs. 3.6; P<0.001] and fatigue [5.4 vs. 4.2; P<0.001] were observed in PD patients with abnormal nutritional status. Except for stigma, all other domains of the PDQ-39 were significantly correlated with the total score of the MNA. CONCLUSION: Our study demonstrates that disease duration, severity of motor and psychiatric symptoms (depression, anxiety and fatigue are associated with nutritional status in PD. Different aspects of the HRQoL were

  19. Impaired causal awareness and associated cortical–basal ganglia structural changes in youth psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Kristi R. Griffiths

    2016-01-01

    Discussion: Low causal awareness occurs across diagnoses and stages of illness and is associated with poor functional outcomes. Our results suggest that there may be shared neural underpinnings of its dysfunction in the early course of mood and psychotic disorders, however in more established illness, there is greater neurobiological divergence in causal awareness correlates between diagnoses.

  20. Oxytocin Receptor Genetic and Epigenetic Variations: Association with Child Abuse and Adult Psychiatric Symptoms

    Science.gov (United States)

    Smearman, Erica L.; Almli, Lynn M.; Conneely, Karen N.; Brody, Gene H.; Sales, Jessica M.; Bradley, Bekh; Ressler, Kerry J.; Smith, Alicia K.

    2016-01-01

    Childhood abuse can alter biological systems and increase risk for adult psychopathology. Epigenetic mechanisms, alterations in DNA structure that regulate the gene expression, are a potential mechanism underlying this risk. While abuse associates with methylation of certain genes, particularly those in the stress response system, no study to date…

  1. Joint Association of Active and Passive Smoking with Psychiatric Distress and Violence Behaviors in a Representative Sample of Iranian Children and Adolescents: the CASPIAN-IV Study.

    Science.gov (United States)

    Kelishadi, Roya; Babaki, Amir Eslami Shahr; Qorbani, Mostafa; Ahadi, Zeinab; Heshmat, Ramin; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Ataie-Jafari, Asal; Asayesh, Hamid; Mohammadi, Rasool

    2015-10-01

    Mental health and smoking have been receiving increasing attention in adolescents all over the world. Although some studies have assessed the independent association of active/passive smoking with mental health, joint association of active and passive smoking with mental health remains unclear. This study was designed to evaluate the joint association of smoking status (active and passive smoking) with psychiatric distress and violent behaviors in Iranian children and adolescents. In this national survey, 13,486 students, aged 6-18 years, living in rural and urban areas of 30 provinces of Iran were selected via multistage, cluster sampling method. Psychiatric distress (including worthless, angriness, worrying, insomnia, confusion, depression, and anxiety), violence behaviors (including bullying, victim, and physical fight), and smoking status (nonsmoker, only passive smoker, only active smoker, and active and passive smoker) were assessed. The questionnaire was prepared based on the World Health Organization Global School-based Student Health Survey (WHO-GSHS). Data were analyzed by the Stata package. Psychiatric distress and violent behaviors had linearly positive association with smoking status (p trend passive smoking besides active tobacco use were at increased risk of having angriness (odds ratio (OR) 2.55, 95 % confidence interval (CI) 1.86-3.48), worrying (OR 1.66, 95 % CI 1.24-2.20), and anxiety (OR 1.99, 95 % CI 1.52-2.61) and victim (OR 1.77, 95 % CI 1.34-2.33) and bully behaviors (OR 3.08, 95 % CI 2.33-4.07). The current findings suggest that active and passive tobacco smoking has synergistic effect on psychiatric distress. Since majority of smokers with psychiatric distress do not receive mental health services or counseling on smoking, strategies to address mental health problems and smoking prevention should be included as a part of school health services.

  2. Hair Cortisol and Its Association With Psychological Risk Factors for Psychiatric Disorders: A Pilot Study in Adolescent Twins.

    Science.gov (United States)

    Rietschel, Liz; Streit, Fabian; Zhu, Gu; McAloney, Kerrie; Kirschbaum, Clemens; Frank, Josef; Hansell, Narelle K; Wright, Margaret J; McGrath, John J; Witt, Stephanie H; Rietschel, Marcella; Martin, Nicholas G

    2016-10-01

    Measuring cortisol in hair is a promising method to assess long-term alterations of the biological stress response system, and hair cortisol concentrations (HCC) may be altered in psychiatric disorders and in subjects suffering from chronic stress. However, the pattern of associations between HCC, chronic stress and mental health require clarification. Our exploratory study: (1) assessed the association between HCC and perceived stress, symptoms of depression and neuroticism, and the trait extraversion (as a control variable); and (2) made use of the twin design to estimate the genetic and environmental covariance between the variables of interest. Hair samples from 109 (74 female) subjects (age range 12-21 years, mean 15.1) including 8 monozygotic (MZ) and 21 dizygotic (DZ) twin pairs were analyzed. Perceived stress was measured with the Perceived Stress Scale and/or the Daily Life and Stressors Scale, neuroticism, and extraversion with the NEO-Five Factor Inventory or the Junior Eysenck Personality Questionnaire, and depressive symptoms with the Somatic and Psychological Health Report. We found a modest positive association between HCC and the three risk factors - perceived stress, symptoms of depression, and neuroticism (r = 0.22-0.33) - but no correlation with extraversion (-0.06). A median split revealed that the associations between HCC and risk factors were stronger (0.47-0.60) in those subjects with HCC >11.36 pg/mg. Furthermore, our results suggest that the genetic effects underlying HCC are largely shared with those that influence perceived stress, depressive symptoms, and neuroticism. These results of our proof of principle study warrant replication in a bigger sample but raise the interesting question of the direction of causation between these variables.

  3. Comorbidity was associated with neurologic and psychiatric diseases: a general practice-based controlled study.

    NARCIS (Netherlands)

    Nuyen, J.; Schellevis, F.G.; Satariano, W.A.; Spreeuwenberg, P.M.; Birkner, M.D.; Bos, G.A.M. van den; Groenewegen, P.P.

    2006-01-01

    BACKGROUND AND OBJECTIVE: To comprehensively examine comorbidity in unselected cohorts of patients with depression, stroke, multiple sclerosis (MS), Parkinson's disease/parkinsonism (PD/PKM), dementia, migraine, and epilepsy. METHODS: This cross-sectional study used morbidity data recorded by Dutch

  4. Stigma resistance is positively associated with psychiatric and psychosocial outcomes: A meta-analysis.

    Science.gov (United States)

    Firmin, Ruth L; Luther, Lauren; Lysaker, Paul H; Minor, Kyle S; Salyers, Michelle P

    2016-08-01

    To better understand how stigma resistance impacts functioning-related domains, we examined mean effect sizes between stigma resistance and: 1) symptoms (overall, positive, negative, and mood symptoms); 2) self-stigma; 3) self-efficacy; 4) quality of life; 5) recovery; 6) hope; 7) insight, and 8) overall outcomes (the average effect size across the constructs examined in each study). The mean effect size between stigma resistance and overall outcomes was significant and positive (r=0.46, presistance and self-stigma (r=-0.57, pself-efficacy (r=0.60, presistance had a significant medium and small relationship with insight and symptoms, respectively. Race significantly moderated overall outcomes, self-stigma, mood symptoms, functioning, and hope associations. Education significantly moderated symptoms, functioning, and mood symptoms associations, and age significantly moderated self-stigma and negative symptom associations. Stigma resistance may be a key requirement for recovery. Individual characteristics influence resisting stigma and future work should prioritize cultural factors surrounding stigma resistance. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. [Arterial Hyper- and Hypotension associated with psychiatric medications: a risk assessment based on the summaries of product characteristics (SmPCs)].

    Science.gov (United States)

    Freudenmann, Roland W; Freudenmann, Ninja; Zurowski, Bartosz; Schönfeldt-Lecuona, Carlos; Maier, Ludwig; Schmieder, Roland E; Lange-Asschenfeldt, Christian; Gahr, Maximilian

    2017-08-01

    Introduction  Psychiatric medications are well-known triggers of clinically relevant blood pressure changes. Therefore, we aimed at creating ranking lists for their risk of causing arterial hyper- or hypotension. Methods  We analyzed 784 Summaries of Product characteristics (SmPCs, available online from "Rote Liste" or "Gelbe Liste" websites) from 105 psychiatric medications registered in adult psychiatry in Germany and extracted the standardized reported risks of increasing or decreasing arterial blood pressure. Results  According to the SmPCs, atomoxetine had the highest risk of arterial hypertension ("very frequent", > 10 %), and another 15 substances followed in the category "frequent" (> 1 %): duloxetine, milnacipran, venlafaxine, bupropion, citalopram, tranylcypromine (particularly with certain diets), reboxetine, methylphenidate, clozapine, paliperidone, risperidone, buprenorphine+naloxone, memantine, galantamine, and rivastigmine. Conversely, 7 substances, namely amitriptyline, tranylcypromine, chlorprothixen, flupentixol, levomepromazine, olanzapine and trimipramine had the highest reported risk of low blood pressure ("very frequent"), and another 25 substances had the risk "frequent". No risk of hypertension or hypotension was documented for many other substances. Incidentally, we observed that the reported effects on blood pressure for single substances (e. g. citalopram) markedly differed between the SmPCs from different manufacturers, rendering a clear risk assessment impossible for many medications. Discussion  According to the German SmPc, many psychiatric medications are associated with the risk of arterial hypertension and, even more so, hypotension. We hardly observed substance group effects, such as high blood pressure with noradrenergic antidepressants. Commonly used tables summarising secondary causes of arterial hypertension should be revised in terms of psychiatric medications. Our rank orders of risk may aid choosing the

  6. Prevalence of self-medication practice with herbal products among non-psychotic psychiatric patients from southeastern Serbia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nikola M. Stojanović

    2017-09-01

    Full Text Available The aim of this study was to evaluate the usage prevalence of herbal products (HP and to ascertain the identity, mode and adverse effects of plant taxa used in self-medication practice for anxiety, depression and insomnia in patients with non-psychotic disorders originating from southeastern Serbia. Also, we compared HP users and non-users on the variables of socio-demographic characteristics, information source and origin of HP. The study was done by a face-to-face interview with a trained psychiatrist using a structured questionnaire administered to 136 adult patients suffering from non-psychotic mental disorders. A typical herbal-product user among non-psychotic psychiatric patients from southeastern Serbia is a middle-aged married woman, with a secondary level of education, unemployed and living in an urban area. Non-psychotic psychiatric patients, although not living predominantly in rural areas, were familiar with a variety of ethno-medicines and were often using HP primarily without the consultation of their psychiatrists/physicians. HP stated to be most frequently used for psychiatry-related symptoms included: Melissa officinalis, Mentha × piperita, Hypericum perforatum and Valeriana officinalis. The interviewees rarely stated adverse reactions related to the HP usage; however, this should not be generalized, since HP are known to vary in the content of their adverse reaction-causing constituents.

  7. Are psychiatric comorbidities and associated cognitive functions related to treatment response to methylphenidate in boys with attention-deficit/hyperactivity disorder?

    Directory of Open Access Journals (Sweden)

    Chan MH

    2017-04-01

    Full Text Available Mandy H Chan,1 Patrick WL Leung,2 Ting-pong Ho,3 Se-fong Hung,4 Chi-chiu Lee,5 Chun-pan Tang,5 Ka-chai Cheung,2 Fung-yee Ching,2 Fefe HK Chan,6 Lu-hua Chen,2 Merce Garcia-Barcelo,7 Pak-chung Sham3 1Department of Clinical Psychology, Kowloon Hospital, Hospital Authority, 2Department of Psychology, The Chinese University of Hong Kong, 3Department of Psychiatry, University of Hong Kong, 4Department of Psychiatry, The Chinese University of Hong Kong, 5Department of Psychiatry, Kwai Chung Hospital, Hospital Authority, 6Department of Clinical Psychology, Alice Ho Mui Ling Nethersole Hospital, Hospital Authority, 7Department of Surgery, University of Hong Kong, Hong Kong, People’s Republic of China Background: Methylphenidate (MPH has been found to be an effective medication for attention-deficit/hyperactivity disorder (ADHD. However, there are neither consistent nor sufficient findings on whether psychiatric comorbidities and associated cognitive functions of ADHD are related to treatment response to MPH in ADHD children.Objectives: This study investigated whether psychiatric comorbidities, IQ, and neurocognitive deficits are related to treatment response to MPH in ADHD children. In some ways, it is preferable to have a drug that the effectiveness of which to a disorder is not affected by its associated cognitive functions and psychiatric comorbidities. On the other hand, it is likely that the baseline symptom severity of ADHD is associated with the effectiveness of MPH treatment on the symptoms post treatment.Methods: A total of 149 Chinese boys (aged 6–12 years with ADHD, combined type, and normal IQ participated in this study. Assessment of ADHD symptom severity was conducted pre and post MPH treatment, while assessment of psychiatric comorbidities, IQ, and neurocognitive deficits was performed in a non-medicated condition. Treatment response was defined as the ADHD symptom severity post MPH treatment.Results: Results indicated that MPH

  8. Association of the 5-HTT gene-linked promoter region (5-HTTLPR polymorphism with psychiatric disorders: review of psychopathology and pharmacotherapy

    Directory of Open Access Journals (Sweden)

    Kenna GA

    2012-01-01

    Full Text Available George A Kenna1, Nick Roder-Hanna2, Lorenzo Leggio3, William H Zywiak4, James Clifford5, Steven Edwards3, John A Kenna6, Jessica Shoaff1, Robert M Swift11Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence; 2College of Pharmacy, University of Rhode Island, Kingston; 3Center for Alcohol and Addiction Studies, Department of Community Health, Brown University, Providence; 4Butler Hospital, Providence, RI; 5Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA; 6College of Nursing, University of Rhode Island, Kingston, RI, USAAbstract: Serotonin (5-HT regulates important biological and psychological processes including mood, and may be associated with the development of several psychiatric disorders. An association between psychopathology and genes that regulate 5-HT neurotransmission is a robust area of research. Identification of the genes responsible for the predisposition, development, and pharmacological response of various psychiatric disorders is crucial to the advancement of our understanding of their underlying neurobiology. This review highlights research investigating 5-HT transporter (5-HTTLPR polymorphism, because studies investigating the impact of the 5-HTTLPR polymorphism have demonstrated significant associations with many psychiatric disorders. Decreased transcriptional activity of the S allele (“risk allele” may be associated with a heightened amygdala response leading to anxiety-related personality traits, major depressive disorder, suicide attempts, and bipolar disorder. By contrast, increased transcriptional activity of the L allele is considered protective for depression but is also associated with completed suicide, nicotine dependence, and attention deficit hyperactivity disorder. For some disorders, such as post-traumatic stress disorder and major depressive disorder, the research suggests that treatment

  9. [Psychiatric Emergencies in the Preclinical Emergency Medicine Service in Ulm, Germany in 2000 and 2010, and Practical Consequences].

    Science.gov (United States)

    Schönfeldt-Lecuona, Carlos; Gahr, Maximilian; Schütz, Stefan; Lang, Dirk; Pajonk, Frank Gerald Bernhard; Connemann, Bernhard J; Muth, Claus-Martin; Freudenmann, Roland W

    2017-07-01

    Background  Psychiatric emergencies (PE) in preclinical emergency medical services are about 5 - 10 % of all emergencies and represent often a source of difficulties in handling for the non-psychiatric professional helpers that deal with them. Studies informing about quantitative and qualitative changes of PEs in preclinical emergency medicine in Germany are scarce. Methods  Therefore, we conducted a retrospective cross-sectional study of PE in a preclinical emergency medical service based on the protocols of the emergency ambulance of the Section for Emergency Medicine at the University Hospital Ulm comparing the years 2000 and 2010. Results  We observed a significant increase of PEs from 8.8 % in the year 2000 (n = 285, from a total of n = 3227) to 10.3 % in 2010 (n = 454, from a total of n = 4425). In both years intoxications were the most common PE [2000: n = 116 (44.4 %); 2010: n = 171 (37.7 %)], followed by suicide-related behavior [2000: n = 59 (22.6 %); 2010: n = 78 (17.2 %)] and acute anxiety disorders [2000: n = 37 (13 %); 2010: n = 105 (23.1 %)]. The mentioned three conditions accounted for about 80 % of all PE. Most frequently PE occurred at the weekend and with the highest density in the evening and at night (18 - 24 h) in both years. Patients with PE were predominantly men, but the rate of women causing PE increased between 2000 and 2010. Discussion/Conclusion  This study provides preliminary data on current trends in PEs in preclinical emergency medicine in Germany and has implications for improving the medical care provided. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Psychiatric disorders among offspring of depressed mothers: associations with paternal psychopathology.

    Science.gov (United States)

    Marmorstein, Naomi R; Malone, Stephen M; Iacono, William G

    2004-09-01

    The association between maternal depression and offspring dysfunction is well documented; however, little attention has been paid to psychopathology in the partners of these depressed mothers or to how paternal psychopathology might influence the relationship between maternal depression and offspring dysfunction. The purpose of this study was to explore whether major depression and/or antisocial behavior tended to occur more frequently among partners of depressed mothers (compared to partners of nondepressed mothers) and to examine how these paternal disorders related to offspring psychopathology. Participants were drawn from the Minnesota Twin Family Study, a community-based study of twins and their parents. Depressed and nondepressed mothers, their partners (the biological fathers of the twins), and their 17-year-old offspring were included. Structured interviews were used to assess participants for the presence of major depression, conduct disorder, and adult antisocial behavior. Depressed mothers tended to partner with antisocial fathers. Depression in mothers and antisocial behavior in fathers were both significantly and independently associated with offspring depression and conduct disorder. No interactions of the parental diagnoses with each other or with the gender of the offspring were found. Many offspring of depressed mothers experience the additional risk of having an antisocial father. The implications of these findings for risk among the offspring of depressed mothers are discussed.

  11. Managing the classification of psychiatric diagnoses: a systematics perspective.

    Science.gov (United States)

    Westermeyer, Joseph John

    2012-09-01

    For almost a century, the American Psychiatric Association has improved psychiatric practice via its diagnostic manual series. However, the increasing number of diagnoses has created predicaments for clinicians and society. This report suggests explanations for this "inflation" and, using systematics, proposes the following five linked strategies for improving our diagnostic schema. First, criteria based on purposes underlying diagnosis should form the basis for including and excluding psychiatric diagnoses. Second, the major categories (or classes) should be reduced from 17 to one half to one third that number. Third, many psychiatric diagnoses should be removed from their current status as independent diagnoses (or subclasses) and relegated to a more specific taxonomic stratum (e.g., infraclass). Fourth, promising information for new or modified taxons would compose a fourth stratum (or parvclass). Fifth, comorbidity would become a more useful concept if defined as major, intermediate, and minor comorbidity, occurring at class, subclass, and infraclass levels.

  12. Cognitive behavioral therapy for patients with primary insomnia or insomnia associated predominantly with mixed psychiatric disorders: a randomized clinical trial.

    Science.gov (United States)

    Edinger, Jack D; Olsen, Maren K; Stechuchak, Karen M; Means, Melanie K; Lineberger, Margaret D; Kirby, Angela; Carney, Colleen E

    2009-04-01

    This study was conducted to evaluate the efficacy of cognitive behavioral therapy (CBT) against a sleep hygiene education control therapy in patients with primary or comorbid insomnia. Randomized, parallel-group, clinical trial conducted at a single Veterans Affairs medical center, with recruitment from March 2001 to June 2005. Eighty-one adults (n = 11 women; mean age, 54.2 years) with chronic primary (n = 40) or comorbid insomnia associated predominantly with mixed psychiatric disorders (n = 41). Patients, screened via structured interviews and diagnostic polysomnography, were randomly assigned to receive CBT (sleep education, stimulus control, and time-in-bed restrictions; 20 patients with primary and 21 with comorbid insomnia), or sleep hygiene (SH: education about aspects of lifestyle and the bedroom environment that affect sleep; 20 patients with primary and 20 with comorbid insomnia). Outpatient treatment included 4 biweekly sessions with a posttreatment assessment and a follow-up conducted at 6 months. Participants completed actigraphy and sleep diaries for 2 weeks prior to therapy, during a 2-week posttreatment assessment, and during 2 weeks at follow-up. They also completed questionnaires measuring global insomnia symptoms, general sleep quality, and sleep-disruptive beliefs before treatment, immediately following treatment, and at the follow-up time point. Consistent with previous studies, CBT outperformed sleep hygiene across several study outcome measures for the sample as a whole. Statistical analyses showed no significant 3-way interaction of treatment group, time, and insomnia type for any of the sleep or questionnaire measures, suggesting the benefits of CBT over sleep hygiene were comparable for patients with primary insomnia and comorbid insomnia. Moreover, only 1 of several indexes of clinically notable improvement suggested a significantly better response to CBT by patients with primary insomnia, as compared with those with comorbid insomnia. A

  13. Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Arnaud-Gil, Carlos Alberto; Hernández-Tinoco, Jesús; Molina-Espinoza, Luis Fernando; Rábago-Sánchez, Elizabeth

    2014-03-01

    Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (Pattempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; Pattempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients.

  14. Associations between olfactory identification and verbal memory in patients with schizophrenia, first-degree relatives, and non-psychiatric controls.

    Science.gov (United States)

    Compton, Michael T; McKenzie Mack, LaTasha; Esterberg, Michelle L; Bercu, Zachary; Kryda, Aimee D; Quintero, Luis; Weiss, Paul S; Walker, Elaine F

    2006-09-01

    Olfactory identification deficits and verbal memory impairments may represent trait markers for schizophrenia. The aims of this study were to: (1) assess olfactory identification in patients, first-degree relatives, and non-psychiatric controls, (2) determine differences in verbal memory functioning in these three groups, and (3) study correlations between olfactory identification and three specific verbal memory domains. A total of 106 participants-41 patients with schizophrenia or related disorders, 27 relatives, and 38 controls-were assessed with the University of Pennsylvania Smell Identification Test (UPSIT) and the Wechsler Memory Scale-Third Edition. Linear mixed models, accounting for clustering within families and relevant covariates, were used to compare scores across groups and to examine associations between olfactory identification ability and the three verbal memory domains. A group effect was apparent for all four measures, and relatives scored midway between patients and controls on all three memory domains. UPSIT scores were significantly correlated with all three forms of verbal memory. Age, verbal working memory, and auditory recognition delayed memory were independently predictive of UPSIT scores. Impairments in olfactory identification and verbal memory appear to represent two correlated risk markers for schizophrenia, and frontal-temporal deficits likely account for both impairments.

  15. The association between self-image and defence mechanisms in a group of adolescent patients receiving psychiatric treatment.

    Science.gov (United States)

    Treger, Bartosz; Matusiak, Feliks; Pilecki, Maciej; Rogoż, Monika

    2015-01-01

    The aim of the study was to explore the relationship between various areas of self-image and defence mechanisms in adolescents. The study included a division into groups according to whether or not they were receiving psychiatric treatment. Data were obtained from two groups: a clinical group (30 persons), consisting of adolescent patients of the Adolescent Inpatient Ward of the Child and Adolescent Psychiatry Clinic and a control group (40 persons), adolescents attending upper secondary school. The Defence Style Questionnaire DSQ-40 and the Offer Self Image Questionnaire were used in the study. Results showed no differences, in the maturity levels of the defence mechanisms, between the two groups. Subjects from the clinical group had a significantly lower self-image of themselves than subjects from the control group.. In both groups, the use of mature defence mechanisms was accompanied by a positive self-image, while the use of less mature defence mechanisms was associated with a lower self-image. Comparison of the groups revealed different relationships between the aspects of self-image and used defence mechanisms, in particular the mechanism of projection. Number of significant correlations was greater in the clinical group. In the context of lower self-image, the study revealed the importance of such defence mechanisms as projection, acting out, somatization or schizoid fantasies. The obtained results seem to confirm a hypothesis that the assessment of the maturity of defence mechanisms in the period of adolescence is less clear and clinically useful.

  16. Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation.

    Science.gov (United States)

    Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S; van Hout, Moniek; Scholten, Marcoen; van der Palen, Job

    2013-09-01

    Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD). We examined associations between previous anxiety and depressive disorder, type D personality, anxiety or depressive symptoms, and health status in ICD patients prior to ICD implantation. Patients (N = 278; 83 % men; mean age = 62.2 years ±11) receiving a first ICD from September 2007 through April 2010 at the Medisch Spectrum Twente, The Netherlands completed validated questionnaires before implantation assessing type D personality (14-item Type D Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), and health status (36-item Short Form Health Survey). History of anxiety or depressive disorder was assessed with the Mini International Neuropsychiatric Interview structural interview. Previous anxiety or depressive disorder was prevalent in 8 and 19 % of patients, respectively. Type D personality was present in 21 %, depressive symptoms in 15 %, and anxiety in 24 %. In adjusted analyses, type D personality was a dominant correlate of previous depressive disorder (odds ratio (OR) 6.2, p anxiety disorder (OR 3.9, p = 0.004). Type D personality (OR 4.0, p anxiety symptoms at baseline. Type D personality (OR 5.9. p depressive symptoms at baseline. Heart failure and type D personality were related to poorer health status. In ICD patients, prior to ICD implantation, a previous anxiety or depressive disorder, type D personality, and anxiety and depressive symptoms were associated with poorer health status. Type D personality was also independently associated with increased anxiety and depression symptoms.

  17. Stones, bones, groans, thrones, and psychiatric overtones: Systemic associations of sclerochoroidal calcification

    Directory of Open Access Journals (Sweden)

    Jordan A Sugarman

    2017-01-01

    Full Text Available Sclerochoroidal calcification (SCC is a frequent masquerader of choroidal melanoma with important systemic associations such as hyperparathyroidism and parathyroid adenoma. Herein, we describe a case of a 67-year-old male who presented with an amelanotic choroidal lesion in the right eye (OD and a history of kidney stones. Ultrasonography showed the lesion to be flat and calcified OD. Incidentally, a subclinical calcified plaque was also found in the fellow eye. Optical coherence tomography showed an elevated suprachoroidal mass in a table mountain configuration OD and flat configuration left eye, consistent with type 4 and type 1 SCC. The patient was referred for metabolic testing to rule out the underlying electrolyte imbalance and was found to be normal.

  18. Caffeine Use: Association with Nicotine Use, Aggression, and Other Psychopathology in Psychiatric and Pediatric Outpatient Adolescents

    Directory of Open Access Journals (Sweden)

    Catherine A. Martin

    2008-01-01

    Full Text Available The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 ± 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian. Most (47% were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained from parents and assent from the youth. High caffeine consumption was associated with daily cigarette use; aggressive behavior; conduct, attention deficit/hyperactivity, and social problems; and increased somatic complaints in adolescents.

  19. Extramarital sexual practices and perceived association with HIV ...

    African Journals Online (AJOL)

    Despite evident association between such practice and spread in HIV infection, to date multiple sexual partnerships is a common practice. Among the Borana pastoral community, where awareness about HIV and AIDS is documented to be limited, engagement in extramarital sexual practice is believed to be the norm rather ...

  20. High maternal cortisol levels during pregnancy are associated with more psychiatric symptoms in offspring at age of nine - A prospective study from Nicaragua.

    Science.gov (United States)

    Isaksson, J; Lindblad, F; Valladares, E; Högberg, U

    2015-12-01

    Maternal exposure to stress or adversity during pregnancy has been associated with negative health effects for the offspring including psychiatric symptoms. Programming of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested as one mediating process. In order to investigate possible long term effects of stressors during pregnancy, we followed 70 children and their mothers from pregnancy up to nine years aiming to investigate if maternal cortisol levels and distress/exposure to partner violence were associated with child psychiatric symptoms and child cortisol levels at follow-up. Maternal distress was evaluated using The Self Reporting Questionnaire, exposure to partner violence by an instrument from WHO and child psychiatric symptoms with Child Behavior Checklist (CBCL). We adjusted the analyses for gestational week, gender, SES, perinatal data and maternal distress/exposure to partner violence at child age of nine years. Elevated maternal cortisol levels during pregnancy, as a possible marker of maternal stress load, were correlated with higher CBCL-ratings, especially concerning externalizing symptoms. Maternal cortisol levels during pregnancy were not associated with child cortisol levels at child age of nine years. Maternal distress and exposure to partner violence during pregnancy were neither associated with child psychiatric symptoms nor child cortisol levels. To conclude, intrauterine exposure to elevated cortisol levels was associated with higher ratings on offspring psychopathology at nine years of age. The lack of association between maternal cortisol levels during pregnancy and child cortisol levels does not support the hypothesis of fetal programming of the HPA-axis, but reliability problems may have contributed to this negative finding. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Association between dopaminergic polymorphisms and borderline personality traits among at-risk young adults and psychiatric inpatients

    Directory of Open Access Journals (Sweden)

    Faludi Gabor

    2010-01-01

    Full Text Available Abstract Background In the development of borderline personality disorder (BPD both genetic and environmental factors have important roles. The characteristic affective disturbance and impulsive aggression are linked to imbalances in the central serotonin system, and most of the genetic association studies focused on serotonergic candidate genes. However, the efficacy of dopamine D2 receptor (DRD2 blocking antipsychotic drugs in BPD treatment also suggests involvement of the dopamine system in the neurobiology of BPD. Methods In the present study we tested the dopamine dysfunction hypothesis of impulsive self- and other-damaging behaviors: borderline and antisocial traits were assessed by Structured Clinical Interview for Diagnosis (SCID for DSM-IV in a community-based US sample of 99 young adults from low-to-moderate income families. For the BPD trait analyses a second, independent group was used consisting of 136 Hungarian patients with bipolar or major depressive disorder filling out self-report SCID-II Screen questionnaire. In the genetic association analyses the previously indicated polymorphisms of the catechol-O-methyl-transferase (COMT Val158Met and dopamine transporter (DAT1 40 bp VNTR were studied. In addition, candidate polymorphisms of the DRD2 and DRD4 dopamine receptor genes were selected from the impulsive behavior literature. Results The DRD2 TaqI B1-allele and A1-allele were associated with borderline traits in the young adult sample (p = 0.001, and p = 0.005, respectively. Also, the DRD4 -616 CC genotype appeared as a risk factor (p = 0.02. With severity of abuse accounted for in the model, genetic effects of the DRD2 and DRD4 polymorphisms were still significant (DRD2 TaqIB: p = 0.001, DRD2 TaqIA: p = 0.008, DRD4 -616 C/G: p = 0.002. Only the DRD4 promoter finding was replicated in the independent sample of psychiatric inpatients (p = 0.007. No association was found with the COMT and DAT1 polymorphisms. Conclusions Our results

  2. The association between parental history of diagnosed mood/anxiety disorders and psychiatric symptoms and disorders in young adult offspring

    Directory of Open Access Journals (Sweden)

    Low Nancy CP

    2012-11-01

    Full Text Available Abstract Background Parental history of mood or anxiety disorders is one of the strongest and most consistent risk factors for the development of these disorders in offspring. Gaps remain however in our knowledge of whether maternal or paternal disorders are more strongly associated with offspring disorders, and whether the association exists in non-clinical samples. This study uses a large population-based sample to test if maternal or paternal history of mood and/or anxiety disorders increases the risk of mood and/or anxiety disorders, or symptoms of specific anxiety disorders, in offspring. Methods Data were drawn from the Nicotine Dependence in Teens Study, a prospective cohort investigation of 1293 grade 7 students. Data on mental health outcomes were collected in mailed self-report questionnaires when participants were aged 20.4 (0.7 years on average. Parental data were collected in mailed self-report questionnaires. This current analysis pertains to 564 participants with maternal and/or paternal data. The association between maternal and paternal history and each of diagnosed anxiety disorder, diagnosed mood disorder, and symptoms of specific anxiety disorders in offspring was studied in multivariate logistic regression. Results A higher proportion of mothers than fathers had a diagnosed mood/anxiety disorder (23% versus 12%. Similarly, 14% of female offspring had a diagnosed mood/anxiety disorder, compared to 6% of male offspring. The adjusted odds ratio (95% confidence interval for maternal history was 2.2 (1.1, 4.5 for diagnosed mood disorders, 4.0 (2.1, 7.8 for diagnosed anxiety disorders, and 2.2 (1.2, 4.0 for social phobia symptoms. Paternal history was not associated with any of the mental health outcomes in offspring. Conclusion Maternal, but not paternal mood/anxiety disorders were associated with diagnosed psychiatric disorders, as well as symptoms of specific anxiety disorders, in offspring. Efforts to detect mood and anxiety

  3. Factors Associated With Full Implementation of Scope of Practice.

    Science.gov (United States)

    Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit

    2016-05-01

    To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses

  4. C-reactive protein and white blood cell levels in schizophrenia, bipolar disorders and depression - associations with mortality and psychiatric outcomes

    DEFF Research Database (Denmark)

    Horsdal, H T; Köhler-Forsberg, O; Benros, Michael E

    2017-01-01

    BACKGROUND: Mental disorders have been associated with increased levels of inflammatory markers, which can affect disease trajectories. We aimed to assess levels of C-reactive protein (CRP) and white blood cells (WBC) across individuals with schizophrenia, bipolar disorder, and depression......, and to investigate associations with subsequent psychiatric admission and mortality. METHODS: We identified all adults in the Central Denmark Region during 2000-2012 with a first diagnosis of schizophrenia, bipolar disorder, or depression and a baseline measurement of CRP and/or WBC count. We followed...... these individuals until outcome of interest (psychiatric admission or death), emigration or December 31, 2012, using Cox regression analysis to estimate hazard ratios (HRs). RESULTS: Baseline median CRP differed significantly between mental disorders (P=0.01) being highest in individuals with bipolar disorder (3...

  5. What can we learn from consumer reports on psychiatric adverse drug reactions with antidepressant medication? Experiences from reports to a consumer association.

    Science.gov (United States)

    Vilhelmsson, Andreas; Svensson, Tommy; Meeuwisse, Anna; Carlsten, Anders

    2011-10-25

    According to the World Health Organization (WHO) the cost of adverse drug reactions (ADRs) in the general population is high and under-reporting by health professionals is a well-recognized problem. Another way to increase ADR reporting is to let the consumers themselves report directly to the authorities. In Sweden it is mandatory for prescribers to report serious ADRs to the Medical Products Agency (MPA), but there are no such regulations for consumers. The non-profit and independent organization Consumer Association for Medicines and Health, KILEN has launched the possibility for consumers to report their perceptions and experiences from their use of medicines in order to strengthen consumer rights within the health care sector. This study aimed to analyze these consumer reports. All reports submitted from January 2002 to April 2009 to an open web site in Sweden where anyone could report their experience with the use of pharmaceuticals were analyzed with focus on common psychiatric side effects related to antidepressant usage. More than one ADR for a specific drug could be reported. In total 665 reports were made during the period. 442 reports concerned antidepressant medications and the individual antidepressant reports represented 2392 ADRs and 878 (37%) of these were psychiatric ADRs. 75% of the individual reports concerned serotonin-reuptake inhibitor (SSRI) and the rest serotonin-norepinephrine reuptake inhibitor (SNRI). Women reported more antidepressant psychiatric ADRs (71%) compared to men (24%). More potentially serious psychiatric ADRs were frequently reported to KILEN and withdrawal symptoms during discontinuation were also reported as a common issue. The present study indicates that consumer reports may contribute with important information regarding more serious psychiatric ADRs following antidepressant treatment. Consumer reporting may be considered a complement to traditional ADR reporting.

  6. A Qualitative Study on the Practice of Yoga for Women with Pain-Associated Endometriosis.

    Science.gov (United States)

    Gonçalves, Andrea Vasconcelos; Makuch, Maria Y; Setubal, Maria Silvia; Barros, Nelson Filice; Bahamondes, Luis

    2016-12-01

    To understand the meaning women with pain-associated endometriosis attribute to yoga practice regarding their physical and emotional state at the beginning of the practice; pain management by integrating body and mind; secondary benefits of the practice of yoga, such as self-knowledge, self-care, and autonomy; and the role of the yoga group as psychosocial support. Qualitative study conducted simultaneously with a randomized clinical trial. Public university hospital in southeastern Brazil between August 2013 and December 2014. Fifteen women with pain-associated endometriosis who practiced yoga for 8 weeks. After completing the twice-a-week program, all women participated in a single, semi-structured interview. Interviews were recorded and transcribed verbatim, and thematic analyses were performed. The main themes of analysis were women's expectations regarding the practice of yoga, physical and emotional state of women at the beginning of yoga practice, control and pain management through the integration of body and mind, secondary benefits, acquisition of self-knowledge and autonomy, and the role of yoga group as psychosocial support. All participants reported that yoga was beneficial to control pelvic pain. They related that they were aware of the integration of body and psyche during yoga practice and that this helped in the management of pain. Women said they had identified a relationship between pain management and breathing techniques (pranayama) learned in yoga and that breathing increased their ability to be introspective, which relieved pain. The participants have developed greater self-knowledge, autonomy, and self-care and have reduced the use of pain and psychiatric medications. They created ties among themselves, suggesting that the yoga group allowed psychosocial support. Bodily and psychosocial mechanisms to control pain were identified in women with endometriosis. To reach such control, it is crucial that mind and body integrative techniques are

  7. Proposed changes to the American Psychiatric Association diagnostic criteria for autism spectrum disorder: implications for young children and their families.

    Science.gov (United States)

    Grant, Roy; Nozyce, Molly

    2013-05-01

    The American Psychiatric Association has revised the diagnostic criteria for their DSM-5 manual. Important changes have been made to the diagnosis of the current (DSM-IV) category of Pervasive Developmental Disorders. This category includes Autistic Disorder (autism), Asperger's Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM-5 deletes Asperger's Disorder and PDD-NOS as diagnostic entities. This change may have unintended consequences, including the possibility that the new diagnostic framework will adversely affect access to developmental interventions under Individuals with Disabilities Education Act (IDEA) programs, Early Intervention (for birth to 2 years olds) and preschool special education (for 3 and 4 years olds). Changing the current diagnosis of PDD-NOS to a "Social Communication Disorder" focused on language pragmatics in the DSM-5 may restrict eligibility for IDEA programs and limit the scope of services for affected children. Young children who meet current criteria for PDD-NOS require more intensive and multi-disciplinary services than would be available with a communication domain diagnosis and possible service authorization limited to speech-language therapy. Intensive behavioral interventions, inclusive group setting placements, and family support services are typically more available for children with an autism spectrum disorder than with diagnoses reflecting speech-language delay. The diagnostic distinction reflective of the higher language and social functioning between Asperger's Disorder and autism is also undermined by eliminating the former as a categorical diagnosis and subsuming it under autism. This change may adversely affect treatment planning and misinform parents about prognosis for children who meet current criteria for Asperger's Disorder.

  8. State dependent gene-environment interaction: serotonin transporter gene-child abuse interaction associated with suicide attempt history among depressed psychiatric inpatients.

    Science.gov (United States)

    Shinozaki, Gen; Romanowicz, Magdalena; Passov, Victoria; Rundell, James; Mrazek, David; Kung, Simon

    2013-05-01

    The serotonin transporter gene polymorphism (5HTTLPR) and child abuse history have been associated with an increased suicide risk for general population, but such association is not clear among psychiatric depressed inpatients. A chart review identified 422 depressed inpatients genotyped for 5HTTLPR. Child abuse and suicide attempt history were recorded. The relationship between 5HTTLPR, child abuse, and suicide attempts were analyzed. There was a significant relationship between 5HTTLPR and history of suicide attempt (the long/long versus the short carriers, 47.9% versus 31.8%, p=0.0015). There was also a significant main effect from child abuse history (abused versus not abused, 45.1% versus 28.6%, p=0.0001). The likelihood ratio test showed a significant result for the l/l genotype group with child abuse history (odds ratio 4.11, χ2 = 23.5, pchild abuse history and suicide attempt history is needed. The rs25531 variant among a long allele (long-A and long-G) of 5HTTLPR was not genotyped. In addition to the direct effect from 5HTTLPR and child abuse history, an interaction between the 5HTTLPR gene and child abuse history influenced psychiatric profiles of depressed inpatients. Contrary to the widely recognized "reactivity" associated with the short allele, our patients with the l/l genotype and child abuse history showed significantly severer psychiatric pathology than short carriers with child abuse history. Published by Elsevier B.V.

  9. The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry.

    Science.gov (United States)

    Gandré, Coralie; Gervaix, Jeanne; Thillard, Julien; Macé, Jean-Marc; Roelandt, Jean-Luc; Chevreul, Karine

    2017-03-21

    International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients', psychiatric sectors' and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients' characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

  10. Undertreatment of human immunodeficiency virus in psychiatric inpatients: a cross-sectional study of seroprevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Gonzalez-Torres MA

    2015-06-01

    Full Text Available Miguel Angel Gonzalez-Torres,1,2 Miguel Angel Salazar,3 Manuel Imaz,4 Lucía Inchausti,1,2 Berta Ibañez,5 Aranzazu Fernandez-Rivas,1,2 Javier Pastor,3 Bosco Anguiano,3 Pedro Muñoz,3 Eduardo Ruiz,1,2 Rodrigo Oraa,3 Sonia Bustamante,1,2 Sofia Alvarez de Eulate,2 Ramón Cisterna4,61Department of Neuroscience, University of the Basque Country, 2Psychiatry Service, Basurto University Hospital, Bilbao, 3Mental Health Network of Biscay, Basque Health Service, Biscay, 4Microbiology Service, Basurto University Hospital, Bilbao, 5Navarra Biomed-Miguel Servet Foundation, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC, Pamplona, 6Department of Microbiology, University of the Basque Country, Bilbao, SpainBackground: The aims of this study were to evaluate the prevalence of HIV and its associated demographic and clinical factors among psychiatric inpatients of a general hospital.Methods: This was a single-center, observational, cross-sectional study that included patients consecutively admitted to our unit aged 16 years or older and with no relevant cognitive problems. The patients were evaluated using a semistructured interview and an appropriate test for HIV infection.Results: Of the 637 patients who were screened, 546 (86% who consented to participate were included in the analyses. Twenty-five (4.6%, 95% confidence interval [CI] 3.0–6.8 patients were HIV-positive. The prevalence was higher among patients with substance misuse (17.4%, 95% CI 9.7–28.8. All except one of the 25 patients knew of their seropositive condition prior to participation in the study. Only 14 (56% of the 25 seropositive patients had previously received pharmacological treatment for their infection. According to the multiple logistic regression analysis, the likelihood of HIV infection was lower in patients with higher levels of education and higher among patients who were single, had history of intravenous drug use, and had an HIV

  11. Self-reported symptoms of attention-deficit/hyperactivity disorder: rate of endorsement and association with neuropsychological performance in an adult psychiatric sample.

    Science.gov (United States)

    Schneider, Brooke C; Thoering, Teresa; Cludius, Barbara; Moritz, Steffen

    2015-05-01

    The lack of specificity of attention-deficit/hyperactivity disorder (ADHD) symptoms represents a diagnostic challenge, especially when assessing psychiatric patients reporting a wide range of complaints. Rate of endorsement of ADHD symptoms, and their association with neuropsychological performance, was examined in a psychiatric sample of 71 adults, who had been referred for a neuropsychological evaluation. Patients completed two self-report measures of ADHD symptoms, the ADHD Self-Report Scale (ADHD-SR) and the Wender Utah Rating Scale-Short Form, as well as measures of attention, executive functioning, visuoconstructional ability, and verbal learning and memory. On the ADHD-SR, 74.6% of the sample met the cutoff for inattention or hyperactivity, while 81.7% met the cutoff for impulsivity. Neuropsychological performance was weakly associated with self-reported symptoms. Our results suggest that psychiatric patients commonly report symptoms of inattention, hyperactivity, and impulsivity. Assessment utilizing multiple sources is necessary to confirm whether self-reported symptoms are indicative of ADHD or reflect other causes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Stimulation-Induced Transient Nonmotor Psychiatric Symptoms following Subthalamic Deep Brain Stimulation in Patients with Parkinson's Disease: Association with Clinical Outcomes and Neuroanatomical Correlates.

    Science.gov (United States)

    Abulseoud, Osama A; Kasasbeh, Aimen; Min, Hoon-Ki; Fields, Julie A; Tye, Susannah J; Goerss, Stephan; Knight, Emily J; Sampson, Shirlene M; Klassen, Bryan T; Matsumoto, Joseph Y; Stoppel, Cynthia; Lee, Kendall H; Frye, Mark A

    2016-01-01

    The clinical and neurobiological underpinnings of transient nonmotor (TNM) psychiatric symptoms during the optimization of stimulation parameters in the course of subthalamic nucleus deep brain stimulation (STN-DBS) remain under intense investigation. Forty-nine patients with refractory Parkinson's disease underwent bilateral STN-DBS implants and were enrolled in a 24-week prospective, naturalistic follow-up study. Patients who exhibited TNM psychiatric manifestations during DBS parameter optimization were evaluated for potential associations with clinical outcome measures. Twenty-nine TNM+ episodes were reported by 15 patients. No differences between TNM+ and TNM- groups were found in motor outcome. However, unlike the TNM- group, TNM+ patients did not report improvement in subsyndromal depression or quality of life. TNM+ episodes were more likely to emerge during bilateral monopolar stimulation of the medial STN. The occurrence of TNM psychiatric symptoms during optimization of stimulation parameters was associated with the persistence of subsyndromal depression and with lower quality of life ratings at 6 months. The neurobiological underpinnings of TNM symptoms are investigated yet remain difficult to explain. © 2016 S. Karger AG, Basel.

  13. Stimulation-Induced Transient Non-Motor Psychiatric Symptoms Following Subthalamic Deep Brain Stimulation in Patients with Parkinson’s Disease: Association with Clinical Outcomes and Neuroanatomical Correlates

    Science.gov (United States)

    Abulseoud, Osama A.; Kasasbeh, Aimen; Min, Hoon-Ki; Fields, Julie A.; Tye, Susannah J.; Goerss, Stephan; Knight, Emily J.; Sampson, Shirlene M.; Klassen, Bryan T.; Matsumoto, Joseph Y.; Stoppel, Cynthia; Lee, Kendall H.; Frye, Mark A.

    2016-01-01

    Background The clinical and neurobiological underpinnings of transient non-motor (TNM) psychiatric symptoms during the optimization of stimulation parameters in the course of STN-DBS remain under intense investigation. Methods Forty-nine patients with refractory PD underwent bilateral STN-DBS implants and were enrolled in a 24-week prospective, naturalistic follow-up study. Patients who exhibited transient non-motor (TNM) psychiatric manifestations during DBS parameter optimization were evaluated for potential associations with clinical outcome measures. Results Twenty nine TNM(+) episodes were reported by 15 patients. No differences between TNM(+) and TNM(−) groups were found in motor outcome. However, unlike the TNM(−) group, TNM(+) patients did not report improvement in subsyndromal depression or quality of life. TNM(+) episodes were more likely to emerge during bilateral monopolar stimulation of the medial STN. Conclusions The occurrence of TNM psychiatric symptoms during optimization of stimulation parameters was associated with the persistence of subsyndromal depression and with lower quality of life ratings at 6 months. The neurobiological underpinnings of TNM are investigated yet remain difficult to explain. PMID:27093641

  14. General dentist characteristics associated with rural practice location.

    Science.gov (United States)

    McKernan, Susan C; Kuthy, Raymond A; Kavand, Golnaz

    2013-08-01

    To examine whether there is a difference in the likelihood that a general dentist practices in a rural location based on individual characteristics, including dental school attended, birth state, practice arrangement, sex, and age. All private practice, general dentists in Iowa were included in this study. Data were extracted from the year 2010 version of the Iowa Dentist Tracking System, which monitors practice patterns of active dentists. Rurality of primary office location, categorized using Rural-Urban Commuting Area codes, served as the outcome variable. Chi-square tests and multivariable logistic regression were used to explain associations between rural practice location and dentist characteristics. Fifteen percent of the state's population resided in isolated small rural towns, but only 8% of general dentists practiced here. Approximately 17% of dentists in isolated small rural towns were age 40 or younger, compared to 32% of dentists in urban areas. Among male dentists, those who were born in Iowa (P = .002) were older (P = .020), and graduated from dental schools other than the University of Iowa (P = .009) were more likely to practice in rural areas than were their counterparts. Conversely, among female dentists, solo practice (P = .016) was the only variable significantly associated with rural practice location. The dentist workforce in rural areas of Iowa is dominated by older males who were born in Iowa. As this generation retires and increasing numbers of women enter the profession, state policy makers and planners will need to monitor changing trends in the rural workforce. © 2013 National Rural Health Association.

  15. Prevalence of premarital sexual practice and associated factors ...

    African Journals Online (AJOL)

    Prevalence of premarital sexual practice and associated factors among undergraduate health science students of Madawalabu University, Bale Goba, South ... at the university to bring behavior change among the students in order to detain the usual consequences of premarital sexual practices and risky sexual behavior ...

  16. Infant milk feeding practices in the Netherlands and associated factors

    NARCIS (Netherlands)

    Lanting, C.I.; Wouwe, J.P. van; Reijneveld, S.A.

    2005-01-01

    Aim: The aim of the study was to describe infant feeding practices and associated factors, and to explore mothers' main reasons for starting and stopping breastfeeding. Methods: We performed a national inquiry into milk feeding practices among 9133 Dutch infants aged <7 mo by means of a

  17. Psychiatric comorbidity and cognitive profile in children with narcolepsy with or without association to the H1N1 influenza vaccination.

    Science.gov (United States)

    Szakács, Attila; Hallböök, Tove; Tideman, Pontus; Darin, Niklas; Wentz, Elisabet

    2015-04-01

    -scale IQ compared to those without. Our study indicates increased psychiatric comorbidity in children and adolescents with narcolepsy. The identified cognitive profile with significantly lower verbal comprehension and working memory compared with the normal mean index could have important implications for social relations and schooling. The small numbers of patients with nPHV narcolepsy make it difficult to draw firm conclusions about the possible differences between the two groups of patients. © 2015 Associated Professional Sleep Societies, LLC.

  18. Relationship between occupational stress and depression among psychiatric nurses in Japan.

    Science.gov (United States)

    Yoshizawa, Kaori; Sugawara, Norio; Yasui-Furukori, Norio; Danjo, Kazuma; Furukori, Hanako; Sato, Yasushi; Tomita, Tetsu; Fujii, Akira; Nakagam, Taku; Sasaki, Masahide; Nakamura, Kazuhiko

    2016-01-01

    Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression Scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of these results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions.

  19. [Prevalence and Phenomenology of Psychotic-Like Symptoms in Borderline Personality Disorders - Associations with Suicide Attempts and Use of Psychiatric Inpatient Treatment].

    Science.gov (United States)

    Schroeder, Katrin; Schätzle, Anja; Kowohl, Pauline; Leske, Lisa; Huber, Christian G; Schäfer, Ingo

    2018-01-19

    Psychotic-like symptoms are found in a subgroup of borderline patients (BPD). Reported prevalence is heterogeneous (up to 50% affected). Investigations in Germany have not been conducted so far. Furthermore, the precise phenomenology of the psychotic symptoms and the effects on suicidal behavior and the use of inpatient psychiatric treatment are unclear. The aim of the study was to investigate prevalence rates and phenomenology of psychotic-like symptoms. Associations between the latter and suicidality as well as the use of inpatient psychiatric treatment were examined. Further influencing factors were taking into account. Psychotic-like symptoms were assessed with the Structured Clinical Interview-I in 95 BPD patients. To investigate the associations between psychotic-like symptoms and suicidality as well as the use of inpatient psychiatric treatment, correlation and regression analyzes were calculated, considering severity of PTSD, BPD and depression. 36% of the patients reported alterations of perception and 21% delusions, both multiform and long lasting. The number of suicide attempts was associated with delusions, alterations of perception and severity of PTSD, BPS, and depression. Only delusions and severity of PTSD explained together 25.8% of the variance for the prediction of the number of suicide attempts. Age of initial hospitalization showed fewer and number of hospitalizations no associations at all. Psychotic-like symptoms should not be trivialized, which may happen by using terms such as pseudo-hallucinations or transient paranoid ideas, and may be particularly associated with suicidal tendencies complicating the clinical course. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Borderline intellectual functioning is associated with poor social functioning, increased rates of psychiatric diagnosis and drug use--a cross sectional population based study.

    Science.gov (United States)

    Gigi, Karny; Werbeloff, Nomi; Goldberg, Shira; Portuguese, Shirly; Reichenberg, Abraham; Fruchter, Eyal; Weiser, Mark

    2014-11-01

    Borderline intellectual functioning is defined by the DSM IV as an IQ range that is between one to two standard deviations below the mean (71borderline intellectual functioning is associated with various mental disorders, problems in everyday functioning, social disability and poor academic or occupational achievement. Using data from the Israeli military, we retrieved the social and clinical characteristics of 76,962 adolescents with borderline intellectual functioning and compared their social functioning, psychiatric diagnoses and drug abuse with those of 96,580 adolescents with average IQ (± 0.25 SD from population mean). The results demonstrated that the borderline intellectual functioning group had higher rates of poor social functioning compared to the control group (OR=1.9, 95% CI=1.85-1.94). Individuals with borderline intellectual functioning were 2.37 times more likely to have a psychiatric diagnosis (95% CI=2.30-2.45) and 1.2 times more likely to use drugs (95% CI=1.07-0.35) than those with average IQ. These results suggest that adolescents with borderline intellectual functioning are more likely to suffer from psychiatric disorders, poor social functioning and drug abuse than those with average intelligence, and that borderline intellectual functioning is a marker of vulnerability to these poor outcomes. Copyright © 2014. Published by Elsevier B.V.

  1. Atopic dermatitis is associated with anxiety, depression, and suicidal ideation, but not with psychiatric hospitalization or suicide

    DEFF Research Database (Denmark)

    Thyssen, J P; Hamann, C R; Linneberg, A

    2017-01-01

    of hospitalization and suicide. METHODS: We utilized questionnaire data from a large general population study with data on social habits and psychiatric symptoms to compare prevalences of depression, anxiety, suicidal ideation, and anxiety attacks, in adults with and without a history of AD. Additionally, we used...... and anxiety more often than non-AD subjects, and had an increased prevalence of suicidal ideation and depressive symptoms. In the health registry study, moderate-severe AD patients had increased risk of antidepressant and anxiolytic medication use, while patients with mild AD only had increased risk...... of anxiolytic medication use. There was no increased risk of hospitalization or outpatient contacts due to depression or anxiety, or risk of suicide in AD patients. CONCLUSIONS: Depression, anxiety, and suicidal ideation are more common among AD individuals, but do not lead to psychiatric consultations...

  2. Transformational leadership practices of nurse leaders in professional nursing associations.

    Science.gov (United States)

    Ross, Erin J; Fitzpatrick, Joyce J; Click, Elizabeth R; Krouse, Helene J; Clavelle, Joanne T

    2014-04-01

    This study describes the transformational leadership (TL) practices of nurse leaders in professional nursing associations (PNAs). Professional nursing associations are vehicles to provide educational opportunities for nurses as well as leadership opportunities for members. Little has been published about the leadership practices of PNA members. E-mail surveys of 448 nurse leaders in PNAs were conducted in 2013 using the Leadership Practices Inventory (LPI). The top 2 TL practices of these nurse leaders were enabling others to act and encouraging the heart. Respondents with more leadership training reported higher TL practices. This is the 1st study to describe TL practices of nurse leaders in PNAs. Results of this study show that nurse leaders of PNAs emulate practices of TL. Transformational leaders can mobilize and direct association members in reaching shared values, objectives, and outcomes. Understanding TL practices of nurse leaders in PNAs are important to the future of nursing in order to enable nurses to lead change and advance health through these organizations.

  3. Association of Breakfast Intake with Psychiatric Distress and Violent Behaviors in Iranian Children and Adolescents: The CASPIAN- IV Study.

    Science.gov (United States)

    Ahadi, Zeinab; Kelishadi, Roya; Qorbani, Mostafa; Zahedi, Hoda; Aram, Mahtab; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Shafiee, Gita; Arzaghi, Seyed Masoud; Asayesh, Hamid; Heshmat, Ramin

    2016-09-01

    To assess the relationship of breakfast intake with psychiatric distress and violent behaviors among Iranian children and adolescents. This national survey was conducted among 14,880 students, aged 6-18 y. They were selected by stratified multistage sampling method from urban and rural areas of 30 provinces of Iran. Breakfast intake, psychiatric distress, and violent behaviors were assessed by a questionnaire prepared based on the Global school-based student health survey of the World Health Organization. The data were analyzed by the STATA package. The participation rate was 90.6 %. The percentage of psychiatric distress among breakfast skippers, semi-skippers and non-skippers was 13.4-50.4, 10.1-41.9, and 7.0-33.3 % respectively. The prevalence of psychiatric distress was significantly higher among breakfast skippers than semi-skippers and non-skippers (P value breakfast skippers to non-skippers. The prevalence of violent behaviors was significantly higher among breakfast skippers than non-skippers. Students who skipped breakfast reported to be more victimized (29.2 % vs. 26.7 %, respectively, P = 0.04), bullied (21.0 % vs. 16.2 %, respectively, P breakfast were less likely to experience mental health disorders and violent behavior. Adhering to a regular and balanced diet, besides the awareness of parents on the importance of breakfast eating, may be an appropriate approach for preventing mental health problems and violent behavior in children and adolescents.

  4. Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana

    OpenAIRE

    Paramita Sengupta; Anoop I Benjamin

    2015-01-01

    Background: Depression, the most common psychiatric disorder among the elderly, is not yet perceived as an important health problem in India, where few population-based studies have addressed this problem. Objectives: To estimate the prevalence of depression and identify the associated risk factors in the elderly population. Materials and Methods: 3038 consenting elderly (>60 years old) rural and urban residents of both sexes from the field practice areas were interviewed and examined in a cr...

  5. Psychiatric hospital treatment of children with autism and serious behavioral disturbance.

    Science.gov (United States)

    Siegel, Matthew; Gabriels, Robin L

    2014-01-01

    Children with autism spectrum disorder are psychiatrically hospitalized much more frequently than children in the general population. Hospitalization occurs primarily because of externalizing behaviors and is associated with behavioral disturbance, impaired emotion regulation, and psychiatric comorbidity. Additionally, a lack of practitioner and/or administrator training and experience with this population poses risks for denial of care by third-party payers or treatment facilities, inadequate treatment, extended lengths of stay, and poor outcomes. Evidence and best practices for the inpatient psychiatric care of this population are presented. Specialized treatment programs universally rely on multidisciplinary approaches, including behaviorally informed interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The PsyCoLaus study: methodology and characteristics of the sample of a population-based survey on psychiatric disorders and their association with genetic and cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Middleton Lefkos

    2009-03-01

    Full Text Available Abstract Background The Psychiatric arm of the population-based CoLaus study (PsyCoLaus is designed to: 1 establish the prevalence of threshold and subthreshold psychiatric syndromes in the 35 to 66 year-old population of the city of Lausanne (Switzerland; 2 test the validity of postulated definitions for subthreshold mood and anxiety syndromes; 3 determine the associations between psychiatric disorders, personality traits and cardiovascular diseases (CVD, 4 identify genetic variants that can modify the risk for psychiatric disorders and determine whether genetic risk factors are shared between psychiatric disorders and CVD. This paper presents the method as well as sociodemographic and somatic characteristics of the sample. Methods All 35 to 66 year-old persons previously selected for the population-based CoLaus survey on risk factors for CVD were asked to participate in a substudy assessing psychiatric conditions. This investigation included the Diagnostic Interview for Genetic Studies to elicit diagnostic criteria for threshold disorders according to DSM-IV and algorithmically defined subthreshold syndromes. Complementary information was collected on potential risk and protective factors for psychiatric disorders, migraine and on the morbidity of first-degree relatives, whereas the collection of DNA and plasma samples was already part of the original CoLaus survey. Results A total of 3,691 individuals completed the psychiatric evaluation (67% participation. The gender distribution of the sample did not differ significantly from that of the general population in the same age range. Although the youngest 5-year band of the cohort was underrepresented and the oldest 5-year band overrepresented, participants of PsyCoLaus and individuals who refused to participate revealed comparable scores on the General Health Questionnaire, a self-rating instrument completed at the somatic exam. Conclusion Despite limitations resulting from the relatively low

  7. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    Science.gov (United States)

    Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. Main outcome measures Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. Results The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. Conclusion There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others. PMID:27259522

  8. Associations between DSM-5 section III personality traits and the Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scales in a psychiatric patient sample.

    Science.gov (United States)

    Anderson, Jaime L; Sellbom, Martin; Ayearst, Lindsay; Quilty, Lena C; Chmielewski, Michael; Bagby, R Michael

    2015-09-01

    Our aim in the current study was to evaluate the convergence between Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Section III dimensional personality traits, as operationalized via the Personality Inventory for DSM-5 (PID-5), and Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scale scores in a psychiatric patient sample. We used a sample of 346 (171 men, 175 women) patients who were recruited through a university-affiliated psychiatric facility in Toronto, Canada. We estimated zero-order correlations between the PID-5 and MMPI-2-RF substantive scale scores, as well as a series of exploratory structural equation modeling (ESEM) analyses to examine how these scales converged in multivariate latent space. Results generally showed empirical convergence between the scales of these two measures that were thematically meaningful and in accordance with conceptual expectations. Correlation analyses showed significant associations between conceptually expected scales, and the highest associations tended to be between scales that were theoretically related. ESEM analyses generated evidence for distinct internalizing, externalizing, and psychoticism factors across all analyses. These findings indicate convergence between these two measures and help further elucidate the associations between dysfunctional personality traits and general psychopathology. (c) 2015 APA, all rights reserved.

  9. Web-based support for daily functioning of people with mild intellectual disabilities or chronic psychiatric disorders: A feasibility study in routine practice

    Directory of Open Access Journals (Sweden)

    Jessica de Wit

    2015-05-01

    Conclusion: The initial results of the use of web-based support for this client population seem promising and justify further research on online support for clients with mild intellectual disabilities or chronic psychiatric disorders.

  10. Truncating mutations in SPAST patients are associated with a high rate of psychiatric comorbidities in hereditary spastic paraplegia.

    Science.gov (United States)

    Chelban, Viorica; Tucci, Arianna; Lynch, David S; Polke, James M; Santos, Liana; Jonvik, Hallgeir; Groppa, Stanislav; Wood, Nicholas W; Houlden, Henry

    2017-08-01

    The hereditary spastic paraplegias (HSPs) are a rare and heterogeneous group of neurodegenerative disorders that are clinically characterised by progressive lower limb spasticity. They are classified as either 'pure' or 'complex' where spastic paraplegia is complicated with additional neurological features. Mutations in the spastin gene (SPAST) are the most common cause of HSP and typically present with a pure form. We assessed in detail the phenotypic and genetic spectrum of SPAST-related HSP focused on 118 patients carrying SPAST mutations. This study, one of the largest cohorts of genetically confirmed spastin patients to date, contributes with the discovery of a significant number of novel SPAST mutations. Our data reveal a high rate of complex cases (25%), with psychiatric disorders among the most common comorbidity (10% of all SPASTpatients). Further, we identify a genotype-phenotype correlation between patients carrying loss-of-function mutations in SPAST and the presence of psychiatric disorders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Transient Impact of Rituximab in H1N1 Vaccination-associated Narcolepsy With Severe Psychiatric Symptoms.

    Science.gov (United States)

    Sarkanen, Tomi; Alén, Reija; Partinen, Markku

    2016-09-01

    Narcolepsy type 1 is an organic sleep disorder caused by the destruction of hypocretin producing neurons in hypothalamus. In addition to daytime sleepiness, the spectrum and severity of symptoms are very variable. Psychiatric comorbidity and phenomena resembling psychotic symptoms are also common. Current treatment options for narcolepsy are symptomatic but there are few case reports of positive effect of immunotherapy. We report a very severely affected young boy treated with rituximab (RXB). A 12-year-old boy developed narcolepsy after Pandemrix H1N1 vaccination in 2010. He started to express severe psychiatric symptoms shortly after the onset. Cataplexy and sleepiness were devastatingly disabling. Conventional treatments did not have any effect on symptoms so we decided to try RXB, chimeric human monoclonal antibody against CD20 expressed in B lymphocytes. After the first treatment his condition ameliorated dramatically. Unfortunately, the effect lasted only for 2 months. Following attempts did not show any effect. Effect of RXB on narcolepsy has not been reported before. Remarkable but short-lasting effect of RXB in narcolepsy is intriguing as it could imply that there is still ongoing B cell-mediated autoimmune response possible contributing to symptoms in narcolepsy.

  12. Is exposure to domestic violence and violent crime associated with bullying behaviour among underage adolescent psychiatric inpatients?

    Science.gov (United States)

    Mustanoja, Susanna; Luukkonen, Anu-Helmi; Hakko, Helinä; Räsänen, Pirkko; Säävälä, Hannu; Riala, Kaisa

    2011-08-01

    We examined the relationship of exposure to domestic violence and violence occurring outside home to bullying behaviour in a sample (508; 40.9% males, 59.1% females) of underage psychiatric inpatient adolescents. Participants were interviewed using K-SADS-PL to assess DSM-IV psychiatric diagnoses and to gather information about domestic and other violence and bullying behaviour. Witnessing interparental violence increased the risk of being a victim of bullying up to 2.5-fold among boys. For girls, being a victim of a violent crime was an over 10-fold risk factor for being a bully-victim. Gender differences were seen in witnessing of a violent crime; girls were more likely to be bullies than boys. Further, as regards being a victim of a violent crime outside home and physical abuse by parents at home, girls were significantly more often bully-victims than boys. When interfering and preventing bullying behaviour, it is important to screen adolescents' earlier experiences of violence.

  13. Exploring the perceptions of psychiatric patients regarding ...

    African Journals Online (AJOL)

    2012-03-13

    Mar 13, 2012 ... recommendations for nursing education, nursing research and nursing practice, with the aim of reducing the readmission of ... impairment of memory, concentration, motivation, self- esteem, relationships with others and ..... at increasing nursing students' and psychiatric nurses' insight about psychiatric ...

  14. Exploring the perceptions of psychiatric patients regarding ...

    African Journals Online (AJOL)

    The purpose of this study was to explore and describe the perceptions of psychiatric patients with regard to marijuana use in Potchefstroom, North West Province, as well as to formulate recommendations for nursing education, nursing research and nursing practice, with the aim of reducing the readmission of psychiatric ...

  15. One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Pikalov Andrei

    2011-01-01

    Full Text Available Abstract Background This study compared 1-year risk of psychiatric hospitalization and treatment costs in commercially insured patients with bipolar disorder, treated with aripiprazole, ziprasidone, olanzapine, quetiapine or risperidone. Methods This was a retrospective propensity score-matched cohort study using the Ingenix Lab/Rx integrated insurance claims dataset. Patients with bipolar disorder and 180 days of pre-index enrollment without antipsychotic exposure who received atypical antipsychotic agents were followed for up to 12 months following the initial antipsychotic prescription. The primary analysis used Cox proportional hazards regression to evaluate time-dependent risk of hospitalization, adjusting for age, sex and pre-index hospitalization. Generalized gamma regression compared post-index costs between treatment groups. Results Compared to aripiprazole, ziprasidone, olanzapine and quetiapine had higher risks for hospitalization (hazard ratio 1.96, 1.55 and 1.56, respectively; p Conclusions In commercially insured adults with bipolar disorder followed for 1 year after initiation of atypical antipsychotics, treatment with aripiprazole was associated with a lower risk of psychiatric hospitalization than ziprasidone, quetiapine, olanzapine and risperidone, although this did not reach significance with the latter. Aripiprazole was also associated with significantly lower total healthcare costs than quetiapine, but not the other comparators.

  16. Association of codon 108/158 catechol-O-methyltransferase gene polymorphism with the psychiatric manifestations of velo-cardio-facial syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lachman, H.M.; Papolos, D.F.; Veit, S. [Albert Einstein College of Medicine, Bronx, NY (United States)] [and others

    1996-09-20

    Velo-cardio-facial-syndrome (VCFS) is a common congenital disorder associated with typical facial appearance, cleft palate, cardiac defects, and learning disabilities. The majority of patients have an interstitial deletion on chromosome 22q11. In addition to physical abnormalities, a variety of psychiatric illnesses have been reported in patients with VCFS, including schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder. The psychiatric manifestations of VCFS could be due to haploinsufficiency of a gene(s) within 22q11. One candidate that has been mapped to this region is catechol-O-methyltransferase (COMT). We recently identified a polymorphism in the COMT gene that leads to a valine{r_arrow}methionine substitution at amino acid 158 of the membrane-bound form of the enzyme. Homozygosity for COMT158{sup met} leads to a 3- to 4-fold reduction in enzymatic activity, compared with homozygotes for COMT158{sup met}. We now report that in a population of patients with VCFS, there is an apparent association between the low-activity allele, COMT158{sup met}, and the development of bipolar spectrum disorder, and in particular, a rapid-cycling form. 33 refs., 3 tabs.

  17. Sexual practice associated with knowledge in adolescents in ninth grade.

    Science.gov (United States)

    Lauszus, Finn Friis; Nielsen, Jacob Lauesgaard; Boelskifte, Jane; Falk, Jørgen

    2012-07-01

    The aim of the present study was to reveal any association of sexual practice with knowledge about sex education, reproductive physiology and abortion. The study was performed in a non-intervention setting to minimize information bias. A cross-sectional questionnaire was handed out without prior notice to all ninth grade pupils in the Municipality of Viborg, Denmark, in 2007. We found that sexual debut was associated with a greater probability of knowing that chlamydia is the most common sexually transmitted infection (STI). Knowledge of chlamydia was strongly associated with knowledge about the first symptom of pregnancy. A high general level of knowledge of STI was associated with the father being the source of the knowledge among pupils who had not yet had their sexual debut (p sexual knowledge and practice is a fact. The discrepancy, however, varies according to sexual experience, gender and whether the respondent's actual behaviour aimed at avoiding unwanted pregnancy or STI.

  18. Profile of children placed in residential psychiatric program: Association with delinquency, involuntary mental health commitment, and reentry into care.

    Science.gov (United States)

    Yampolskaya, Svetlana; Mowery, Debra; Dollard, Norín

    2014-05-01

    This study examined characteristics and profiles of youth receiving services in 1 of Florida's Medicaid-funded residential mental health treatment programs--State Inpatient Psychiatric Program (SIPP)--between July 1, 2004, and June 30, 2008 (N=1,432). Latent class analysis (LCA) was used to classify youth, and 3 classes were identified: Children With Multiple Needs, Children With No Caregivers, and Abused Children With Substantial Maltreatment History. The results of LCA showed that Children With Multiple Needs experienced the greatest risk for adverse outcomes. Compared with youth in the other 2 classes, these children were more likely to get readmitted to SIPP, more likely to become involved with the juvenile justice system, and more likely to experience involuntary mental health assessments. Implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

  19. Past and future American Psychological Association guidelines for statistical practice

    NARCIS (Netherlands)

    Finch, S; Thomason, N; Cumming, G

    2002-01-01

    We review the publication guidelines of the American Psychological Association (APA) since 1929 and document their advice for authors about statistical practice. Although the advice has been extended with each revision of the guidelines, it has largely focused on null hypothesis significance testing

  20. Independent practice associations and physician-hospital organizations can improve care management for smaller practices.

    Science.gov (United States)

    Casalino, Lawrence P; Wu, Frances M; Ryan, Andrew M; Copeland, Kennon; Rittenhouse, Diane R; Ramsay, Patricia P; Shortell, Stephen M

    2013-08-01

    Pay-for-performance, public reporting, and accountable care organization programs place pressures on physicians to use health information technology and organized care management processes to improve the care they provide. But physician practices that are not large may lack the resources and size to implement such processes. We used data from a unique national survey of 1,164 practices with fewer than twenty physicians to provide the first information available on the extent to which independent practice associations (IPAs) and physician-hospital organizations (PHOs) might make it possible for these smaller practices to share resources to improve care. Nearly a quarter of the practices participated in an IPA or a PHO that accounted for a significant proportion of their patients. On average, practices participating in these organizations provided nearly three times as many care management processes for patients with chronic conditions as nonparticipating practices did (10.4 versus 3.8). Half of these processes were provided only by IPAs or PHOs. These organizations may provide a way for small and medium-size practices to systematically improve care and participate in accountable care organizations.

  1. Psychiatric screening of admissions to an accident and emergency ward.

    Science.gov (United States)

    Bell, G; Reinstein, D Z; Rajiyah, G; Rosser, R

    1991-04-01

    One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.

  2. Examining the effects of a novel training program and use of psychiatric service dogs for military-related PTSD and associated symptoms.

    Science.gov (United States)

    Kloep, Megan L; Hunter, Richard H; Kertz, Sarah J

    2017-01-01

    This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's Diagnostic and Statistical Manual formulation with implications for treatment

    Directory of Open Access Journals (Sweden)

    Christopher J Andrews

    2017-01-01

    Full Text Available In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a systematic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM. The major neuropsychological consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a DSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

  4. Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's Diagnostic and Statistical Manual formulation with implications for treatment.

    Science.gov (United States)

    Andrews, Christopher J; Reisner, Andrew D; Cooper, Mary Ann

    2017-09-01

    In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a systematic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM). The major neuropsychological consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a DSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

  5. Psychiatric characteristics of homicide defendants.

    Science.gov (United States)

    Martone, Christine A; Mulvey, Edward P; Yang, Suzanne; Nemoianu, Andrei; Shugarman, Ryan; Soliman, Layla

    2013-09-01

    The authors examined the rate of mental disorders in an unselected sample of homicide defendants in a U.S. jurisdiction, seeking to identify psychiatric factors associated with offense characteristics and court outcomes. Defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. Bivariate analyses examined differences by age group and by race, and logistic models examined predictors of multiple victims, firearm use, guilty plea, and guilty verdict. Fifty-eight percent of the sample had at least one axis I or II diagnosis, most often a substance use disorder (47%). Axis I or II diagnoses were more common (78%) among defendants over age 40. Although 37% of the sample had prior psychiatric treatment, only 8% of the defendants with diagnosed axis I disorders had outpatient treatment during the 3 months preceding the homicide; African Americans were less likely than non-African Americans to be in treatment. African American males were more likely to use a firearm and to have a male victim. In exploratory analyses, psychiatric factors did not predict multiple victims, firearm use in the crime, or a guilty verdict. Rates of axis I disorders were lower than reported in previous studies. Few homicide defendants were in psychiatric treatment at the time of the crime, suggesting limited opportunities for prevention by mental health providers.

  6. Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria.

    Science.gov (United States)

    Benjet, Corina; González-Herrera, Irene; Castro-Silva, Everardo; Méndez, Enrique; Borges, Guilherme; Casanova, Leticia; Medina-Mora, Maria Elena

    2017-06-01

    Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Definition and management of suicidality in psychiatric patients.

    Science.gov (United States)

    Fawcett, Jan A; Baldessarini, Ross J; Coryell, William H; Silverman, Morton M; Stein, Dan J

    2009-10-01

    The US Food and Drug Administration warnings that psychotropic medications may increase the risk of suicidality have generated concern about prescribing these agents to patients with psychiatric disorders, many of whom are already at increased risk for suicide. To effectively prevent suicidal behaviors and suicide in clinical practice, clinicians must understand the dangers and benefits associated with psychotropic medications. In addition, they must learn how to identify and manage suicidal risk during treatment. Copyright 2009 Physicians Postgraduate Press, Inc.

  8. History of the Nordic psychiatric cooperation.

    Science.gov (United States)

    von Knorring, Lars

    2012-03-01

    The Nordic countries include Denmark, Finland, Iceland, Norway and Sweden as well the Faroe Islands, Greenland, Svalbard and Åland. The countries share much common history as well as common traits in their respective societies. As early as 1906, a Scandinavian Psychiatric Association was suggested. The first Nordic Psychiatric Congress was held in Copenhagen 1913. After the First World War, at the 6th Nordic Psychiatric Congress in Stockholm 1935, a Nordic Psychiatric Association was founded and it was decided that a Nordic Journal of Psychiatry should be founded. After the Second World War, at the 8th Nordic Psychiatric Congress in Copenhagen 1946, the Nordic Psychiatric Association was terminated. At this time, the most important task of the Association, to found a Nordic Journal of Psychiatry, had been achieved. After 1946, there has been a close cooperation between the Nordic countries but no common Nordic Psychiatric Association. Today, the Nordic Psychiatric Cooperation is active and ongoing. The 30th Nordic Psychiatric Congress is scheduled to be held in Tromsö, in 2012. The Nordic Journal of Psychiatry is publishing its 64 th volume. The Journal is indexed in the important international databases and the impact factor is increasing. The Joint Committee of the Nordic psychiatric associations has established itself as the owner of the Journal and the organizer of the congresses. There are also a series of Nordic cooperations in a series of different fields, such as the Scandinavian Societies of Biological Psychiatry, the Scandinavian College of Neuropsychopharmacology (SCNP), the bi-annual Nordic Psychoanalytical Congresses, the Scandinavian Psychoanalytic Review, the Nordic Association of Psychiatric Epidemiology, NAPE, and so on.

  9. Stigmatization of psychiatric symptoms and psychiatric service use: a vignette-based representative population survey.

    Science.gov (United States)

    Sowislo, Julia F; Lange, Claudia; Euler, Sebastian; Hachtel, Henning; Walter, Marc; Borgwardt, Stefan; Lang, Undine E; Huber, Christian G

    2017-06-01

    Background There is evidence for two different types and/or sources of mental illness stigma, namely the display of psychiatric symptoms and the use of psychiatric service institutions. However, no current study has compared the two. Furthermore, gaps exist in our knowledge of both types of stigma. Little is known about the perceived stigma of specific psychiatric service treatment environments, for instance forensic settings. In addition, systematic research on stigma attached to symptoms of personality disorders in the general population is scarce, and for borderline personality disorder, nonexistent. Methods We conducted a representative survey of the general population (N = 2207) in the canton of Basel-Stadt, Switzerland. Participants were asked to read a vignette depicting either the psychiatric symptoms of a fictitious character or a psychiatric service institution to which the character had been admitted, and indicate desired social distance (an indicator for stigma). Type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied between vignettes. Findings Desired social distance was significantly lower in relation to psychiatric service use than to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and the fictitious character's being male tend to increase stigmatization. Interestingly, the character's being hospitalized in a psychiatric unit at a general hospital and also respondent familiarity with psychiatric services tend to decrease stigmatization. Interpretation Familiarity of the general population with psychiatric patients should be increased. Furthermore, treatment in psychiatric units located within general hospitals should be promoted, as such treatment is associated with decreased stigma.

  10. Psychiatric hospitalisation and suicide among the very old in Denmark

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Mortensen, Preben Bo; Vach, Werner

    2005-01-01

    BACKGROUND: Very old people have higher suicide rates than the younger elderly population. Psychiatric disorders are known to have a strong association with suicide among elderly people. AIMS: To analyse the analyse the suicide risk associated with psychiatric hospitalisation among the very old......: The association between suicide and psychiatric hospitalisation is much weaker for the very old than for the old. Psychiatric disorders among very old people may be interacting with other disorders, may be underdiagnosed or treated in other healthcare settings....

  11. The use of cyproterone acetate in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning

    Directory of Open Access Journals (Sweden)

    Gian Lippi

    2017-03-01

    Full Text Available Background: Cyproterone acetate (CPA is a steroidal anti-androgenic medication used in the field of psychiatry for the treatment of paraphilic disorders, hypersexuality, and inappropriate sexual behaviour which may be present in patients with disorders such as mild and major neurocognitive disorders. In the forensic psychiatric population, it is prescribed for these indications especially for patients with a history of committing a sexual offence or who are at moderate to high risk of recidivism. Objectives: To investigate the use of CPA in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning. Methods: Seventy-six forensic psychiatric patients from Weskoppies Hospital in Pretoria, South Africa, participated in the study which measured their sexual functioning. A specifically designed questionnaire was used to capture relevant background information. The use of CPA was studied. The Changes in Sexual Functioning Questionnaire, Male Clinical Version (CSFQ-M-C was used to measure sexual functioning of participants. The CSFQ-M-C scores, and those of all its subscales, of participants on CPA were compared to those not on the drug. Relevant statistical analyses were performed. Results: Thirteen out of the 76 participants were being treated with CPA (17.11%. In total, 53.85% of the participants on CPA and 65.08% not on CPA had scores indicating the presence of sexual dysfunction. The total CSFQ-M-C scores for participants on CPA (mean = 40.54; median = 42 were not statistically significantly lower than those not on the drug (mean = 41.22; median = 41. More notable is that the use of CPA in this population was associated with lower levels of desire, frequency of and pleasure from sexual activity. There was an association between having intellectual disability and being treated with CPA. Conclusion: That all the participants were being treated with psychotropic medication could account for

  12. [Psychiatric complications of abortion].

    Science.gov (United States)

    Gurpegui, Manuel; Jurado, Dolores

    2009-01-01

    The psychiatric consequences of induced abortion continue to be the object of controversy. The reactions of women when they became aware of conception are very variable. Pregnancy, whether initially intended or unintended, may provoke stress; and miscarriage may bring about feelings of loss and grief reaction. Therefore, induced abortion, with its emotional implications (of relief, shame and guilt) not surprisingly is a stressful adverse life event. METHODOLOGICAL CONSIDERATIONS: There is agreement among researchers on the need to compare the mental health outcomes (or the psychiatric complications) with appropriate groups, including women with unintended pregnancies ending in live births and women with miscarriages. There is also agreement on the need to control for the potential confounding effects of multiple variables: demographic, contextual, personal development, previous or current traumatic experiences, and mental health prior to the obstetric event. Any psychiatric outcome is multi-factorial in origin and the impact of life events depend on how they are perceived, the psychological defence mechanisms (unconscious to a great extent) and the coping style. The fact of voluntarily aborting has an undeniable ethical dimension in which facts and values are interwoven. No research study has found that induced abortion is associated with a better mental health outcome, although the results of some studies are interpreted as or Some general population studies point out significant associations with alcohol or illegal drug dependence, mood disorders (including depression) and some anxiety disorders. Some of these associations have been confirmed, and nuanced, by longitudinal prospective studies which support causal relationships. With the available data, it is advisable to devote efforts to the mental health care of women who have had an induced abortion. Reasons of the woman's mental health by no means can be invoked, on empirical bases, for inducing an abortion.

  13. Suicide among older psychiatric inpatients

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Zarit, Steven H; Tu, Xin

    2006-01-01

    characteristics. RESULTS: Affective disorders were found to be associated with an almost twofold higher risk of suicide among psychiatric inpatients than other types of disorders (95% confidence interval [CI]: 1.5-2.6). Patients with dementia had a significantly lower risk ratio of 0.2 (95% CI: 0......OBJECTIVE: Older adults have elevated suicide rates, especially in the presence of a psychiatric disorder, yet not much is known about predictors for suicide within this high-risk group. The current study examines the characteristics associated with suicide among older adults who are admitted...

  14. Psychiatric Genomics and Mental Health Treatment: Setting the Ethical Agenda.

    Science.gov (United States)

    Kong, Camillia; Dunn, Michael; Parker, Michael

    2017-04-01

    Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health.

  15. Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases.

    Science.gov (United States)

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S

    2013-02-01

    substances producing an addiction status may be assembled in depressants (alcohol, benzodiazepines, opiates), stimulants (cocaine, amphetamines, nicotine, caffeine, modafinil), hallucinogens (mescaline, LSD, ecstasy) and other substances (cannabis, dissociatives, inhalants). Anxiety disorders can occur in intoxication by stimulants, as well as in withdrawal syndrome, both by stimulants and sedatives. Substance induced mood disorders and psychotic symptoms are as much frequent conditions in ED, and the recognition of associated organic symptoms may allow to achieve diagnosis. Finally, psychiatric and organic symptoms may be caused by prescription and doping medications, either as a direct effect or after withdrawal. Adverse drug reactions can be divided in type A, dose dependent and predictable, including psychotropic drugs and hormones; and type B, dose independent and unpredictable, usually including non psychotropic drugs, more commonly included being cardiovascular, antibiotics, anti-inflammatory and antineoplastic medications.

  16. Child psychiatric disorders in a primary care Arab population.

    Science.gov (United States)

    Eapen, Valsamma; Al-Sabosy, Moza; Saeed, Mohammed; Sabri, Sufyan

    2004-01-01

    Physical and psychiatric comorbidity is relatively common in general practice but there have been few systematic studies using clinical interviews of children attending the primary care services in the Arab population, and none from the Gulf countries. This study was undertaken to determine the prevalence and nature of child psychiatric morbidity in primary care in the United Arab Emirates (UAE). Systematic psychiatric evaluations were carried out on consecutive children aged 6 to 18 years visiting their primary care doctors in Al Ain. The sample consisted of 141 (50.7%) boys and 137 (49.3%) girls. Forty-three percent of the 278 children received a DSM-IV diagnosis. Of these, 46 (38%) were males and 74 (62%) were females. However, only 1.1% (3/120) of the patients consulted general practitioners for a primary psychiatric symptom. The most common diagnosis was anxiety disorder followed by depression. Obsessive compulsive disorder was present in 11%, conduct disorder in 7%, and attention deficit hyperactivity disorder in 3% of those with a diagnosis. A statistically significant association was found between DSM-IV caseness and female gender, higher number of children in the household, relationship problems in the family, physical illness and family history of psychiatric disorder. Other factors that did not show any significant association were age, nationality, socioeconomic status, parental education or occupation, scholastic performance or developmental delay in the child, or parental consanguinity. Our findings suggest that psychiatric disorders are common among young people of Arab origin attending primary care facilities, and that doctors need to be vigilant about this possibility.

  17. Social and practical representations in pneumonia associated to ventilation mechanics

    OpenAIRE

    Giovane Mendieta I; Amparo E. Cristancho M

    2009-01-01

    Objective: To identify the practice and social representations of the respiratory therapists, on the strategies of prevention of pneumonia associated to mechanical ventilation, of the unit intensive care of the Kennedy Hospital. Methodology:Qualitative inquiry, descriptive and explanatory character, the population, respiratorys therapist of the unit’s intensives cares, with a sample of captive type for convenience, conformed by seventeen respiratorys therapists who were applied a semistructu...

  18. The association between childhood physical and sexual abuse and functioning and psychiatric symptoms in a sample of U.S. Army soldiers.

    Science.gov (United States)

    Seifert, Abby E; Polusny, Melissa A; Murdoch, Maureen

    2011-02-01

    We examined associations between abusive childhood experiences and functioning and psychiatric symptoms in an active duty sample of U.S. Army soldiers. Cross-sectional survey of 204 soldiers stationed at a southern U.S. Army facility. Forty-six percent of individuals reported childhood physical abuse alone, whereas 25% reported both childhood physical and sexual abuse. Soldiers' work, role, and social functioning; physical functioning; depression severity; and severity of alcohol misuse did not differ significantly with childhood abuse status (p > 0.22 for all). However, individuals who reported both childhood physical and sexual abuse reported severer posttraumatic stress disorder symptoms than did soldiers who reported no childhood abuse or childhood physical abuse only (p = 0.007). Although abusive childhood experiences were common, soldiers with such experiences reported functioning as well as those soldiers without such experiences. Posttraumatic stress disorder symptoms were significantly elevated only in those who reported both childhood physical and sexual abuse.

  19. Psychiatric sequelae of traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Suprakash Chaudhury

    2013-01-01

    Full Text Available Almost half of the people suffering traumatic brain injury (TBI may later be diagnosed with psychiatric disorders. The literature (PubMed, IndMed of past 30 years on psychiatric disturbances associated with TBI is reviewed. The authors highlight the close link between head injury and psychiatry and provide an overview of the epidemiology, risk-factors, and mechanisms of psychiatric sequelae including, cognitive deficits, substance abuse, psychoses, mood disorders, suicide, anxiety disorders, dissociative disorders, post-concussion syndrome, and personality changes following head injury. The various psychiatric sequelae are briefly discussed.

  20. What is the significance of onconeural antibodies for psychiatric symptomatology?

    DEFF Research Database (Denmark)

    Sæther, Sverre Georg; Schou, Morten; Kondziella, Daniel

    2017-01-01

    BACKGROUND: Patients with intracellular onconeural antibodies may present with neuro-psychiatric syndromes. We aimed to evaluate the evidence for an association between well-characterized onconeural antibodies and psychiatric symptoms in patients with and without paraneoplastic central nervous sy...

  1. Utilization of the American Telemedicine Association's Clinical Practice Guidelines

    Science.gov (United States)

    Antoniotti, Nina; Bernard, Jordana

    2013-01-01

    Abstract Background: The American Telemedicine Association (ATA) Standards and Guidelines Committee develops practice standards and guidelines. Key to the Committee's mission is dissemination so the standards can be used in the practice of telemedicine. Over a 2-year period, when a standards document was accessed from the ATA Web site, a short survey was completed, but it did not assess how the documents were used once downloaded. A more formal survey was conducted to determine the impact ATA standards and guidelines are having on healthcare delivery via telemedicine. Materials and Methods: A survey was developed and distributed via SurveyMonkey to 13,177 ATA members and nonmembers in November 2011. Results were compiled and analyzed after a 90-day open period for responses to be submitted. Results: The majority of respondents (96%) believe the practice of telemedicine/telehealth should have standards and guidelines and that the ATA and other professional societies/associations should be responsible for developing them. The top uses of guidelines include guidance for clinical practice, training, gaining reimbursement, and research. Respondents indicating a need for standards and guidelines said the ATA (78.7%) and other professional societies/associations (74.5%) should be responsible for development. When asked to list specific practice guidelines or standards they are using for telehealth, the majority (21.5%) are using in-house (e.g., hospital, company)-developed guidelines, followed by those from professional associations/societies (20.4%) and those developed by the ATA (18.2%). Conclusions: Overall, the survey results indicate guidelines documents developed by the ATA and other professional societies and those developed in-house are being regularly accessed and used in both public and private sectors. Practitioners of telemedicine believe that standards and guidelines are needed for guidance for clinical practice, training, gaining reimbursement, and research

  2. Motor, Psychiatric and Fatigue Features Associated with Nutritional Status and Its Effects on Quality of Life in Parkinson’s Disease Patients

    Science.gov (United States)

    Fereshtehnejad, Seyed-Mohammad; Ghazi, Ladan; Shafieesabet, Mahdiyeh; Shahidi, Gholam Ali; Delbari, Ahmad; Lökk, Johan

    2014-01-01

    Objectives Parkinson’s disease (PD) patients are more likely to develop impaired nutritional status because of the symptoms, medications and complications of the disease. However, little is known about the determinants and consequences of malnutrition in PD. This study aimed to investigate the association of motor, psychiatric and fatigue features with nutritional status as well as the effects of malnutrition on different aspects of quality of life (QoL) in PD patients. Methods One hundred and fifty patients with idiopathic PD (IPD) were recruited in this study. A demographic checklist, the Unified Parkinson’s Disease Rating Scale (UPDRS), the Hospital Anxiety and Depression Scale (HADS) and the Fatigue Severity Scale (FSS) were completed through face-to-face interviews and clinical examinations. The health-related QoL (HRQoL) was also evaluated by means of the Parkinson’s Disease Questionnaire (PDQ-39). For evaluation of nutritional status, the Mini Nutritional Assessment (MNA) questionnaire was applied together with anthropometric measurements. Results Thirty seven (25.3%) patients were at risk of malnutrition and another 3 (2.1%) were malnourished. The total score of the UPDRS scale (r = −0.613, Pnutritional status [2.5 vs. 2.0; Pnutritional status. Except for stigma, all other domains of the PDQ-39 were significantly correlated with the total score of the MNA. Conclusion Our study demonstrates that disease duration, severity of motor and psychiatric symptoms (depression, anxiety) and fatigue are associated with nutritional status in PD. Different aspects of the HRQoL were affected by patients’ nutritional status especially the emotional well-being and mobility domains. PMID:24608130

  3. Disorder-Specific Mental Health Service Use for Mood and Anxiety Disorders: Associations with Age, Sex, and Psychiatric Comorbidity

    Science.gov (United States)

    Mackenzie, Corey S.; Reynolds, Kristin; Cairney, John; Streiner, David L.; Sareen, Jitender

    2013-01-01

    Background The objectives of this study are to examine the prevalence of disorder-specific mental health service use for mood and anxiety disorders, and relationships between helpseeking and age, sex, and psychiatric comorbidity. Methods The authors used Wave 2 data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), which included 34,653 adults. Cross tabulations provided helpseeking prevalence rates for five anxiety disorders and three mood disorders by age and sex, as well as for individuals with and without comorbid anxiety and mood disorders. Logistic regression analyses explored the likelihood of helpseeking among younger and middle-aged adults in comparison to older adults. Results The prevalence of helpseeking was highest for panic disorder (45.3%) and dysthymia (44.5%) and lowest for specific phobias (7.8%). For each condition except panic disorder service use was most likely among middle-aged adults and especially unlikely among older individuals. Sex differences in treatment seeking favoring women showed only modest variability with age. Finally, the prevalence of helpseeking was generally lower among individuals without comorbid anxiety or mood disorders, and the hill-shaped influence of age on service use was attenuated in this pure group. Conclusions The results of this study highlight the highest prevalence of disorder-specific service use among middle-aged adults and women, and among individuals with panic disorder and dysthymia. For purposes of identifying groups who are in need of targeted efforts to increase service use, helpseeking was especially unlikely among people suffering from specific phobia, as well as among men and older adults. PMID:22065571

  4. Psychiatric Comorbidity Is Associated Prospectively with Diminished Opioid Analgesia and Increased Opioid Misuse in Patients with Chronic Low Back Pain.

    Science.gov (United States)

    Wasan, Ajay D; Michna, Edward; Edwards, Robert R; Katz, Jeffrey N; Nedeljkovic, Srdjan S; Dolman, Andrew J; Janfaza, David; Isaac, Zach; Jamison, Robert N

    2015-10-01

    Opioids are frequently prescribed for chronic low back pain (CLBP), but there are little prospective data on which patient subgroups may benefit. Psychiatric comorbidity, such as high levels of depression and anxiety symptoms (termed comorbid negative affect [NA]), is a common presentation and may predict diminished opioid analgesia and/or increased opioid misuse. The authors conducted a 6½-month prospective cohort study of oral opioid therapy, with an active drug/placebo run-in period, in 81 CLBP patients with low, moderate, and high levels of NA. Treatment included an opioid titration phase with a prescribing physician blinded to NA group assignment and a 4-month continuation phase, during which subjects recorded daily pain levels using an electronic diary. The primary outcome was the percent improvement in average daily pain, summarized weekly. There was an overall 25% dropout rate. Despite the high NA group being prescribed a higher average daily dose of morphine equivalents, linear mixed model analysis revealed that the 24 study completers in each of the high NA and low NA groups had an average 21 versus 39% improvement in pain, respectively (P < 0.01). The high NA group also had a significantly greater rate of opioid misuse (39 vs. 8%, P < 0.05) and significantly more and intense opioid side effects (P < 0.01). These results indicate that the benefit and risk considerations in CLBP patients with high NA versus low NA are distinctly different. Thus, NA is an important phenotypic variable to characterize at baseline, before deciding whether to prescribe opioids for CLBP.

  5. Problemas conjugais e outros fatores associados a transtornos psiquiátricos do pós-parto Marital problems and other factors associated with postpartum psychiatric disorder

    Directory of Open Access Journals (Sweden)

    Suzi Roseli Kerber

    2011-06-01

    Full Text Available OBJETIVO: Estudar a associação entre transtornos mentais pós-parto e fatores demográficos e psicossociais, pré e perinatais. MÉTODOS: Todas as familias com crianças de quatro meses da Vila Jardim - Porto Alegre (RS - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20 e entrevistas clínicas semiestruturadas individuais e do casal para fundamentar uma hipótese diagnóstica segundo os critérios do da quarta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV. Realizou-se a avaliação da relação conjugal e do relacionamento da mãe com as famílias de origem e a rede social utilizando-se a Escala de Avaliação Global do Funcionamento Relacional (GARF. RESULTADOS: Foram avaliadas 148 mães e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das mães e 25,4% dos pais apresentaram suspeita de transtorno psiquiátrico. Clinicamente os percentuais foram maiores. Coabitar ou não com companheiro não esteve associado com transtorno mental materno. Na análise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; pPURPOSE: To study the association between postpartum psychiatric disorder and demographic and psychosocial, pre- and perinatal factors. METHODS: All families having 4-month-old infants in Vila Jardim, a district of Porto Alegre, Brazil, born at a public hospital from November 1998 through December 1999 were assessed. The Self-Report Questionnaire (SRQ-20 and semi-structured interviews were used for the psychiatric assessment that included a possible diagnosis using Diagnostic and Statistical Manual of Mental Disorders IV (DSM- IV criteria. Relational functioning between couples, the relationship with mother's family of origin and social network were assessed using the DSM-IV Global Assessment of Relational Functioning Scale (GARF. RESULTS: A total of 148 mothers and 116 cohabiting fathers were assessed

  6. [Program and practice of psychiatric genetics at the German Research Institute of Psychiatry under Ernst Rüdin: on the relationship between science, politics and the concept of race before and after 1993].

    Science.gov (United States)

    Roelcke, Volker

    2002-01-01

    The first research institution exclusively devoted to psychiatric genetics was the Department of Genealogy and Demography at the German Psychiatric Research Institute (Deutsche Forschungsanstalt für Psychiatrie) in Munich. From its foundation in 1917 until 1945 it was directed by Ernst Rüdin, one of the protagonists of the racial hygiene movement in Germany. In scientific terms, colleagues from abroad regarded the research undertaken by Rüdin and his collaborators as outstanding in 1933/34, and as remarkable even in the post-1945 period. This paper analyses programme and practice of psychiatric genetics at the Munich Institute as well as Rüdin's involvement in Nazi mental health policy including his active support of the systematic patient killings ('euthanasia'). It is argued that the idea of a healthy 'race' was a guiding principle motivating all of Rüdin's research and political activities, and that it is not possible to distinguish in his work a phase of 'good' research (in scientific terms) untainted by racial ideas from a phase of 'bad' (pseudo-) research contaminated by racial ideology.

  7. Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia.

    Science.gov (United States)

    Nurasikin, M S; Khatijah, L A; Aini, A; Ramli, M; Aida, S A; Zainal, N Z; Ng, C G

    2013-06-01

    Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies. To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level. Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE). A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p < .05). Psychiatric patients were religiously committed and used more positive religious coping methods. Practices of negative religious coping, severe psychiatric symptoms and anxiety/depression were associated with higher distress.

  8. Associations between child disciplinary practices and bullying behavior in adolescents

    Directory of Open Access Journals (Sweden)

    Graziela A.H. Zottis

    2014-07-01

    Full Text Available OBJECTIVE: to investigate associations between different types of child disciplinary practices and children and adolescents' bullying behavior in a Brazilian sample. METHODS: cross-sectional study, with a school-based sample of 10-to 15-year-old children and adolescents. Child disciplinary practices were assessed using two main subtypes: power-assertive and punitive (psychological aggression, corporal punishment, deprivation of privileges, and penalty tasks and inductive (explaining, rewarding, and monitoring. A modified version of the Olweus Bully Victim Questionnaire was used to measure the frequency of bullying. RESULTS: 247 children and adolescents were evaluated and 98 (39.7% were classified as bullies. Power-assertive and punitive discipline by either mother or father was associated with bullying perpetration by their children. Mothers who mostly used this type of discipline were 4.36 (95% CI: 1.87-10.16; p < 0.001 times more likely of having a bully child. Psychological aggression and mild forms of corporal punishment presented the highest odds ratios. Overall inductive discipline was not associated with bullying. CONCLUSIONS: bullying was associated to parents' assertive and punitive discipline. Finding different ways of disciplining children and adolescents might decrease bullying behavior.

  9. Psychiatric sequelae of traumatic brain injury: Retrospective ...

    African Journals Online (AJOL)

    2011-12-23

    Dec 23, 2011 ... Objective: Traumatic brain injury (TBI) is a public health problem and is associated with many complications. However little is known about the psychiatric sequelae of TBI in Nigeria. This study described the pattern and determinants of psychiatric sequelae among subjects with TBI. Materials and Methods: ...

  10. Human Immunodeficiency Virus Infection among Psychiatric ...

    African Journals Online (AJOL)

    Background: Psychiatric patients are considered high risked group for Human immunodeficiency virus (HIV) infection. This has been found to be as a result of poor judgment and irrationality associated with some of the disorders. However, there is dearth of literature on the prevalence of HIV infection among psychiatric ...

  11. Psychiatric disorders and urbanization in Germany

    NARCIS (Netherlands)

    Dekker, J.J.M.; Peen, J.; Koelen, J.A.; Smit, H.F.E.; Schoevers, R.A.

    2008-01-01

    Background. Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a

  12. Psychiatric disorders and urbanization in Germany

    NARCIS (Netherlands)

    Dekker, J.J.M.; Peen, J.; Koelen, J.A.; Smit, H.F.E.; Schoevers, R.A.

    2008-01-01

    Abstract Background Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in

  13. Social and practical representations in pneumonia associated to ventilation mechanics

    Directory of Open Access Journals (Sweden)

    Giovane Mendieta I

    2009-05-01

    Full Text Available Objective: To identify the practice and social representations of the respiratory therapists, on the strategies of prevention of pneumonia associated to mechanical ventilation, of the unit intensive care of the Kennedy Hospital. Methodology:Qualitative inquiry, descriptive and explanatory character, the population, respiratorys therapist of the unit’s intensives cares, with a sample of captive type for convenience, conformed by seventeen respiratorys therapists who were applied a semistructured interview, applying the content analysis technique for their study. Results: Practices and social representations, are given around the patient, and therefore avoid prolonged mechanical ventilation, the suction procedure should be carried out by means of aseptic technique, on the other and, the strict execution of handling protocols of airway; as long as it should be norm for the whole personnel, hand washing. Conclusions:it is observed the strategies of prevention are influenced by the theoretical references, however, these actors don’t know the full prevention strategies, likewise the represented practices are related with the prevention through asepsis transmission of pathogens, and has an effect on the construction of social representations and therefore the knowledge of new practices will change the structure of representation.

  14. Association of respondent psychiatric comorbidity with family history of comorbidity: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

    Science.gov (United States)

    Jung, Jeesun; Goldstein, Risë B; Grant, Bridget F

    2016-11-01

    Substance use disorders and major psychiatric disorders are common, highly comorbid with each other, and familial. However, the extent to which comorbidity is itself familial remains unclear. The purpose of this study is to investigate associations between comorbidity among respondents with family history of comorbidity. We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions-III to study the associations of family history (FH) of comorbidity among alcoholism, drug problems, depression, antisocial behavior, and anxiety disorders in parents and maternal and paternal grandparents with corresponding DSM-5 diagnostic comorbidity among respondents. We utilized multivariable multinomial logistic regression models controlling for age, sex, race, education, family income, marital status, and adverse childhood experiences (ACEs). All comorbid associations of any two disorders with FH were statistically significant; almost all adjusted odds ratios (ORs) for respondent comorbidity in the presence of FH of the parallel comorbidity exceeded 10. ORs involving antisocial behavior in relatives and antisocial personality disorder in respondents were consistently larger than those for any other pairs of disorders. After further adjustment for ACEs, most patterns of association were similar but the ORs were reduced twofold to threefold. ACEs may be mediators in relationships between familial and respondent comorbidities. Further investigations of relationships among familial comorbidity, ACEs, and respondents' diagnoses may improve understanding of comorbidity. Published by Elsevier Inc.

  15. Parricide: Psychiatric morbidity

    Directory of Open Access Journals (Sweden)

    Dunjić Bojana

    2008-01-01

    Full Text Available INTRODUCTION Parricide is defined as a murder of parents by their children; the patricide is murder of father, while matricide is murder of mother. This entity is classified as homicide, but it differs in the fact that victims are parents and the killers are their children. Mostly, it is associated with psychiatric morbidity. OBJECTIVE To describe sociodemographic and psychopathological characteristics of parricide committers and to analyze circumstances of parricide and psychiatric morbidity in order to achieve better recognition and prevention of risks. METHOD This retrospective study included all homicide autopsy records (1991-2005 performed at the Institute of Forensic Medicine, Medical School, University of Belgrade. For further analyses, all parricide records were selected out. The study analyzed all available parameters, which concerned parricide committers, victims and the act itself. Methods of descriptive statistics were used. RESULTS Between 1991 and 2005, there were 948 cases of homicide; of these, 3.5% were parricides. The committers of parricide were on average 31.2±11.9 years old, 87.8% were males, 60.6% with psychiatric symptoms most commonly with schizophrenia, alcohol dependence, personality disorder etc. Victims were on average 63.7±11.9 years old, 54.5% males, and 21.2% had a diagnosed mental illness. CONCLUSION Parricide is a rare kind of homicide accounting for 3% of all homicides. Committers are mostly unemployed males in early adulthood who have mental disorder. The phenomenon of parricide deserves a detailed analysis of the committer (individual bio-psycho-social profile and the environ- mental factors (family, closely related circumstances to enable a precise prediction of the act and prevention of the fatal outcome, which logically imposes the need of further studies.

  16. Associations between child disciplinary practices and bullying behavior in adolescents.

    Science.gov (United States)

    Zottis, Graziela A H; Salum, Giovanni A; Isolan, Luciano R; Manfro, Gisele G; Heldt, Elizeth

    2014-01-01

    to investigate associations between different types of child disciplinary practices and children and adolescents' bullying behavior in a Brazilian sample. cross-sectional study, with a school-based sample of 10- to 15-year-old children and adolescents. Child disciplinary practices were assessed using two main subtypes: power-assertive and punitive (psychological aggression, corporal punishment, deprivation of privileges, and penalty tasks) and inductive (explaining, rewarding, and monitoring). A modified version of the Olweus Bully Victim Questionnaire was used to measure the frequency of bullying. 247 children and adolescents were evaluated and 98 (39.7%) were classified as bullies. Power-assertive and punitive discipline by either mother or father was associated with bullying perpetration by their children. Mothers who mostly used this type of discipline were 4.36 (95% CI: 1.87-10.16; pbullying. bullying was associated to parents' assertive and punitive discipline. Finding different ways of disciplining children and adolescents might decrease bullying behavior. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. Shared decision making in psychiatric practice and the primary care setting is unique, as measured using a 9-item Shared Decision Making Questionnaire (SDM-Q-9

    Directory of Open Access Journals (Sweden)

    De las Cuevas C

    2013-07-01

    Full Text Available Carlos De las Cuevas,1,2 Wenceslao Peñate,3 Lilisbeth Perestelo-Pérez,2,4 Pedro Serrano-Aguilar2,41Department of Psychiatry, University of La Laguna, Tenerife, Spain; 2Health Services Research Network for Chronic Diseases (REDISSEC, Tenerife, Spain; 3Department of Personality, Assessment and Psychological Treatments, University of La Laguna, Tenerife, Spain; 4Evaluation Unit, Canary Island Health Service, Santa Cruz de Tenerife, SpainBackground: To measure and compare the extent to which shared a decision making (SDM process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient’s perspective.Methods: A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9 immediately after their consultation. MANCOVA, Student’s t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples.Results: No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients’ age, education, type of appointment, and treatment decision all play a specific role in predicting SDM.Conclusion: The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.Keywords: primary care patients, psychiatric outpatients, SDM-Q-9, shared decision making

  18. [Social psychiatric service as a cornerstone of psychiatric community care].

    Science.gov (United States)

    Hoffmann, P; Tiggemann, H G

    1991-12-01

    Psychiatric care has gradually been shifting in Germany from its original inpatient basis to outpatient and complementary treatment. This shift of emphasis resulted in a transfer of psychiatry-political responsibility to communal bodies and hence also to communal public health services. Sociopsychiatric service ranks high in communal psychiatric care setups, since it promotes cooperation and helps to coordinate efforts in individual cases in respect of focal points on which such care is centered. For the future, an expert commission has suggested that the various institutions actively engaged in community psychiatric care should team up in each region. This applies in particular to mobile services visiting the patients in their homes, and to the offices providing contracts to sociopsychiatric services of public health offices. Despite positive outlooks there are also quite a few negative aspects of present-day practice. One of them is poor definition of tasks and functions of communal sociopsychiatric services, whereas another one are the unsatisfactory quantitative and qualitative means at their disposal. It is also too often overlooked that psychiatric patients and disabled persons are entitled to compensation insurance payments to promote their rehabilitation, as provided for by individual legislation in the various German laender. To tap these sources sufficiently well, sociopsychiatric services must be better equipped in every respect. The professional competence of social workers and physicians, as well as of the relevant staff, must be safeguarded by continuing education and specialist training measures.

  19. Intermediary cooperative associations and the institutionalization of participative work practices

    DEFF Research Database (Denmark)

    Sørensen, Ole Henning; Doellgast, Virginia; Bojesen, Anders

    2015-01-01

    of the Centre for the Development of Human Resources and Quality Management (SCKK), a social partnership-based organization that funds workplace development Projects at state workplaces, and of nine participative development projects that received financial and logistical support from the SCKK. These projects...... increased union and management commitment to partnership-based approaches to problem-solving, despite their ambiguous results for both groups. This suggests that intermediary cooperative associations help to enhance the normative legitimacy of participative work practices through the provision of resources...... and ‘best practice’ management approaches....

  20. Parental psychiatric hospitalisation and offspring schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2009-01-01

    The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...

  1. PSYCHIATRIC DISORDERS AND SLEEP

    Science.gov (United States)

    Krystal, Andrew D.

    2012-01-01

    SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143

  2. Psychiatric Thoughts in Ancient India*

    OpenAIRE

    Ravi Abhyankar

    2015-01-01

    A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

  3. Psychiatric thoughts in ancient India.

    Science.gov (United States)

    Abhyankar, Ravi

    2015-01-01

    A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

  4. Psychiatric Thoughts in Ancient India*

    Science.gov (United States)

    Abhyankar, Ravi

    2015-01-01

    A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry. PMID:25838724

  5. Workroles of staff nurses in psychiatric settings.

    Science.gov (United States)

    Morrison, E G; Shealy, A H; Kowalski, C; LaMont, J; Range, B A

    1996-01-01

    The purpose of this research was to operationalize Peplau's workroles of the psychiatric staff nurse. Thirty registered nurses audiotaped one-to-one interactions with 62 adult, child, and adolescent psychiatric patients. Content analysis was used to identify role behaviors and to identify roles that were different from those outlined by Peplau. The counselor role was the most frequently occurring primary workrole. Overlap was found between behaviors indicative of autocratic leader versus surrogate and those of resource person versus teacher. The findings supported Peplau's contention that the counselor role is central to the practice of psychiatric nursing.

  6. Indian - American contributions to psychiatric research.

    Science.gov (United States)

    Pandurangi, Anand K

    2010-01-01

    The Indian Diaspora, especially in North America, is a visible force in the field of psychiatric medicine. An estimated 5000 persons of Indian origin practice psychiatry in the USA and Canada, and an estimated 10% of these are in academic psychiatry. Wide ranging contributions, from molecular biology of psychiatric disorders to community and cultural psychiatry, are being made by this vibrant group of researchers. This article is a brief summary and work-in-progress report of the contributions by Indian - American psychiatric researchers. Although not exhaustive in coverage, it is meant to give the reader an overview of the contributions made by three waves of researchers over a span of 50 years.

  7. Neural activity during interoceptive awareness and its associations with alexithymia – An fMRI study in major depressive disorder and non-psychiatric controls

    Directory of Open Access Journals (Sweden)

    Christine eWiebking

    2015-05-01

    Full Text Available Objective: Alexithymia relates to difficulties recognizing and describing emotions. It has been linked to subjectively increased interoceptive awareness (IA and to psychiatric illnesses such as major depressive disorder (MDD and somatization. MDD in turn is characterized by aberrant emotion processing and IA on the subjective as well as on the neural level. However, a link between neural activity in response to IA and alexithymic traits in health and depression remains unclear. Methods: A well-established fMRI task was used to investigate neural activity during IA (heartbeat counting and exteroceptive awareness (tone counting in non-psychiatric controls (NC and MDD. Firstly, comparing MDD and NC, a linear relationship between IA-related activity and scores of the Toronto Alexithymia Scale (TAS was investigated through whole-brain regression. Secondly, NC were divided by median-split of TAS scores into groups showing low (NC-low or high (NC-high alexithymia. MDD and NC-high showed equally high TAS scores. Finally, IA-related neural activity was compared on a whole-brain level between the three independent samples (MDD, NC-low, NC-high. Results: Whole-brain regressions between MDD and NC revealed neural differences during IA as a function of TAS-DD (subscale difficulty describing feelings in the supragenual anterior cingulate cortex (sACC; BA 24/32, which were due to negative associations between TAS-DD and IA-related activity in NC. Contrasting NC subgroups, high TAS scores were associated with decreased neural activity during IA in the sACC and increased insula activity. Though having equally high alexithymia scores, NC-high showed increased insula activity during IA compared to MDD, whilst both groups showed decreased activity in the sACC. Conclusions: Within the context of decreased sACC activity during IA in alexithymia (NC-high and MDD, increased insula activity might mirror a compensatory mechanism in NC-high, which is disrupted in MDD.

  8. The association between formal thought disorder and finger print asymmetry in children with a psychiatric disorder: an exploratory study

    NARCIS (Netherlands)

    de Bruin, E.I.; de Nijs, P.F.A.; Verhulst, F.C.; Huizink, A.C.

    2012-01-01

    Dermatoglyphics are the ridge constellations found on the hand palms and foot soles that are permanently formed by the 24th week of pregnancy. Associations have been found between adult schizophrenia and irregularities and asymmetries in dermatoglyphics. Children have not been studied before. The

  9. Association of academic education and practical capabilities of radiology technologists

    Directory of Open Access Journals (Sweden)

    Alireza Farajollahi

    2015-03-01

    Full Text Available Introduction: Radiology is a complex health science and profession, requiring experienced use of academic technology, beside the ability of thinking critically, independent judgment, solving problems creatively and communicating effectively to make the best clinical performance. The present study was designed to evaluate the practical capability of radiology technologists working in radiology wards, for determining the level of association between capability and academic education. Methods: In a cross-sectional analytical study carried out at Tabriz University of Medical Sciences, Iran, in 2010-2012, the radiology technologists were asked to fill the previously-designed questionnaires which was included a checklist related to the participants’ social and demographic characteristics, and a questionnaire on the radiology technologists’ performance regarding the medical applications of X-ray. Results: The mean age was 35.03 ± 8.01 year, and 64 (53.3% were male. The technologists’ capability had a significant relation with their educational degree, and the capability of staff with BS was more than those with an associate degree (P < 0.001. The technologists’ capability was directly related to their grade point average (GPAs within "associate degree" group (P < 0.001, but no such correlation was found among "BSc" group. In total, there was a direct relation between the academic training and practical capability (P = 0.040. Conclusion: A great majority of the technologists do not seem to base their capability on the recognized scientific sources. Teaching or familiarizing the students with the true concept of performing on the basis of the prior training, and the significance of implementing such training in professional activities is one of the approaches, which could lead the technologists to appreciate the relationship between classical training and their providing quality services.

  10. Psychiatric treatment and research unit for adolescent intensive care: the first adolescent forensic psychiatric service in Finland.

    Science.gov (United States)

    Kahila, K; Kilkku, N; Kaltiala-Heino, R

    2004-04-01

    Finland does not have a history of providing forensic adolescent psychiatric units although the need for this kind of service has been established. According to legislation patients who are minors have to be treated separately from adults, however, this has not been possible in practice. Also, adolescent psychiatric wards have not always been able to admit the most severely ill patients, those with impulsive and aggressive behaviours, because of lack of staff resources, problems associated with protecting other vulnerable patients and a shortage of secure environments. A previous report demonstrated the significant increase in adolescent's involuntary treatment within adult psychiatric wards. Data from this report were acknowledged as an important starting point in the planning process for the psychiatric treatment and research unit for adolescent intensive care. This paper describes the background, development process, plan of action, tailor-made education programme and supporting evidence for the first Finnish adolescent forensic service opened in April 2003 in the Department of Psychiatry, Tampere University Hospital. The tool used for planning the unit's activities and staff education programme was the Balanced Score Card approach, the structure and development of which is also outlined within the paper.

  11. Psychiatric/ psychological forensic report writing.

    Science.gov (United States)

    Young, Gerald

    Approaches to forensic report writing in psychiatry, psychology, and related mental health disciplines have moved from an organization, content, and stylistic framework to considering ethical and other codes, evidentiary standards, and practice considerations. The first part of the article surveys different approaches to forensic report writing, including that of forensic mental health assessment and psychiatric ethics. The second part deals especially with psychological ethical approaches. The American Psychological Association's Ethical Principles and Code of Conduct (2002) provide one set of principles on which to base forensic report writing. The U.S. Federal Rules of Evidence (2014) and related state rules provide another basis. The American Psychological Association's Specialty Guidelines for Forensic Psychology (2013) provide a third source. Some work has expanded the principles in ethics codes; and, in the third part of this article, these additions are applied to forensic report writing. Other work that could help with the question of forensic report writing concerns the 4 Ds in psychological injury assessments (e.g., conduct oneself with Dignity, avoid the adversary Divide, get the needed reliable Data, Determine interpretations and conclusions judiciously). One overarching ethical principle that is especially applicable in forensic report writing is to be comprehensive, scientific, and impartial. As applied to forensic report writing, the overall principle that applies is that the work process and product should reflect integrity in its ethics, law, and science. Four principles that derive from this meta-principle concern: Competency and Communication; Procedure and Protection; Dignity and Distance; and Data Collection and Determination. The standards or rules associated with each of these principles are reviewed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  12. Factors associated with serum cholesterol level in a pediatric practice. Cholesterol screening in a pediatric practice.

    Science.gov (United States)

    Donker, G A; Goff, D C; Ragan, J D; Killinger, R P; Harrist, R B; Labarthe, D R

    1993-01-01

    The associations between age, sex, height, Quetelet index, blood pressure, and serum cholesterol level were examined among 1406 routinely screened children, aged 4 to 19 years, in a pediatric practice. After adjustment for sex and age, height and Quetelet index were associated with serum cholesterol levels. Quetelet index was shown by multiple linear regression to be positively related to cholesterol levels (b = 0.780, P Quetelet index was marginal. Clustering of elevated serum cholesterol level, Quetelet index, and systolic blood pressure was observed. Familial aggregation of cholesterol levels was demonstrated using analysis of variance for 742 children from 342 families included in the regression analysis (F341,400 = 1.56, P Quetelet index, and familial aggregation accounted for 10.6% of the variance in serum cholesterol levels. Siblings of children with high cholesterol levels are a high-yield group in cholesterol screening.

  13. Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization.

    Science.gov (United States)

    Casalino, Lawrence P; Chenven, Norman

    2017-03-01

    Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs. We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA. The IPAs studied vary in size and sophistication, but overall are performing well and are highly regarded by hospital and health plan executives. IPAs can grow rapidly without the cost of purchasing and operating physician practices and make it possible for physicians to remain independent in their own practices while providing the scale and care management infrastructure to make it possible to succeed in VBP. However, it can be difficult for IPAs to gain cooperation from hundreds to thousands of independent physicians, and the need for capital for growth and care management infrastructure is increasing as VBP becomes more prevalent and more demanding. Some IPAs are succeeding at VBP. As VBP raises the performance bar, IPAs will have to demonstrate that they can achieve results equal to more highly capitalized and tightly structured large medical groups and hospital-owned practices. Physicians should be aware of IPAs as a potential option for participating in VBP. Payers are aware of IPAs; the Medicare ACO program and health insurer ACO programs include many IPAs. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The Impact of Psychiatric Patient Boarding in Emergency Departments

    Directory of Open Access Journals (Sweden)

    B. A. Nicks

    2012-01-01

    Full Text Available Objectives. Studies have demonstrated the adverse effects of emergency department (ED boarding. This study examines the impact of resource utilization, throughput, and financial impact for psychiatric patients awaiting inpatient placement. Methods. The authors retrospectively studied all psychiatric and non-psychiatric adult admissions in an Academic Medical Center ED (>68,000 adult visits from January 2007-2008. The main outcomes were ED length of stay (LOS and associated reimbursement. Results. 1,438 patients were consulted to psychiatry with 505 (35.1% requiring inpatient psychiatric care management. The mean psychiatric patient age was 42.5 years (SD 13.1 years, with 2.7 times more women than men. ED LOS was significantly longer for psychiatric admissions (1089 min, CI (1039–1140 versus 340 min, CI (304–375; <0.001 when compared to non-psychiatric admissions. The financial impact of psychiatric boarding accounted for a direct loss of ($1,198 compared to non-psychiatric admissions. Factoring the loss of bed turnover for waiting patients and opportunity cost due to loss of those patients, psychiatric patient boarding cost the department $2,264 per patient. Conclusions. Psychiatric patients awaiting inpatient placement remain in the ED 3.2 times longer than non-psychiatric patients, preventing 2.2 bed turnovers (additional patients per psychiatric patient, and decreasing financial revenue.

  15. Psychiatric disorders of patients seeking obesity treatment

    Directory of Open Access Journals (Sweden)

    Lin Hung-Yen

    2013-01-01

    Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

  16. Shame, Dissociation, and Complex PTSD Symptoms in Traumatized Psychiatric and Control Groups: Direct and Indirect Associations With Relationship Distress.

    Science.gov (United States)

    Dorahy, Martin J; Corry, Mary; Black, Rebecca; Matheson, Laura; Coles, Holly; Curran, David; Seager, Lenaire; Middleton, Warwick; Dyer, Kevin F W

    2017-04-01

    Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group. Participants were drawn from the DID (n = 20), conflict-related chronic PTSD (n = 65), and nonclinical (n = 125) populations and completed questionnaires assessing the variables of interest. A model examining the direct impact of shame and dissociation on relationship functioning, and their indirect effect via complex PTSD symptoms, was tested through path analysis. The DID sample reported significantly higher dissociation, shame, complex PTSD symptom severity, relationship anxiety, relationship depression, and fear of relationships than the other two samples. Support was found for the proposed model, with shame directly affecting relationship anxiety and fear of relationships, and pathological dissociation directly affecting relationship anxiety and relationship depression. The indirect effect of shame and dissociation via complex PTSD symptom severity was evident on all relationship variables. Shame and pathological dissociation are important for not only the effect they have on the development of other complex PTSD symptoms, but also their direct and indirect effects on distress associated with relationships. © 2016 Wiley Periodicals, Inc.

  17. Management of opioid-dependent patients: comparison of the cost associated with use of buprenorphine/naloxone or methadone, and their interactions with concomitant treatments for infectious or psychiatric comorbidities.

    Science.gov (United States)

    Roncero, Carlos; Domínguez-Hernández, Raquel; Díaz, Tomás; Fernández, José Manuel; Forcada, Rafael; Martínez, José Manuel; Seijo, Pedro; Terán, Antonio; Oyagüez, Itziar

    2015-09-15

    The objective was to estimate the annual interaction management cost of agonist opioid treatment (AOT) for opioid-dependent (OD) patients with buprenorphine-naloxone (Suboxone®) (B/N) or methadone associated with concomitant treatments for infectious (HIV) or psychiatric comorbidities. A costs analysis model was developed to calculate the associated cost of AOT and interaction management. The AOT cost included pharmaceutical costs, drug preparation, distribution and dispensing, based on intake regimen (healthcare center or take-home) and type and frequency of dispensing (healthcare center or pharmacy), and medical visits. The cost of methadone also included single-dose bottles, monthly costs of custody at pharmacy, urine toxicology drug screenings and nursing visits. Potential interactions between AOT and concomitant treatments (antivirals, antibacterials/antifungals, antipsychotics, anxiolytics, antidepressant and anticonvulsants), were identified to determine the additional use of healthcare resources for each interaction management. The annual cost per patient of AOT was €1,525.97 for B/N and €1,467.29 for methadone. The average annual cost per patient of interaction management was €257.07 (infectious comorbidities), €114.03 (psychiatric comorbidities) and €185.55 (double comorbidity) with methadone and €7.90 with B/N in psychiatric comorbidities. Total annual costs of B/N were €1,525.97, €1,533.87 and €1,533.87 compared to €1,724.35, €1,581.32 and €1,652.84 for methadone per patient with infectious, psychiatric or double comorbidity respectively.Compared to methadone, the total cost per patient with OD was lower with B/N (€47.45-€198.38 per year). This is due to the differences in interaction management costs associated with the concomitant treatment of infectious and/or psychiatric comorbidities.

  18. Psychiatric disorders: The psychiatrist's contribution to sport.

    Science.gov (United States)

    Currie, Alan; Johnston, Allan

    2016-12-01

    Athletes experience a range of mental health problems with at least an equivalent prevalence to the general population. This chapter explores the psychiatrist's role in sport, along a pathway of mental healthcare from 'upstream' prevention, screening, and early detection of mental stress to 'downstream' assessment, treatment, rehabilitation, and recovery from mental illness. At each stage on this pathway the psychiatrist has a broad spectrum of bio-psycho-social strategies to employ in clinical practice. Upstream, the importance of psychological resilience is described along with the concept of mental 'pre-habilitation' (a term usually associated with the prevention of physical injury). Alongside these preventative measures, early detection is improved by education, increased awareness, and by the use of effective mental health screening measures. Further downstream ready access to psychiatric expertise and good collaboration between the psychiatrist and the world of sport improve access to treatment, delivery of that treatment, rehabilitation, and return to sport during recovery.

  19. How to Use the School Survey of Practices Associated with High Performance. REL 2016-162

    Science.gov (United States)

    Weinstock, Phyllis; Yumoto, Futoshi; Abe, Yasuyo; Meyers, Coby; Wan, Yinmei

    2016-01-01

    This report describes and explains how to use the School Survey of Practices Associated with High Performance, which measures the degree to which schools are engaging in practices associated with high performance. State education departments and school districts can use the survey results to identify and describe school practices associated with…

  20. Psychiatry and the Necker Cube. Neurological and Psychological Conceptions of Psychiatric Disorder

    Directory of Open Access Journals (Sweden)

    D. Rogers

    1988-01-01

    Full Text Available Neurological and psychological conceptions of psychiatric disorder are in conflict at the present time. This conflict is considered in the context of the history of psychiatry and the philosophy of science. Its practical consequences are considered for the motor disorder of schizophrenia, the cognitive impairment in psychiatric illnesses, the use of the terms organic and functional and the association of neurological disorder with psychotic and neurotic disorders. The conflict is also examined in individual cases and the implications for treatment assessed.

  1. Subjective anger and overt aggression in psychiatric outpatients.

    Science.gov (United States)

    Genovese, Timothy; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark

    2017-02-01

    The attention given to anger and aggression in psychiatric patients pales in comparison to the attention given to depression and anxiety. Most studies have focused on a limited number of psychiatric disorders, and results have been inconsistent. The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project sought to replicate and extend prior findings examining which psychiatric disorders and demographic characteristics were independently associated with elevated levels of anger and aggression. 3800 individuals presenting to the Rhode Island Hospital Department of Psychiatry outpatient practice underwent a semi-structured interview to determine current Axis I (N=3800) and Axis II (N=2151) pathology. Severity of subjective anger and overt aggression within the past week were also assessed for each patient, and odds ratios were determined for each disorder. Multiple regression analyses were conducted to determine which diagnoses independently contributed to increased levels of anger and aggression. Almost half of the sample reported moderate-to-severe levels of current subjective anger, and more than 20% endorsed moderate-to-severe levels of current overt aggression. The frequency of anger was similar to the frequencies of depressed mood and psychic anxiety. Anger and aggression were elevated across all diagnoses except adjustment disorder. Anger and aggression were most elevated in patients with major depressive disorder, panic disorder with agoraphobia, post-traumatic stress disorder, intermittent explosive disorder, and cluster B personality disorders. Anger is as common as depressed mood and psychic anxiety amongst psychiatric outpatients, and problems with anger cut across diagnostic categories. Given the high prevalence of problems with anger in psychiatric patients, more research should be directed towards its effective treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Psychiatric disorders among the elderly on non-psychiatric wards in an African setting.

    Science.gov (United States)

    Nakasujja, Noeline; Musisi, Seggane; Walugembe, James; Wallace, Daphne

    2007-08-01

    The elderly are vulnerable to illness and particularly to psychiatric illness. Many mentally ill elderly patients end up on non-psychiatric wards owing to somatization of their illnesses. Even for these patients, a psychiatric diagnosis may not be made. The literature on the elderly in Uganda is very scanty. This study aims to establish the prevalence and factors associated with psychiatric disorders among elderly patients admitted to non-psychiatric wards. We carried out a descriptive cross-sectional study of 127 consenting elderly patients. They were administered a standardized questionnaire comprising the Self Reporting Questionnaire 25, the Mini-mental State Examination and the Structured Clinical Interview for the Diagnostic and Statistical Manual IV. Study variables included socio-demographic characteristics, physical illnesses, psychiatric disorders and the treatment given. The rate of psychiatric morbidity was 48%. The sex ratio was 1:1; however, women had a higher rate of psychiatric illness than men, 54.6% and 41.3% respectively. Being widowed or separated and having cancer were associated with SRQ>5, p=0.02 and p=0.04 respectively. Depressive disorders were the most common at 25.2% and were more common in women. Increasing age was associated with dementia (pUganda. Particular attention should be given to the psychological health of elderly people admitted to general hospitals.

  3. Psychiatric morbidity following Hurricane Andrew.

    Science.gov (United States)

    David, D; Mellman, T A; Mendoza, L M; Kulick-Bell, R; Ironson, G; Schneiderman, N

    1996-07-01

    The nature of psychiatric morbidity in previously non-ill subjects from the area most affected by Hurricane Andrew was investigated at 6-12 months posthurricane. Preliminary associations of morbidity with personal and event-related risk factors were also determined. Fifty one percent (31/61) met criteria for a new-onset disorder, including posttraumatic stress disorder (PTSD) in 36%, major depression (MD) in 30%, and other anxiety disorders in 20%. Thirty four subjects (56%) had significant symptoms persisting beyond 6 months. Having sustained "severe damage" was the risk factor most strongly associated with outcome. Our data underscore the range of psychiatric morbidity related to a natural disaster, and suggest a relationship to chronic stressors.

  4. Psychiatric disorders and pregnancy

    Directory of Open Access Journals (Sweden)

    "SH. Akhondzadeh

    2006-07-01

    Full Text Available Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy. In majority of cases both psychotherapy and pharmacotherapy should be considered. However, psychiatric disorders in pregnancy are often under treated because of concerns about potential harmful effects of medication. This paper reviews findings about the presentation and course of major psychiatric disorders during pregnancy.

  5. Primary Psychiatric Diseases

    Directory of Open Access Journals (Sweden)

    Sibel Mercan

    2010-07-01

    Full Text Available The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.

  6. Perinatal psychiatric episodes

    DEFF Research Database (Denmark)

    Munk-Olsen, Trine; Maegbaek, M L; Johannsen, B M

    2016-01-01

    and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods......Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed...... psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy...

  7. Psychiatric disorders after radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kokai, Masahiro [Hyogo Coll. of Medicine, Nishinomiya (Japan); Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka

    2001-04-01

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  8. Assessing the outcome of compulsory treatment orders on management of psychiatric patients at 2 McGill University-associated hospitals.

    Science.gov (United States)

    Nakhost, Arash; Perry, John Christopher; Frank, Daniel

    2012-06-01

    Some literature suggests that compulsory community treatment orders (CTOs) are effective in reducing hospitalizations in a subgroup of psychiatric patients with histories of repeated hospitalization, allowing them to be treated in the community under less restrictive measures. However, studies have yielded contradictory findings, in part because of methodological differences. Our study examines the effectiveness of CTOs in reducing hospitalizations and increasing community tenure of such patients. The sample included all psychiatric patients who had been given a CTO during a 9-year period at 2 of McGill University's hospitals. This is a naturalistic, observational, retrospective, before-and-after study where patients acted as their own control subjects. We examined variables, including the number, duration, and time to psychiatric admissions, comparing 4 time periods: early, pre-index, index (when the first CTO was in force), and post-index periods. The total study duration per subject encompasses the longest period of observation within existing studies in Canada. Psychiatric patients with histories of frequent readmissions demonstrated a significant reduction in their number of hospitalizations as well as an increase in the median time to re-hospitalization, during the period when they were treated under a CTO. This effect of CTO was sustained even after the CTO had expired. Our study suggests that CTOs are effective in assisting psychiatric patients with histories of repeated hospitalizations to live and be treated in the community, diminishing the occurrence of frequent hospitalization.

  9. Barometric pressure, emergency psychiatric visits, and violent acts.

    Science.gov (United States)

    Schory, Thomas J; Piecznski, Natasha; Nair, Sunil; el-Mallakh, Rif S

    2003-10-01

    Associations between human behaviour and psychiatric decompensation and weather variables have been inconsistent. We studied the association of certain weather variables (specifically, humidity, wind speed, and barometric pressure) with emergent psychiatric presentations, psychiatric admissions, incidence of violent crimes, and suicides in a metropolitan area. We performed a retrospective study for the year 1999 in a mid-sized city. We included all documented emergent psychiatric visits to the city's psychiatric emergency room. We obtained violence data from the city police department and suicide data from the country medical examiner. The data suggest that total numbers of acts of violence and emergency psychiatry visits are significantly associated with low barometric pressure. Psychiatric inpatient admissions and suicides are not associated with any of the weather variables investigated. While alternate conclusions can be drawn, we propose that the data support the interpretation that low barometric pressure is associated with an increase in impulsive behaviours. Additional investigation is warranted.

  10. Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

    OpenAIRE

    Virve Pekurinen; Laura Willman; Marianna Virtanen; Mika Kivimäki; Jussi Vahtera; Maritta Välimäki

    2017-01-01

    Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 e...

  11. The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP)

    DEFF Research Database (Denmark)

    Larsen, Julie Rask; Siersma, Volkert Dirk; Davidsen, Annette Sofie

    2016-01-01

    OBJECTIVE: To assess the effectiveness of an intervention in Type 2 diabetic patients with concurrent psychiatric illness (PI) and compare this with the effectiveness in patients without PI. METHOD: In the Diabetes Care in General Practice trial, 1381 patients newly diagnosed with Type 2 diabetes...... were randomized to 6 years of structured personal diabetes care or routine diabetes care (ClinicalTrials.gov NCT01074762). In this observational post-hoc analysis, the effectiveness of the intervention for diabetes in 179 patients with concurrent PI was analyzed. RESULTS: During the 19-year follow......-up period, patients with PI in the structured personal care group experienced a lower risk for all-cause mortality [105.3 vs. 140.4 events per 1000 patient-years; hazard ratio (HR): 0.63, P=0.023, multivariably adjusted], diabetes-related death (66.0 vs. 95.1; HR: 0.57, P=0.015), any diabetes...

  12. Beliefs in genetic determinism and attitudes towards psychiatric genetic research: psychometric scale properties, construct associations, demographic correlates, and cross-cultural comparisons.

    Science.gov (United States)

    Voracek, Martin; Swami, Viren; Loibl, Lisa Mariella; Furnham, Adrian

    2007-12-01

    Using two new scales, this study examined beliefs in genetic determinism and attitudes towards psychiatric genetic research in student samples from Austria, Malaysia, Romania, and the United Kingdom. For both constructs, effects of culture were detectable, whereas those related to key demographics were either small and inconsistent across samples (political orientation and religiosity) or zero (sex and age). Judged from factorial dimensionality and internal consistency, the psychometric properties of both scales were satisfactory. Belief in genetic determinism had lower prevalence and corresponded only modestly to positive attitudes towards psychiatric genetic research which had higher prevalence. The correlations of both constructs with a preference of inequality among social groups (social dominance orientation) were modest and inconsistent across samples. Both scales appear appropriate for cross-cultural applications, in particular for research into lay theories and public perceptions regarding genetic vs environmental effects on human behavior, mental disorders, and behavioral and psychiatric genetic research related to these.

  13. Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply?

    Science.gov (United States)

    Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan

    2015-02-01

    In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

  14. Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children.

    Science.gov (United States)

    Alvarenga, Pedro G; do Rosario, Maria C; Cesar, Raony C; Manfro, Gisele G; Moriyama, Tais S; Bloch, Michael H; Shavitt, Roseli G; Hoexter, Marcelo Q; Coughlin, Catherine G; Leckman, James F; Miguel, Euripedes C

    2016-02-01

    Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.

  15. Psychiatric phenotypes in chronic traumatic encephalopathy.

    Science.gov (United States)

    Mahar, Ian; Alosco, Michael L; McKee, Ann C

    2017-09-06

    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder involving cognitive, motor, and psychiatrically-relevant symptoms resulting from repetitive head impacts. Psychiatric phenotypes of CTE, including depression and suicidality, present particular challenges for CTE research, given that the diagnosis requires postmortem neuropathological examination. The pathognomonic lesion of CTE is the perivascular accumulation of hyperphosphorylated tau (ptau) protein at the depths of cortical sulci. These lesions are found in the earliest disease stages, and with advancing pathological severity, ptau deposition occurs in widespread brain regions in a four-stage scheme of severity. We review the psychiatric phenotypes of individuals neuropathologically diagnosed with CTE, and suggest that earlier CTE stages hold particular interest for psychiatric CTE research. In the early CTE stages, there is ptau pathology in frontal cortex and axonal loss in the frontal white matter, followed by progressive ptau neurofibrillary degeneration in the amygdala and hippocampus. Neuropathological changes in the frontal and medial temporal lobes may underlie psychiatric phenotypes. Additional insight into the association between CTE pathology and psychiatric sequelae may come from advancements in in vivo methods of CTE detection. Further epidemiological, clinical, and postmortem studies are needed to validate the nature of psychiatric sequelae in CTE. Copyright © 2017. Published by Elsevier Ltd.

  16. Psychiatric disorders and urbanization in Germany

    OpenAIRE

    Koelen Jurrijn; Peen Jaap; Dekker Jack; Smit Filip; Schoevers Robert

    2008-01-01

    Abstract Background Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization. Method...

  17. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2009-07-01

    Full Text Available Abstract Background The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Methods Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Results and discussion Workload and job stress are associated with practice performance. Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16. After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45. When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care. Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21 and insufficient practice management (b = 0.25. Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35. Conclusion Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using

  18. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    Science.gov (United States)

    van den Hombergh, Pieter; Künzi, Beat; Elwyn, Glyn; van Doremalen, Jan; Akkermans, Reinier; Grol, Richard; Wensing, Michel

    2009-07-15

    The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Workload and job stress are associated with practice performance.Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16). After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45). When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care.Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21) and insufficient practice management (b = 0.25). Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35). Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using this kind of data feedback could benefit both patients and GP.

  19. Rabeprazole and psychiatric symptoms.

    Science.gov (United States)

    Polimeni, Giovanni; Cutroneo, Paola; Gallo, Adele; Gallo, Salvatore; Spina, Edoardo; Caputi, Achille P

    2007-07-01

    To report the case of a patient who developed marked anxiety associated with episodes of panic attacks after starting rabeprazole therapy. An otherwise healthy 55-year-old woman was prescribed rabeprazole 20 mg/day administered in the morning for persistent symptoms of dyspepsia. Ten days later, she presented with a 7 day history of marked anxiety associated with panic attacks, night terror (pavor nocturnus), episodic mental confusion, and attention deficit. Within 2 days of discontinuing rabeprazole, the patient recovered completely from the neuropsychiatric manifestations. Subsequent esomeprazole therapy did not cause psychiatric symptoms. Rabeprazole-induced hypergastrinemia may have played a role in this neuropsychiatric adverse reaction. Several lines of evidence have indicated that gastrin-releasing peptide, whose release is mediated by proton pump inhibitor (PPI)-induced secretion of gastrin, is involved in regulating aspects of behavior that might be altered in disorders such as anxiety, depression, and dementia. The fact that rabeprazole has the highest capacity of inducing gastrin increase compared with other PPIs might explain why our patient's panic symptoms disappeared after switching to esomeprazole. Based on the Naranjo probability scale, rabeprazole was the probable cause of the adverse reaction. Specific studies are needed to investigate the potential role of PPI-induced hypergastrinemia in neuropsychiatric adverse reactions.

  20. Serotonin transporter gene polymorphism and psychiatric disorders: Is there a link?

    Science.gov (United States)

    Margoob, Mushtaq A.; Mushtaq, Dhuha

    2011-01-01

    Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders. PMID:22303036

  1. The Association between Preschool Teachers' Beliefs and Practices about Developmentally Appropriate Practices

    Science.gov (United States)

    Mohamed, Ahmed Hassan Hemdan; Al-Qaryouti, Ibrahim Amin

    2016-01-01

    The purpose of this study was to explore whether preschool teachers' self-reported beliefs could predict their self-reported practices about developmentally appropriate practices (DAP). A related purpose was to examine whether classroom size and teachers' experience are significant predictors of their self-reported beliefs and practices. A total…

  2. Burnout na clínica psiquiátrica: relato de um caso Burnout in psychiatric practice: a case report

    Directory of Open Access Journals (Sweden)

    Isabela Vieira

    2006-12-01

    Full Text Available A síndrome de burnout, identificada na década de 1970, caracteriza-se por uma tríade de dimensões (exaustão emocional, despersonalização e redução da realização pessoal e é uma condição relacionada à organização do trabalho. Entretanto, não consta nas classificações psiquiátricas. O artigo apresenta o conceito de burnout, estabelece o seu atual status nosológico e introduz uma breve discussão sobre a diferença entre burnout e depressão, a partir do relato de um caso atendido no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro.The burnout syndrome was first described in the 1970's and is characterized by three dimensions (emotional exhaustion, depersonalization and reduced personal accomplishment. Burnout is a work organization-related health condition. Nevertheless, it is not part of any psychiatric classification. This article presents the concept of burnout, establishes its nosological status and introduces a brief discussion on the difference between burnout and depression, based on the report of a clinical case treated at Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro.

  3. Oxytocin and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Gokce Nur Say

    2016-06-01

    Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113

  4. Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives.

    Science.gov (United States)

    Nevin, Remington L; Croft, Ashley M

    2016-06-22

    The modern medical literature implicates malaria, and particularly the potentially fatal form of cerebral malaria, with a risk of neurocognitive impairment. Yet historically, even milder forms of malaria were associated in the literature with a broad range of psychiatric effects, including disorders of personality, mood, memory, attention, thought, and behaviour. In this article, the history of psychiatric effects attributed to malaria and post-malaria syndromes is reviewed, and insights from the historical practice of malariotherapy in contributing to understanding of these effects are considered. This review concludes with a discussion of the potentially confounding role of the adverse effects of anti-malarial drugs, particularly of the quinoline class, in the unique attribution of certain psychiatric effects to malaria, and of the need for a critical reevaluation of the literature in light of emerging evidence of the chronic nature of these adverse drug effects.

  5. Tooth wear: prevalence and associated factors in general practice patients.

    Science.gov (United States)

    Cunha-Cruz, Joana; Pashova, Hristina; Packard, J D; Zhou, Lingmei; Hilton, Thomas J

    2010-06-01

    To estimate the prevalence of tooth wear and to investigate factors associated with tooth wear in patients from general practices in the Northwest United States. Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients (n= 1530) visiting general dentists from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) (n=80). Prevalence ratios (PRs) of moderate to severe occlusal and incisal tooth wear by patient characteristics were estimated using cluster-adjusted multiple binomial regression for adults (18+ years) and children/adolescents (3-17 years). For adults, the mean number of teeth with wear facets was 5.4 [95% confidence interval (CI) =4.6-6.2] and 51% of the adults had four or more teeth with wear. Participants 45-64 and 65+ years old were 1.3 (95% CI=1.1-1.6) and 1.4 (95% CI=1.1-1.8) times as likely to have 4+ teeth with moderate to severe wear facets as participants 18-44 years old. Adult males had a 20% (PR=1.2; 95% CI=1.1-1.4) higher prevalence of wear than adult females. Adults who were using, or had ever used occlusal splints had higher prevalence of tooth wear compared to those who never used such appliances (PR=1.3; 95% CI=1.0-1.5). Adults with any periodontal bone loss also had a 20% higher prevalence of wear than adults without periodontal disease (PR=1.2; 95% CI=1.0-1.4). For children/adolescents, the mean number of teeth with moderate to severe wear facets was 1.6 (95% CI=0.9-2.6) and 31% of the children had one or more teeth with wear facets. The adjusted prevalence ratio of tooth wear (1+ teeth with wear facets) for boys was 1.6 times as high (95% CI=1.1-2.4) as compared with girls. The prevalence of wear for children 12+ years old was 50% (PR=0.5; 95% CI=0.3-0.8) lower than that of children treatment, missing teeth, and race/ethnicity. Tooth wear is a prevalent condition in this population. Among adults, higher

  6. Sleep disturbances in a clinical forensic psychiatric population

    NARCIS (Netherlands)

    Kamphuis, Jeanine; Karsten, Julie; de Weerd, Al; Lancel, Marike

    2013-01-01

    Objective: Poor sleep is known to cause detrimental effects on the course of diverse psychiatric disorders and is a putative risk factor for hostility and aggression. Thus, sleep may be crucial in forensic psychiatric practice. However, little is known about the prevalence of sleep disturbances in

  7. A Closer Evaluation of Current Methods in Psychiatric Assessments

    Science.gov (United States)

    2009-01-01

    The biopsychosocial model, the current method in psychiatric assessments, is reviewed and critiqued. The history and original intents leading to the conception of the biopsychosocial model are briefly discussed. Five inherent problems with the use of the biopsychosocial model in psychiatric assessments and training programs are presented. Two alternative approaches are discussed and promoted for clinical, educational, and research practices in medicine. PMID:19724745

  8. Psychiatric/Mental health nursing education in Victoria, Australia: barriers to specialization.

    Science.gov (United States)

    Happell, Brenda

    2006-04-01

    The introduction of undergraduate comprehensive nursing education in Victoria, Australia, during the 1990s has resulted in significant changes in undergraduate preparation for psychiatric/mental health nursing. Comprehensive programs became charged with the responsibility of preparing graduates to provide care for people experiencing a mental illness across a broad range of health-care settings, as well as providing a pathway for graduates with an interest in specialist practice in this field. The aim of this article is to clearly articulate the issues associated with psychiatric/mental health nursing education at the undergraduate level, including prevalence of mental illness, the inadequacy of psychiatric/mental health nursing theory and practice at undergraduate level, the negative attitudes of students toward this field of practice, and the subsequent failure of nursing education and practice initiatives to provide a clear mechanism for specialization in this important area of nursing practice. Throughout the article, the distinction between generalist and specialist preparation is argued and accompanied by a call for nursing education to recognize and address the issues associated with both domains.

  9. Comprehensive Psychiatric Evaluation

    Science.gov (United States)

    ... Guide - Table of Contents Facts For Families Guide - View by Topic Chinese Facts for Families Guide ... Psychiatric Evaluation No. 52; Updated October 2017 Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent ...

  10. Integrating a professional apprenticeship model with psychiatric clinical simulation.

    Science.gov (United States)

    Crider, Mark C; McNiesh, Susan G

    2011-05-01

    In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates the application of this model of professional apprenticeship in psychiatric-mental health education. Applications of the concept presented may be used in training nurses new to the practice of psychiatric-mental health nursing. Copyright 2011, SLACK Incorporated.

  11. Culture and Psychiatric Diagnosis

    OpenAIRE

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, a number of components related to psychiatric diagnosis have come under criticism for their inaccuracies and inadequacies. Neurobiologists and anthropologists have particularly criticized the rigidity of DSM-IV diagnostic criteria that appear to exclude whole classes of alternate illness presentations as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopat...

  12. Psychiatric aspects of Parkinson′s disease

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2015-01-01

    Full Text Available Parkinson′s disease (PD is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the "tip of the iceberg" of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control, sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD.

  13. Psychiatric disorders and sleep issues.

    Science.gov (United States)

    Sutton, Eliza L

    2014-09-01

    Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Can Psychiatric Rehabilitation Be Core to CORE?

    Science.gov (United States)

    Olney, Marjorie F.; Gill, Kenneth J.

    2016-01-01

    Purpose: In this article, we seek to determine whether psychiatric rehabilitation principles and practices have been more fully incorporated into the Council on Rehabilitation Education (CORE) standards, the extent to which they are covered in four rehabilitation counseling "foundations" textbooks, and how they are reflected in the…

  15. Change in stated clinical practice associated with participation in the Dental Practice-Based Research Network

    DEFF Research Database (Denmark)

    Gilbert, Gregg H; Richman, Joshua S; Qvist, Vibeke

    2010-01-01

    Clinical researchers have attempted many methods to translate scientific evidence into routine clinical practice, with varying success. Practice-based research networks (PBRNs) provide an important, practitioner-friendly venue to test these methods. Dentist practitioner-investigators from the Den...

  16. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders.

    Science.gov (United States)

    McLaughlin, Katie A; Green, Jennifer Greif; Gruber, Michael J; Sampson, Nancy A; Zaslavsky, Alan M; Kessler, Ronald C

    2010-02-01

    Although significant associations of childhood adversities (CAs) with adult mental disorders have been widely documented, associations of CAs with onset and persistence of disorders have not been distinguished. This distinction is important for conceptual and practical purposes. To examine the multivariate associations of 12 retrospectively reported CAs with persistence of adult DSM-IV disorders in the National Comorbidity Survey Replication. Cross-sectional community survey. Household population in the United States. Nationally representative sample of 5692 adults. Recency of episodes was assessed separately for each of 20 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance use disorders in respondents with a lifetime history of these disorders using the Composite International Diagnostic Interview. Predictors of persistence were examined using backward recurrence survival models to predict time since most recent episode controlling for age at onset and time since onset. The CAs involving maladaptive family functioning (parental mental illness, substance use disorder, criminality, family violence, physical and sexual abuse, and neglect) but not other CAs were significantly but modestly related to persistence of mood, substance abuse, and anxiety disorders. Number of maladaptive family functioning CAs had statistically significant, but again substantively modest, subadditive associations with the same outcomes. Exposure to multiple other CAs was significantly associated with persistence of mood and anxiety disorders. Associations remained statistically significant throughout the life course, although the substantive size of associations indicated by simulations showing time to most recent episode would increase by only 1.6% (from a mean of 8.3 years to a mean of 8.4 years) in the absence of CAs. The overall statistically significant associations of CAs with adult DSM-IV/Composite International Diagnostic Interview disorders are due largely to

  17. Psychiatric aspects of bariatric surgery

    Science.gov (United States)

    Yen, Yung-Chieh; Huang, Chih-Kuan; Tai, Chi-Ming

    2014-01-01

    Purpose of review Bariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery. Recent findings This article reviews the specific psychopathologies before surgery, changes in psychopathologies after surgery, suicide risk related to bariatric surgery, factors associated with weight loss, and recommendations for presurgical and postsurgical assessment and management. Research indicates a decrease in certain psychiatric symptoms after weight loss with bariatric surgery. However, the risk of suicide and unsuccessful weight loss in some bariatric surgery patients make monitoring following surgery as important as careful assessment and management before surgery. Specific considerations for youth and older populations and future potential research foci are discussed. Summary Recent publications suggest new directions for psychiatric evaluation and interventions for bariatric surgery patients. Future research on outcomes of specific populations, effectiveness of psychopharmacotherapy, and underlying pathophysiology are warranted for the advancement of treating bariatric surgery patients. PMID:25036421

  18. Experiences from consumer reports on psychiatric adverse drug reactions with antidepressant medication: a qualitative study of reports to a consumer association.

    Science.gov (United States)

    Vilhelmsson, Andreas; Svensson, Tommy; Meeuwisse, Anna; Carlsten, Anders

    2012-12-23

    The new European pharmacovigilance legislation has been suggested as marking the beginning of a new chapter in drug safety, making patients an important part of pharmacovigilance. In Sweden since 2008 it has been possible for consumers to report adverse drug reactions (ADRs) to the Medical Products Agency (MPA), and these reports are now understood as an increasingly valuable contribution in the monitoring of safety aspects in medicines. Already in 2002 it was possible to report experiences with medicines to the non-profit and independent organization Consumer Association for Medicines and Health (KILEN) through a web-based report form with an opportunity to describe ADR experiences in free text comments. The aim of this study was to qualitatively analyze the free text comments appended to consumer reports on antidepressant medication. All reports of suspected adverse reactions regarding antidepressant medications submitted from January 2002 to April 2009 to KILEN's Internet-based reporting system in Sweden were analyzed according to reported narrative experience(s). Content analysis was used to interpret the content of 181 reports with free text comments. Three main categories emerged from the analyzed data material: (1) Experiences of drug treatment with subcategories (a) Severe psychiatric adverse reactions, and (b) Discontinuation symptoms; (2) Lack of communication and (3) Trust and distrust. A majority of the reports to KILEN were from patients experiencing symptoms of mental disturbances (sometimes severe) affecting them in many different ways, especially during discontinuation. Several report included narratives of patients not receiving information of potential ADRs from their doctor, but also that there were no follow-ups of the treatment. Trust was highlighted as especially important and some patients reported losing confidence in their doctor when they were not believed about the suspected ADRs they experienced, making them attempt to discontinue their

  19. Mentoring in psychiatric residency programs: a survey of chief residents.

    Science.gov (United States)

    Lis, Lea DeFrancisci; Wood, William C; Petkova, Eva; Shatkin, Jess

    2009-01-01

    Mentorship is an important component of graduate education. This study assessed the perceptions of general psychiatry chief residents regarding the adequacy of mentorship provided during training. The authors surveyed 229 chief residents participating in the APA National Chief Residents Leadership Program in 2004 and 2005. The survey assessed domains such as work hours, didactics, home and family life, and mentorship. Of the chief psychiatric residents surveyed, 49% reported that they did not have a clearly defined career development mentor, and 39% reported that they did not feel adequately mentored. Gender, race/ethnicity, marital status, moonlighting, medical school (American versus international), and type of residency program (academic versus community based) did not show significant association with either "having a clearly defined mentor" or "feeling adequately mentored," based on chi-squared tests for independence. Chief residents who had authored peer-reviewed publications were significantly more likely to report having a clearly defined mentor and to feel adequately mentored than those who did not author publications. Logistic regression analysis showed that having a clearly defined mentor was associated with twice the odds for feeling well prepared to practice psychiatry upon graduation compared with those who did not have a clearly defined mentor, even after controlling for gender, race, medical school, and residency program type. Half of the psychiatric chief residents surveyed reported the lack of a clearly defined career development mentor. In addition, a chief resident's response of lacking a clear mentor was associated with the perception of being less prepared to practice psychiatry upon graduation. Psychiatric residency training programs may benefit from further clarification and implementation of effective mentorship programs.

  20. "Treat me with respect". A systematic review and thematic analysis of psychiatric patients' reported perceptions of the situations associated with the process of coercion

    DEFF Research Database (Denmark)

    Tingleff, E B; Bradley, S K; Gildberg, F A

    2017-01-01

    Introduction: There is a lack of research into psychiatric patients' perceptions of coercion that discriminates between different types of coercive measures, while also investigating patients' perceptions of undergoing coercion as a process. This knowledge is required to improve our understanding......' individual needs. Professionals also need to articulate concern and empathy towards the patient and to improve communication skills before, during and after a coercive incident. Use of de-escalation and noncoercive strategies is required....

  1. Relational coordination is associated with productivity in general practice: a survey and register based study

    DEFF Research Database (Denmark)

    Lundstrøm, Sanne Lykke; Edwards, Kasper; Reventlow, Susanne

    2014-01-01

    In this paper we investigate the association between relational coordination among the practice team in general practice and number of consultations performed in a general practice per staff, i.e. a proxy of productivity. We measured relational coordination using the Relational Coordination Survey...

  2. Food practices associated with increased risk of bacterial food ...

    African Journals Online (AJOL)

    blignautas

    ISSN 0378-5254 Journal of Family Ecology and Consumer Sciences, Vol 33, 2005. Food practices .... LITERATURE REVIEW ... risk raw food items include minced meat and shellfish. Although the ... raw and ready-to-eat food products during storage, or applying the ..... on the usual behaviour of the respondents with “usual”.

  3. Extramarital sexual practices and perceived association with HIV ...

    African Journals Online (AJOL)

    admin

    Sexual violence and coercion such as rape, forced marriage, and abduction were found to be taboo among the Borana and discouraged in the community. Breaking such taboo would lead to the application of punitive measure by local Gada2 leaders. For women and girls, sexual practice before marriage is considered a ...

  4. Knowledge, attitudes and practices associated with pesticide use ...

    African Journals Online (AJOL)

    This work takes a limited but significant look at knowledge, attitudes and practices (KAP) vis-à-vis pesticide use in two farming communities in The Gambia. Most of the users have no formal education and they never received any formal training related to pesticide use. However, for the most part, there was a very high level ...

  5. Psychiatric Aspects of Infertility

    Directory of Open Access Journals (Sweden)

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  6. Psychiatric hospitalization and suicide among the very old in Denmark: population-based register study

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Mortensen, Preben Bo; Vach, Werner

    2005-01-01

    BACKGROUND: Very old people have higher suicide rates than the younger elderly population. Psychiatric disorders are known to have a strong association with suicide among elderly people. AIMS: To analyse the analyse the suicide risk associated with psychiatric hospitalisation among the very old......: The association between suicide and psychiatric hospitalisation is much weaker for the very old than for the old. Psychiatric disorders among very old people may be interacting with other disorders, may be underdiagnosed or treated in other healthcare settings....

  7. O caso "estrela": práticas de desinstitucionalização na reforma psiquiátrica The "estrela" case: practices of desinstitucionalization in the psychiatric reform

    Directory of Open Access Journals (Sweden)

    Giceli Carvalho Batista

    2013-01-01

    Full Text Available Este artigo discute o processo de consolidação e institucionalização da reforma psiquiátrica em Aracaju/Sergipe a partir de uma pesquisa realizada entre 2009 e 2010, que teve como objeto as práticas da equipe de gestão Rede de Atenção Psicossocial (REAP. Foram realizadas entrevistas com sujeitos que compunham ou já haviam composto a equipe de gestão e análise documental dos relatórios anuais de gestão, seguindo o método da análise das configurações tomado como estudo de caso social e da análise do discurso de base foucaultiana. Constrói-se uma breve história da reforma psiquiátrica no município, pontuando em que medida a função de gerir articula-se com alguns dispositivos biopolíticos. Evidencia-se que a governamentalidade, inerente ao exercício de poder que caracteriza as funções estatais, efetiva-se através do exercício de gestão configurando práticas normativas a serviço do controle dos corpos, mas não impede a produção de práticas de resistência, como mostra o caso "Estrela" aqui apresentado.This paperwork is a discussion about the process of the Psychiatric Reform in Aracaju, state of Sergipe, were considered, taking into account the practices of the management group of the Psychosocial Attention Network between 2007 and 2009. The investigation adopted the analysis of configuration e analysis of discourse as studied by Michel Foucault. It is done a brief history about the psychiatric reform process, emphasizing the level in which the function of manager is articulated to mechanisms of control was considered, also considering the partisanship in vogue. What becomes clear is that the "governmentalization"- essential when exercising the power in state functions- takes place throughout exercises of management, configuring normative practices, those which are in service of body control, therefore, resistance is in attendance, represented in the "Estrela" case.

  8. Psychiatric conditions in an evolutionary context.

    Science.gov (United States)

    Fabrega Jr, Horacio

    2004-01-01

    Psychiatric conditions and the institutions and practices that modern society has evolved to handle them originated during the nineteenth century in Anglo European societies. They are products of a historically contingent and culture specific formulation of a class of social problems of behavior that came to the fore in relation to intellectual and political economic changes of those societies. However, such problems have a long ancestry. They are intrinsic to human species and the social and cultural systems that its members have evolved since their emergence. This article reviews intellectual quandaries raised by evolutionary study of psychiatric conditions, those of crossing the human/animal divide and crossing historically contingent cultures; and of framing history of psychiatry in terms of social and cultural evolution. The biological architecture underlying psychiatric conditions and the breakthroughs that indigenous psychiatry of different types of societies underwent in formulating signs and symptoms are discussed. Copyright (c) 2004 S. Karger AG, Basel.

  9. Indian – American contributions to psychiatric research

    Science.gov (United States)

    Pandurangi, Anand K.

    2010-01-01

    The Indian Diaspora, especially in North America, is a visible force in the field of psychiatric medicine. An estimated 5000 persons of Indian origin practice psychiatry in the USA and Canada, and an estimated 10% of these are in academic psychiatry. Wide ranging contributions, from molecular biology of psychiatric disorders to community and cultural psychiatry, are being made by this vibrant group of researchers. This article is a brief summary and work-in-progress report of the contributions by Indian – American psychiatric researchers. Although not exhaustive in coverage, it is meant to give the reader an overview of the contributions made by three waves of researchers over a span of 50 years. PMID:21836715

  10. Tentativas inovadoras na prática de ensino e assistência na área de saúde mental - I The changing practice and teaching in psychiatric nursing

    Directory of Open Access Journals (Sweden)

    Sônia Barros

    1999-06-01

    Full Text Available RESUMO No atual contexto de transformações no campo da assistência à saúde mental no Brasil, a Universidade tem a responsabilidade de redirecionar a qualificação profissional da força de trabalho em saúde. Este artigo versa sobre a experiência de um Programa de Integração Docente-Assistencial envolvendo a Secretaria de Estado de Saúde e a Universidade de São Paulo. Particulariza a experiência de estudantes de enfermagem cursando a disciplina de enfermagem psiquiátrica. A análise da avaliação dos alunos do programa teórico-prático desenvolvido na unidade, ancorado nos pressupostos da Reabilitação Psicossocial indica, ao mesmo tempo, que o modelo de atenção interfere diretamente na qualificação das práticas e, simultaneamente, desenvolve nos alunos atitudes e conhecimentos que os qualificam para desempenhar de forma coerente suas funções.ABSTRACT In the context of recent changes that are taking place in the field of mental health care in Brazil, the University has the responsibility to redimensioning human, resources qualification of mental health workers: At the Mental Health Care and Educational Program of the University of São Paulo and São Paulo Health Office (São Paulo/Brazil, an experience still in course, the nursing students attending to psychiatric nurse training evaluated that theoretical practical education, dealing with health care issues in the field of Psychosocial Rehabilitation purpose, at the same time that directly interferes in the qualification of practices, simultaneously develops the students attitudes and knowledge that qualify them to perform coherent practices in accordance with rehabilitation models of care.

  11. Psychiatric patient and anaesthesia

    Directory of Open Access Journals (Sweden)

    Joginder Pal Attri

    2012-01-01

    Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.

  12. Factors associated with infant feeding practices and nutritional ...

    African Journals Online (AJOL)

    A high proportion of mothers 94.3% and of their spouses 88.9% had attended formal education at varying levels. Out of the 350 children in the study, 56.3% were males while 43.7% were females, 84.5% of all children being one year and below. Majority of mothers 68.6% had knowledge on infant feeding practices, mainly ...

  13. Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

    Directory of Open Access Journals (Sweden)

    Virve Pekurinen

    2017-10-01

    Full Text Available Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine. A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability. Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have

  14. On the Moral Acceptability of Physician-Assisted Dying for Non-Autonomous Psychiatric Patients.

    Science.gov (United States)

    Varelius, Jukka

    2016-05-01

    Several authors have recently suggested that the suffering caused by mental illness could provide moral grounds for physician-assisted dying. Yet they typically require that psychiatric-assisted dying could come to question in the cases of autonomous, or rational, psychiatric patients only. Given that also non-autonomous psychiatric patients can sometimes suffer unbearably, this limitation appears questionable. In this article, I maintain that restricting psychiatric-assisted dying to autonomous, or rational, psychiatric patients would not be compatible with endorsing certain end-of-life practices commonly accepted in current medical ethics and law, practices often referred to as 'passive euthanasia'. © 2015 John Wiley & Sons Ltd.

  15. Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.

    Science.gov (United States)

    Sahlsten, Hanna; Taiminen, Tero; Karukivi, Max; Sjösten, Noora; Nikkilä, Johanna; Virtanen, Juuso; Paavola, Janika; Joutsa, Juho; Niinivirta-Joutsa, Katri; Takala, Mari; Holm, Anu; Rauhala, Esa; Löyttyniemi, Eliisa; Johansson, Reijo; Jääskeläinen, Satu K

    2017-11-30

    Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus. Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES). 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32. The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4. Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).

  16. Psychiatric nursing education in Nebraska: 1989-1990.

    Science.gov (United States)

    Moller, M D; Pierce, A; Roach, R; Shanahan, C; Loch, E

    1991-01-01

    The academic and clinical content of psychiatric nursing curricula in the registered nurse basic educational programs in Nebraska for academic year 1989-1990 was explored by the Nebraska Sub-group of the Nursing Curriculum and Training Task Force of the National Alliance for the Mentally Ill. The review includes literature regarding the history, development, and future trends of psychiatric nursing; factors affecting nursing student attitudes toward psychiatric patients; basic content included in psychiatric and psychosocial nursing curricula; and concepts essential in working with the seriously, persistently mentally ill. Contrary to current trends in the United States, all Nebraska schools of nursing have a generic psychiatric nursing course taught by clinical specialists in psychiatric-mental health nursing. Hands-on clinical time spent with patients with psychiatric diagnoses as well as those with psychosocial needs varies from 84 to 200 hr per semester. Not all students are exposed to patients with severe and persistent mental illness. Fewer than 5% of Nebraska graduates choose psychiatric nursing as their area of practice. The authors express grave concern for the future of psychiatric nursing education. Implications for curriculum revision and replication studies are suggested.

  17. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service......, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics...

  18. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    , and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics......A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  19. Animal cruelty and psychiatric disorders.

    Science.gov (United States)

    Gleyzer, Roman; Felthous, Alan R; Holzer, Charles E

    2002-01-01

    Animal cruelty in childhood, although generally viewed as abnormal or deviant, for years was not considered symptomatic of any particular psychiatric disorder. Although animal cruelty is currently used as a diagnostic criterion for conduct disorder, research establishing the diagnostic significance of this behavior is essentially nonexistent. In the current study, investigators tested the hypothesis that a history of substantial animal cruelty is associated with a diagnosis of antisocial personality disorder (APD) and looked for associations with other disorders commonly diagnosed in a population of criminal defendants. Forty-eight subjects, criminal defendants who had histories of substantial animal cruelty, were matched with defendants without this history. Data were systematically obtained from the files by using four specifically designed data retrieval outlines. A history of animal cruelty during childhood was significantly associated with APD, antisocial personality traits, and polysubstance abuse. Mental retardation, psychotic disorders, and alcohol abuse showed no such association.

  20. Contact lens associated microbial keratitis: practical considerations for the optometrist

    OpenAIRE

    Zimmerman AB; Nixon AD; Rueff EM

    2016-01-01

    Aaron B Zimmerman, Alex D Nixon, Erin M Rueff College of Optometry, The Ohio State University, Columbus, OH, USAAbstract: Microbial keratitis (MK) is a corneal condition that encompasses several different pathogens and etiologies. While contact lens associated MK is most often associated with bacterial infections, other pathogens (fungi, Acanthamoeba species, etc) may be responsible. This review summarizes the risk factors, microbiology, diagnostic characteristics, and treatment options for a...

  1. Conceptions of mobile emergency service health professionals concerning psychiatric emergency

    Directory of Open Access Journals (Sweden)

    Diego Bonfada

    2012-06-01

    Full Text Available Under the Brazilian Psychiatric Reformation, assistance to psychological seizures represents a challenge for the emergency services. Therefore, the objective of this paper is the analysis of the conceptions of health professionals who work at the Mobile Emergency Service in Natal on psychiatric emergency care. This paper is, then, a qualitative study that used interviews as tools for collecting information. By using thematic analysis, the speeches were grouped into three categories: the stigma on patients and the professionals' fear of services interventions in psychiatric emergencies; having psychiatric emergencies regarded as harmful to patients and others' security; psychiatric emergencies being taken as patients' aggressiveness or severe depression. The data collected indicate that the interviewed professionals' ideas are supported by elements associated with the ideology that insanity implies social segregation and dangerousness. Thus, the survey prompted reflection on relevant issues to the process of psychiatric reformation implementation.

  2. Seasonality of suicides with and without psychiatric illness in Denmark

    DEFF Research Database (Denmark)

    Yip, P.S.; Yang, K.C.; Qin, Ping

    2006-01-01

    This paper studied the seasonality of suicides among persons with and without psychiatric illness in Denmark from 1970 to 1999. A non-homogenous Poisson process was used to examine the data. The seasonality of suicides was shown to be associated with gender and their psychiatric histories...... with a declining trend of suicide incidence noted over the captured period. A mild seasonal component was reported in the period of the late 70s to early 80s (1975-1984) among females who did not have any psychiatric treatment history, while in the 80s the significant seasonality was mainly contributed by male...... suicides without a psychiatric history. Another mild possible invoked seasonality in the 90s was in males who suffered from psychiatric illness. The rest could be treated as random events. Apparently, the seasonality among suicides with psychiatric illness exists but its effect could vary in different...

  3. The Measurement of Adolescent Alcohol Problems via Item Response Theory and Their 15-Year Prospective Associations with Alcohol and Other Psychiatric Disorders.

    Science.gov (United States)

    Windle, Michael; Windle, Rebecca C

    2017-02-01

    A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period. High school students (N = 832) completed the 13-item Alcohol Problems Index (API) at age 18 years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic (ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period. The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70. Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan. Copyright © 2017 by the Research Society on Alcoholism.

  4. Legal duties of psychiatric patients.

    Science.gov (United States)

    Beahrs, J O

    1990-01-01

    Psychiatric practice involves an implied contract in which each party fulfills a specialized role and incurs corresponding duties and obligations to be discharged as best able. Patients incur duties at three levels. First are specific duties that arise from patients' specialized role in their own health care: (1) to provide accurate and complete information, and (2) to cooperate with treatment within the bounds of informed consent. Second are general duties that apply to all citizens, but are especially relevant within the mental health context: (1) to respect the physical integrity of self, others, and property, and (2) to obey the law. The controversial "duty to protect" is at a third level, a transcendent duty that is specific to the context at hand, but in principle can apply to more than one party. Advantages of enforcing patients' duties include better care by treating professionals, optimum level of functioning of patients, and improved systems-wide morale and safety. Breach of patients' duty has many potential consequences in the forensic sphere: termination of care, malpractice defense, criminal prosecution, and tort liability. Complicating factors include the degree and effect of patients' psychiatric impairment, patients' legal status, and the role played by psychotherapeutic transference.

  5. Breaking the code: Statistical methods and methodological issues in psychiatric genetics

    NARCIS (Netherlands)

    Stringer, S.

    2015-01-01

    The genome-wide association (GWA) era has confirmed the heritability of many psychiatric disorders, most notably schizophrenia. Thousands of genetic variants with individually small effect sizes cumulatively constitute a large contribution to the heritability of psychiatric disorders. This thesis

  6. Prevalence of serum anti-neuronal autoantibodies in patients admitted to acute psychiatric care

    DEFF Research Database (Denmark)

    Schou, M; Sæther, S G; Borowski, K

    2016-01-01

    BACKGROUND: Autoimmune encephalitis associated with anti-neuronal antibodies may be challenging to distinguish from primary psychiatric disorders. The significance of anti-neuronal antibodies in psychiatric patients without clear evidence of autoimmune encephalitis is unknown. We investigated the...

  7. Variations in dementia diagnosis in England and association with general practice characteristics.

    Science.gov (United States)

    Walker, Ian F; Lord, Paul A; Farragher, Tracey M

    2017-05-01

    Improving dementia diagnosis rates in England has been a key strategic aim of the UK Government but the variation and low diagnosis rates are poorly understood. The aim of this study was to explore the variation in actual versus expected diagnosis of dementia across England, and how these variations were associated with general practice characteristics. A cross-sectional, ecological study design using secondary data sources and median regression modelling was used. Data from the year 2011 for 7711 of the GP practices in England (92.7%). Associations of dementia diagnosis rates (%) per practice, calculated using National Health Service England's 'Dementia Prevalence Calculator' and various practice characteristics were explored using a regression model. The median dementia diagnosis rate was 41.6% and the interquartile range was 31.2-53.9%. Multivariable regression analysis demonstrated positive associations between dementia diagnosis rates and deprivation of the population, overall Quality and Outcomes Framework performance, type of primary care contract and size of practice list. Negative associations were found between dementia diagnosis rates and average experience of GPs in the practice and the proportion of the practice caseload over 65 years old. Dementia diagnosis rates vary greatly across GP practices in England. This study has found independent associations between dementia diagnosis rates and a number of patient and practice characteristics. Consideration of these factors locally may provide targets for case-finding interventions and so facilitate timely diagnosis.

  8. Psychiatric impairment and

    African Journals Online (AJOL)

    2002-12-03

    Dec 3, 2002 ... Impairment and disability assessment on psychiatric grounds has always been subjective, controversial ... informed medical advisors doing their disability assessments. Many of these advisors have expressed ..... that will empower the affected employee and that is non- stigma- tising. In order to do so it is ...

  9. Aggression in Psychiatric Wards

    DEFF Research Database (Denmark)

    Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil

    2016-01-01

    Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated wh...

  10. Psychiatric genetics:AJP

    African Journals Online (AJOL)

    Pippa

    their caregivers in South Africa. The heritability of the majority of the psychiatric disorders is ... linkage analyses in a cohort of Bantu-speaking black South. Africans.17-22 Areas of implied linkage to schizophrenia ... one of the studies of a Bantu-speaking schizophrenia cohort. Table I. Glossary of genetic terminology. Allele.

  11. Cerebellum and psychiatric disorders

    OpenAIRE

    Baldaçara,Leonardo; Borgio,João Guilherme Fiorani; Lacerda,Acioly Luiz Tavares de; Jackowski,Andrea Parolin

    2008-01-01

    OBJECTIVE: The objective of this update article is to report structural and functional neuroimaging studies exploring the potential role of cerebellum in the pathophysiology of psychiatric disorders. METHOD: A non-systematic literature review was conducted by means of Medline using the following terms as a parameter: "cerebellum", "cerebellar vermis", "schizophrenia", "bipolar disorder", "depression", "anxiety disorders", "dementia" and "attention deficit hyperactivity disorder". The electron...

  12. Contact lens associated microbial keratitis: practical considerations for the optometrist

    Directory of Open Access Journals (Sweden)

    Zimmerman AB

    2016-01-01

    Full Text Available Aaron B Zimmerman, Alex D Nixon, Erin M Rueff College of Optometry, The Ohio State University, Columbus, OH, USAAbstract: Microbial keratitis (MK is a corneal condition that encompasses several different pathogens and etiologies. While contact lens associated MK is most often associated with bacterial infections, other pathogens (fungi, Acanthamoeba species, etc may be responsible. This review summarizes the risk factors, microbiology, diagnostic characteristics, and treatment options for all forms of contact lens-related MK.Keywords: corneal ulcer, fungal keratitis, bacterial keratitis, Acanthamoeba, Fusarium, Pseudomonas

  13. Psychiatric Genomics: An Update and an Agenda.

    Science.gov (United States)

    Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M; Andreassen, Ole A; Børglum, Anders D; Breen, Gerome; Cichon, Sven; Edenberg, Howard J; Faraone, Stephen V; Gelernter, Joel; Mathews, Carol A; Nievergelt, Caroline M; Smoller, Jordan W; O'Donovan, Michael C

    2018-01-01

    The Psychiatric Genomics Consortium (PGC) is the largest consortium in the history of psychiatry. This global effort is dedicated to rapid progress and open science, and in the past decade it has delivered an increasing flow of new knowledge about the fundamental basis of common psychiatric disorders. The PGC has recently commenced a program of research designed to deliver "actionable" findings-genomic results that 1) reveal fundamental biology, 2) inform clinical practice, and 3) deliver new therapeutic targets. The central idea of the PGC is to convert the family history risk factor into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691 twin pairs was the largest in the field for nearly four decades. (Am J Psychiatry 1946; 103:309-322 )].

  14. Factors associated with self medication practice among pregnant ...

    African Journals Online (AJOL)

    Introduction: studies in different parts of the world indicate that there is high level use of self medication among pregnant women. But there are no scientific evidences on it and factors associated with it in Bahir Dar city administration. The aim of this study was therefore to assess level of self medication and identify factors ...

  15. Association of health professional leadership behaviors on health promotion practice beliefs.

    Science.gov (United States)

    Stone, Jacqueline D; Belcher, Harolyn M E; Attoh, Prince; D'Abundo, Michelle; Gong, Tao

    2017-04-01

    Leadership is a process by which an individual influences a group or individual to achieve a common goal, in this case health promotion for individuals with disabilities. (1) To examine the association between the transformational leadership behaviors of the Association of University Centers on Disabilities (AUCD) network professionals and their practice beliefs about health promotion activities, specifically cardiovascular fitness and healthy weight, for people with disabilities. (2) To determine if discipline and/or years of practice moderate the association between transformational leadership behaviors and practice beliefs regarding health promotion. There is a positive association between transformational leadership behaviors and health professionals practice beliefs regarding health promotion activities for persons with disabilities. A quantitative cross-sectional web-based survey design was used to determine the association between leadership behaviors and practices beliefs regarding health promotion for people with disabilities. The Multifactor Leadership Questionnaire and an adapted version of the Role of Health Promotion in Physical Therapy Survey were used to measure leadership and practice beliefs, respectively. Multiple regression analysis was applied to determine the association of leadership behaviors with health promotion practice beliefs variables. Transformational leadership behaviors of the AUCD network professionals were positively associated with health promotion practice beliefs about cardiovascular fitness for people with disabilities. Years post licensure and discipline did not moderate the association between transformational leadership and practice beliefs regarding health promotion. Transformational leadership may facilitate health professionals' health promotion practices for people with disabilities. Further research and training in leadership is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population.

    Science.gov (United States)

    Shacham, Enbal; Önen, Nur F; Donovan, Michael F; Rosenburg, Neal; Overton, E Turner

    2016-01-01

    As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status. © The Author(s) 2014.

  17. Predictive factors for psychiatric morbidity among women with ...

    African Journals Online (AJOL)

    Predictive factors for psychiatric morbidity among women with infertility attending a gynaecology clinic in Nigeria. ... p < 0.0001), discrimination (Χ2 = 69.91, p < 0.0001) and history of induced abortion (Χ2 = 30.40, p < 0.0001) were found to be significantly associated with psychiatric morbidity among patients with infertility ...

  18. Predictive factors for psychiatric morbidity among women with ...

    African Journals Online (AJOL)

    Objective: To determine the psychosocial and clinical factors that are associated with psychiatric morbidity among women with infertility attending ... difference in the rate of psychiatric morbidity between women with primary infertility and those with secondary infertility (χ2 = ..... Emotional distress of infertile women in Japan.

  19. Patterns and determinants of acute psychiatric readmissions | Behr ...

    African Journals Online (AJOL)

    Patterns and determinants of acute psychiatric readmissions. Graham Michael Behr, Cathy Christie, Neil Soderlund, Tennyson Lee. Abstract. Objectives. Deinstitutionalisation and shortage of psychiatric beds worldwide has led to extensive research into the risk factors and interventions associated with rapid and recurrent ...

  20. Assessment of pre and postoperative psychiatric comorbidity among ...

    African Journals Online (AJOL)

    Objective: Comorbid psychiatric disorders have been reported to be associated with pre and postoperative periods. Studies on pre and postoperative comorbid psychiatric disorders among ophthalmological patients are scanty in Nigeria and other sub-Saharan countries. This study was aimed at determining pre and ...

  1. Psychiatric Disorders Among People Living With HIV/AIDS Attending ...

    African Journals Online (AJOL)

    Human Immunodeficiency Virus (HIV) infection has been associated with development of psychiatric disorders in people living with HIV/AIDS (PLWHA). These disorders could occur at any stage of the disease. The presence of these psychiatric disorders may affect the adherence to the use of anti-retroviral medications as ...

  2. Challenges of Recognition of the Psychiatric Aspects of Intimate ...

    African Journals Online (AJOL)

    Background: Even though intimate partner violence represents a major public health problem in Nigeria, much of its associated burden of psychiatric morbidity presenting in the clinical setting goes unrecognized and untreated. Objectives: The purpose of this paper is to clarify the psychiatric perspectives on intimate partner ...

  3. Psychiatric research in an international perspective: the role of the ...

    African Journals Online (AJOL)

    Psychiatric research in an international perspective: the role of the World Psychiatric Association. Ahmed Okasha. Abstract. SA Psych Rev 2003;6:4-6. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

  4. Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

    Directory of Open Access Journals (Sweden)

    Blazer DG

    2011-07-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu2, Bruce Burchett2, Dan G Blazer2, George E Woody3, Walter Ling41Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY; 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC; 3Department of Psychiatry, School of Medicine, University of Pennsylvania and Treatment Research Institute, Philadelphia, PA; 4David Geffen School of Medicine, NPI/Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USABackground: In response to the rising rate of treatment admissions related to illicit use of amphetamines (eg, methamphetamine, we examined the prevalence of amphetamine use among treatment-seeking, opioid-dependent adults, explored whether amphetamine users were as likely as nonamphetamine users to enroll in opioid-dependence treatment trials, and determined whether amphetamine users manifested greater levels of medical and psychiatric comorbidity than nonusers.Methods: The sample included 1257 opioid-dependent adults screened for participation in threemultisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-003, which studied the effectiveness of buprenorphine for opioid detoxification under varying treatment conditions. Patients were recruited from 23 addiction treatment programs across the US. Medical and psychiatric comorbidity were examined by past-month amphetamine use (current vs former and route of administration. Five mutually exclusive groups were examined, ie, nonusers, current amphetamine injectors, current amphetamine noninjectors, former amphetamine injectors, and former amphetamine noninjectors.Results: Of the sample (n = 1257, 22.3% had a history of regular amphetamine use. Of the 280 amphetamine users, 30.3% reported injection as their primary route. Amphetamine users were more likely than nonusers to be white and use more

  5. Time Perception and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Hatice Ceviz

    2013-09-01

    Full Text Available Time perception is an ability which we use in every moment of daily life, that guides the formation and continuation of our behaviors and from an evolutionary perspective ensures survival. Internal clock models help us to understand time perception. Time perception is known to vary between individuals and particular situations. This variability is explained with the mechanisms which is associated with the processes related to attention, the speed of the internal clock and the memory unit. It is suggested that time perception is mainly associated with the activities of dopamine and acetylcholine. Some dopaminergic psychoactive substances like cocaine and amphetamine have all been shown to change time perception by increasing the speed of internal clock while on the other hand some antipsychotic drugs make an opposite change in time perception by descreasing the speed of the clock. Similarly, time perception is affected in some psychiatric disorders and an ethiopathological relationship between time perception disturbances and psychiatric disorders is suggested. In this article time perception changes in schizophrenia, attention deficit/hyperactivity syndrome, depression, anxiety disorders and personality disorders are briefly reviewed.

  6. Modifiable practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study.

    Science.gov (United States)

    Jadoul, Michel; Thumma, Jyothi; Fuller, Douglas S; Tentori, Francesca; Li, Yun; Morgenstern, Hal; Mendelssohn, David; Tomo, Tadashi; Ethier, Jean; Port, Friedrich; Robinson, Bruce M

    2012-05-01

    Sudden death is common in hemodialysis patients, but whether modifiable practices affect the risk of sudden death remains unclear. This study analyzed 37,765 participants in 12 countries in the Dialysis Outcomes and Practice Patterns Study to explore the association of the following practices with sudden death (due to cardiac arrhythmia, cardiac arrest, and/or hyperkalemia): treatment time [TT] 5.7% of postdialysis weight, low dialysate potassium [K(D) deaths, 26% of which were sudden (crude mortality rate, 15.3/100 patient-years; median follow-up, 1.59 years). Associations with sudden death included hazard ratios of 1.13 for short TT, 1.15 for large ultrafiltration volume, and 1.10 for low Kt/V. Compared with K(D) ≥3 mEq/L, the sudden death rate was higher for K(D) ≤1.5 and K(D)=2-2.5 mEq/L. The instrumental variable approach yielded generally consistent findings. The sudden death rate was elevated for patients taking amiodarone, but not other Q wave/T wave interval-prolonging drugs. This study identified modifiable dialysis practices associated with higher risk of sudden death, including short TT, large ultrafiltration volume, and low K(D). Because K(D) deaths. This hypothesis merits testing in clinical trials.

  7. [Association between paracetamol exposure and asthma: update and practice guidelines].

    Science.gov (United States)

    Moral, L; Torres-Borrego, J; Korta Murua, J; Valverde-Molina, J; Pellegrini Belinchón, J; Praena-Crespo, M; Ortega Casanueva, C; Callén-Blecua, M T; Fernández-Llamazares, C M; Calvo Rey, C

    2013-09-01

    Asthma prevalence has increased over the last few decades, especially in developed countries, and possibly due to different reasons. An association between paracetamol use or exposure at different periods of life, including gestation and childhood, and asthma prevalence has been observed in the last few years. Causality can not be established from observational reports, due to the arguable presence of many confounding factors and biases. Randomised trials are needed to elucidate the nature of this association. The Spanish Paediatric societies subscribing to this paper consider that current evidence is insufficient to discourage the use of paracetamol during gestation or in children with or at risk of asthma. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Celebrating our past. The history of Hamilton Psychiatric Hospital.

    Science.gov (United States)

    Forchuk, C; Tweedell, D

    2001-10-01

    1. There is a risk of losing important parts of our psychiatric nursing history as a result of the rapid rate of mental health reform and the closing or changing of governance of major psychiatric facilities. 2. Hamilton Psychiatric Hospital provided leadership in psychiatric nursing in Canada for more than a century and is now changing governance from being a provincial psychiatric hospital to part of a community general hospital. 3. The hospital's tradition includes nonrestrictive care policies that have been in place for more than a century, a humanistic approach to care, being the first facility in Canada to require theory-based nursing care from all nursing staff, innovative practice models, and achieving authorship or co-authorship from more than 17% of the RN staff.

  9. Acupuncture therapy for psychiatric illness.

    Science.gov (United States)

    Pilkington, Karen

    2013-01-01

    Acupuncture has traditionally been used for problems including anxiety, insomnia, stress, and depression in China and other East Asian countries. A range of different neurobiological responses to acupuncture have been investigated including modulation of serotonergic, noradrenergic, and dopaminergic systems; effects on GABA and the hypothalamic-pituitary-adrenal axis; and inflammatory responses. Interpretation of the findings is challenging because the neurobiology of psychiatric disorders has yet to be fully elucidated. Limitations also arise from the use of animal models and the selection of appropriate control treatments. Further complexity is added by acupuncture treatment being nonstandardized with acupuncture points often selected on the basis on traditional practice and theory. Potentially promising findings require further investigation and substantiation. © 2013 Elsevier Inc. All rights reserved.

  10. Mindful Parenting and Emotion Socialization Practices: Concurrent and Longitudinal Associations.

    Science.gov (United States)

    McKee, Laura G; Parent, Justin; Zachary, Chloe R; Forehand, Rex

    2017-11-01

    Caregivers play a crucial role in the socialization of youth emotion understanding, competence, and regulation, which are implicated in youth social and emotional health; however, there is less understanding of parental psychosocial or cognitive factors, like mindful parenting, that may be associated with the use of particular emotion socialization (ES) strategies. This study tests a model of the cross-sectional and short-term longitudinal associations between mindful parenting and supportive and nonsupportive ES strategies in a community sample of parents (N = 246; 63.8% mothers) of youth ranging from ages 3-12. Caregivers reported on mindful parenting and ES strategies at two time points 4 months apart. The structural equation model indicated that higher levels of mindful parenting are positively related to supportive ES responses and negatively related to nonsupportive ES responses both concurrently and over time. The longitudinal association between mindful parenting and nonsupportive, but not supportive, ES was marginally larger for fathers as compared to mothers. Given the documented impact of ES strategies on youth emotional and behavioral outcomes and interventions emerging to educate parents about how to provide a healthy emotional atmosphere, incorporating a focus on mindful parenting strategies may provide one pathway to increase supportive responses and decrease nonsupportive ones. © 2017 Family Process Institute.

  11. Application of The APA Practice Guidelines on Suicide to Clinical Practice.

    Science.gov (United States)

    Jacobs, Douglas G; Brewer, Margaret L

    2006-06-01

    This article presents charts from The American Psychiatric Association Practice Guideline for the Assessment and Treatment of Patients with Suicidal Behaviors, part of the Practice Guidelines for the Treatment of Psychiatric Disorders Compendium, and a summary of the assessment information in a format that can be used in routine clinical practice. Four steps in the assessment process are presented: the use of a thorough psychiatric examination to obtain information about the patient's current presentation, history, diagnosis, and to recognize suicide risk factors therein; the necessity of asking very specific questions about suicidal ideation, intent, plans, and attempts; the process of making an estimation of the patient's level of suicide risk is explained; and the use of modifiable risk and protective factors as the basis for treatment planning is demonstrated. Case reports are used to clarify use of each step in this process.

  12. The knowledge, attitude, priority of usage, and benefits associated with management accounting practices

    DEFF Research Database (Denmark)

    Nielsen, Steen; Melander, Preben; Jakobsen, Morten

    2009-01-01

    There have been several studies of the diffusion of new management accounting practices. This study adds a new dimension: in order to indicate the number of practices associated with the respondents, their interrelationships, the respondents, were asked to answer questions in a questionnaire...... management accounting practices. Our results reveal that companies in general experience a high level of benefit from the practices. However, significance differences between low priority of usage and high number of practices associated with the company are very likely to contribute to a more modest level...... and those companies seldom use a theoretical concept but are inspired to design home-made models. This also confirms that accounting practices are used for inspiration of design. The findings can provide a further basis for the discussion and development of a theory for new management accounting models....

  13. Psychiatric specialty training in Greece.

    Science.gov (United States)

    Margariti, M; Kontaxakis, V; Ploumpidis, D

    2017-01-01

    specialty, the European Board of Psychiatry. In the US, the supervising bodies are the Accreditation Council on Graduate Medical Education (ACGME) and the American Board of Psychiatry and Neurology, in the United Kingdom the Royal College of Psychiatrists, in Canada the Royal College of Physicians and Surgeons, etc. In our country, the debate on the need to reform the institutional framework for Psychiatric training has been underway since the mid-90s, with initiatives especially by the Hellenic Psychiatric Association, aiming to raise awareness and concern among psychiatrists while responding to requests from competent central bodies of the state, as well as establishing Panhellenic training programs for psychiatric trainees and continuing education programs. But what is the situation of the educational map in the country today, what would be the objectives, and how might we proceed? These questions we will try to answer in an effort initiated by Hellenic Psychiatric Association (HPA) and the journal "Psychiatriki" with the publication of thematic articles starting by presenting in the next issue of "Psychiatriki"a comparative study of the training in the specialty of psychiatry at two distinct periods of time (2000 and 2014). These time-frames are of great importance, since the first is a period that in retrospect can be considered as wealthier yet missing robust priorities, while the second, at the peak of the economic crisis, constitutes a difficult environment with limited resources. Already in the year 2000, psychiatric residency training in our country had major difficulties due to its outdated framework and its fragmentation. All areas in which training is assessed (clinical experience, theoretical training and training in psychotherapy exhibited inadequacies and limited convergence with European golden standards, in the absence of a plan and the implementation of a national education curriculum. Certain university clinics constituted an important exception, though

  14. Psychiatric care in the German prison system.

    Science.gov (United States)

    Lehmann, Marc

    2012-01-01

    The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

  15. Psychiatric comorbidities in women with celiac disease.

    Science.gov (United States)

    Arigo, Danielle; Anskis, Alicia M; Smyth, Joshua M

    2012-03-01

    Although the physical consequences of Celiac Disease are well studied, less is known about co-occurring psychiatric symptoms. This study examines psychiatric risk and comorbidities of women with Celiac Disease, who may be at increased risk for psychiatric symptoms (e.g. depression, and disordered eating behaviours). Women (N = 177) with Celiac Disease responded to an extensive web-mediated survey assessing dietary compliance, illness symptoms, psychiatric functioning, and disordered eating. Despite high reported dietary compliance, patients reported marked illness symptoms and impaired quality of life. A substantial minority endorsed symptoms that met criteria for the diagnosis of psychiatric disorders: 37% (n = 65) met the threshold suggesting depression, and 22% (n = 39) for disordered eating. Participants whose symptoms exceeded these clinical thresholds reported greater perceived stress and reduced overall mental health, relative to women below the clinical cutoffs. Despite largely adhering to a gluten-free diet, a substantial subset of women with Celiac Disease report clinically relevant symptoms of depression and disordered eating; such symptoms are associated with increased psychosocial distress in other domains. These results suggest potential to improve the patient well-being through attention to psychosocial care, in addition to existing dietary recommendations for individuals with Celiac Disease.

  16. Onconeural Antibodies in Acute Psychiatric Inpatient Care

    DEFF Research Database (Denmark)

    Sæther, Sverre Georg; Schou, Morten; Stoecker, Winfried

    2017-01-01

    Paraneoplastic neurological disorders associated with onconeural antibodies often appear with neuropsychiatric symptoms. To study the prevalence of onconeural antibodies in patients admitted to acute psychiatric inpatient care, the serum of 585 such patients was tested for antibodies targeting MOG......, GLRA1B, DPPX, GRM1, GRM5, DNER, Yo, ZIC4, GAD67, amphiphysin, CV2, Hu, Ri, Ma2, and recoverin. Only one sample was positive (antirecoverin IgG). The present findings suggest that serum onconeural antibody positivity is rare among patients acutely admitted for inpatient psychiatric care. The clinical...

  17. Psychiatric disorders, acne and systemic retinoids: comparison of risks.

    Science.gov (United States)

    Le Moigne, M; Bulteau, S; Grall-Bronnec, Marie; Gerardin, M; Fournier, Jean-Pascal; Jonville-Bera, A P; Jolliet, Pascale; Dreno, Brigitte; Victorri-Vigneau, C

    2017-09-01

    The link between isotretinoin, treatment of a severe form of acne, and psychiatric disorders remains controversial, as acne itself could explain the occurrence of psychiatric disorders. This study aims at assessing the disproportionality of psychiatric adverse events reported with isotretinoin in the French National PharmacoVigilance Database, compared with other systemic acne treatments and systemic retinoids. Data were extracted from the French National PharmacoVigilance Database for systemic acne treatments, systemic retinoids and drugs used as comparators. Each report was subjected to double-blind analysis by two psychiatric experts. A disproportionality analysis was performed, calculating the number of psychiatric ADRs divided by the total number of notifications for each drug of interest. Concerning acne systemic treatments: all 71 reports of severe psychiatric disorders involved isotretinoin, the highest proportion of mild/moderate psychiatric adverse events was reported with isotretinoin (14.1%). Among systemic retinoids, the highest proportion of severe and mild/moderate psychiatric events occurred with isotretinoin and alitretinoin. Our study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.

  18. [Statin associated myopathy in clinical practice. Results of DAMA study].

    Science.gov (United States)

    Millán, Jesús; Pedro-Botet, Juan; Climent, Elisenda; Millán, Joaquín; Rius, Joan

    Muscle symptoms, with or without elevation of creatin kinase are one of the main adverse effects of statin therapy, a fact that sometimes limits their use. The aim of this study was to evaluate the clinical characteristics of patients treated with statins who have complained muscle symptoms and to identify possible predictive factors. A cross-sectional one-visit, non-interventional, national multicenter study including patients of both sexes over 18 years of age referred for past or present muscle symptoms associated with statin therapy was conducted. 3,845 patients were recruited from a one-day record from 2,001 physicians. Myalgia was present in 78.2% of patients included in the study, myositis in 19.3%, and rhabdomyolysis in 2.5%. Patients reported muscle pain in 77.5% of statin-treated individuals, general weakness 42.7%, and cramps 28.1%. Kidney failure, intense physical exercise, alcohol consumption (>30g/d in men and 20g/d in women) and abdominal obesity were the clinical situations associated with statin myopathy. Myalgia followed by myositis are the most frequent statin-related side effects. It should be recommended control environmental factors such as intense exercise and alcohol intake as well as abdominal obesity and renal function of the patient treated with statins. Copyright © 2016 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Psychiatric epidemiology and disaster exposure in Australia.

    NARCIS (Netherlands)

    Reifels, L.; Mills, K.; Dückers, M.L.A.; O'Donnell, M.L.

    2017-01-01

    Aims. To examine the lifetime prevalence and risk of psychiatric disorders associated with natural and man-made disaster exposure in Australia. Methods. We utilised data from a nationally representative population survey (N = 8841) which were analysed through univariate and multivariate logistic

  20. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    NARCIS (Netherlands)

    Hombergh, P. van den; Kunzi, B.; Elwyn, G.; Doremalen, J.H.M. van; Akkermans, R.P.; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    BACKGROUND: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. METHODS: Secondary analysis of data

  1. Ethical Challenges in Psychiatric Administration and Leadership.

    Science.gov (United States)

    Moffic, H Steven; Saeed, Sy Atezaz; Silver, Stuart; Koh, Steve

    2015-09-01

    As with all professional ethical principles, those in psychiatry have to evolve over time and societal changes. The current ethical challenges for psychiatric administration and leadership, especially regarding for-profit managed care, need updated solutions. One solution resides in the development by the American Association of Psychiatric Administrators (AAPA) of the first set of ethical principles designed specifically for psychiatric administrators. These principles build on prior Psychological Theories of leadership, such as those of Freud, Kernberg, and Kohut. Supplementing these theories are the actual real life models of psychiatrist leadership as depicted in the memoirs of various psychiatrists. Appreciating these principles, theories, and models may help emerging leaders to better recognize the importance of ethical challenges. A conclusion is that psychiatrists should have the potential to assume more successful leadership positions once again. In such positions, making the skills and well-being of all in the organization seems now to be the foremost ethical priority.

  2. Obstructive sleep apnea: management considerations in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Heck T

    2015-10-01

    Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: