Academic literature on the topic 'Psychiatry Case studies'
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Journal articles on the topic "Psychiatry Case studies"
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Goi, Pedro Domingues, Julia Domingues Goi, Kariny Larissa Cordini, Keila Mendes Ceresér, and Neusa Sica da Rocha. "Evaluating psychiatric case-control studies using the STROBE (STrengthening the Reporting of OBservational Studies in Epidemiology) statement." Sao Paulo Medical Journal 132, no. 3 (2014): 178–83. http://dx.doi.org/10.1590/1516-3180.2014.1323653.
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CONTEXT AND OBJECTIVE:Case-control studies are important in developing clinical and public health knowledge. The STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) was developed to establish a checklist of items that should be included in articles reporting observational studies. Our aim was to analyze whether the psychiatric case-control articles published in Brazilian journals with CAPES Qualis rating B1/B2 in 2009 conformed with the STROBE statement.DESIGN AND SETTING:Descriptive study on psychiatric papers published in Brazilian journals, within the Postgraduate Medical Program on Psychiatry, at Universidade Federal do Rio Grande do Sul.METHODS:All psychiatric case-control studies from Brazilian Qualis B1/B2 journals of psychiatry, neurology and public health in 2009 were analyzed. The four most specific items of the STROBE statement were used to evaluate whether these studies fitted within the case-control parameters: 1) selection of cases and controls; 2) controlling for bias; 3) statistical analysis; and 4) presentation of results.RESULTS:Sixteen case-control studies were identified, of which eleven (68.75%) were in psychiatry-focused journals. From analysis using the STROBE statement, all of the articles conformed with item 1; two (12.5%) completely conformed with item 2; none completely conformed with item 3; and only three (18.8%) conformed with item 4.CONCLUSION:The case-control studies analyzed here did not completely conform with the four STROBE statement items for case-control design. In view of the inadequate methodology of the published studies, these findings justify focusing on research and methodology and expanding the investigations on adherence of studies to their designs.
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Al Mosawi, Aamir. "Case Studies in Pediatric Psychiatry: An Approach to Deep Learning and Experience Acquisition." Journal of Clinical Research and Reports 5, no. 2 (2020): 01–14. http://dx.doi.org/10.31579/2690-1919/106.
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Stewart, Ronald B., Kimberly C. Yedinak, and Michael R. Ware. "Polypharmacy in Psychiatry: Three Case Studies and Methods for Prevention." Annals of Pharmacotherapy 26, no. 4 (1992): 529–33. http://dx.doi.org/10.1177/106002809202600415.
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OBJECTIVE: To illustrate problems of overprescribing in the elderly and to make practical suggestions for prevention of polypharmacy. DESIGN: Three cases of polypharmacy in psychiatric patients admitted to the hospital between January and March 1990 are described. Intervention to correct drug-related problems in these patients is described and methods of preventing polypharmacy are discussed. SETTING: Inpatient psychiatry service in a tertiary-care center. PATIENTS: Elderly psychiatry patients (n=3) taking an excessive number of medications. This polypharmacy was believed to contribute to decreased cognitive and/or physical function. INTERVENTIONS: Medication regimens were reviewed by the physician and pharmacist. Those considered unnecessary or believed to be adversely affecting the patient were discontinued. RESULTS: All patients were discharged on a reduced number of medications, with improvement in cognitive and/or physical function. CONCLUSIONS: Polypharmacy contributes to an increased incidence of adverse reactions in the elderly. Implementation of practical methods for reducing polypharmacy can lead to a reduction in the number of drug-related adverse effects and improved care of the elderly patient.
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Sjoden, P. O. "Single Case Studies in Psychology and Psychiatry." Scandinavian Journal of Gastroenterology 23, sup147 (1988): 11–21. http://dx.doi.org/10.3109/00365528809099153.
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Sathe, Harshal Shriram, Shraddha Borhade, Aishwarya Awalekar, Janhavi Purandare, and Sagar Karia. "Alexithymia in Alcohol Dependence – A Case Control Study from a Rural Tertiary Health Care Center." Archives of Psychiatry 1, no. 1 (2023): 39–44. http://dx.doi.org/10.33696/psychiatry.1.005.
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Background: Alexithymia is a personality trait characterized by difficulty in identifying, expressing, and describing one’s emotions. In recent years, there has been a growing interest in the relationship between alexithymia and alcohol dependence. Several studies have found that alexithymia is more prevalent in individuals with alcohol dependence compared to healthy controls. Objectives: The current research aimed to compare alexithymia between individuals with Alcohol Dependence Syndrome (ADS) and healthy controls among residents of rural India. Additionally, the study sought to assess the association of alexithymia with the duration, severity of drinking, and obsessive-compulsive drinking behaviors. Materials and Methods: A case-control study was conducted involving 49 patients with alcohol dependence and 52 healthy controls in the Psychiatry department of a rural tertiary healthcare center in central India. The Toronto Alexithymia Scale (TAS-20) was utilized to evaluate alexithymia, while patterns of drinking were assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the Obsessive-Compulsive Drinking Scale (OCDS). Results: Significant differences were observed in alexithymia levels between patients with alcohol dependence and healthy controls. Furthermore, alexithymia levels were significantly associated with the duration and severity of alcohol consumption, as well as with the presence of obsessive-compulsive drinking patterns. Conclusion: This study underscores the noteworthy association between alexithymia and obsessive-compulsive drinking behaviors in individuals with alcohol dependence. The findings underscore the importance of addressing emotional difficulties and alexithymia in patients with alcohol dependence.
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Lee, William, Jonathan Bindman, Tamsin Ford, et al. "Bias in psychiatric case–control studies." British Journal of Psychiatry 190, no. 3 (2007): 204–9. http://dx.doi.org/10.1192/bjp.bp.106.027250.
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BackgroundCase–control studies are vulnerable to selection and information biases which may generate misleading findings.AimsTo assess the quality of methodological reporting of case–control studies published in general psychiatric journals.MethodAll the case–control studies published over a 2-year period in the six general psychiatric journals with impact factors of more than 3 were assessed by a group of psychiatrists with training in epidemiology using a structured assessment devised for the purpose. The measured study quality was compared across type of exposure and journal.ResultsThe reporting of methods in the 408 identified papers was generally poor, with basic information about recruitment of participants often absent. Reduction of selection bias was described best in the ‘pencil and paper’ studies and worst in the genetic studies. Neuroimaging studies reported the most safeguards against information bias. Measurement of exposure was reported least well in studies determining the exposure with a biological test.ConclusionsPoor reporting of recruitment strategies threatens the validity of reported results and reduces the generalisability of studies.
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Lewis, Glyn, and Anthony J. Pelosi. "The Case-Control Study in Psychiatry." British Journal of Psychiatry 157, no. 2 (1990): 197–207. http://dx.doi.org/10.1192/bjp.157.2.197.
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Case-control studies involve ‘cases' being compared to ‘controls' with respect to ‘exposures', possible aetiological (or associated) factors. Associations between a disease and an exposure can be explained by chance, reverse causality, confounding and biases or, lastly, by causality. However, confounders as well as information and selection biases can be adjusted for at the design (or analysis) stage of the study. The strength of an association can be measured by means of relative risk, calculated indirectly using the odds ratio. Well conducted control studies should produce accurate estimates of relative risks in many psychiatric investigations.
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Simon, Joel. "Three Case Studies." Journal of Family Psychotherapy 16, no. 1-2 (2005): 149–54. http://dx.doi.org/10.1300/j085v16n01_38.
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Feeney, Sean. "Psychopharmacology Case Studies." International Clinical Psychopharmacology 3, no. 3 (1988): 273. http://dx.doi.org/10.1097/00004850-198807000-00011.
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Jackson, W. Clay. "Case Studies in Psychopharmacology." Primary Care Companion to The Journal of Clinical Psychiatry 05, no. 03 (2003): 142. http://dx.doi.org/10.4088/pcc.v05n0309.
Full textDissertations / Theses on the topic "Psychiatry Case studies"
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Coetzee, Jacobus (Ockert). "Caregiving experiences of South African mothers of adults with intellectual disability who display aggression: clinical case studies." Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23048.
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Background: Adults who have an intellectual disability (ID) often continue to live with their parents long after their siblings have left home. While an increasing body of research has described positive parental experiences, research has also found that parents of adults who have ID and behavioural difficulties are more vulnerable to develop parental stress and depression. Aggression is one of the most difficult forms of problem behaviours to manage and could have a negative impact on the parent-child relationship, the child's social inclusivity and the psychological well-being of parents. Method: A case-based psychotherapy design was used to explore maternal experiences among mothers of adults with ID and aggression who access a specialised mental health service in Cape Town. Psychotherapy was used with six participants to attempt to reduce parental stress and other negative psychological states. In an area of research that has received scant attention in South Africa, the study extensively describes the psychotherapy process and the role of contextual factors in the lives of the participating mothers. The study used a mixed methods design which included psychometric measurements that were conducted at various intervals of intervention. Thematic analysis was used in all the case studies and interviews were scheduled before and after completing psychotherapy. External credibility was enhanced through the use of different qualitative strategies that included peer supervision and reflexivity. Findings: Besides elevated parental stress, the majority of participants presented with symptoms of depression and other mental health problems that varied according to their individual profiles. Although parental stress showed a discernible relationship with the child's behavioural difficulties, other significant life stressors contributed to maternal stress and depressive symptoms. Psychotherapy produced only modest improvement of parental stress among some of the participants. However, therapeutic input appeared to be more effective in reducing depressive symptoms among the majority of mothers. Critical reflection and discussion are centred on the clinical implications and meaning of findings on a psychological level.
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Carney, Nancy Ann. "Patient-Guided Investigation of the Restoration of Health Following Traumatic Brain Injury." PDXScholar, 1998. https://pdxscholar.library.pdx.edu/open_access_etds/2697.
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The development of emergency department medical interventions and the implementation of fast-transport trauma systems has decreased the rate of death resulting from traumatic brain injury (TBI). Without corresponding methods for long-term treatment and recovery, the prevalence of people disabled by TBI has increased, creating a growing public health problem. Investigations generated by physicians, rehabilitation programs, and social scientists, which attempt to associate standard measures of injury severity with outcome, leave unexplained variance in long-term functional status for persons with TBI.
The purpose of this investigation was to use persons with brain injury and their family members, to guide an analysis of the factors that foster successful recovery from brain injury. Three studies were conducted. In Study #1, the method for observation generated by Kurt Goldstein (1934) was adopted to conduct 20 case studies of persons who sustained brain injury. The Schema of the EsEx Couple (Maynard. 1992) was used to orient the investigation. The EsEx Couple Schema proposes that events in human life must be understood by considering the whole system of Person (Essence) in the Environment (Exchange), and the transactions that flow in a recursive loop from Person to Environment and back. Kurt Goldstein's Laws of Organismic Life (1934), a model consistent with that of the EsEx Couple, was used to evaluate the data. Strong patterns associated family and social networks, autonomy, and perceived self-determination with higher levels of recovery, and were used to generate a Model for Recovery.
In Study #2. the Motivational Analysis of Self-Systems Processes (Connell & Wellborn, 1991) was combined with results from Study #1 to generate a Development Model, and to build a survey which was administered to 248 persons with brain injury. Results (1) confirmed the model, indicating factors that contribute to recovery were hypothesized measures of Social Context, Perception, and Engagement; and (2) established a valid instrument, generated by persons with brain injury and their families, for measuring functional status.
In Study #3. results of the survey research were used to return to the case studies to consider where individual lives differ from expected patterns, and why. Deviations from expected patterns were explored to identify how individual differences operate to affect outcome. Recommendations for clinical practice include (1) directing interventions toward family as well as patient, as a method of enhancing the Social Context for the patient, and (2) using careful evaluation of each patient's idiosyncrasies to consider individual interventions.
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Entwistle, P. A. "The use of hypnosis as an auto-ethnographic modality in the exploration and management of overweight and obesity : selected case studies." Thesis, Liverpool John Moores University, 2016. http://researchonline.ljmu.ac.uk/4212/.
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The increasing incidence of obesity around the world has become a major problem with health and economic implications for most countries, and one which currently available methods of weight management including diet, exercise and lifestyle advice all seem incapable of controlling. The premise of this project was that some instances of adult obesity could be due to adverse, unresolved childhood traumas and experiences the consequences of which were continuing to act subconsciously in those individuals to impede effective and maintained adult weight loss; and that hypnosis was an appropriate exploratory tool for identifying and resolving these problems to facilitate more effectual weight management. For this purpose a group of seven overweight female volunteers were invited to undertake a series of “state”, dissociative hypnosis sessions involving regression back through their childhood and early adulthood. The resulting recalled autobiography from each participant’s series of hypnosis sessions was recorded, transcribed and analysed to constitute a piece of narrative autoethnography of their childhood past. All seven participants in this project were able to utilise hypnosis effectively to enable them to recall barely remembered past events, feelings and connections which, they realised for the first time as adults, had had a major and long-lasting impact on how they felt about food, their body weight or their body image. Hypnotically recalled memories of guilt and anger were associated with dysfunctional family relationships and childhood eating experiences. For most of these participants the strength of the association between these past times and feelings, and their current long-term overweight problem came as a total surprise. Even in advance of any weight loss most participants were inspired by their discoveries and felt that the telling of this hidden story had had a transformative benefit for them in bringing about reconciliation with the past, understanding of the present and planning for their future. These narrative accounts and results suggest that hypnosis might have wider application for use as an ethnological modality in sociology and health studies more generally.
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Walton, Merrilyn. "Kept in the dark. Chelmsford: a case study of patients being denied information." Thesis, The University of Sydney, 1990. https://hdl.handle.net/2123/26443.
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This thesis is about the administration of deep-sleep therapy to patients at Chelmsford Private Hospital. Deep-sleep therapy is examined in the context of the practice of psychiatry in Australia, and the relative powerlessness of patients in terms of diagnosis and treatment in the doctor -patient relationship . Four doctor s treate d patien ts with deep- sleep thera py betwe en 1963 and 1979. This thera py invol ved the admin istra tion of large amoun ts of drugs combi ned with electr o-conv ulsive therap y. Psychi atrist s are in a trust ed positi on when it comes to diagnosing and treating patients. Patie nts do not usual ly challe nge the decisi ons of doctor s. The relative powerlessness of patients is under stand able in the context of the doctor -patient relationship.
Advancements in psychiatric care come from trial and error, and treatments once thought effective now remain historic al reminders of the state of knowledge at that time. Deep-sl eep therapy does not comfort ably fit into this frame; it was used by Dr. Bailey and others long afier it was discard ed by the psychiatric community because of the serious side effects and its ineffectiveness in alleviating psychiatric conditions. Dr. Bailey’s method of administering deep-sleep therapy , which depended on the patient being continuously unconscious, was also markedly different from that reported in the psychiatric literature.
Twenty-five patients died directly as a result of Dr. Bailey’s deep-sleep therapy. Many patients have described both short and long-term side effects from deep-sleep therapy.
The monitoring and regulation of the standard of care provided to patients is a relatively new concept within the psychiatric
profession and medicine in general. The doctors practising at Chelmsford Hospital were able to administer this outmoded therapy to hundreds of patients over a span of sixteen years without question. That they were able to do so was directly related to the organisation of psychiatric practice in Australia. The few mechanisms existing to protect patients from negligent care did not have sufficient force to stop the Chelmsford doctors from administering deep-sleep therapy.
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Missa, Jean-Noël. "Naissance de la psychiatrie biologique: enquête historico-empirique sur le traitement des maladies mentales (1920-1960)." Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/211028.
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Andersson, Liselotte, and Päivi Jakum. "Inte som i Gökboet : sjuksköterskors beskrivningar av omvårdnadsprocessen inom den rättspsykiatriska vården : en kvalitativ studie." Thesis, University West, Department of Nursing, Health and Culture, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-1564.
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<p>Forensic psyhiatric care protects the society by giving patients care to diminish risks of serious crimes. In their work the nurses use different care methods to help and support the patient in managing his or her life situation. To clarify how a group of nurses describe the nursing process in forensic psychiatric care. A qualitative study based on interviews. Six nurses were interviewed about their work in four different forensic psychiatric care units. The nursing process in is divided into four categories: evaluation, planning, implementation and assessment. The results are based on the way the interviewed nurses described the essential roles of nurse-patient relationship and structured routines in nursing process. The study also shows some specific difficulties in nursing work, for example the mental dysfunctions of patients, the level of competence among staff and the patients need for social interaction and existence beyond their specific needs.</p>
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Eriksson, Linnea. "”ha någonting att göra på dagarna, det sociala liksom” En kvalitativ studie om träfflokalen ur ett brukarperspektiv." Thesis, Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-135002.
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The purpose of this study has been to examine if the participation within a social psychiatric day care is to be helpful for the participants. The aim was to find out if the day care has been helpful, what kind of support has been helpful and what have the participants been helped with. This has been researched from the participators view by conducting qualitative interviews. The data was analyzed by using thematic analysis. Antonovsky’s theory, Sense of Coherence was used as theoretical instrument to understand the collection of data. The main findings of this study indicate that occupations aimed for social purpose is important for the participators. In the study social support and the social interaction between staff and other participators appears to be the most important findings. Another important finding was the lack of research within the field of studies regarding social occupations such as day care.
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Säävälä, H. (Hannu). "Isänsä surmannut poika - psykiatrinen tutkimus." Doctoral thesis, University of Oulu, 2001. http://urn.fi/urn:isbn:9514265645.
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Abstract This study focuses on a son's violence against his father. It consists of three substudies. The first substudy examines the incidence of patricide in Finland. The incidence was essentially the same in the beginning and in the end of 20th century: 0.07 and 0.06 cases of patricide per 100 000 per year respectively. At the same time the incidence of matricide increased from 0.01 to 0.07 per 100 000 respectively. The proportion of patricide and matricide of all homicides increased due to the decrease of all homicides in Finland during the study period. The incidences of parricides seem to be of the order of other western countries. In the second substudy, all the reports of 107 serious violent offences by a son against his father were extracted from among all the forensic psychiatric examination reports made in Finland in 1973-96. These index cases were compared to 107 control cases of homicide against other people. Various statistically significant differences were found between the groups. The controls had the following characteristics more commonly than the indexes: developmental problems (especially conduct disorders) in childhood, personality disorders, dependence on alcohol or drugs and criminal histories as adults. They were also married and left their childhood home before the crime more commonly than the indexes. The indexes had psychotic diseases and dependence on parents more commonly, but also better educational and professional success. The indexes were more commonly diagnosed as 'without legal responsibility' (33% vs. 12%) and the controls more commonly 'with diminished legal responsibility'. In the third substudy, five major predisposing factors for a son's violence against his father were identified (incidence in parenthesis): A son's dependence on his parents (70%), a son's tendency to violence (65%), psychotic disease of the son (31%), the fathers oppressive and violent behaviour against the son (36%), protection of the mother against the father's violence by the son (21%). One or more of these factors could be involved in any single case. It was found that oedipality could not explain the violence of a son against his father. Distant and aggressive fathering and close and caring mothering can be seen as predisposing factors both to violence against the father and to the claimed general high prevalence of oedipality in our culture<br>Tiivistelmä Tämä työ koostuu kolmesta osatutkimuksesta. Ensimmäisessä tutkittiin pojan tekemän patrisidin eli isän surmaamisen esiintyvyyttä Suomessa. Patrisidin esiintyvyys pysyi suunnilleen samana, 0.07 ja 0.06 tapausta 100 000 asukasta kohti vuodessa, 1900-luvun alussa ja lopussa. Sen sijaan matrisidin eli äidin surmaamisen esiintyvyys kasvoi 0.01:stä 0.07:ään tapaukseen 100 000 asukasta kohti vuodessa. Patrisidien ja matrisidien osuus kaikista henkirikoksista Suomessa kasvoi 1900-luvun aikana, koska yleinen henkirikoskuolleisuus aleni kyseisen jakson aikana. Patrisidin ja matrisidin esiintyvyys vastaa muissa länsimaissa havaittuja esiintyvyyslukuja. Työn toisessa osassa tutkittiin mielentutkimuksessa vuosina 1973-96 olleiden 107 isänsä surmanneen tai pahoinpidelleen pojan ja heidän 107 verrokkinsa teon taustalla olleita tekijöitä. Useita tilastollisesti merkitseviä eroja havaittiin: verrokit kärsivät indeksejä yleisemmin lapsuudessa kehitysongelmista, etenkin käytöshäiriöistä, ja aikuisena persoonallisuushäiriöistä ja päihderiippuvuudesta sekä tekivät yleisemmin rikoksia. He myös solmivat parisuhteen ja lähtivät kotoa ennen väkivallantekoaan yleisemmin kuin indeksit Indeksit olivat yleisemmin psykoottisia ja riippuvaisia vanhemmistaan, mutta menestyivät paremmin koulussa ja työelämässä kuin verrokit. Indeksit todettiin mielentilatutkimuksessa yleisemmin syyntakeettomiksi kuin verrokit ja verrokit taas yleisemmin alentuneesti syyntakeiseksi kuin indeksit. Tutkimuksen kolmannessa osassa isään kohdistuneelle väkivallalle todettiin viisi keskeistä altistavaa tekijää (tekijöiden esiintyvyys 107 indeksin joukossa suluissa prosentteina): Pojan riippuvuus vanhemmistaan (70%), pojan väkivaltataipumus (65%), pojan psykoottinen sairaus (31%), isän alistava ja väkivaltainen käytös poikaa kohtaan (36%), äidin suojelu isän väkivallalta (21%). Kuhunkin tapaukseen saattoi liittyä samanaikaisesti yksi tai useampia tekijöitä. Oidipaalisuuden ei havaittu olevan keskeinen altistava tekijä pojan väkivallalle isää kohtaan. Etäinen ja väkivaltainen isyys ja suojaava ja huolehtiva äitiys voivat olla altistavia tekijöitä paitsi isään kohdistuvalle väkivallalle myös aiemmissa tutkimuksissa havaitulle oidipaalisuuden yleisyydelle kulttuurissamme
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Rees, Christopher Lewis. "An examination of patients' responses to framework breaks in psychotherapy in an institutional context." Thesis, Rhodes University, 1998. http://hdl.handle.net/10962/d1002551.
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This study examines the workings of the ground rules which make up the framework of psychotherapy, in an institutional context, by analysing transcripts of twelve audio taped sessions of therapy conducted in a psychiatric hospital. The breaks in the ground rules of the sessions are noted and the patients' responses to these breaks are analysed using Langs's (1982, 1988) method for decoding patients' material, suitably modified for use as a hermeneutic research method. Although all of the ground rules are broken in the institutional context, only one of the ten ground rules appears to be essentially affected by this particular institutional context. Other ground rules are broken out of choice of technique or through error. The institutional context has a structural impact only on the ground rule requiring a one to one relationship with privacy and confidentiality and this ground rule is transgressed in a number of ways in all twelve sessions examined in this study. However the patients' responses to this breach only occur in ways predicted by communicative theory when the break in the ground rule involves actual entry into the therapy space by another person. Other contraventions to this ground rule that do not involve such an entry do not elicit the predicted patient responses. The many other ground rule breaks occurring in the institutional context evoke the predicted responses in the patients' material. In the study, no therapist interventions are found to comply with the communicative therapy requirements for sound interventions; concomitantly it was found that no therapist interventions receive the required derivative validation. The results indicate that it is possible to conduct therapy of a substantially secure frame variety in this institutional context with minimum effort on the part of therapists and given proper training and supervision of therapists in the techniques of communicative psychotherapy. Furthermore the results lend weight to the importance of the communicative methodology for listening to patients' material in psychotherapy in an institutional context. However, further rigorous study of competently performed therapy, executed within the context of a secure frame within an institutional context, is needed in order to demonstrate the benefits of the communicative psychotherapy interventions and interpretations in this context.
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Samuelsson, Mats. "Attempted suicide : studies of attitudes and psychiatric care /." Stockholm, 1997. http://www.kibic.ki.se/ki/diss/971031samu.html.
Full textBooks on the topic "Psychiatry Case studies"
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1943-, Neale John M., and Davison Gerald C, eds. Case studies in abnormal psychology. 2nd ed. Wiley, 1986.
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1943-, Neale John M., and Davison Gerald C, eds. Case studies in abnormal psychology. 5th ed. John Wiley & Sons, 1999.
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1943-, Neale John M., and Davison Gerald C, eds. Case studies in abnormal psychology. 4th ed. Wiley, 1995.
Find full textBook chapters on the topic "Psychiatry Case studies"
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Caldwell, Janice, and Mark W. Flanagan. "In-Patient Psychiatric Case Management." In Social Work Case Management: Case Studies From the Frontlines. SAGE Publications, Inc., 2018. http://dx.doi.org/10.4135/9781483396910.n16.
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Hodgson, Jennifer, Charles Shuman, Ryan Anderson, Amy Blanchard, Patrick Meadors, and Janie Sowers. "Bringing the Family into Focus: Collaborative Inpatient Psychiatric Care." In Collaborative Medicine Case Studies. Springer New York, 2008. http://dx.doi.org/10.1007/978-0-387-76894-6_29.
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Lennox, Belinda. "The Division Between Psychiatric and Neurological Practice Does Not Help Patients with Disorders That Span the Two." In Neuropsychiatry Case Studies. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-42190-2_30.
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Agarwal, Amit, Ranil Fernando, Rajeev Parameswaran, Anand Mishra, and Roma Pradhan. "PHPT Presenting with Psychiatric Symptoms." In Case Studies in Thyroid and Parathyroid Tumors. Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-99-0938-4_9.
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Freebody, Jane. "Introduction." In Mental Health in Historical Perspective. Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-13105-9_1.
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AbstractThis comparative study of patient work and occupation throws new light on a topic that has only recently attracted scholarly attention. Patient work emerged in the context of moral treatment in the early nineteenth century in both France and England and was used similarly in both asylum systems until World War I. After the war, the approach to patient work and occupation diverged, as Freebody demonstrates using three institutional case studies from each country. An overview of the historiography, not only of patient work and occupational therapy but also of the history of work and working practices, welfare, the emergence of the asylum system, psychiatry, mental nursing and the patient experience, puts Freebody’s analysis in context. Criticism of the use of patient labour in 1918 by asylum medical officer Montagu Lomax provides a benchmark for developments during the interwar period.
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Patel, Khyati. "Treatment of delusions of exceptionality in an adult male with sexual offences against children in a secure psychiatric setting." In Further Case Studies in Forensic Psychology. Routledge, 2022. http://dx.doi.org/10.4324/9781003213116-5.
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"Case Studies." In Occupational Therapy in Forensic Psychiatry. Routledge, 2014. http://dx.doi.org/10.4324/9781315821252-8.
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"Case Studies in Psychiatry." In The Physician Assistant Student’s Guide to the Clinical Year: Behavioral Health. Springer Publishing Company, 2019. http://dx.doi.org/10.1891/9780826195388.0008.
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McCabe, Thomas, Willie Stewart, Mayur Pandya, Joe Kasper, and Steve Sanders. "American Football: Cognitive Impairment." In Case Studies in Sports Psychiatry. Cambridge University Press, 2020. http://dx.doi.org/10.1017/9781108767187.003.
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Dudgeon, Emily, Renee McGregor, and Rebecca Robinson. "Athletics: Energy Levels, Exercise Addiction and Disordered Eating." In Case Studies in Sports Psychiatry. Cambridge University Press, 2020. http://dx.doi.org/10.1017/9781108767187.004.
Full textConference papers on the topic "Psychiatry Case studies"
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Sapira, Violeta, Mihaiela Lungu, Alexandru Paul Baciu, et al. "FROM DEPRESSION TO HUMAN IMMUNODEFICIENCY VIRUS – A CASE REPORT." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.19.
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Introduction: Human immunodeficiency virus (HIV) infection is often preceded or accompanied by neuropsychiatric symptoms, including depression. This fact has been evaluated in most of the clinical studies to date as associated with HIV infection already diagnosed. Case report: We report a case of a 46-year-old woman patient with no prior diagnosed pathology, suffering from depressive disorder for roughly 6 months, with a progressive evolution under treatment. Blood tests showed a moderate normochromic normocytic anemic syndrome of unspecified origin. Given the fact that depressive syndrome has not improved under treatment, a cerebral computed tomography (CT) scan and a cerebral magnetic resonance imaging (MRI) are decided, revealing an expansive cerebral process which in turn recommends performing stereotactic biopsy, but the family of the patient refuses the procedure. The patient is neurologically evaluated and after considering the cerebral MRI pattern and the presence of anemia, an HIV and syphilis detection test is decided, revealing a positive result for HIV infection. An antiretroviral therapy has been initiated, resulting in favorable clinical and imaging outcomes. Conclusions: Each patient and each case are individual and is to be approached as such. Depression in a progressive evolution under treatment requires imaging evaluation (cerebral CT scan, ideally cerebral MRI).
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"CANNABIS USE AND ANXIETY DISORDERS DURING PREGNANCY - DUAL DISORDER TO DUAL PATIENTS." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p144s.
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Objectives From clinical cases of patients observed in Perinatal Psychiatry - Setúbal Hospital Center (Portugal), we conducted a review of the impact of both cannabis use and anxiety disorders during pregnancy. Methods and material Case reports and literature review of PubMed for cannabis use, anxiety disorders and pregnancy. Results and conclusions In Outpatient Perinatal Psychiatry we observed women with anxiety disorders who reported using cannabis during pregnancy. Indeed, pregnancy is a highly vulnerable period to the onset or worsening of previous anxiety symptoms. Anxiety disorders may adversely impact not only the mother, but also fetal maturation and child development. In fact, preterm labor and low birth weight are consistently linked with anxiety during pregnancy. Recent studies reveal a general increase in the use of cannabis during pregnancy, representing the most commonly used illicit drug during the perinatal period. The endocannabinoid system appears to be involved in the regulation of human fertility and pregnancy. Although still conflicting, there is data demonstrating that cannabis use during pregnancy is associated with stillbirth, preterm birth, small for gestational age, low birth weight, smaller head circumferences and increased admission to neonatal intensive care units. The use of cannabis during pregnancy is frequently a way to improve symptoms of anxiety disorders. All patients should be screened to substance use comorbid to other frequent psychiatric disorders during pregnancy, such as anxiety disorders, in order to improve the health and well-being not only of the mother, but also of the developing baby, as a dual disorder has a negative effect in both individuals.
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Pâslaru, Ana-Maria, Ana Fulga, Elena Niculet, Laura Florentina Rebegea, Iuliu Fulga, and Anamaria Ciubara. "SUPRACLAVICULAR AND CERVICAL LYMPH NODE METASTASES HAVING CERVICAL CANCER AS STARTING POINT. CASE PRESENTATION." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.10.
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Introduction: Cervical cancer is the fourth most frequently found cancer among women worldwide. Numerous studies have underlined that persistent infection with human papilloma virus is the most important risk factor, two strains of the same virus – 16 and 18 being responsible for approximately 70% of the cases. Cervical cancer rarely metastasizes in the cervical lymph nodes and this indicates a poor prognosis. Literature data reports an incidence for left supraclavicular M1LYm of 0.1-1.5%. Material and Method: We bring attention to the case of a 44-year-old patient from the rural area who was diagnosed in January 2019 with stage IIIB cervical cancer, represented morphologically by a poorly differentiated squamous cell carcinoma. When admitted, the patient presented clinically with vaginal hemorrhage, intense abdominal and pelvic pain, fatigue, a dynamic, significant weight loss. The physiological personal history revealed nine pregnancies, the first one when she was 16. After pretherapeutic evaluation, the multidisciplinary committee decides performing simultaneous radio-chemotherapy with platinum salts. During the second week of treatment clinical examination revealed left cervical and supraclavicular adenopathy, both documented through imaging evaluation. Lymph node biopsy is done and its histopathological aspect, correlated with the immunohistochemistry profile supports the diagnosis of poorly differentiated squamous cell carcinoma lymph node metastasis. The initial treatment scheme is maintained, the patient being discharged with clinical remission of cervical and supraclavicular lymph node metastasis. Conclusions: The peculiarity of the case is determined by the distant metastases in the left cervical and supraclavicular lymph nodes, a rare finding during treatment, which was associated with a poor prognosis; in this case treatment was done for palliative purposes. Rapid diagnosis is the main factor that conditions the therapeutic results and chances for healing.
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Farias, Suzi Maria Fernandes de, Monica Teixeira Signorini, Daniel Aragão Machado, Carlos Luiz Dias, and Flávio Vaz Machado. "The role of ketamine in the treatment of major depressive disorder: Multidisciplinary approach in psychiatry." In V Seven International Multidisciplinary Congress. Seven Congress, 2024. http://dx.doi.org/10.56238/sevenvmulti2024-140.
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Depression is a prevalent psychiatric condition, affecting millions of people around the world. Major Depressive Disorder (MDD), in turn, is a particularly serious form that can be resistant to conventional treatments. In this context, ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a promising therapy due to its rapid effects in cases of severe and treatment-resistant depression. Symptoms may improve within a few hours after administration and last for up to two weeks. This study seeks to evaluate the efficacy and safety of ketamine as a treatment for MDD, as well as the importance of a multidisciplinary approach in psychiatry to manage this condition. This is a literature review using studies that presented randomized, double-blind, placebo-controlled clinical trials that evaluated ketamine in the treatment of major depressive episodes. Studies that addressed the participation of multidisciplinary teams in the treatment of MDD were also examined. Most side effects observed were transient and well tolerated. Multidisciplinary teams, composed of psychologists, psychiatrists, anesthesiologists and nurses, proved to be essential for a more effective therapeutic approach, identifying a variety of patients' needs, which resulted in improvements in treatment results and quality of life. To improve understanding of ketamine's mechanisms of action and develop even more effective treatment strategies, more studies are needed, especially those that emphasize the importance of multidisciplinary teamwork in psychiatry.
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Dimkov, Petar. "Kandinsky-Clérambault syndrome: Narration and psychosis." In 6th International e-Conference on Studies in Humanities and Social Sciences. Center for Open Access in Science, Belgrade, 2020. http://dx.doi.org/10.32591/coas.e-conf.06.18207d.
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Interpretation by means of retelling a story is an ordinary event in human life. However, under abnormal circumstances, e. g. delusions of the narrator, this process is altered and even distorted to various degrees in both qualitative and quantitative aspects. In such cases, the assumption of misrepresentation of the actual story emerges as most striking as it is in contradiction with the objective reality. In the current paper, I will focus on the discourse features in the narratives of patients with the Kandinsky-Clérambault syndrome since it provides some of the best cases that serve to support the main focus of my search, i.e. establishing to what degree we can believe the subjective interpretative narratives of mentally ill patients. This perspective, on its own, has given rise to some doubts in psychiatry as objective science. Our hypothesis is that there are clear-cut features of delusion, which can be outlined by linguistic analysis irrespective of the cultural belonging of the patient and described following the method of the omnipotence of language as a tool of semiotics. For our purpose, additional aspects of the problem will be developed in detail, such as the semantic levels in narration in general and outlined concepts of schizophrenia and delusion transparent in discourse carried out in any language.
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Dimkov, Petar. "Kandinsky-Clérambault syndrome: Narration and psychosis." In 6th International e-Conference on Studies in Humanities and Social Sciences. Center for Open Access in Science, Belgrade, 2020. http://dx.doi.org/10.32591/coas.e-conf.06.18207d.
Full textAbstract:
Interpretation by means of retelling a story is an ordinary event in human life. However, under abnormal circumstances, e. g. delusions of the narrator, this process is altered and even distorted to various degrees in both qualitative and quantitative aspects. In such cases, the assumption of misrepresentation of the actual story emerges as most striking as it is in contradiction with the objective reality. In the current paper, I will focus on the discourse features in the narratives of patients with the Kandinsky-Clérambault syndrome since it provides some of the best cases that serve to support the main focus of my search, i.e. establishing to what degree we can believe the subjective interpretative narratives of mentally ill patients. This perspective, on its own, has given rise to some doubts in psychiatry as objective science. Our hypothesis is that there are clear-cut features of delusion, which can be outlined by linguistic analysis irrespective of the cultural belonging of the patient and described following the method of the omnipotence of language as a tool of semiotics. For our purpose, additional aspects of the problem will be developed in detail, such as the semantic levels in narration in general and outlined concepts of schizophrenia and delusion transparent in discourse carried out in any language.
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Darie, Cristina, Mihai Terpan, Alexia Balta, et al. "DUAL DIAGNOSIS. ALCOHOL CONSUMPTION ASSOCIATED WITH DEPRESSIVE SPECTRUM DISORDERS." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.20.
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Introduction: According to the studies, a quarter of people who drink alcohol suffer at least one depressive episode in their lifetime. It has also been found that one-third of people who suffer from depression, abusively consume psychoactive substances, such as alcohol, as a form of self-healing. Aim: In this retrospective study, we propose to statistically quantify the relationship between alcohol-related mental and behavioural illnesses and depression spectrum disorders. Method: The retrospective study was conducted on a group of hospitalized patients, between January 1st and June 30th, 2018, at "Elisabeta Doamna" Psychiatric Hospital, in Galati, Romania. For diagnosis we used the ICD-10 (The ICD-10 Classification of Mental and Behavioral Disorders. (Clinical description, diagnostic guidelines and psychometric tests, such as HAM-D (Hamilton Depression Rating Scale)), AUDIT (Alcohol Use Disorders Identification Test). Patients were selected among those who had a combination of mental and behavioural disorders due to alcohol and depressive spectrum disorders. Results: Between January 1st and June 30th, 2018, a quarter of total 6316 hospitalized patients, or 24.79% (1566 patients) were diagnosed with alcohol-related disorders, and 5.4% (341 cases) had a dual diagnosis, with alcohol-related disorders associated with depressive elements. During this 6-month period, of all cases of alcohol-related disorders, it was found that approximately 22% had a dual diagnosis, respectively, the combination of alcohol-related disorders with depressive spectrum disorders or depressive elements. Conclusions: Unfortunately, it is estimated that depression will become a secondary cause of disability worldwide after cardiovascular disease. According to the WHO (World Health Organization), this disease affects more than 320 million people worldwide, and its combination with alcohol abuse is alarming. Therefore, patients with dual diagnosis require a multidisciplinary therapeutic approach to reduce or even neutralize the adverse consequences that may occur in the psycho-social, medical, family, economic, or behavioural context.
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Nunes, Fátima, Renan Aranha, Rafael Testa, and Matheus Ribeiro. "Virtual Reality, Augmented Reality and beyond: Laboratory of Computer Applications for Health Care at University of São Paulo." In Anais Estendidos do Simpósio de Realidade Virtual e Aumentada. Sociedade Brasileira de Computação, 2020. http://dx.doi.org/10.5753/svr_estendido.2020.12971.
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The Laboratory of Computer Applications for Health Care at University of São Paulo develop multidisciplinary research involving Computer Science areas and other knowledge fields such as Physiotherapy, Psychiatry, Radiology, and Cardiology. Most studies use concepts besides Computer Science, by aggregating knowledge to solve real problems. In this paper we present the main projects in Virtual Reality and Augmented Reality areas, highlighting serious games, computer-aided diagnosis and therapy, simulation and training. Besides the social and scientific impact inherent to the type of the developed research, some systems are available to health professionals in order to allow technology transfer and consequent technological and economic impact in daily activities of health tasks.
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Sófi, Gyula, and Johanna Farkas. "MAIN CHARACTERISTICS OF JUVENILE PSYCHOPATHY IN LAW ENFORCEMENT ASPECTS." In SECURITY HORIZONS. Faculty of Security- Skopje, 2021. http://dx.doi.org/10.20544/icp.2.5.21.p22.
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It is well recognized that there is a link between psychopathy, violent behaviour, and crime. Psychopathy is a personality construct typically related to deficits in interpersonal (e.g., manipulative, selfish), emotional (e.g., callous-unemotional) functioning, and social deviance with developmental origins. Characteristics associated with adult antisocial behaviour have been identified in children and adolescents. A large number of studies have provided empirical pieces of evidence. Despite researchers agreeing with the most essential components of psychopathy such as agreeableness, conscientiousness, fearlessness, or dominance, there has been some debate in certain areas. The existing literature on the construct of juvenile psychopathy shows that most youths start manifesting antisocial acts in their early life. The focus of this study was to present the role of psychopathic traits in juveniles and connect it to law enforcement, criminal law, child and adolescent psychiatry, and other forensic sciences (criminology, criminal psychology). Juvenile psychopathy is a subgroup of antisocial youth, and their identification is very important because of preventative measures, law enforcement, and more. Youth with high psychopathic traits establish their antisocial career early on. They are aggressive to people and animals, in most cases destroy others’ property, lie, deceive, thieve and commit other serious violent behaviours (not respecting rules). Ultimately, the recognition of such factors has a predictive value not only from the point of view of child and adolescent psychiatry but also from the point of view of law enforcement and forensic psychology, as they can be applied in crime prevention. Keywords: Child and Adolescent Psychiatry, Mental disorders, Fearless Dominance, Agreeableness, Callous/unemotional
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Gogulescu, Bogdan Adrian. "THE PREVALENCE OF COGNITIVE IMPAIRMENT IN PATIENTS WITH PROXIMAL FEMORAL FRACTURES." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.7.
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Introduction: Fractures of the proximal femur are becoming more common. Through the data, this medical problem became a humanitarian, economic and social has imposed the first evidence-based review in our clinic. It is necessary to find out if there is a causal relationship between postural instability, hip fractures and cognitiv impairment. Methods: Clinical data were recorded, removing any information about personal identity. Consecutive patients aged over 65 years were included in the study. They were admitted during the period 01.01.2021-31.12.2021 and had primary fractures of the proximal femur caused by low energy trauma produced by falling from the same level. Results: 360 cases with a mean age of 78.73 years and having a proximal femoral fracture were analyzed. The prevalence of cognitive impairment was 27.22%, significantly undifferentiated by the type of fracture or age group. The relatively small age of the batch of 72-100000 indicates the existance of a socio-economic problem besides the high medical problems raised by a major fracture occurring in the context of comorbidity of 86.36%. Conclusions: The existence of proximal femur fractures in elderly people with certain cognitive involution creates personal dramas and socio-medical problems that require complex studies.
Reports on the topic "Psychiatry Case studies"
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Köck, Patrick, Arndt-Lukas Klaassen, M. Meyer, J. Kindler, and M. Kaess. Cannabinoids as therapeutics in child and adolescent psychiatry. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2023. http://dx.doi.org/10.37766/inplasy2023.3.0017.
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Review question / Objective: P = Children and adolescents with psychiatric disorders; I = Cannabinoids as therapeutic product / medication; C = if randomised controlled trial, placebo; O = Evaluation of psychiatric symptoms (BDI for depression, symptom severity scales in case of ADHD or Autism Spectrum Disorders); S = Randomized controlled trials, controlled trials, case studies. Rationale: Cannabinoids especially THC and CBD have gained increasing scientific interest. Various studies have been published assessing the therapeutic applications of cannabinoids in psychiatry. Several systematic reviews have been published for application of cannabinoids in psychiatry for adults, however there is no recent systematic review assessing applications for child and adolescent psychiatry.
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Lee, Hee Jin, Min Cheol Chang, Yoo Jin Choo, and Sae Yoon Kim. The Associations between Headache (Migraine and Tension-type Headache) and Psychotic Symptoms (Depression and Anxiety) in Pediatrics: A Systematic Review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2022. http://dx.doi.org/10.37766/inplasy2022.10.0078.
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Review question / Objective: The purpose of this study was to investigate the association with specific psychiatric symptoms such as depression and anxiety in pediatric patients suffering from migraine and TTH. In our meta-analysis for a detailed evaluation of depression and anxiety, we attempted to review the research using various psychodiagnostic tools. Eligibility criteria: The detailed inclusion criteria for the network meta-analysis were studies with (1) inclusion of pediatric patients; (2) patients with migraine and TTH; (3) evaluation of association between headache (migraine or TTH) and psychotic symptoms (depression and anxiety); (4) comparison between group with headache (migraine or TTH) and control group; (5) using tools for evaluating degree of depression or anxiety; and (6) written in English. Review articles, case reports, letters, and studies with insufficient data or results were excluded.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, et al. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, 2022. http://dx.doi.org/10.23970/ahrqepccer254.
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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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Madu, Laura, Jacqueline Sharp, and Bobby Bellflower. Efficacy of Integrating CBT for Mental Health Care into Substance Abuse Treatment in Patients with Comorbid Disorders of Substance Abuse and Mental Illness. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/con.dnp.2021.0004.
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Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It is a retrospective chart review. The review examines CBT's efficacy for engaging individuals with co-occurring mood and substance u se disorders in treatment by enhancing adherence and preventing disengagement and relapse. Methods: Forty adults aged 26-55 with a DSM-IV diagnosis of a mood disorder of Major Depressive Disorder and/or anxiety and concurrent substance use disorder (at least weekly use in the past month). Participants received 12 sessions of individual integrated CBT treatment delivered with case management over a 12-week period. Results: The intervention was associated with significant improvements in mood disorder, substance use, and coping skills at 4, 8, and 12 weeks post-treatment. Conclusions: These results provide some evidence for the effectiveness of the integrated CBT intervention in individuals with co-occurring disorders. Of note, all psychotherapies are efficacious; however, it would be more advantageous to develop a standardized CBT that identifies variables that facilitate treatment outcomes specifically to comorbid disorders of substance use and mood disorders. It is concluded that there is potentially more to be gained from further studies using randomized controlled designs to determine its efficacy.
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Young, Matthew M. Proposed Methods For Estimating Costs Of Mental Health In Canada (2007-2020). Greo Evidence Insights, 2023. http://dx.doi.org/10.33684/2023.002.
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This report presents the results of an investigation by Greo Evidence Insights into how Canadian mental health (MH) costs could be estimated. It begins by conducting a review of studies estimating the costs of MH in Canada since 2010 and examines the various approaches employed. Based on this analysis the next section makes recommendations regarding cost types to include, the granularity of the estimates, and the approach to missing/ incomplete data. The report then recommends a phased approach to estimating the cost of mental health: Phase I describes in detail the data sources and methods to estimate public, direct health care costs associated with general and psychiatric MH-related hospitalizations and emergency room visits and non-hospital-based interventions (i.e., physician costs, pharmaceutical costs, community MH services). Phase II describes methods for estimating social and income support payments and indirect costs. Finally, Phase III describes data sources and methods for estimating private health and lost productivity costs.
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Bogdanov, Sergey I. Electronic educational resource "Ambulance and emergency medical care for mental disorders and behavioral disorders at the prehospital stage". SIB-Expertise, 2024. http://dx.doi.org/10.12731/er0784.29012024.
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The Electronic educational resource (hereinafter referred to as EER) “Basic aspects of narcology” is designed for 36 training hours. This distance learning course aims to develop communicative competence, prepare for solving standard problems of professional activity using information resources, medical and biological terminology, and is also aimed at optimizing the educational process at the university, creating conditions for achieving the required level of modern education and comprehensive development of the personality of students . The EER was developed in accordance with the Federal State Educational Standard of Higher Education. Intended for medical school students as a material that allows future doctors to become more in-depth acquainted with the basic aspects of narcology, as well as for psychiatrists, psychiatrists-narcologists, and doctors of other specialties who, due to the specifics of their work, systematically interact with patients with drug addiction pathology. The EER was developed by Doctor of Medical Sciences, Associate Professor, highly qualified psychiatrist-narcologist with 37 years of experience in the specialty of psychiatry-narcology. The structure of the EER is classic and includes an abstract, glossary, instructions for working with the course, brief information about the authors, a methodological block, 4 lectures in presentation format and video lectures on the following topics: “Ethanol from the birth of modern civilization to the creation of new stars”, “Alcoholism”, “General issues of addiction” and “Classification of substances and drugs that cause addiction.” To control the studied material, clinical tasks and final testing on the topic being studied are used. To receive feedback from cadets and students, there is a feedback form. A student who has mastered the program is able to possess professional competencies, including the ability to: professionally navigate issues of terminology and definitions related to the subject of the educational material; master the amount of knowledge on the mechanisms of the effects of psychoactive substances on the human body; correctly navigate the issues of modern classification of surfactants; correctly diagnose pathological conditions associated with chronic ethanol intoxication; apply distance educational technologies (DET) in professional activities; use automated information systems and knowledge bases in professional activities.
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Viswanathan, Meera, Jennifer Cook Middleton, Alison Stuebe, et al. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions. Agency for Healthcare Research and Quality (AHRQ), 2021. http://dx.doi.org/10.23970/ahrqepccer236.
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Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.
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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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Bogdanov, Sergey I. Electronic educational resource "Basic aspects of narcology". SIB-Expertise, 2024. http://dx.doi.org/10.12731/er0783.29012024.
Full textAbstract:
The electronic educational resource (hereinafter referred to as EER) “Basic aspects of narcology” is designed for 36 training hours. This distance learning course aims to develop communicative competence, prepare for solving standard problems of professional activity using information resources, medical and biological terminology, and is also aimed at optimizing the educational process at the university, creating conditions for achieving the required level of modern education and comprehensive development of the personality of students . The EER was developed in accordance with the Federal State Educational Standard of Higher Education. Intended for medical school students as a material that allows future doctors to become more in-depth acquainted with the basic aspects of narcology, as well as for psychiatrists, psychiatrists-narcologists, and doctors of other specialties who, due to the specifics of their work, systematically interact with patients with drug addiction pathology. The EER was developed by Doctor of Medical Sciences, Associate Professor, highly qualified psychiatrist-narcologist with 37 years of experience in the specialty of psychiatry-narcology. The structure of the EER is classic and includes an abstract, glossary, instructions for working with the course, brief information about the authors, a methodological block, 4 lectures in presentation format and video lectures on the following topics: “Ethanol from the birth of modern civilization to the creation of new stars”, “Alcoholism”, “General issues of addiction” and “Classification of substances and drugs that cause addiction.” To control the studied material, clinical tasks and final testing on the topic being studied are used. To receive feedback from cadets and students, there is a feedback form. A student who has mastered the program is able to possess professional competencies, including the ability to: professionally navigate issues of terminology and definitions related to the subject of the educational material; master the amount of knowledge on the mechanisms of the effects of psychoactive substances on the human body; correctly navigate the issues of modern classification of surfactants; correctly diagnose pathological conditions associated with chronic ethanol intoxication; apply distance educational technologies (DET) in professional activities; use automated information systems and knowledge bases in professional activities.