Innovations in clinical neuroscience最新文献

Objective: The aim of this study was to measure levels of ethical awareness and burnout among mental health professionals, while also investigating the relationship between age, ethical awareness, and burnout. Additionally, the study aimed to compare the exhaustion level between mental health professionals working in public and private sectors.

Methods: A correlational study was conducted in Lahore, Pakistan. Data was collected using the Santa Clara Ethics Scale and the Counselor's Burnout Inventory from 319 mental health professionals with at least two years of experience. The analysis of the collected data was carried out using SPSS version 23.

Results: The mean±standard deviation levels of ethical awareness and burnout were found to be 31.4±4.46 and 48.4±13.91, respectively. Ethical awareness was positively correlated with age and negatively correlated with dimensions of burnout (exhaustion, incompetence, negative work environment, devaluing clients, and personal life deterioration) and overall burnout. There were significant positive correlations among these burnout factors. Furthermore, mental health professionals in the public sector exhibited significantly higher levels of exhaustion than those working in private sector.

Conclusion: This study underscores the significant association between age, ethical awareness, and burnout in mental health professionals and urges tailored interventions that enhance the ability to make ethical decisions while minimizing the risk of burnout, especially among early-career mental health professionals and professionals working in the public sector.

A small proportion of people are exceptionally sensitive to slights from others, and they might then heap shame upon themselves and even consider suicide. Often, however, these patients might also have a "gift" that their sensitivity to feelings concurrently provides them. They might be especially able to accurately infer the more subtle, underlying feelings of others and with this capacity connect with them in ways that most other persons cannot. However, these individuals might have no idea that their sensitivity is the strength that it is. They might regard their sensitivity as only a liability. Viewing this trait as an asset can change how they see themselves and, therefore, their quality of life. This article will address how therapists can reduce these patients' sense of liability and enhance their ability to make maximal use of their sensitivity.

Cultural concepts of distress, previously referred to as culture-bound syndromes, are psychiatric conditions influenced by cultural beliefs, history, and social norms. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, these syndromes manifest as culturally specific expressions of psychosocial distress, though there is a lack of formal diagnostic criteria. This article explores three cultural concepts of distress, koro, Dhat, and latah syndromes, through fictional case vignettes to illustrate their clinical presentation, underlying psychiatric associations, and potential management strategies. Each syndrome and case contain unique factors of psychosocial distress and highlights necessary considerations with avenues for improved patient care.

Objective: Cannabis use and chronic diseases have both been associated with impaired cognitive ability. The current study will explore their independent and co-occurring effects on cognitive difficulty concentrating, remembering, or making decisions on the population level.

Methods: This study used a probability sample of United States (US) adults aged 18 years or older from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a telephone-administered survey. The cross-sectional survey collects data from a representative sample regarding health-related risk behaviors, chronic health conditions, and use of preventive services.

Results: The study sample consisted of 94,918 participants in the BRFSS survey that completed the optional module on cannabis use. The prevalence of having difficulty concentrating, remembering, or making decisions was 12.7 percent (standard error [SE]: 0.21%), prevalence of monthly cannabis use was 14.9 percent (SE: 0.24%), that of daily cannabis use was 7.4 percent (SE: 0.18%), and prevalence of any chronic medical condition was 59.2 percent (SE: 0.32%). The prevalence of having difficulty concentrating, remembering, or making decisions was higher for those with a chronic medical condition (17.6% [SE: 0.31%] vs. 5.7% [SE: 0.25%], Rao-Scott p<0.0001). Such difficulty was also higher for those who used cannabis monthly (24.4% [SE: 0.731%] vs. 10.7% [SE: 0.21%], Rao-Scott p<0.0001) or daily (29.1% [SE: 1.12%] vs. 11.4% [SE: 0.21%], Rao-Scott p<0.0001). Greater cognitive difficulty for those with a chronic medical condition was accentuated by cannabis use; daily cannabis (vs. nonuse) was associated with 145-percent higher prevalence of cognitive difficulty and monthly cannabis use (vs. nonuse) was associated with 76-percent higher prevalence of cognitive difficulty. For those without a chronic medical condition, the prevalence of cognitive difficulty was 183- and 97-percent higher in daily and monthly cannabis users (vs. nonusers), respectively.

Conclusion: In the general population, having a chronic medical condition significantly increased cognitive difficulty concentrating, remembering, or making decisions. Cannabis use (particularly daily use) significantly increased cognitive difficulty for people with each chronic condition included in this study. The greater cognitive difficulty with cannabis use was less pronounced in individuals with chronic conditions with higher difficulty at the outset, such as depression.

Delusional parasitosis is a psychiatric disorder in which one experiences persistent, false delusions of being infected by parasites or other organisms. Symptoms include formication, pruritis, and self-inflicted cutaneous manifestations. In this article, we discuss the complicated case of a 45-year-old male patient with history of Crohn's disease, opioid use disorder, and post-traumatic stress disorder to highlight key concepts of the disease. The clinical presentation often leads to a broad differential diagnosis, which can complicate and delay treatment.

Patients with concussion often receive insufficient and/or ineffective diagnostic workups. A limiting factor for prompt and accurate diagnosis is the scarcity of practical and effective concussion diagnostics that can be used by private-practice physicians. This gap in the diagnostic process can delay the implementation of crucial interventions. The absence of an affirmative concussion diagnosis leaves patients with few options when follow-up treatment would otherwise be indicated, potentially leading to worsening symptoms, prolonged recovery, and a higher likelihood of developing long-term complications. Neurophysiological assessments such as electroencephalography (EEG) and event-related potentials (ERPs) offer an opportunity for an objective evaluation of brain deficits that can occur after a concussion. By detecting abnormalities in brain patterns that are often associated with concussive injuries, these tests can help provide timely diagnosis and treatment of the disorder, thus reducing the likelihood of chronification of post-concussive symptoms. We reviewed a battery of neurophysiological assessments that have been scientifically validated to detect the pathophysiological effects of concussion and can be performed in office settings by nonspecialist technicians. These assessments are designed to help with diagnosis and prognosis of concussion, while also being accessible and practical to administer for private-practice physicians who can incorporate them into routine evaluations of patients with traumatic brain injury (TBI). The implementation of neurophysiological tools in primary care and outpatient settings has the potential to bridge the gap between symptom presentation and definitive diagnosis, thus mitigating the risk for long-term adverse outcomes.

Objective: This case series is an inaugural attempt to provide a feasible management plan for symptoms of dissociative (conversion) disorders among adolescent girls and women using pranayama, a systematic and rhythmic yogic breathing technique. Dissociative disorders are frequently reported among adolescent girls and women across different cultures and states in India. The neurobiology of dissociative disorders is not clearly understood. Hence, there is no effective medication available. There are no scientific reports available on the use of pranayama for dissociative disorders.

Methods: This study presents three female patients (aged 17 years, 26 years, and 14 years) who underwent pranayama therapy instead of conventional management in outpatient settings for four weeks. A pranayama intervention module was designed based on their specific symptoms, using the Dissociative Experiences Measurement Oxford (DEMO) scale. After four weeks, the results were documented, and all three patients were advised to continue the daily practice of pranayama for 30 minutes in the morning and evening.

Results: All three patients reported improvement in breathlessness, restlessness, sleep, focus and concentration, feeling numb and disconnected, memory blanks, and vivid internal world. A follow-up was done after four weeks of completion of the pranayama intervention. No adverse effects were noted during the four weeks of intervention and at follow-up.

Conclusion: This case series testifies to the potential efficacy of pranayama intervention in managing the symptoms of dissociative disorders among adolescent girls and women. Further studies are required on a large sample size to validate the role of pranayama in the management of symptoms of dissociative disorders as an independent intervention.

Objective: In 2019, the authors began implementing a measurement-based care (MBC) curriculum into two residency programs at West Virginia University (WVU) and Delaware Psychiatric Center (DPC). The authors present findings from the four-year implementation period and describe a web-based MBC course that aims to train attendings and residents across the United States (US) and abroad.

Methods: The web-based MBC course includes four readings (the MBC instruction manual, the Standard for Clinicians' Interview in Psychiatry [SCIP] glossary, clinician-administered [CA] scales, and self-administered [SA] scales), four didactic presentations (MBC basics, psychopathology assessment, epidemiological concepts, and psychiatric measures), and four video interviews. The web-based MBC course is accessible through the WVU online continuing medical education (CME) web courses. The modified MBC psychiatry residency training curriculum includes four didactic lectures taught by MBC-trained faculty members and attendings. Residents practice using the scales during their inpatient and outpatient rotations and complete the web-based MBC course before graduation.

Results: The web-based MBC course was used to train most of the attendings in the WVU and DPC residency programs. Both programs now require residents to complete the web-based MBC course before graduation. Of the 52 residents in both programs, 26 residents (50%) had completed the training at the time of writing this article.

Conclusion: The web-based MBC course was successfully implemented in two US residency programs and is now available for clinicians around the world to access. Free access to the SCIP scales will be granted to psychiatry residency programs implementing the MBC curriculum.