Psychiatria Danubina最新文献

Purposes: Capacity-oriented workplace-description is on the one hand, the basis for occupational health action, e.g. for reintegration and work adjustment. On the other hand, it is also necessary for preventive action, e.g. mental hazard analysis or job-matching. When self-ratings are used for a work description, that description must not be confused by an affective judgment about the workplace, e.g. work-satisfaction. Health professionals are especially prone for high workload and potentially a very broad spectrum of work-duties. Studying health professionals is valuable for gaining empirical insights into how these employees, in a similar environment but with different tasks, perceive their work-capacity-demands. Subjective work-perception is an important predictor of work ability.

Methods: The work capacity demands of 122 health professionals were studied, by comparing administrative staff, physicians, psychologists and co-therapists (ergotherapists, sport therapists, social workers, nurses). They all reported their work demands according to the Mini-ICF-APP-WS work demands rating.

Results: Different professional groups reported different psychological work-capacity-demands to different degrees. Correlations between the work-capacity-demands and the work condition were low to moderate, indicating discriminant validity. Also, work capacity demands are independent from work ability, which is another validity aspect.

Conclusion: The work capacity demands rating was able to differentiate between capacity demands in different professional fields, even if the workplace context was the same (employees from similar work environments). The work capacity demands rating can be a useful short rating for mental hazard analysis in health care professions. It gives a differentiated description of workplace demands, which is the basis for creating person-job-fit, by targeted work adjustment, capacity training, or combined interventions.

Background: The inhumane events during the era of National Socialism with persecution, sterilization and mass murder still have consequences and influence individuals and the society.

Method: By describing the typical steps of trauma therapy (secure - working through - reconnect) the author suggests to use these elements as parts of a "collective trauma therapy".

Result: The different local actions and events of the commemoration culture in Carinthia are divided into these three areas.

Conclusion: The Commemoration Culture, very often spread in single events and actions without connection, can thus be planned and structured. The authors hope to be able to contribute to a relief of the horror caused also by transgenerational phenomena.

Background: Climate change is increasingly affecting not only physical health but also mental well-being. Psychological consequences such as eco-anxiety, depression, and post-traumatic stress disorder (PTSD) following climate-related disasters are being reported with growing frequency.

Subjects and methods: This study was conducted with mental health professionals who attended the Medforum Psychiatry Congress in 2024. A 22-question, closed-ended questionnaire was used to assess perceptions of the impact of climate change on mental health, the prevalence of eco-anxiety, and workplace preparedness for responding to climate-related disasters.

Results: A total of 208 individuals participated in the survey. Of those, 51.9% rated the impact of climate change on mental health as moderate, and 13.9% considered it to be very significant. Although eco-anxiety is increasingly recognized by professionals, most admitted that they rarely encounter patients who report this issue directly.

Conclusions: Climate change affects mental health in two ways: directly, through the experience of disasters, and indirectly, by inducing chronic anxiety. Educational initiatives and the implementation of procedures to support mental health during climate-related crises are essential.

Background: The aim of the study is to determine the changes in insulin-like growth factor 1 (IGF-1) and its receptor (IGF-1R) in the emergence of bipolar disorder and its treatment with olanzapine.

Subjects and methods: Of all 48 adult male albino wistar rats, the control group (n=12) saline, ketamine group (n=12) ketamine (25mg/kg), olanzapine group (n=12) olanzapine (2mg/kg), ketamine+olanzapine group (n=12) ketamine (25 mg/kg) was administered once a day/14 days. Olanzapine (2mg/kg) was administered once a day to the ketamine+olanzapine group between 8 and 14 days. Volume, IGF-1, and IGF-1R gene expression and protein levels were measured in the prefrontal cortex and hippocampus.

Results: In the prefrontal cortex, there was a decrease in volume, IGF-1R gene expression, and protein levels in the ketamine group, an increase in IGF-1 gene expression and protein levels in the olanzapine group; an increase in IGF-1R gene expression, IGF-1, and IGF-1R protein levels in the ketamine+olanzapine group. In hippocampus, there was a decrease in volume, IGF-1 gene expression and protein levels in ketamine group, a decrease in volume and IGF-1 protein levels, increase in IGF-1R gene expression and protein levels in olanzapine group; a decrease in volume, IGF-1 protein levels and IGF-1R gene expression and protein levels in ketamine+olanzapine group.

Conclusions: One of the underlying causes of bipolar disorder may be changes in the IGF-1 and IGF-1R regions in the prefrontal cortex and hippocampus. Olanzapine has a neuroprotective effect by increasing IGF-1 and IGF-1R levels in the prefrontal cortex, and a neurodegenerative effect by decreasing IGF-1 and IGF-1R levels in the hippocampus.

Background: This study aims to analyse certain populations' sociodemographic factors and to investigate the use of polypharmacy for inpatients assigned to involuntary treatment at the National Center of Mental Health, Riga, Latvia.

Methods: A retrospective review of clinical data was undertaken in adult inpatients assigned to involuntary psychiatric treatment in the period from December 17th, 2024, till February 4th, 2025. The data about the participants' sociodemographic factors, hospitalisation duration, diagnosis, and treatment strategies were obtained from the hospital's databases. Only data from a fixed 30-day window at the time of analysis were considered, irrespective of hospitalization duration, to ensure consistency and avoid bias from ongoing treatment modifications. The Antipsychotic Total Daily Dose Calculator was used to assess polypharmacy load by estimating the BNF (British National Formulary) coefficient relative to the recommended maximum daily dose. All data were collected in MS Excel and analysed using IBM SPSS 29.0.1.0.

Results: The study included 88 inpatients with compulsory medical measures. Results showed a mean age of the participants equal to 41.49±2.41 years, males' dominance making 86.36% (n=76) of the study group, and schizophrenia (F20, ICD-10) noted as the most dominant diagnostic category. Polypharmacy with more than one antipsychotic medication was observed in 89.77% (n=79) of the inpatients. The most common treatment combination was an antipsychotic with a mood stabilizer, prescribed to 44.32% (n=39) of participants. Treatment was primarily guided by antipsychotics, with haloperidol emerging as the most commonly used drug, representing 72.72% (n=64) of the cases, and mood stabilizers received by 57.95% (n=51) of the inpatients. The analysis revealed that 34.09% (n=30) of participants had a BNF coefficient within the recommended maximum daily dose, while the majority, or 65.9% (n=58), exceeded the recommended threshold.

Conclusions: This study contributes to existing knowledge of currently available data about polypharmacy in psychiatric practice and certain population groups undergoing involuntary hospitalisation. The results about treatment patterns may support the optimization of treatment practices and warrant closer attention to safety, side effect profiles, and possible long-term outcomes when polypharmacy is used.

From time to time, tragic cases occur when patients with serious Mental illness commit homicide. We describe two cases which are in the public domain.These cases are not isolated incidents but part of a broader, systemic failure to provide sustained, assertive, and well-resourced community-based mental health care. It is crucial that the techniques of Assertive Outreach we have discussed are not only adopted in principle but also fully integrated into everyday practice, backed by proper funding, staff training, and institutional support. Without this commitment, we risk continuing the tragic cycle of preventable deaths, where both patients with severe mental illness and innocent bystanders pay the price for gaps in the system. By applying assertive outreach models effectively, we have the opportunity to change the trajectory of care, ensuring that vulnerable individuals receive the intensive, proactive support they need to remain stable, safe, and ultimately, to prevent such tragedies from happening again.

Background: The rise of synthetic opioids, particularly fentanyl, has intensified the global drug abuse crisis, posing serious challenges to healthcare systems. Nurses and nursing students play a crucial role in prevention, early identification, and emergency management of opioid-related cases. Health Literacy (HL), the ability to access, understand, and use health information, has been proposed as a critical determinant of clinical competence in this context. This study aims to assess the knowledge, awareness, and health literacy of nurses and nursing students in relation to fentanyl and drug abuse, exploring potential associations between HL levels and preparedness to manage substance-related emergencies.

Subjects and methods: A national multicenter cross-sectional study was conducted from October 2024 to January 2025, involving 157 participants (nurses and nursing students) across Italy. A structured questionnaire was administered online, covering four domains: sociodemographic information, health literacy (HL), drug addiction knowledge and specific knowledge of fentanyl. Descriptive and inferential statistics were performed using SPSS.

Results: Participants demonstrated good overall knowledge about fentanyl clinical use and effects. However, misconceptions were identified - particularly regarding lethal dosages and the inability to detect fentanyl with the senses. Notably, HL scores did not consistently correlate with higher knowledge levels; in some cases, participants with lower HL scores showed better understanding of specific topics such as routes of administration and naloxone use. A significant negative correlation was found between HL and knowledge of drug availability (r = -0.35; p < 0.001). No significant differences emerged between students and professionals.

Conclusions: Findings challenge the assumption that higher HL always predicts better preparedness. Standard HL measures may fail to capture contextual and experiential knowledge essential for managing opioid-related emergencies. Nursing education should incorporate more experiential and clinically focused training on drug abuse, integrating HL as an operational - rather than merely promotional - competency. Further research with larger samples and qualitative methods is recommended.