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Measurement-Based Care Implementation Challenges and Opportunities in Real-World Practice 基于测量的护理实施在现实世界实践中的挑战和机遇
4区 医学 Q4 PSYCHIATRY Pub Date : 2023-09-01 DOI: 10.3928/00485713-20230818-02
Kathryn K. Ridout, Erik R. Vanderlip, Samuel J. Ridout, Carol L. Alter
Measurement-based care is an evidence-based practice shown to improve patient outcomes in a variety of psychiatric disorders compared to usual care. Despite the evidence, measurement-based care is not routinely implemented in real-world clinical practice. This report uses an implementation science framework to review the literature regarding perceived barriers and facilitators to real-world measurement-based care implementation at the patient, clinician, organizational, and systems level. Further, we highlight the importance of treatment guideline implementation in parallel with measurement-based care, which helps ensure clinician action responsive to symptom measurement. [ Psychiatr Ann . 2023;53(9):405–409.]
基于测量的护理是一种基于证据的实践,与常规护理相比,可以改善各种精神疾病患者的预后。尽管有证据,基于测量的护理并没有在现实世界的临床实践中常规实施。本报告使用实施科学框架来回顾有关在患者、临床医生、组织和系统层面实施基于测量的现实世界护理的感知障碍和促进因素的文献。此外,我们强调治疗指南的实施与基于测量的护理并行的重要性,这有助于确保临床医生对症状测量做出反应。[精神病医生安。]2023; 53(9): 405 - 409。)
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引用次数: 1
The Importance of Social Fitness for a Good Life 社会健康对美好生活的重要性
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230728-03
A. Nierenberg
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引用次数: 0
MAOIs: Reconsideration and Re-education 毛:反思与再教育
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230719-01
P. K. Gillman, Vincent Van den Eynde
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引用次数: 0
The Effect of Fear of COVID-19 on Prenatal Attachment and Pregnancy Stress in Pregnant Women COVID-19恐惧对孕妇产前依恋和妊娠应激的影响
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230721-01
H. Unver, I. Turan
The coronavirus disease (COVID-19) pandemic has disrupted the lives of people around the world, causing illness, death, fear, and trauma. This study aims to determine the effect of fear of contracting COVID-19 on pregnancy stress and prenatal attachment in pregnant women. This cross-sectional and descriptive study was conducted with 270 pregnant women who were registered in the family health center of a city located in the eastern part of Turkey. Data were collected between November 2020 and March 2021. The average age of the participants was 28.24 ± 5.69. A positive and weak correlation was found between the Fear of COVID-19 Scale Mean score and the Prenatal Attachment Inventory (PAI) and Pregnancy Stress Rating Scale (PSRS) mean scores ( r = 0.379, 0.478; P < 0.001, respectively). In addition, a weak correlation was detected between the PAI mean score and the PSRS mean score ( r = 0.495; P < 0.001). Results showed that the fear of COVID-19 affected prenatal attachment at a proportion of 14% and pregnancy stress at a proportion of 22%. This study found that the fear of COVID-19 had effects on pregnancy stress and prenatal attachment. Healthcare professionals should consider the fear caused by the pandemic as a factor in the treatment-care and consultancy services provided to pregnant women in extraordinary, unprecedented times like the COVID-19 pandemic. [ Psychiatr Ann . 2023;53(8):381–388.]
冠状病毒病(COVID-19)大流行扰乱了世界各地人们的生活,造成疾病、死亡、恐惧和创伤。本研究旨在确定对感染COVID-19的恐惧对孕妇妊娠压力和产前依恋的影响。这项横断面和描述性研究是对在土耳其东部一个城市的家庭保健中心登记的270名孕妇进行的。数据收集于2020年11月至2021年3月。参与者平均年龄28.24±5.69岁。新冠肺炎恐惧量表平均得分与产前依恋量表(PAI)和妊娠压力评分量表(PSRS)平均得分呈正相关(r = 0.379, 0.478;P < 0.001)。PAI均分与PSRS均分呈弱相关(r = 0.495;P < 0.001)。结果显示,对COVID-19的恐惧影响产前依恋的比例为14%,怀孕压力的比例为22%。这项研究发现,对COVID-19的恐惧对怀孕压力和产前依恋有影响。在COVID-19大流行等非常、前所未有的时期,医疗保健专业人员应将大流行引起的恐惧视为向孕妇提供治疗、护理和咨询服务的一个因素。[精神病医生安。]2023; 53(8): 381 - 388。)
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引用次数: 0
An Expert Roundtable Discussion on the Use of Classic Monoamine Oxidase Inhibitors in the Treatment of Depression – Part One 关于使用经典单胺类氧化酶抑制剂治疗抑郁症的专家圆桌讨论——第一部分
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230717-01
Allan Young, J. Rucker, Vincent Van den Eynde, Charles Redhead, B. Barnett, Lila Godet, A. Cleare, John Cosgrove, S. Stahl, T. Birkenhäger, P. K. Gillman
Experienced clinicians and academics from the International MAOI (monoamine oxidase inhibitor) Expert Group comment on questions of interest concerning MAOI pharmacotherapy for depression, especially as they pertain to the illustrative case summaries presented in this part one of the Expert Roundtable Discussion. These comments focus on practical therapeutics and aspects of difficult cases that guidelines simply do not, and cannot, address, such as the important fact that psychotic depression may respond rapidly to MAOIs. The ethical and medico-legal issues relating to cost and ongoing availability are also discussed. [ Psychiatr Ann . 2023;53(8):359–363.]
来自国际单胺氧化酶抑制剂专家组的经验丰富的临床医生和学者对有关抑郁症MAOI药物治疗的感兴趣的问题发表了评论,特别是与专家圆桌讨论第一部分中介绍的说明性病例摘要有关。这些评论集中在实用的治疗方法和指导方针根本没有也不能解决的疑难病例方面,例如精神病性抑郁症可能对MAOIs反应迅速这一重要事实。还讨论了与成本和持续可用性有关的伦理和医疗法律问题。【精神病学年鉴,2023;53(8):359–363。】
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引用次数: 1
The Pocket Guide to Classic Monoamine Oxidase Inhibitors for Treatment-Resistant Depression 经典单胺类氧化酶抑制剂治疗难治性抑郁症袖珍指南
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230713-01
S. Stahl, Vincent Van den Eynde, Lila Godet, Charles Redhead, P. K. Gillman
Treatment-resistant depression (TRD) remains a significant challenge for clinicians and patients alike, necessitating exploration and understanding of potent but underutilized antidepressant options, such as classic monoamine oxidase inhibitors (MAOIs). This article presents a condensed overview of the fundamental principles outlined in the international consensus guideline on using MAOIs in TRD (the Prescriber's Guide), explicitly focusing on phenelzine and tranylcypromine. These drugs are powerful treatment options for severe depression, including atypical and melancholic subtypes, that have insufficiently responded to first- and second-line treatments. MAOIs are generally indicated before electroconvulsive therapy due to their favorable side-effect profile. However, several contraindications and drug interactions must be considered. This article aims to provide clinicians with a practical, accessible resource for implementing classic MAOIs in the management of TRD. [ Psychiatr Ann . 2023;53(8):347–352.]
耐治性抑郁症(TRD)对临床医生和患者来说仍然是一个重大挑战,需要探索和理解有效但未充分利用的抗抑郁药选择,如经典的单胺氧化酶抑制剂(MAOIs)。这篇文章简要概述了关于在TRD中使用MAOIs的国际共识指南(处方指南)中概述的基本原则,明确侧重于吩嗪和tranylcyromine。这些药物是治疗严重抑郁症的有力选择,包括非典型和忧郁症亚型,这些药物对一线和二线治疗反应不足。MAOIs由于其良好的副作用,通常在电惊厥治疗前使用。但是,必须考虑几个禁忌症和药物相互作用。本文旨在为临床医生在TRD管理中实施经典MAOI提供一个实用、可访问的资源。【精神病学年鉴,2023;53(8):347-352。】
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引用次数: 0
The Correlation Between Eating Behaviors and Depression Levels After Bariatric Surgery 减肥手术后饮食行为与抑郁水平的相关性
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230724-01
Mustafa Kavak, Meral Özkan
In recent years, the prevalence of obesity has been increasing. Obese patients can be treated with medication, diet, exercise, and bariatric surgery. Studies on bariatric surgery have mostly focused on the physiological aspect of the surgery, with little attention paid to its psychological effects. There are a limited number of national and international studies that investigate eating behaviors and depression after bariatric surgery together. This descriptive and correlational study aimed to determine the correlation between eating behaviors and depression levels of patients after bariatric surgery. The study was conducted at Fırat University Hospital General Surgery Outpatient Clinic between July 2018 and August 2019. The population of the study was 1,000 adult patients. The sample consisted of 278 patients determined by the power analysis. The Descriptive Characteristics Form was used to determine the descriptive characteristics of the patients, the Dutch Eating Behavior Questionnaire to determine the patients' eating behaviors, and the Beck Depression Inventory to determine their depression levels. Data was gathered through face-to-face interviews at least 1 month after the surgery. The data was assessed using percent distribution, arithmetic mean, and Pearson's correlation analysis. The eating behaviors of the participants were found to be high (104.38 ± 10.29), while their depression levels were low (17.87 ± 7.71). It was determined that there was a positive and weak correlation between the patients' eating behaviors and depression levels, which was statistically significant ( r = 0.190, P = 0.002). Consequently, it was determined that the eating behaviors of the patients improved, and their depression levels were low. Furthermore, as the patients' depression levels increased, so did their eating behaviors. To improve the mental health of patients after bariatric surgery, we must identify mental problems and develop solutions. We suggest that nurses plan training to help patients regulate their eating behaviors and reduce their depression levels. [ Psychiatr Ann . 2023;53(8):374–380.]
近年来,肥胖的患病率一直在上升。肥胖患者可以通过药物、饮食、锻炼和减肥手术进行治疗。对减肥手术的研究大多集中在手术的生理方面,很少关注其心理影响。国内和国际上对减肥手术后的饮食行为和抑郁进行调查的研究数量有限。这项描述性和相关性研究旨在确定减肥手术后患者的饮食行为与抑郁水平之间的相关性。该研究于2018年7月至2019年8月在Fırat大学医院普通外科门诊进行。研究对象为1000名成年患者。样本由278名患者组成,通过功率分析确定。描述性特征表用于确定患者的描述性特征,荷兰饮食行为问卷用于确定患者饮食行为,贝克抑郁量表用于确定其抑郁水平。数据是在手术后至少1个月通过面对面的访谈收集的。使用百分比分布、算术平均值和Pearson相关分析对数据进行评估。参与者的饮食行为较高(104.38±10.29),而抑郁水平较低(17.87±7.71)。确定患者的饮食行为与抑郁水平之间存在正相关和弱相关,具有统计学意义(r=0.190,P=0.002)。因此,确定患者的饮食行为得到改善,并且他们的抑郁水平较低。此外,随着患者抑郁程度的增加,他们的饮食行为也会增加。为了改善减肥手术后患者的心理健康,我们必须发现心理问题并制定解决方案。我们建议护士计划培训,帮助患者调节饮食行为,降低抑郁水平。【精神病学年鉴,2023;53(8):374–380。】
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引用次数: 0
Monoamine Oxidase Inhibitors and Clinically Relevant Drug Interactions: A Guide for Preventing Serotonin Toxicity and Hypertensive Reactions 单胺类氧化酶抑制剂和临床相关药物相互作用:预防血清素毒性和高血压反应的指南
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230713-02
P. K. Gillman, Vincent Van den Eynde, Lila Godet, Charles Redhead, A. Horwitz, Brian Barnett
This article describes and clarifies the two significant interactions encountered with monoamine oxidase inhibitors (MAOIs): serotonin toxicity and the tyramine pressor response. This is important because of the amount of inaccurate and misleading information (including in United States Food and Drug Administration-approved product information sheets and online resource and database systems) promulgated over the last few decades, which continues to cause confusion and undue concern. There are few if any clinically relevant CYP450 interactions with psychotropic drugs and no significant pharmacokinetic interactions. Serotonin toxicity is now well understood and only occurs in a problematic form when MAOIs are given in conjunction with serotonin reuptake inhibitors. Major prolonged elevations of blood pressure from tyramine are now less of a concern because of greatly reduced tyramine levels in foods. Therefore, MAOIs are safer and simpler to use in clinical practice than has usually been stated and should be considered earlier in the treatment algorithm for both atypical and melancholic depression. [ Psychiatr Ann . 2023;53(8):353–358.]
本文描述并阐明了单胺氧化酶抑制剂(MAOIs)遇到的两种重要相互作用:血清素毒性和酪胺升压反应。这一点很重要,因为在过去几十年中颁布了大量不准确和误导性的信息(包括美国食品和药物管理局批准的产品信息表以及在线资源和数据库系统),这些信息继续引起混乱和不应有的担忧。CYP450与精神药物之间几乎没有临床相关的相互作用,也没有显著的药代动力学相互作用。血清素毒性现在已经得到了很好的理解,只有当MAOIs与血清素再摄取抑制剂联合使用时,才会以有问题的形式出现。由于食物中的酪胺水平大大降低,酪胺导致的血压长期升高现在不那么令人担忧了。因此,MAOIs在临床实践中比通常所说的更安全、更简单,在非典型抑郁症和忧郁症的治疗算法中应该更早考虑。【精神病学年鉴,2023;53(8):353–358。】
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引用次数: 2
An Expert Roundtable Discussion on the Use of Classic Monoamine Oxidase Inhibitors in the Treatment of Depression – Part Two 经典单胺氧化酶抑制剂治疗抑郁症的专家圆桌讨论-第二部分
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-08-01 DOI: 10.3928/00485713-20230718-01
M. Berk, Vincent Van den Eynde, Karthikeyan Ganapathy, C. Andrade, T. Birkenhäger, J. Bodkin, David Nutt, B. Barnett, Simeon Shalom Feinberg, Gordon Parker, E. Ruhe, M. Fornaro, Charles Redhead, Lila Godet, P. K. Gillman
Experienced clinicians and academics from the International MAOI Expert Group comment on questions of interest concerning monoamine oxidase inhibitor (MAOI) pharmacotherapy for depression. These comments in this Part Two of the Expert Roundtable Discussion emphasize good pharmacological practice, starting with a low dose and progressing slowly and only changing one element at a time. Issues related to augmentation and drug combinations are also mentioned, including comments about the safety of ketamine. The special ability of MAOIs to improve dopamine function is highlighted, especially in relation to melancholic and psychotic depression. [ Psychiatr Ann . 2023;53(8):364–369.]
来自国际MAOI专家组的经验丰富的临床医生和学者对抑郁症单胺氧化酶抑制剂(MAOI)药物治疗感兴趣的问题发表评论。专家圆桌讨论第二部分的这些评论强调良好的药理学实践,从低剂量开始,缓慢进展,一次只改变一种元素。还提到了与增强和药物组合有关的问题,包括对氯胺酮安全性的评论。MAOIs改善多巴胺功能的特殊能力被强调,特别是在抑郁症和精神病性抑郁症中。[精神病医生安。]2023; 53(8): 364 - 369。)
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引用次数: 0
Stigma Resistance Scale: A Psychometric Study in a Turkish Mental Illness Sample 污名抵抗量表:土耳其精神疾病样本的心理测量研究
IF 0.5 4区 医学 Q4 PSYCHIATRY Pub Date : 2023-07-01 DOI: 10.3928/00485713-20230207-04
A. Okanlı, Merve İnan Budak, E. Yılmaz, Y. O. Ozdemir
The aim of this study was to evaluate the reliability and validity of the Turkish version of the Stigma Resistance Scale in patients with psychiatric disorders. This methodological study included 190 patients diagnosed with various psychiatric disorders in a psychiatry outpatient clinic of two hospitals in Turkey. The data were analyzed using SPSS and LISREL software. Explanatory and confirmatory factor analyses, Cronbach's alpha coefficients, and test-retest methods were used to determine the validity and reliability of the scale. The Cronbach's alpha coefficient of the scale was 0.89 for the entire scale and ranged between 0.72 and 0.82 for the five subscales; the item-total point correlations were between 0.43 and 0.63; and the correlation value of the test-retest was 0.78. The results of the explanatory factor analysis revealed that a five-factor structure, with factor loadings in the range of 0.44 to 0.70, explained 60.11% of the total variance. According to the results, acceptable adaptation values were computed (χ 2 /SD = 1.840, root-mean-square error of approximation = 0.06, standardized root-mean-square residuals = 0.070, comparative fit index = 0.96). In light of the findings, it was concluded that the Turkish version of the Stigma Resistance Scale could be used as a reliable and valid tool in assessing stigma resistance of Turkish psychiatric patients. Health care professionals may use this instrument in clinical practice to identify patients with mental illness who are experiencing stigma. [ Psychiatr Ann . 2023;53(7):333–339.]
本研究的目的是评估土耳其版污名抵抗量表在精神障碍患者中的可靠性和有效性。这项方法学研究包括土耳其两家医院的精神病门诊中190名被诊断为各种精神障碍的患者。使用SPSS和LISREL软件对数据进行分析。使用解释性和验证性因素分析、Cronbachα系数和重测方法来确定量表的有效性和可靠性。整个量表的克朗巴赫α系数为0.89,五个分量表的克朗巴赫α系数在0.72至0.82之间;项目总分相关性在0.43和0.63之间;重测的相关值为0.78。解释因素分析的结果表明,五因素结构,因子负荷在0.44至0.70之间,解释了60.11%的总方差。根据结果,计算出可接受的适应值(χ2/SD=1.840,近似均方根误差=0.06,标准均方根残差=0.070,比较拟合指数=0.96),得出的结论是,土耳其版的污名抵抗量表可以作为评估土耳其精神病患者污名抵抗力的可靠和有效的工具。卫生保健专业人员可以在临床实践中使用该仪器来识别正在经历耻辱的精神疾病患者。【精神病学年鉴,2023;53(7):333–339。】
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引用次数: 0
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Psychiatric Annals
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