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Medical students' levels of empathy and stigma toward the mentally ill 医学生对精神病患者的共情和污名水平
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001047I
L. Injac-Stevović, T. Radojičić, S. Repišti
The main aim of this paper was to investigate levels of empathy in medical students as well as their attitudes toward people with mental disorders. We recruited 144 students from the School of Medicine in Podgorica (Montenegro), out of which 37.7% were males and 62.3% were females. The mean age of the sample was 21.85 (SD = 2.65). We designed Scale of attitudes toward mentally ill people (SAMIP), and principal component analysis revealed that this instrument could be divided into two subscales – Positive attitudes toward the mentally ill (PAMI, α= .903) and Stigmatization of the mentally ill (SMI, α= .875). These subscales had high levels of reliability (i.e. internal consistency). The second measure was Empathy Questionnaire which is a unidimensional tool with a very high level of internal consistency (α= .924). The results revealed a high positive correlation between empathy levels and positive attitudes towards people with mental illness, a low correlation of empathy with the year of study, a low negative correlation between stigmatizing the mentally ill and participants' age, as well as low positive correlations of proneness to stigma with students' GPA and expectations of their profession. Recommendations for further research in this field were listed as well.
本研究的主要目的是探讨医学生的共情水平,以及他们对精神障碍患者的态度。我们从波德戈里察(黑山)医学院招募144名学生,其中37.7%为男性,62.3%为女性。样本平均年龄21.85岁(SD = 2.65)。我们设计了精神病人态度量表(SAMIP),主成分分析表明,该量表可分为对精神病人的积极态度(PAMI, α= .903)和对精神病人的污名化(SMI, α= .875)两个子量表。这些量表具有高水平的可靠性(即内部一致性)。第二种测量是共情问卷,它是一种单向度的工具,具有很高的内部一致性(α= .924)。结果显示,共情水平与对精神疾病患者的积极态度呈高度正相关,共情水平与学习年份呈低相关,对精神疾病患者的污名化与参与者的年龄呈低负相关,而污名化倾向与学生的GPA和职业期望呈低正相关。并对该领域的进一步研究提出了建议。
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引用次数: 0
Obesity and schizophrenia: New drugs, new hopes 肥胖和精神分裂症:新药,新希望
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001113M
Č. Miljević, O. Vuković
Obesity is one of the leading problems in our society. The spread of obesity in developed societies is reaching pandemic lengths. In schizophrenic patients obesity raises an important issue. Patients suffering from schizophrenia have a shorter life span compared to the general population. Prevalence of obesity in schizophrenic patients is high. Obesity is the key factor in developing a metabolic syndrome. Metabolic syndrome is a frequent somatic complication in schizophrenia. Nowadays, it is clear that metabolic syndrome shortens the lifespan of people who developed an illness. Because of this, the treatment of obesity represents a major problem. Review of currently approved medications for treatment of obesity is the goal of this paper.
肥胖是我们社会的主要问题之一。肥胖在发达社会的蔓延已达到流行病的程度。在精神分裂症患者中,肥胖是一个重要的问题。与一般人群相比,精神分裂症患者的寿命较短。精神分裂症患者中肥胖的患病率很高。肥胖是导致代谢综合征的关键因素。代谢综合征是精神分裂症常见的躯体并发症。如今,很明显,代谢综合征缩短了患病患者的寿命。正因为如此,肥胖的治疗成了一个大问题。回顾目前批准的治疗肥胖的药物是本文的目的。
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引用次数: 0
A case report of the inaccuracy of the questionnaire as a meriod of the patient's condition 一个病例报告的不准确的调查问卷作为一个时期的病人的状况
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001067K
M. Kostic, A. Munjiza, Ana Jakoviljević
Scales for assessment of patients with depression are in use for several decades. Among the most used are Hamilton's depression scale and the younger Patient Health Questionnaire. Even though both are heavily used in research and clinical practice they are still controversial and with questionable usefulness. This case report shows that the question whether a patient is better or worse can be diametrically opposite depending on the scale used (using these two most influential ones as examples) and what are the reasons for this.
用于评估抑郁症患者的量表已经使用了几十年。其中最常用的是汉密尔顿抑郁量表和年轻患者健康问卷。尽管这两种方法在研究和临床实践中被大量使用,但它们仍然存在争议,是否有用也值得怀疑。这个病例报告表明,根据所使用的量表(以这两个最具影响力的量表为例),病人是好还是坏的问题可能完全相反,原因是什么。
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引用次数: 0
Treatment of mentally disturbed persons in medieval Serbia 中世纪塞尔维亚对精神病患者的治疗
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001005S
Mirjana Stojković-Ivković
The treatment of mental health patients in Serbia in the Middle ages was the same as in other European countries. Medicine of that time was based on science, the use of magic rituals and witchcraft was banned. Doctors from Serbia, Byzantium and the national doctors had been educated in Salerno and Montpellier, the most developed centers of medicine. They took the exam in front of the government Medical testimony. The development of medicine was followed in the Hodoloski code which was considered the oldest record of folk medicine and the Hilandar medical code which represented a collection of medieval scientific European medicine and Serbian medicine culture (XII-XV). The first Serbian hospital was established in Hilandar in 1199. The founder was Saint Sava who wrote the rules about the work of the hospital. Actually, it was the practice for all medical facilities that were opened later. We know about mental diseases and healing in Serbia from Lives of Saints in monasteries Zica (from 1207) and Decani (1327) and from the biography of Medieval ruler (king) Stephen of Decani. The illustrations of healing some patients with mental diseases were shown on frescoes and in the lives of saints. In Medieval Serbia, there were 49 foreign doctors working (15 in XIV, 30 in XV and 4 in XVI century) and until Turkish conquest Serbia took a very important place in Medieval Europe. Objective of this paper is to show where psychiatric patients were treated in Medieval Serbia, the way they were treated, who treated them, where the hospitals were and what kind of treatment wereapplied.
在中世纪,塞尔维亚对精神疾病患者的治疗与其他欧洲国家相同。当时的医学是以科学为基础的,使用魔法仪式和巫术是被禁止的。来自塞尔维亚、拜占庭和国家医生的医生在最发达的医学中心萨莱诺和蒙彼利埃接受教育。他们在政府面前做了体检证明。医学的发展紧随其后的是被认为是民间医学最古老记录的《霍多洛斯基法典》和代表中世纪科学欧洲医学和塞尔维亚医学文化的《希兰达尔法典》(第十二至第十五章)。1999年在希兰达尔建立了第一所塞尔维亚医院。医院的创始人是圣萨瓦,他制定了医院的工作规则。事实上,所有后来开业的医疗机构都是这么做的。我们从《齐卡修道院的圣徒生活》(1207年)和《德卡尼修道院的圣徒生活》(1327年)以及中世纪统治者(国王)德卡尼的斯蒂芬传记中了解到塞尔维亚的精神疾病和治疗。在壁画和圣徒的生活中,出现了一些治疗精神病患者的插图。在中世纪的塞尔维亚,有49名外国医生在工作(14世纪15名,15世纪30名,16世纪4名),直到土耳其征服塞尔维亚,塞尔维亚在中世纪欧洲占据了非常重要的地位。本文的目的是展示在中世纪的塞尔维亚,精神病患者在哪里接受治疗,他们接受治疗的方式,谁治疗他们,医院在哪里,采用了什么样的治疗。
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引用次数: 0
Duration of psychiatric appointments for patients with Psychosis spectrum disorders in Serbia: Is it significantly prolonged by DIALOG+ psychosocial intervention? 塞尔维亚精神病谱系障碍患者的精神科就诊时间:DIALOG+社会心理干预是否显著延长?
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001013R
I. Ristić, Sanja Andrić-Petrović, S. Jerotić, M. Zebić, N. Jovanović, N. Marić
Despite national and international guidelines recommending inclusion of psychotherapy and psychosocial interventions as regular part of treatment for patients with psychosis spectrum disorders (PSD), outpatient psychiatric care in Southeastern Europe (SEE) is mostly limited to medication prescription. DIALOG+ is a recently developed technology-based, patient centered psychosocial intervention that provides an economically viable intervention for treatment and comprehensive evaluation of multiple life domains. Its effectiveness in a range of psychiatric disorders has been shown in several studies conducted in high-income countries. Before an ongoing study evaluating DIALOG+ implementation and effectiveness in developing SEE countries is completed, we aimed to explore general impressions of mental health clinicians towards such an intervention and to compare the duration of treatment as usual (TAU) with DIALOG+ enriched appointments of PSD outpatients. The attendees of the national professional educational symposium were presented with DIALOG+, after which they completed a short survey on their general impressions towards the intervention. To obtain the information regarding duration of psychiatric appointments for patients with PSD in Serbia, we used data from a currently ongoing randomized clinical trial where DIALOG+ is being tested for effectiveness. The impressions of the survey (n=110) from mostly psychiatrists and psychiatry residents towards the concept of this intervention were overwhelmingly positive. However, the question arose if TAU is being prolonged by DIALOG+ to the extent that might limit its implementation. Although significant difference in average session duration was observed between DIALOG+ and TAU (31.96±16.47 vs. 19.75±6.11 minutes, p<0.01), providing structured interventions and patient evaluation might be of additional benefit for long term care and quality of life of PSD patients. To the best of our knowledge, this was the first evaluation of the duration of psychiatric appointments for outpatients with PSD in Serbia. Present information could be useful for different stakeholders in education of MH workers and implementation of DIALOG+ in the local settings.
尽管国家和国际指南建议将心理治疗和社会心理干预作为精神病谱系障碍(PSD)患者治疗的常规部分,但东南欧(SEE)的门诊精神科护理大多局限于药物处方。DIALOG+是最近开发的以技术为基础,以患者为中心的社会心理干预,为多种生命领域的治疗和综合评估提供经济上可行的干预。在高收入国家进行的几项研究表明,它对一系列精神疾病有效。在一项正在进行的评估DIALOG+在发展中SEE国家实施和有效性的研究完成之前,我们的目的是探索心理健康临床医生对这种干预措施的总体印象,并比较常规治疗(TAU)与DIALOG+门诊患者预约的PSD门诊时间。全国专业教育研讨会的与会者获得了DIALOG+,之后他们完成了关于他们对干预的总体印象的简短调查。为了获得塞尔维亚PSD患者精神科预约时间的信息,我们使用了目前正在进行的一项随机临床试验的数据,该试验正在测试DIALOG+的有效性。调查的印象(n=110),大多数精神科医生和精神科住院医师对这种干预的概念是压倒性的积极。然而,问题出现了,如果TAU被DIALOG+延长到可能限制其实施的程度。虽然DIALOG+和TAU的平均疗程时间有显著差异(31.96±16.47 vs. 19.75±6.11分钟,p<0.01),但提供结构化干预和患者评估可能对PSD患者的长期护理和生活质量有额外的好处。据我们所知,这是第一次对塞尔维亚精神病患者门诊就诊时间的评估。目前的信息可能对不同的利益相关者在妇幼保健工作者的教育和在当地实施DIALOG+有用。
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引用次数: 1
Mental disorders in the peripartum period 围生期的精神障碍
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001131M
M. Milosavljević, O. Vuković
Perinatal mental health disorders are defined as mental conditions developed during pregnancy or in a year following child delivery. Women are affected but it is possible partners can be too, as a new or additional mental health condition. The aim of perinatal psychiatry is preventing perinatal mental health problems, as well as timely and scientifically based diagnose and offer evidence-based treatment including psychosocial therapy or medications. Undiagnosed or untreated perinatal mental disorders during or after pregnancy can have significant and long-lasting effects on the wellbeing of the women and her overall health, child health and development, as well as partner relationships and society as whole.
围产期精神健康障碍的定义是在怀孕期间或分娩后一年内出现的精神状况。女性受到影响,但作为一种新的或额外的精神健康状况,伴侣也可能受到影响。围产期精神病学的目的是预防围产期心理健康问题,及时和科学地诊断并提供循证治疗,包括社会心理治疗或药物治疗。怀孕期间或之后的围产期精神障碍未经诊断或治疗,可能对妇女的福祉及其整体健康、儿童健康和发育以及伴侣关系和整个社会产生重大和长期的影响。
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引用次数: 0
Mental health of refugees, asylum seekers and migrants: An overview of challenges and good practice examples 难民、寻求庇护者和移徙者的心理健康:挑战概述和良好做法范例
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001073P
B. Pejušković, Maša Vukčević-Marković
In the past few years the number of refugees, migrants and asylum seekers worldwide has increased dramatically. Serbia, as a mainly transit country currently hosts over 6,000 new asylum-seekers and refugees, over 26.200 refugees and 198.500 internally displaced persons from the ex-Yugoslavia region, and 1.950 persons at risk of statelessness. Migrants are often under acute and chronic stress. Many of them were traumatized in their homelands and during their journey, due to persecution, violence, and human right violations, and they are confronted with ongoing stressors in the exile countries. Extensive research has shown increased rates and substantial variability in the prevalence of short-term and long-term mental health problems among refugees, asylum seekers and migrants. The most prevalent psychiatric disorders are depression, anxiety, prolonged grief, somatoform disorders, psychosis, substance use disorders, and disorders specifically related to stress, particularly posttraumatic stress disorder. It’s urgent to offer a systemic and sustainable solutions for mental health protection, in order to reduce trauma related mental health problems and prevent long-term consequences. Multisectoral, evidence-based and multidisciplinary approach is recognized as crucial in identifying needs of these populations and enabling proper protection of their mental health and psychosocial wellbeing.
在过去几年中,全世界难民、移民和寻求庇护者的人数急剧增加。塞尔维亚作为一个主要的过境国,目前收容了6 000多名新的寻求庇护者和难民,来自前南斯拉夫地区的26 200多名难民和198 500多名国内流离失所者,以及1 950名面临无国籍危险的人。移徙者往往处于急性和慢性压力之下。他们中的许多人在他们的家乡和旅途中受到迫害、暴力和侵犯人权的创伤,他们在流亡国家面临着持续的压力。广泛的研究表明,在难民、寻求庇护者和移民中,短期和长期精神健康问题的发病率有所上升,而且存在很大差异。最常见的精神障碍是抑郁、焦虑、长期悲伤、躯体形式障碍、精神病、物质使用障碍和与压力有关的障碍,特别是创伤后应激障碍。迫切需要为心理健康保护提供系统和可持续的解决方案,以减少与创伤相关的心理健康问题并防止长期后果。人们认识到,多部门、循证和多学科方法对于确定这些人群的需求和适当保护他们的精神健康和社会心理健康至关重要。
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引用次数: 0
Congenital adrenal hyperplasia associated with mental disorders: A case report 先天性肾上腺增生伴精神障碍1例
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001057G
R. Grujicic, J. Maslak, Saša Štupar, M. Pejović-Milovančević
Introduction: Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by a defect in the synthesis of steroid hormones of the adrenal cortex. This defect results in elevated serum androgen levels. Androgens have been shown to have a significant effect on the developing brain during prenatal and postnatal period, which can lead to impaired neurocognitive functioning and contribute to the development of psychiatric disorders. The aim: In this paper, we will present a patient with CAH who developed serious psychiatric problems during adolescence. The aim of this case report is to discuss a possible connection between these two conditions and to consider possible diagnostic and therapeutic interventions. Case report: The patient was diagnosed with the classic form of CAH at birth. After months of corticosteroid substitution therapy, the patient was surgically treated at 7 months of age with vaginoplasty and clitoroplasty. The patient developed serious psychiatric problems from the depressive-anxiety spectrum in the early adolescent period, followed by impaired impulse control and aggression. This report illustrates the diagnostic and therapeutic interventions conducted at the Clinical Department for Children and Adolescents of the Institute of Mental Health. Conclusion: Given the abundant evidence on the impact of CAH on cognitive ability and psychosocial functioning, it is necessary to develop and implement complementary multidisciplinary diagnostic and therapeutic interventions in these patients. Such interventions would aim to prevent the onset of psychiatric comorbidities and consequently improve the quality of life and functionality of these patients.
简介:先天性肾上腺增生症(CAH)是一种遗传性常染色体隐性遗传病,其特征是肾上腺皮质合成类固醇激素的缺陷。这一缺陷导致血清雄激素水平升高。雄激素已被证明对产前和产后发育中的大脑有显著影响,这可能导致神经认知功能受损,并有助于精神疾病的发展。目的:在这篇论文中,我们将介绍一位在青春期发展出严重精神问题的CAH患者。本病例报告的目的是讨论这两种情况之间可能的联系,并考虑可能的诊断和治疗干预措施。病例报告:患者在出生时被诊断为典型的CAH。经过几个月的皮质类固醇替代治疗后,患者在7个月大时接受阴道成形术和阴蒂成形术的手术治疗。患者在青少年早期出现严重的抑郁-焦虑精神问题,随后出现冲动控制和攻击性受损。本报告说明了在精神卫生研究所的儿童和青少年临床部进行的诊断和治疗干预。结论:鉴于大量证据表明CAH对认知能力和心理社会功能的影响,有必要对这些患者制定和实施互补的多学科诊断和治疗干预措施。这些干预措施旨在预防精神合并症的发生,从而改善这些患者的生活质量和功能。
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引用次数: 0
Mechanisms of action of conspiracy theories 阴谋论的作用机制
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001141S
Ana Slavković, V. Slavkovic
The paper discusses the reasons why conspiracy theories emerge (the desire to belong, survive, be close with the members of the group, and maintain a positive image of ourselves and the community). Theories and results of research about psychological factors that are believed to influence the emergence of conspiracy theories are presented. The authors conclude that belief in conspiracy theories is highly dependent on epistemological, existential, and social motives. Research has not yet shown that these theories serve to satisfy these motives, and it is even possible to the contrary, that these theories do not strengthen social cohesion at all, do not lead to improvement of self-esteem and a more positive image of ourselves or the group we belong to. Important questions remain open and more research needs to be done about the consequences of believing in conspiracy theories, especially in vulnerable populations, which have been found to have the highest motivation to accept these theories. The tendency to believe in conspiracy theories is a phenomenon influenced by many factors. Some of these factors are belonging to a lower socio-economic background, a lower educational level, a tendency to outsource one's own responsibility for life's failures, or to neglect the genetic and educational factors that led to it. However, many other factors, such as mental health status, also determine this phenomenon. Poorly integrated, deeply insecure personalities who have not overcome the schizoid-paranoid position of development, tend to perceive the environment as perceptual and threatening, with the aim to protect their own self from deeper disintegration.
本文讨论了阴谋论出现的原因(渴望归属,生存,与群体成员保持密切关系,并保持自己和社区的积极形象)。提出了被认为影响阴谋论产生的心理因素的理论和研究结果。作者得出结论,对阴谋论的信仰高度依赖于认识论、存在主义和社会动机。研究还没有表明这些理论能满足这些动机,甚至有可能恰恰相反,这些理论根本不能增强社会凝聚力,不能提高自尊,也不能给我们自己或我们所属的群体带来更积极的形象。重要的问题仍未解决,需要对相信阴谋论的后果进行更多的研究,特别是在弱势群体中,他们被发现有最高的动机接受这些理论。相信阴谋论是一种受多种因素影响的现象。其中一些因素属于较低的社会经济背景,较低的教育水平,倾向于将自己的责任外包给生活中的失败,或忽视导致它的遗传和教育因素。然而,许多其他因素,如心理健康状况,也决定了这一现象。整合不良、极度缺乏安全感的人,没有克服精神分裂-偏执的发展立场,倾向于将环境视为感性和威胁性的,其目的是保护自己免受更深层次的解体。
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引用次数: 0
Hypochondriac fears and beliefs of medical students 医学生对疑病症的恐惧与信念
Pub Date : 2020-01-01 DOI: 10.5937/PSIHDAN2001035S
D. Stefanović, D. Stankić, S. Stoisavljević, O. Vuković
Hypochondria is a mental disorder characterized by a preoccupation with fears that a person may be ill or suffering from a serious illness, based on a misinterpretation of problems that cannot be eliminated by appropriate medical reassurance. A special type of hypochondriasis known as Medical Student Syndrome (MSS) refers to student's fears and beliefs that they are ill or may become ill with the illnesses they are learning while studying in pre-clinical and clinical subjects. A cross-sectional study was conducted during the winter semester of the 2019/2020 school year, with a sample of 90 students of the first, third, and sixth year of the Faculty of Medicine, sampled on a random basis. Subjects completed the Illness Attitude Scale (IAS). The aim of study was to investigate whether there is a difference in the incidence of hypochondrial tendencies and beliefs in the students of the Faculty of Medicine in relation to the year of study. The mean values on certain subscales were statistically significantly higher in students of third compared to students of first and sixth year of medicine. Students who have not renewed a year were found to have significantly higher average scores on the Disease Concerns and Pain Concerns subscale, as well as Disease phobia compared to those who renewed the year, while Hypochondrial beliefs were statistically significantly higher in subjects who renewed the year compared to students who had not renewed the year. The presented results support the hypothesis that health anxiety and all its components among the medical students at the preclinical level is most pronounced in the third year of study, and that it shows declining trend in the later stages of study.
疑病症是一种精神障碍,其特征是对某人可能生病或患有严重疾病的担忧,其基础是对问题的误解,而这些问题无法通过适当的医疗保证来消除。医学生综合症(MSS)是一种特殊类型的疑病症,指的是学生在学习临床前和临床科目时,害怕和相信自己生病了,或者可能会因为他们正在学习的疾病而生病。在2019/2020学年的冬季学期进行了一项横断面研究,随机抽取了医学院一年级、三年级和六年级的90名学生。受试者完成疾病态度量表(IAS)。本研究的目的是调查医学院学生的疑病症倾向和信仰的发生率是否与学习年份有关。在某些子量表上,三年级学生的平均值显著高于一年级和六年级学生。研究发现,与续学一年的学生相比,没有续学一年的学生在疾病担忧和疼痛担忧子量表以及疾病恐惧症方面的平均得分要高得多,而续学一年的学生的疑病症信念在统计上要比没有续学一年的学生高得多。本研究结果支持以下假设:临床前阶段医学生的健康焦虑及其各组成部分在学习的第三年最为明显,在学习的后期呈下降趋势。
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引用次数: 0
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