Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000195
A. Pendergrass, C. Becker, M. Hautzinger, K. Pfeiffer
A variety of psychosocial interventions have been developed to support dementia caregivers. Compar- ing positive effects on caregivers across these intervention studies are difficult because of the diverse endpoints. The objectives of this review were: (1) to show what types of interventions were conducted in international randomized controlled trails with dementia caregivers; (2) to provide an overview of what main caregiver outcome dimensions can be categorized; and (3) what validated instruments are most frequently used to assess these outcomes. A sys- tematic, computerized literature search was conducted using the electronic databases PubMed, Medline, EBSCO, and PsycINFO. Records of interest were randomized controlled trials for informal caregivers of home dwelling care recipients with any type of dementia. In the 69 identified studies 82 different validated assessments were used, which were categorized in 15 dimensions. About two out of three studies examined psychoeducational interventions. The five most prevalent outcomes were: depressive symptoms (N = 34); burden (N = 33); self-efficacy/coping/mastery (N = 19); emotional distress (N = 19); and quality of life (N = 17). These outcomes were mostly assessed with: the Center for Epidemiologic Studies Depression Scale (N = 23); the Zarit Burden Interview (N = 24); the Revised Scale for Caregiving Self-Efficacy (N = 4); the Cohen Perceived Stress Scale (N = 7); and the WHO Quality of Life (N = 5). This literature review serves as the first step to identify outcomes and assessments which have actually been used. An important next step to improve comparability between studies could be the development of taxonomy to classify and describe the key influential components of interventions in this research field.
{"title":"Dementia Caregiver Interventions: A Systematic Review of CaregiverOutcomes and Instruments in Randomized Controlled Trials","authors":"A. Pendergrass, C. Becker, M. Hautzinger, K. Pfeiffer","doi":"10.4172/1522-4821.1000195","DOIUrl":"https://doi.org/10.4172/1522-4821.1000195","url":null,"abstract":"A variety of psychosocial interventions have been developed to support dementia caregivers. Compar- ing positive effects on caregivers across these intervention studies are difficult because of the diverse endpoints. The objectives of this review were: (1) to show what types of interventions were conducted in international randomized controlled trails with dementia caregivers; (2) to provide an overview of what main caregiver outcome dimensions can be categorized; and (3) what validated instruments are most frequently used to assess these outcomes. A sys- tematic, computerized literature search was conducted using the electronic databases PubMed, Medline, EBSCO, and PsycINFO. Records of interest were randomized controlled trials for informal caregivers of home dwelling care recipients with any type of dementia. In the 69 identified studies 82 different validated assessments were used, which were categorized in 15 dimensions. About two out of three studies examined psychoeducational interventions. The five most prevalent outcomes were: depressive symptoms (N = 34); burden (N = 33); self-efficacy/coping/mastery (N = 19); emotional distress (N = 19); and quality of life (N = 17). These outcomes were mostly assessed with: the Center for Epidemiologic Studies Depression Scale (N = 23); the Zarit Burden Interview (N = 24); the Revised Scale for Caregiving Self-Efficacy (N = 4); the Cohen Perceived Stress Scale (N = 7); and the WHO Quality of Life (N = 5). This literature review serves as the first step to identify outcomes and assessments which have actually been used. An important next step to improve comparability between studies could be the development of taxonomy to classify and describe the key influential components of interventions in this research field.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117178446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000154
James Metcalf
Critical literary analysis of Michael Ondaatje’s The English Patient identifies death as a major part of both its theme and its setting. The English patient himself represents the interface between life and death. His fingers are burned and fused. His face is scarred and expressionless, and the remainder of his frame is wrapped in gauze like a mummy: he is death. Death also surrounds Hana, his nurse. Her baby and its father are dead, as is her own father and of course many of her patients. In a larger sense the villa itself is death, the remains of a time and culture now dead from war. Hana is a nurse among the dead and near dead. Euthanasia is routine…merciful enough, but premeditated murder nonetheless. Ondaatje presents such euthanasia as an ethical part of nursing practice. In Ondaatje’s novel, the past, the present, and the future intersect and entwine as they move toward death and beyond. Life and death are segments upon the same continuum. Necrophilia occurs upon that continuum as a post-mortem episode of a continuing passion.
{"title":"Necrophilia and Medical Euthanasia in Michael Ondaatjes TheEnglish Patient: An Illustrated Literary Analysis","authors":"James Metcalf","doi":"10.4172/1522-4821.1000154","DOIUrl":"https://doi.org/10.4172/1522-4821.1000154","url":null,"abstract":"Critical literary analysis of Michael Ondaatje’s The English Patient identifies death as a major part of both its theme and its setting. The English patient himself represents the interface between life and death. His fingers are burned and fused. His face is scarred and expressionless, and the remainder of his frame is wrapped in gauze like a mummy: he is death. Death also surrounds Hana, his nurse. Her baby and its father are dead, as is her own father and of course many of her patients. In a larger sense the villa itself is death, the remains of a time and culture now dead from war. Hana is a nurse among the dead and near dead. Euthanasia is routine…merciful enough, but premeditated murder nonetheless. Ondaatje presents such euthanasia as an ethical part of nursing practice. In Ondaatje’s novel, the past, the present, and the future intersect and entwine as they move toward death and beyond. Life and death are segments upon the same continuum. Necrophilia occurs upon that continuum as a post-mortem episode of a continuing passion.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124895691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000146
P. Bourne, Charlene Sharpe-Pryce, C. Francis, A. Hudson-Davis, I. Solan, D. Lewis, Olive Watson-Coleman, Jodi-Ann Blake
Background: For millennia, women with multiple sexual partners have been labeled and stigmatized as whores, prostitutes, promiscuous and commercial sex workers. However, there is little literature comprehensively addressing factors related to reproductive health in this group. Aim: The aim of the current study is to elucidate the reproductive health matters of women who have multiple sexual partners. Setting and design: The data use for this research is taken from the Jamaica Reproductive Health Survey, 2007. Stratified random sampling is used to design the sampling frame. Materials and Methods: The current study extracts a sample of 225 respondents (from 7,168 women ages 15-49 years) who indicate having had multiple sex partners. Statistical analysis used: Data are analyzed using the Statistical Packages for the Social Sciences for Windows, Version 21.0. Multiple logistic regressions were used to analyze factors that explained current method of contraception. Results: Women with multiple sex partners on average are involved with men at least 9.5 years their senior, and 72% of them have become pregnant. Currently, contraception use can be explained by social class (middle class, Odds ratio (OR) = 0.08, 95% CI= 0.01 – 0.59); age at first sexual intercourse (OR = 0.90, 95% CI = 0.68 – 1.21); employment status (employed, OR = 5.07, 95% CI = 1.06 – 24.36); and marital status (married or common-law, OR = 0.09, 95% CI = 0.02 – 0.38). Conclusion: The early sexual initiation among young women is a public health problem because of the increased incidence of teenage pregnancy and increased incidence of sexually transmitted diseases, which must be addressed with the same intensity and resource allocation used to fight against Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS)
{"title":"Women Promiscuity and Reproductive Health Matters: Findings andPolicy Implications","authors":"P. Bourne, Charlene Sharpe-Pryce, C. Francis, A. Hudson-Davis, I. Solan, D. Lewis, Olive Watson-Coleman, Jodi-Ann Blake","doi":"10.4172/1522-4821.1000146","DOIUrl":"https://doi.org/10.4172/1522-4821.1000146","url":null,"abstract":"Background: For millennia, women with multiple sexual partners have been labeled and stigmatized as whores, prostitutes, promiscuous and commercial sex workers. However, there is little literature comprehensively addressing factors related to reproductive health in this group. Aim: The aim of the current study is to elucidate the reproductive health matters of women who have multiple sexual partners. Setting and design: The data use for this research is taken from the Jamaica Reproductive Health Survey, 2007. Stratified random sampling is used to design the sampling frame. Materials and Methods: The current study extracts a sample of 225 respondents (from 7,168 women ages 15-49 years) who indicate having had multiple sex partners. Statistical analysis used: Data are analyzed using the Statistical Packages for the Social Sciences for Windows, Version 21.0. Multiple logistic regressions were used to analyze factors that explained current method of contraception. Results: Women with multiple sex partners on average are involved with men at least 9.5 years their senior, and 72% of them have become pregnant. Currently, contraception use can be explained by social class (middle class, Odds ratio (OR) = 0.08, 95% CI= 0.01 – 0.59); age at first sexual intercourse (OR = 0.90, 95% CI = 0.68 – 1.21); employment status (employed, OR = 5.07, 95% CI = 1.06 – 24.36); and marital status (married or common-law, OR = 0.09, 95% CI = 0.02 – 0.38). Conclusion: The early sexual initiation among young women is a public health problem because of the increased incidence of teenage pregnancy and increased incidence of sexually transmitted diseases, which must be addressed with the same intensity and resource allocation used to fight against Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS)","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122948053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000304
S. Petrov
This qualitative, phenomenological case-study focuses on physician-reported experiences related to caring for refugees, in order to investigate what experiential factors contribute to effective therapeutic relationships. Findings and medical literature show that caring for refugees can have adverse psychological and physiological repercussions for physicians. Extensive exposure to trauma narratives and vivid examples of human suffering can lead to burnout, vicarious trauma, and/or secondary traumatic stress – affecting physicians’ ability to care for patients effectively. Nonetheless, emerging psychological literature indicates that, over time, providers may be able to develop vicarious resilience by mirroring the resiliency of their patients. This notion is based on theory that chronic exposure to patient suffering can bolster social advocacy and altruistic behavior in providers. Supplementing this theory, the data shows that providers can develop “secondary resilience” after a single exposure to a critical incident, that evaluation of critical incidents is the link between secondary traumatic stress/vicarious trauma and secondary and/or vicarious resilience, and that secondary/vicarious resilience can coexist with vicarious trauma or secondary traumatic stress, allowing physicians to continue caring even as they witness suffering and suffer with their patients.
{"title":"\"Living on the Edge\": The Role of Critical Incidents on the Development of \"Secondary Resilience\" in Physicians","authors":"S. Petrov","doi":"10.4172/1522-4821.1000304","DOIUrl":"https://doi.org/10.4172/1522-4821.1000304","url":null,"abstract":"This qualitative, phenomenological case-study focuses on physician-reported experiences related to caring for refugees, in order to investigate what experiential factors contribute to effective therapeutic relationships. Findings and medical literature show that caring for refugees can have adverse psychological and physiological repercussions for physicians. Extensive exposure to trauma narratives and vivid examples of human suffering can lead to burnout, vicarious trauma, and/or secondary traumatic stress – affecting physicians’ ability to care for patients effectively. Nonetheless, emerging psychological literature indicates that, over time, providers may be able to develop vicarious resilience by mirroring the resiliency of their patients. This notion is based on theory that chronic exposure to patient suffering can bolster social advocacy and altruistic behavior in providers. Supplementing this theory, the data shows that providers can develop “secondary resilience” after a single exposure to a critical incident, that evaluation of critical incidents is the link between secondary traumatic stress/vicarious trauma and secondary and/or vicarious resilience, and that secondary/vicarious resilience can coexist with vicarious trauma or secondary traumatic stress, allowing physicians to continue caring even as they witness suffering and suffer with their patients.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122965387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000319
G. Flett, D. Molnar, P. Hewitt
There is now a voluminous literature on the role of perfectionism in psychopathology, but one topic has been almost entirely neglected – how perfectionists respond following exposure to traumatic stressors. The relatively few research studies conducted thus far are summarized below. First, however, we note some of the reasons why there should be a positive association between perfectionism and post-traumatic symptoms. Traumatic experiences may be responded to quite negatively by people with elevated perfectionism because perfectionists often have a strong need for control and they are highly stressed by events beyond their control (for a discussion see Hewitt & Flett, 2002). Moreover, perfectionists tend to feel overly responsible and have a propensity to experience self-blame and self-criticism following negative outcomes and events. The vulnerable perfectionist who actually makes a serious mistake that escalates into a traumatic experience is someone who most likely will find it quite difficult to stop ruminating and he or she will find it difficult to live with the mistake and their sense of inefficacy.
{"title":"The Traumatized Perfectionist: Understanding the Role of Perfectionism in Post-Traumatic Reactions to Stress","authors":"G. Flett, D. Molnar, P. Hewitt","doi":"10.4172/1522-4821.1000319","DOIUrl":"https://doi.org/10.4172/1522-4821.1000319","url":null,"abstract":"There is now a voluminous literature on the role of perfectionism in psychopathology, but one topic has been almost entirely neglected – how perfectionists respond following exposure to traumatic stressors. The relatively few research studies conducted thus far are summarized below. First, however, we note some of the reasons why there should be a positive association between perfectionism and post-traumatic symptoms. Traumatic experiences may be responded to quite negatively by people with elevated perfectionism because perfectionists often have a strong need for control and they are highly stressed by events beyond their control (for a discussion see Hewitt & Flett, 2002). Moreover, perfectionists tend to feel overly responsible and have a propensity to experience self-blame and self-criticism following negative outcomes and events. The vulnerable perfectionist who actually makes a serious mistake that escalates into a traumatic experience is someone who most likely will find it quite difficult to stop ruminating and he or she will find it difficult to live with the mistake and their sense of inefficacy.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123514898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000242
M. Pompili, P. Venturini, D. Lamis, Rachel N. Waford, D. Erbuto, G. Serafini, M. Amore, P. Girardi
Background: Several studies have shown that substance use disorder (SUD) among adolescents is related to multiple behavioural problems and needs specific treatment compared to adults. Objectives: The aim of the present paper was to investigate the gold standard of rehabilitation efficacy for SUD in adolescence. Methods: A careful systematic review of the literature was conducted on the treatment and rehabilitation of adolescents with SUD. A total of 11 articles from peer-reviewed journals were selected for this review. Results: Family therapy is the treatment with the strongest evidence of effectiveness for reducing SUDs in adolescents, although other types of treatments appear to be beneficial such as cognitive-behavioural therapy and other psychological approaches. Despite the effectiveness of the treatments, the rate of relapse remains high among adolescents with SUD. Conclusion: Currently, psychological treatments, particularly family therapy, are most frequently applied to adolescents with SUD. Pharmacotherapy is reserved for adolescents with a SUD in co-morbidity with other mental disorders and a therapeutic community is suggested for these at-risk adolescents.
{"title":"Rehabilitation of the Adolescent with a Substance Use Disorder: Overview of Treatment Efficacy","authors":"M. Pompili, P. Venturini, D. Lamis, Rachel N. Waford, D. Erbuto, G. Serafini, M. Amore, P. Girardi","doi":"10.4172/1522-4821.1000242","DOIUrl":"https://doi.org/10.4172/1522-4821.1000242","url":null,"abstract":"Background: Several studies have shown that substance use disorder (SUD) among adolescents is related to multiple behavioural problems and needs specific treatment compared to adults. \u0000Objectives: The aim of the present paper was to investigate the gold standard of rehabilitation efficacy for SUD in adolescence. \u0000Methods: A careful systematic review of the literature was conducted on the treatment and rehabilitation of adolescents with SUD. A total of 11 articles from peer-reviewed journals were selected for this review. \u0000Results: Family therapy is the treatment with the strongest evidence of effectiveness for reducing SUDs in adolescents, although other types of treatments appear to be beneficial such as cognitive-behavioural therapy and other psychological approaches. Despite the effectiveness of the treatments, the rate of relapse remains high among adolescents with SUD. \u0000Conclusion: Currently, psychological treatments, particularly family therapy, are most frequently applied to adolescents with SUD. Pharmacotherapy is reserved for adolescents with a SUD in co-morbidity with other mental disorders and a therapeutic community is suggested for these at-risk adolescents.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114945216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000315
Ken Inoue, H. Kaiya, N. Hara, Y. Okazaki
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), panic disorder is one type of anxiety disorder. There have been few detailed reports on the relationship between suicide and panic disorder. We examined the comorbidities and personality inventory tendencies in panic disorder with an increased suicide risk. Our participants were patients with panic disorder. We found that an increased risk of suicide must be kept in mind when treating patients with panic disorder that is accompanied by mood disorders or anxiety disorders. This study also found that such patients are thought to be “very sensitive and emotional and easily distracted”, “introverted, humble and serious”, and “hedonistic”. The risk of suicide must be ascertained during the treatment of panic disorder.
{"title":"Clear Trends in Panic Disorder with a Possibility of Suicide Risk","authors":"Ken Inoue, H. Kaiya, N. Hara, Y. Okazaki","doi":"10.4172/1522-4821.1000315","DOIUrl":"https://doi.org/10.4172/1522-4821.1000315","url":null,"abstract":"In the Diagnostic and Statistical Manual of Mental Disorders (DSM), panic disorder is one type of anxiety disorder. There have been few detailed reports on the relationship between suicide and panic disorder. We examined the comorbidities and personality inventory tendencies in panic disorder with an increased suicide risk. Our participants were patients with panic disorder. We found that an increased risk of suicide must be kept in mind when treating patients with panic disorder that is accompanied by mood disorders or anxiety disorders. This study also found that such patients are thought to be “very sensitive and emotional and easily distracted”, “introverted, humble and serious”, and “hedonistic”. The risk of suicide must be ascertained during the treatment of panic disorder.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123938270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000198
Anish S. Shah
Background: Patients with unipolar depression present a unique challenge for physicians who are considering therapeutic drug treatment. Physicians have historically treated patients who present symptoms of unipolar depression with SSRIs or other medications that are commonly prescribed to patients with non-unipolar depression. Many of these medications are ineffective for patients suffering from unipolar disorder. Recently, an exciting new treatment approach for the depressive symptoms related to unipolar disorder has emerged in the form of secondgeneration atypical antipsychotics. A wealth of empirical support for treating treatment-resistant bipolar depression is becoming increasingly available, but much less is understood regarding the efficacy of atypical psychotics in treating unipolar depression. Methods: An electronic literature review was conducted through PubMed, PsycINFO, the Cochrane Library, Web of Science, and Embase using the following search phrases: depression, unipolar depression, antipsychotics, second-generation antipsychotics, atypical antipsychotics, and depression treatment. There were no restrictions on publication year, type, or language. Meta-analyses and randomized clinical trials (RCTs) were considered. A sensitivity analysis was performed by excluding studies with small sample sizes and a high placebo effect. Discussion: Preliminary evidence for this treatment approach is promising, although additional clinical trials which more clearly elucidate the role of second-generation atypical antipsychotics in treating unipolar depressive symptoms may be warranted. Accordingly, this article discusses the second-generation atypical antipsychotics that have, to date, received empirical support for use in treating patients with unipolar disorder. Proposed mechanisms of action are discussed and current FDA approvals as well as approval status in different countries for usage are reviewed. Indications for future research are also proposed.
背景:单极抑郁症患者对正在考虑药物治疗的医生提出了一个独特的挑战。医生历来用ssri类药物或其他非单极抑郁症患者常用的药物治疗有单极抑郁症症状的患者。许多这些药物对患有单极障碍的患者无效。最近，一种令人兴奋的新治疗方法出现在第二代非典型抗精神病药的形式中，用于治疗与单极障碍相关的抑郁症状。治疗难治性双相抑郁症的经验支持越来越多，但对非典型精神病治疗单相抑郁症的疗效了解甚少。方法:通过PubMed、PsycINFO、Cochrane图书馆、Web of Science和Embase进行电子文献综述，检索词为:抑郁症、单极抑郁症、抗精神病药物、第二代抗精神病药物、非典型抗精神病药物和抑郁症治疗。对出版年份、类型或语言没有限制。我们考虑了meta分析和随机临床试验(rct)。通过排除小样本量和高安慰剂效应的研究进行敏感性分析。讨论:这种治疗方法的初步证据是有希望的，尽管可能需要更多的临床试验来更清楚地阐明第二代非典型抗精神病药物在治疗单相抑郁症状中的作用。因此，本文讨论了第二代非典型抗精神病药物，迄今为止，在治疗单极障碍患者中得到了经验支持。讨论了拟议的作用机制，并审查了目前FDA批准以及不同国家使用的批准状态。并提出了未来研究的适应症。
{"title":"A Review of the Role of Antipsychotics as an Augmentation Agentor Treatment Option for Patients with Treatment Resistant UnipolarDepression","authors":"Anish S. Shah","doi":"10.4172/1522-4821.1000198","DOIUrl":"https://doi.org/10.4172/1522-4821.1000198","url":null,"abstract":"Background: Patients with unipolar depression present a unique challenge for physicians who are considering therapeutic drug treatment. Physicians have historically treated patients who present symptoms of unipolar depression with SSRIs or other medications that are commonly prescribed to patients with non-unipolar depression. Many of these medications are ineffective for patients suffering from unipolar disorder. Recently, an exciting new treatment approach for the depressive symptoms related to unipolar disorder has emerged in the form of secondgeneration atypical antipsychotics. A wealth of empirical support for treating treatment-resistant bipolar depression is becoming increasingly available, but much less is understood regarding the efficacy of atypical psychotics in treating unipolar depression. Methods: An electronic literature review was conducted through PubMed, PsycINFO, the Cochrane Library, Web of Science, and Embase using the following search phrases: depression, unipolar depression, antipsychotics, second-generation antipsychotics, atypical antipsychotics, and depression treatment. There were no restrictions on publication year, type, or language. Meta-analyses and randomized clinical trials (RCTs) were considered. A sensitivity analysis was performed by excluding studies with small sample sizes and a high placebo effect. Discussion: Preliminary evidence for this treatment approach is promising, although additional clinical trials which more clearly elucidate the role of second-generation atypical antipsychotics in treating unipolar depressive symptoms may be warranted. Accordingly, this article discusses the second-generation atypical antipsychotics that have, to date, received empirical support for use in treating patients with unipolar disorder. Proposed mechanisms of action are discussed and current FDA approvals as well as approval status in different countries for usage are reviewed. Indications for future research are also proposed.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126510576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000247
G. d'Ettorre, Mariarita Greco
Background: The wellbeing of mental health workers (MHWs) is a priority for Departments of Mental Health in order to ensure a better protection of MHWs and a better health service. However, to date, several factors affecting the healthcare sector in Italy such as organizational changes involving working time and intensity, type of employment contract, psychosocial factors at work, health and safety policies within the organization, appear to interfere with the workers' wellness. Methods: The authors carried out an integrated analysis of stress sentinel indicators and of objective stress factors of occupational context and content, among two General Hospital Psychiatric Units (GHPUs) and four Community Mental Health Centres (CMHCs), following the European Framework Agreement on Work-Related Stress of 8 October 2004, incorporated in Italy into Legislative Decree 81/08. Results: All the GHPUs and the CMHCs investigated through the objective approach to w.r.s. assessment reported a medium level of w.r.s., among both psychiatrists than nurses. Following the evaluation were identified the priority organizational interventions focused on work context issues; these interventions showed effectives to minimize the sources of w.r.s. among the GHPUs and the CMHCs. Conclusion: The results of this study suggest that organizational interventions focused on improvement of work context issues may contribute to an effective reduction of WRS among nurses and psychiatrists employed in GHPUs and CMHCs. A special effort is required by the head psychiatrists and the head nurses of GHPUs and CMHCs to implement effective policies about the management of WRS.
{"title":"Organizational Interventions as a Strategy to Prevent Work Related Stress among Mental Health Workers","authors":"G. d'Ettorre, Mariarita Greco","doi":"10.4172/1522-4821.1000247","DOIUrl":"https://doi.org/10.4172/1522-4821.1000247","url":null,"abstract":"Background: The wellbeing of mental health workers (MHWs) is a priority for Departments of Mental Health in order to ensure a better protection of MHWs and a better health service. However, to date, several factors affecting the healthcare sector in Italy such as organizational changes involving working time and intensity, type of employment contract, psychosocial factors at work, health and safety policies within the organization, appear to interfere with the workers' wellness. \u0000Methods: The authors carried out an integrated analysis of stress sentinel indicators and of objective stress factors of occupational context and content, among two General Hospital Psychiatric Units (GHPUs) and four Community Mental Health Centres (CMHCs), following the European Framework Agreement on Work-Related Stress of 8 October 2004, incorporated in Italy into Legislative Decree 81/08. \u0000Results: All the GHPUs and the CMHCs investigated through the objective approach to w.r.s. assessment reported a medium level of w.r.s., among both psychiatrists than nurses. Following the evaluation were identified the priority organizational interventions focused on work context issues; these interventions showed effectives to minimize the sources of w.r.s. among the GHPUs and the CMHCs. \u0000Conclusion: The results of this study suggest that organizational interventions focused on improvement of work context issues may contribute to an effective reduction of WRS among nurses and psychiatrists employed in GHPUs and CMHCs. A special effort is required by the head psychiatrists and the head nurses of GHPUs and CMHCs to implement effective policies about the management of WRS.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130754829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000367
Khalid Saaran, Hamad Al-Ghaferi, Abuelgasim Elrasheed, Asma Awadhi, Ahmed. Y. Ali
Objective: Hepatitis is defined as an inflammation of the liver. Our objective is to highlight the devastating effects Hepatitis C, a subtype of viral hepatitis, has on a subpopulation of patients struggling with Alcohol use disorder (AUD) and SUDs (Substance Use Disorders) and specially IDUs, (Intravenous Drug Users) also known as the invisible population. We also aim to describe the clinical picture, viral genotypes and available treatments. Methods: A literature review was conducted, specifically looking at published materials about the objectives above. Conclusion: Hepatitis C is considered a global health problem. Described as a “silent disease” its complications include liver cirrhosis, end-stage liver disease and hepatocellular carcinoma, co-infection with HIV and super infections with different strains of HCV. Recent advances in understanding HCV virology have led to the development of new drugs targeting replication process and proving to be very successful in clearing the infection it is important to note that there is no vaccine yet for HCV infection.
{"title":"Hepatitis C Infection among Intravenous Drug Users. “A Silent Disease in an Invisible Population”","authors":"Khalid Saaran, Hamad Al-Ghaferi, Abuelgasim Elrasheed, Asma Awadhi, Ahmed. Y. Ali","doi":"10.4172/1522-4821.1000367","DOIUrl":"https://doi.org/10.4172/1522-4821.1000367","url":null,"abstract":"Objective: Hepatitis is defined as an inflammation of the liver. Our objective is to highlight the devastating effects Hepatitis C, a subtype of viral hepatitis, has on a subpopulation of patients struggling with Alcohol use disorder (AUD) and SUDs (Substance Use Disorders) and specially IDUs, (Intravenous Drug Users) also known as the invisible population. We also aim to describe the clinical picture, viral genotypes and available treatments. Methods: A literature review was conducted, specifically looking at published materials about the objectives above. Conclusion: Hepatitis C is considered a global health problem. Described as a “silent disease” its complications include liver cirrhosis, end-stage liver disease and hepatocellular carcinoma, co-infection with HIV and super infections with different strains of HCV. Recent advances in understanding HCV virology have led to the development of new drugs targeting replication process and proving to be very successful in clearing the infection it is important to note that there is no vaccine yet for HCV infection.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121605274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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