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Continuity of care for patients with schizophrenia in communities with limited resources. 资源有限的社区对精神分裂症患者护理的连续性。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2018-05-15 DOI: 10.4081/mi.2018.7585
Andy Trang
For psychiatric patients with schizophrenia the rate of readmission to the hospital can be high and the need for continuation of quality care after hospitalization is tremendous and plays a large role in helping patients remain stable to prevent readmission. However, such resources for continuing care are often difficult to obtain, especially in rural communities where access to such services are limited and the burden of care is frequently placed on family members who do not have formal training in caring for patients with such psychiatric illnesses. In such communities, it is important to emphasize education for the caregivers and establishing a system of support from local community organizations for both the patient and their caregivers to reduce caregiver burnout as well as prevent rehospitalization for the patient. Studies by Juntapim et al. evaluated such continuity of care in rural Thailand and emphasized the need for community involvement including family, neighbors, and community leaders for the continuing care of the patient’s mental illness as well as social support. While such community support is invaluable, it often places a large burden on caregivers to provide such social, emotional, and financial support. A meta-analysis by Chen et al. demonstrated that non-pharmacological interventions such as psychoeducation, mutual support, and interventions through counseling, telephone, and the internet for such caregivers was able to improve quality of life without changing family functioning, support, and overall satisfaction.1 In addition to the range of burdens placed on the caregiver in continuing to care for patient’s with schizophrenia, they are also often subjected to violence from the patients and may have fatal consequences, as reported by Kageyama et al.2 The need for patients with schizophrenia to have increased access to continuing care resources after hospitalization remains high and the burden of care is often placed on family members with limited training and resources. Despite such limited resources in rural communities, improvements on quality continuity of care is still possible by emphasizing education for caregivers in the community such as family members, recruiting support from local organizations such as religious centers, and having a clear crisis plan in the event that the patient psychiatric condition worsens. Additionally, intervention such as education, counseling, and community support for caregivers may help to reduce the burden of care and improve quality of life for both the caregiver and the patient. References
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引用次数: 3
Reluctance to change and end psychotherapy. 不愿改变和结束心理治疗。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2018-01-03 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7167
John E Berg
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引用次数: 0
Social anxiety disorder and its impact in undergraduate students at Jazan University, Saudi Arabia. 沙特阿拉伯吉赞大学本科生的社交焦虑障碍及其影响。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2018-01-03 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7274
Ramzi M Hakami, Mohamed S Mahfouz, Abdulrahman M Adawi, Adeebah J Mahha, Alaa J Athathi, Hadi H Daghreeri, Hatim H Najmi, Nuha A Areeshi
Although social anxiety disorder (SAD) is a common mental disorder, it is often under diagnosed and under treated. The aim of this study is to assess the prevalence, severity, disability, and quality of life towards SAD among students of Jazan University, Saudi Arabia. A cross-sectional study was conducted among a stratified sample of 500 undergraduate students to identify the prevalence of SAD, its correlates, related disability, and its impact on the quality life. All participants completed the Social Phobia Inventory, Leibowitz Social Anxiety Scale, Sheehan Disability Scale, and the WHO Quality of Life – BREF questionnaire. Of 476 students, 25.8% were screened positive for SAD. About 47.2% of the students had mild symptoms, 42.3% had moderate to marked symptoms, and 10.5% had severe to very severe symptoms of SAD. Students who resulted positive for SAD reported significant disabilities in work, social, and family areas, and this has adversely affected their quality of life as compared to those who screened negative for SAD. Students reported several clinical manifestations that affected their functioning and social life. Acting, performing or giving a talk in front of an audience was the most commonly feared situation. Blushing in front of people was the most commonly avoided situation. Since the present study showed a marked prevalence of SAD among students, increased disability, and impaired quality of life, rigorous efforts are needed for early recognition and treatment of SAD.
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引用次数: 38
Psychometric testing of immigrants and natives in an acute psychiatry facility. 急性精神病院移民与本地人的心理测试。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2018-01-03 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.6987
John E Berg
The diagnostic process after referral to an acute psychiatric treatment facility consists of more than the clinical investigation and laboratory tests. Psychometric tests in a broad range of languages may be such an augmentation of our diagnostic armamentarium. Whether such tests are in use, and how they are distributed among different patient categories was the aim of the study. All referrals in one calendar year (N=1168), as they are depicted in the hospital computerized medical records, were investigated. Fifty-six (6.1%) out of 926 ethnic Norwegians and six (3.0%) out of 198 non-Western immigrants were tested, whereas none of the 44 Western immigrants. The difference between ethnic Norwegians and the immigrants was significant (Z=-3.05 and P=0.002). Psychometric tests were thus almost not in use, and even lesser so in immigrants. Mean number of resident days was higher among those tested, 11.7 (SD=11.2) versus those not tested, 7.4 (SD=10.4) days, t=2.97 and P=0.004. Length of stay for ethnic Norwegians did not differ from that for non-Western immigrants 11.4 versus 11.7, respectively. The patients tested were older than those not tested. Mean age was 43.0 (SD=14.4) versus 38.8 (SD=12.1), with a t=2.65 and P=0.03. The difference in resident days between all immigrants and ethnic Norwegians was significant with a Z=- 2.232 and P=0.026. Level of testing was higher in ethnic Norwegians, and the tested patients stayed longer, maybe indicating more room for testing. Whether this low test-activity influences treatment quality is an unsettled question.
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引用次数: 1
Changing focus of symptoms: A rare case report of Munchhausen's syndrome. 改变症状的焦点:罕见的Munchhausen综合征病例报告。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-23 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7192
Melanie Hagen, Beatrice Faust, Nina Kunzelmann, Ozan Y Tektas, Johannes Kornhuber, Helge H O Müller
Factitious disorder, commonly called Munchhausen’s syndrome, is a rare disorder that lacks evidence-based guidelines. Reporting clinical cases is important for sharing clinical experiences and treatment strategies. The symptoms and progression of the following case have not been previously reported in the literature. Here, we report a case involving a 41-year-old Caucasian with a suspected psychosomatic disorder. After intensive multi-professional diagnostics, we concluded that the patient had factitious disorder. The symptoms in this case changed rapidly during treatment, which posed a challenge. For factitious disorder, establishing interdisciplinary exchange is important. Symptoms that are normally treated by internists are most commonly described in the literature. This case demonstrates that psychiatrists are challenged by this diagnosis and should consider the possibility of factitious disorder when seeing patients diagnosed with somatoform disorders. The most important clinical conclusion was the importance of involving the patients’ relatives in the treatment of patients with factitious disorder.
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引用次数: 0
Towards a further understanding of prenatal thyroid theory of homosexuality: Autoimmune thyroiditis, polycystic ovary syndrome, autism and low birth weight. 进一步了解同性恋的产前甲状腺理论:自身免疫性甲状腺炎、多囊卵巢综合征、自闭症和低出生体重。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-23 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7325
Osman Sabuncuoglu
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引用次数: 0
Clinical response of clozapine as a treatment for delirious mania. 氯氮平治疗谵妄性躁狂的临床疗效。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-23 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7182
Nabeel Wahid, Garwin Chin, Andia H Turner, Alexis Seegan
Delirious mania is an understudied psychiatric disorder with a mortality rate as high as 75%. Previous case studies suggest that electroconvulsive therapy (ECT) may be an effective treatment for delirious mania, though this procedure may not always be a viable option. We describe the case of a 20-year old patient, with no previous psychiatric history, who developed delirious mania over the course of four months. ECT was not a viable option for this patient due to his religious beliefs, so alternative treatment modalities were explored. After failing trials of risperidone and olanzapine, significant improvements in symptoms were exhibited with a trial of clozapine. We propose that clozapine may be an effective option in cases of delirious mania, when ECT is not a viable option. Additional research is still necessary to understand the pathology of this condition and potential treatment modalities.
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引用次数: 3
Treatment of 22q11.2 deletion syndrome-associated schizophrenia with comorbid anxiety and panic disorder. 22q11.2缺失综合征相关精神分裂症伴焦虑和惊恐障碍的治疗
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-23 eCollection Date: 2017-10-19 DOI: 10.4081/mi.2017.7225
Candace B Borders, Amanda Suzuki, David Safani
22q11.2 deletion syndrome (22q11DS) is a risk factor for psychiatric illnesses, including schizophrenia and anxiety. Small studies have shown that several neuroleptic medications are effective in treating psychosis in this population, but are also associated with an increased risk of adverse effects - particularly, seizures. In this case, we discuss a 34-year-old patient presenting with late onset schizophrenia, which ultimately led to her diagnosis of 22q11DS. Subsequent management of the patient’s psychosis with asenapine was complicated by concurrent anxiety and panic disorder; thus, we examine the role of anxiolytic therapy in conjunction with antipsychotics in this patient population.
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引用次数: 2
Effective and underprescribed: what about clozapine? 有效和处方不足:氯氮平怎么样?
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-19 DOI: 10.4081/mi.2017.7193
Helge H O Müller
Clinical psychiatry, especially pharmacological-based treatment regimens still face the problem of high rates of partial or non-responders to the various treatment strategies. So in schizophrenia, a serious psychiatric disease with regard to overall impairment of patients up to three-quarters will experience a relapse after their first episode and one-fifth is facing long-term symptoms often leading to disability and dramatically reduced quality of life and psychosocial outcome.
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引用次数: 1
Adverse effects of electroconvulsive therapy on cognitive performance. 电休克治疗对认知能力的不良影响。
IF 6.3 Q1 PSYCHIATRY Pub Date : 2017-10-19 DOI: 10.4081/mi.2017.7181
Sasha S Getty, Lawrence R Faziola
Electroconvulsive therapy (ECT) has his-torically been shown to be a highly effective method of treating major depression and catatonic state otherwise resistant to psy-chopharmacotherapy. 1-5 However, ECT has also been associated with a variety of tran-sient impairments in cognitive performance during and following the treatment. 6-10 The side effects, often subjectively reported by the patients, include deficits in orientation, short term memory function, attention, speech fluency, and executive functions lasting from hours to perhaps months in a number of cases. 6-10 These reported attrib-utes often lead to limited use of ECT as an acute treatment of treatment-resistant depression and other conditions where it can potentially produce positive overturn-ing effects. There appears to be a lack of clarity and consensus in the literature regarding ECT-related adverse effects on cognitive performance. While some studies have reported absence of any effects on memory and implicit learning, 6 several oth-ers have shown diverse negative impacts across various domains of cognition includ-ing greatest global decline associated with bitemporal ECT, major deterioration of verbal memory attributed to bifrontal ECT, and largest decline in visual memory related to right unilateral ECT, as measured by tests such as Mini Mental State exam, 7 Trail-Making, Rey visual and verbal fluency. terms
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引用次数: 12
期刊
Mental Illness
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