Consortium psychiatricum最新文献

Background: Interest in the issue of childhood autism has surged in the recent decades. At the same time, despite the significant progress achieved in understanding the etiological and pathogenetic aspects of the condition, effective ways to treat it have continued to elude us. Stem cell therapy appears to hold great promise in the treatment and rehabilitation of patients with both neurological diseases (cerebral palsy, hydrocephalus) and mental disorders (autism, schizophrenia).

Methods: This article presents a case report describing the use of nucleated cord blood cells in a patient with regressive autism and resistance to standard therapies. The child's condition was assessed before treatment and 6 and 12 months after.

Results: Clinical observation, psychometric, and instrumental diagnostic methods led to a significant improvement in the child's condition in the form of perception development, reduction of somatosensory disorders, normalization of emotional status, and a development of social and communication skills.

Conclusion: We assume that the result obtained may be associated with the normalization of the immunological status of our patient thanks to the cord blood cells therapy and consider it necessary to conduct further studies into the effectiveness of the method, taking the pathogenic mechanisms of autism into account.

Background: Despite the fact that schizophrenia has already been described historically and researched for a long time, this disorder remains unclear and controversial in many respects, including its etiology, pathogenesis, classification, diagnosis, and therapy.

Methods: Literature from the selected sources (elibrary.ru, Russian Science Citation Index and the Russian branch of the Cochrane Library) were searched and analyzed using the diachronic method. Priority was given to reviews, guidelines, and original research on schizophrenia written during the past 10 years.

Results: Historically, scientists have described schizophrenia as a single disorder, a group of disorders, or even as a combination of certain syndromes. The polymorphic symptoms and the most typical dynamics of various forms of schizophrenia have been systematized, but neither in Russia nor in other countries have the etiology and pathogenesis been proven. The reasons for the under- and overdiagnosis of schizophrenia cannot cover all possible objective and subjective difficulties arising in the diagnostic process.

Conclusion: The existing literature shows that the problem of schizophrenia may not be regarded as settled for a long time. This largely depends on the position of society, the development of biological sciences, and the pathomorphosis of the disorder itself. Many aspects of schizophrenia can become clearer and less controversial with systematic studies based on previous data, as well as data obtained using new research methods.

As far back as the 14th Century, Egypt had already developed mental health care in a community-based sense in Kalaoon Hospital in Cairo, 600 years before similar institutions were founded across the globe. By 2001, an Egyptian-Finnish bilateral comprehensive reform program was incorporated. A few years later, in 2007, the Minister of Health and Population initiated a proper appraisal of the mental health services in Egypt, which was aimed at achieving better integration and coordination in the mental health sector, as well as supervision and training on the national, governmental, and primary care levels. By 2009, the Mental Health Act of 2009 (Law 71) brought basic conceptual changes to the care of people with a mental illness in Egyptian institutions, replacing the outdated 1944 law that had been used in Egypt for decades. However, despite all of the important steps Egypt is taking to move toward more integrated mental health services, more effort and resources are still needed to fight against stigma and to develop a comprehensive multidisciplinary approach that is approachable and effective to all those who need it.

Background: The peak of the pandemic in Kyrgyzstan occurred in July 2020 with highest infection rates, almost 1000 cases daily, compared to 100 cases prior to this date. The state health system was fatally unprepared to accommodate patients, mobilize medical staff, or provide clear instructions to the population. This study explores personal narratives of healthcare practitioners who were affected by and survived COVID-19 during the "Black July" of 2020 in Bishkek, Kyrgyzstan.

Method: Healthcare workers (n=10) were interviewed using a semi-structured interview protocol. Interviews were transcribed then analyzed in accordance with interpretative phenomenological study guidelines.

Results: The narratives demonstrated both post-traumatic depreciation and post-traumatic growth, resulting in changes of attitudes, lifestyle, and identity. An important aspect of identity shift included an emerging desire for increased self-care, which was characterized by resistance against a heroic Hippocratic ideal to "to save everybody".

Conclusion: COVID-19 is perceived as a psycho-socio-cultural phenomenon, which has transformed the identities of healthcare workers in the Kyrgyz Republic. Further research is recommended into developing rehabilitation programs for healthcare workers.

The COVID-19 pandemic greatly accelerated the use of online technologies for communication, as opposed to contact involving physical presence and touch. This commentary further considers the consequences of this change in individual human terms, in everyday as well as medical situations. It is a kind of discussion paper, specially written for this journal. It develops two directions of argument, the first about the reality of embodiment, the second about figures of speech involving touch and movement, figures of speech about the actions of whole people rather than about mind (spirit) or body separately. The discussion reviews the nature of differences between communication involving physical proximity and physical distance (and electronic media), with comments on the positive and negative aspects of each. An emphasis on the significance of touch (and movement, since all touch involves movement) to people is linked to the basic aspects of the lifecycle in birth, reproduction, and death. In conclusion, the discussion emphasizes the traditional importance of touch and physical participation to people's feeling for reality. New digital forms of relations disturb this feel, with significant consequences.

Guided by international best practice and evidence-based medicine, the Qatar mental health service has undergone a major transformation in the last two decades, replacing the institution-based service with an accessible multidisciplinary community-based service. In this paper, we provide a brief historical background to mental health services in Qatar, and the progress and development towards community-based mental health-care provision. We also explore the challenges facing this new model of care in Qatar including social and cultural sensitivities, and the various solutions adopted to overcome these challenges. We outline the comprehensive plans envisaged to further develop Qatar community mental health services, including the provision of accessible, integrated and multimodal mental health care within primary care settings.

Introduction: This article presents a review of current concepts of gender identity under normal and pathological conditions.

Aim: To analyse the impact of the medical and social paradigm shift for clinical practice.

Results and discussion: The modern academic literature devoted to gender identity disorders is characterized by a variety of terminology, a shift in emphasis from clinical judgement to a socially beneficial normocentric approach and a relatively few advanced, evidence-based research. There is also a lack of evidence for the gender theory underlying the new approach, which raises serious doubts about the validity of the medical and social paradigm revision. In the same time, the position of Russian psychiatrists remains to be more clinically oriented.

Conclusion: Patients who declare the desire to reassign their gender have to be assessed by psychiatrists for differential diagnosis to exclude a mental disorder. In such cases, the destigmatization of mental disorders is more critical than the depathologization of gender identity disorders.

Background: ICD-11 implementation will start in early 2022 in WHO member countries, including Russia. This process should be preceded not only by the official translation and wide distribution of ICD-11 statistical classification and diagnostic guidelines but also by clinicians' training. For recent years ICD-11 development and innovations in the diagnosis of mental disorders were in the focus of attention of mental health professionals in all over the world.

Objectives: This online survey aimed to identify the current views of the Russian psychiatric community on the upcoming implementation of ICD-11.

Methods: A survey was composed in a Google form and circulated through the website of the Russian Society of Psychiatrists and other professional networks. Statistical and narrative analysis was provided. The sample was represented by 148 psychiatrists working in inpatient or outpatient clinical settings.

Results: Expectations for the classification of mental disorders reported by the respondents were wider than the current purpose of ICD-10. In general, the Russian psychiatrists expressed their interests to forthcoming ICD-11 implementation. Positive attitudes to ICD-11 innovations were associated with the familiarity with the ICD-11 draft. Conservative or negative views were related to longer years of clinical experience. Early carrier psychiatrists were more practically oriented than 'old school' clinicians.

Conclusion: This survey may help to promote the ICD-11 by focusing on its advantages for clinical practice and develop targeted training programs.

Introduction: This article presents the history and rationales of conceptualization and classification of homosexuality and transgender identity in both ICD and DSM. We review the efforts that have been made (and those that remain pending) to improve psychiatric classifications with new scientific knowledge, changing social attitudes and human rights standards.

Method: We conducted a literature search of the classification of homosexuality and transgender identity as mental disorders.

Result: We provide a historical description of these concepts in ICD and DSM, including fundamental points of disagreement as well as arguments that have been effective in achieving changes in both classifications.

Conclusions: Fundamental changes have been made in the International Classification of Diseases Eleventh Revision (ICD-11) in terms of the classification of sexual orientation and gender identity based on scientific evidence and the ICD's public health objectives. These changes might support the provision of accessible and high-quality healthcare services, and are responsive to the needs, experience and human rights of the populations involved.

Classifications of mental disorders change regularly. This fact requires analysis, taking into account changes in the epidemiological situation and changes in the organizational structure of mental health service, and development of its technical and human resources. The preliminary analysis of these changes presented in the article using the example of ICD-11 gives us reason to believe that they are almost unrelated to the diagnostic process improvement. On the contrary, each new classification is characterized by an increasing formalization and simplification of the criteria for separate clinical forms. The inevitable losses of clinical accuracy in psychopathological assessment of disorder are compensated for increasing opportunities to deliver care to a significantly greater number of patients.