首页 > 最新文献

Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development最新文献

英文 中文
Use of seclusion for managing behavioural disturbance in patients 隔离治疗患者行为障碍的方法
G. Newton-Howes
Seclusion is a tool used by psychiatrists primarily to manage aggressive and disturbed behaviour that is presumed to be due to the patient's mental disorder. In most parts of the world there are guidelines to using seclusion that are designed to maximise a patient's freedoms and protect their liberty while providing a safe environment. Arguments against the use of seclusion revolve around the deprivation of liberty, the potential for misuse and the concept of seclusion as a form of social control, and patients generally report seclusion as a negative, coercive experience. There is little evidence that seclusion provides long-term benefits in terms of treating symptoms or reducing aggression, although the literature is mixed in this regard. Expert opinion recommends a combination of national policy, ward management and patient-centred interventions to reduce seclusion rates.
隔离是精神病医生使用的一种工具,主要用于管理被认为是由于患者精神障碍造成的攻击性和不安行为。在世界上大多数地区,都有使用隔离的指导方针,旨在最大限度地提高患者的自由,并在提供安全环境的同时保护他们的自由。反对使用隔离的论点围绕着剥夺自由、滥用的可能性以及隔离作为一种社会控制形式的概念,患者通常将隔离报告为一种消极的强制性经历。很少有证据表明隔离在治疗症状或减少攻击方面提供长期益处,尽管文献在这方面好坏参半。专家意见建议将国家政策、病房管理和以患者为中心的干预措施结合起来,以降低隔离率。
{"title":"Use of seclusion for managing behavioural disturbance in patients","authors":"G. Newton-Howes","doi":"10.1192/APT.BP.112.011114","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011114","url":null,"abstract":"Seclusion is a tool used by psychiatrists primarily to manage aggressive and\u0000 disturbed behaviour that is presumed to be due to the patient's mental\u0000 disorder. In most parts of the world there are guidelines to using seclusion\u0000 that are designed to maximise a patient's freedoms and protect their liberty\u0000 while providing a safe environment. Arguments against the use of seclusion\u0000 revolve around the deprivation of liberty, the potential for misuse and the\u0000 concept of seclusion as a form of social control, and patients generally\u0000 report seclusion as a negative, coercive experience. There is little\u0000 evidence that seclusion provides long-term benefits in terms of treating\u0000 symptoms or reducing aggression, although the literature is mixed in this\u0000 regard. Expert opinion recommends a combination of national policy, ward\u0000 management and patient-centred interventions to reduce seclusion rates.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"422-428"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778374","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}
引用次数: 8
Safeguarding vulnerable adults: the psychiatrist’s roles and responsibilities 保护脆弱的成年人:精神科医生的角色和责任
R. Hodgson, Jude Rheade
For decades society has recognised that children are vulnerable and so it has sought to protect them. However, similar legal protection for adults who may be equally vulnerable has been neglected. The incremental introduction of legislation and reports in the UK, along with guidelines on good practice, now afford adults safeguarding procedures similar to those for children. This article offers a practical overview of these developments. In addition, it highlights some of the dilemmas that face practitioners in this evolving arena, as legislation and policy do not anticipate the diverse scenarios in which mental healthcare professionals may be involved. Decisions made can be subject to legal challenge, so it is important that psychiatrists understand their role as well as the role of their organisation in this complex area.
几十年来,社会已经认识到儿童是脆弱的,因此寻求保护他们。然而,对可能同样脆弱的成年人的类似法律保护却被忽视了。在英国,立法和报告的逐步引入,以及良好实践的指导方针,现在为成年人提供了类似于儿童的保护程序。本文提供了对这些发展的实际概述。此外,它还强调了在这个不断发展的领域中,由于立法和政策没有预料到精神保健专业人员可能参与的各种情况,从业人员面临的一些困境。做出的决定可能会受到法律挑战,因此精神科医生了解他们的角色以及他们的组织在这个复杂领域的角色是很重要的。
{"title":"Safeguarding vulnerable adults: the psychiatrist’s roles and responsibilities","authors":"R. Hodgson, Jude Rheade","doi":"10.1192/APT.BP.112.010991","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010991","url":null,"abstract":"For decades society has recognised that children are vulnerable and so it has sought to protect them. However, similar legal protection for adults who may be equally vulnerable has been neglected. The incremental introduction of legislation and reports in the UK, along with guidelines on good practice, now afford adults safeguarding procedures similar to those for children. This article offers a practical overview of these developments. In addition, it highlights some of the dilemmas that face practitioners in this evolving arena, as legislation and policy do not anticipate the diverse scenarios in which mental healthcare professionals may be involved. Decisions made can be subject to legal challenge, so it is important that psychiatrists understand their role as well as the role of their organisation in this complex area.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"437-445"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777892","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}
引用次数: 0
Management of the renal adverse effects of lithium 锂离子对肾脏不良反应的处理
Sumeet Gupta, M. Kripalani, U. Khastgir, J. Reilly
Lithium is one of the most effective psychotropic drugs we have, but it is underused because of its low therapeutic index, the need for regular blood tests and perceptions about its adverse effects, including renal problems. The last include urinary concentration deficits and diabetes insipidus, chronic kidney disease (including renal failure), nephrotic syndrome, hyper calcaemia, hyper parathyroidism and distal tubular acidosis. This article reviews these adverse effects with special emphasis on their management.
锂是我们所拥有的最有效的精神药物之一,但由于其治疗指数低、需要定期血液检查以及对其副作用(包括肾脏问题)的认知,它没有得到充分利用。最后一种包括尿浓度缺陷和尿崩症、慢性肾病(包括肾衰竭)、肾病综合征、高钙血症、甲状旁腺功能亢进和远端小管酸中毒。本文回顾了这些不利影响,并特别强调了它们的管理。
{"title":"Management of the renal adverse effects of lithium","authors":"Sumeet Gupta, M. Kripalani, U. Khastgir, J. Reilly","doi":"10.1192/APT.BP.112.010306","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010306","url":null,"abstract":"Lithium is one of the most effective psychotropic drugs we have, but it is underused because of its low therapeutic index, the need for regular blood tests and perceptions about its adverse effects, including renal problems. The last include urinary concentration deficits and diabetes insipidus, chronic kidney disease (including renal failure), nephrotic syndrome, hyper calcaemia, hyper parathyroidism and distal tubular acidosis. This article reviews these adverse effects with special emphasis on their management.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"457-466"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776576","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}
引用次数: 6
Young people who cut themselves: can understanding the reasons guide the treatment? 割伤自己的年轻人:了解原因能指导治疗吗?
B. Wright, N. Hooke, S. Neupert, Chan Nyein, S. Ker
Young people who cut themselves may do so for reasons that go beyond diagnosis. Relevant processes include responses to trauma, coping, emotion regulation and cultural identification. Some clinicians regard those who self-harm negatively or consider one therapeutic approach to be suitable for all. This article explores the possible mechanisms involved when young people cut themselves and discusses therapeutic approaches in the light of these. Clinicians and researchers are encouraged to refine, develop and research interventions for young people who self-harm by cutting.
割伤自己的年轻人可能是出于诊断之外的原因。相关过程包括对创伤的反应、应对、情绪调节和文化认同。一些临床医生认为那些自残的人是消极的,或者认为一种治疗方法适合所有人。本文探讨了当年轻人割伤自己时可能涉及的机制,并根据这些讨论治疗方法。鼓励临床医生和研究人员改进、开发和研究针对通过割伤自残的年轻人的干预措施。
{"title":"Young people who cut themselves: can understanding the reasons guide the treatment?","authors":"B. Wright, N. Hooke, S. Neupert, Chan Nyein, S. Ker","doi":"10.1192/APT.BP.112.011049","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011049","url":null,"abstract":"Young people who cut themselves may do so for reasons that go beyond\u0000 diagnosis. Relevant processes include responses to trauma, coping, emotion\u0000 regulation and cultural identification. Some clinicians regard those who\u0000 self-harm negatively or consider one therapeutic approach to be suitable for\u0000 all. This article explores the possible mechanisms involved when young\u0000 people cut themselves and discusses therapeutic approaches in the light of\u0000 these. Clinicians and researchers are encouraged to refine, develop and\u0000 research interventions for young people who self-harm by cutting.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"446-456"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778184","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}
引用次数: 2
A guide to intellectual disability psychiatry assessments in the community 社区智障精神病学评估指南
B. Eng, P. Addison, H. Ring
Psychiatric assessment in the community is an important part of both the initial assessment process and delivery of follow-up care in adult intellectual disability services in the UK. This article examines how such assessments can be carried out safely and explores the clinical skills required to perform them effectively. Use of the psychiatric interview and mental state examination to elicit information is discussed. Communication difficulties experienced by people with intellectual disabilities and strategies that may be employed to address these in the assessment process are also explored. The article is directed at psychiatrists, in particular specialty trainees, and other healthcare professionals who work with intellectually disabled people.
在英国,在成人智障服务中,社区精神病学评估是初始评估过程和后续护理的重要组成部分。本文探讨了如何安全地进行这些评估,并探讨了有效执行这些评估所需的临床技能。讨论了利用精神病学访谈和精神状态检查来获取信息。本课程亦探讨了智障人士在评估过程中所遇到的沟通困难,以及可用于解决这些困难的策略。这篇文章针对的是精神科医生,特别是专业培训生,以及其他与智障人士一起工作的医疗保健专业人员。
{"title":"A guide to intellectual disability psychiatry assessments in the community","authors":"B. Eng, P. Addison, H. Ring","doi":"10.1192/APT.BP.113.011213","DOIUrl":"https://doi.org/10.1192/APT.BP.113.011213","url":null,"abstract":"Psychiatric assessment in the community is an important part of both the\u0000 initial assessment process and delivery of follow-up care in adult\u0000 intellectual disability services in the UK. This article examines how such\u0000 assessments can be carried out safely and explores the clinical skills\u0000 required to perform them effectively. Use of the psychiatric interview and\u0000 mental state examination to elicit information is discussed. Communication\u0000 difficulties experienced by people with intellectual disabilities and\u0000 strategies that may be employed to address these in the assessment process\u0000 are also explored. The article is directed at psychiatrists, in particular\u0000 specialty trainees, and other healthcare professionals who work with\u0000 intellectually disabled people.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"429-436"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.113.011213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778673","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}
引用次数: 3
A Confederacy of Dunces : mental illness in the life and work of John Kennedy Toole 傻瓜联盟:约翰·肯尼迪·图尔生活和工作中的精神疾病
Abhijit Pal
SUMMARY This article examines the life and work of John Kennedy Toole, focusing on his 1981 Pulitzer Prize winning novel A Confederacy of Dunces . Toole finished the novel in 1966 and, after failing to rework his manuscript to his editor’s satisfaction, he shelved the project. Following this, he displayed symptoms typical of paranoid schizophrenia and he took his own life at the age of 31. In his novel, Toole parodies both psychoanalysis and the practice of psychiatry at the time, with a strong overlap with the emerging perspectives critical of psychiatry popularised by figures such as Szasz, Laing and Foucault. Toole’s life and work have relevance for psychiatrists interested in the relationship between creativity and mental illness, attitudes towards psychiatry in the 1960s, and the interplay between societal values and judgements of mental health.
本文考察了约翰·肯尼迪·图尔的生活和工作,重点介绍了他1981年获得普利策奖的小说《笨蛋联盟》。1966年,图尔完成了这部小说,但由于未能让编辑满意地修改手稿,他搁置了这个项目。在此之后,他表现出偏执型精神分裂症的典型症状,并在31岁时结束了自己的生命。在他的小说中,图尔模仿了当时的精神分析和精神病学实践,与萨兹、莱恩和福柯等人流行的新兴精神病学批评观点有很大的重叠。对于那些对创造力和精神疾病之间的关系,20世纪60年代对精神病学的态度,以及社会价值观和对精神健康的判断之间的相互作用感兴趣的精神病学家来说,图尔的生活和工作具有相关性。
{"title":"A Confederacy of Dunces : mental illness in the life and work of John Kennedy Toole","authors":"Abhijit Pal","doi":"10.1192/APT.BP.112.010371","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010371","url":null,"abstract":"SUMMARY This article examines the life and work of John Kennedy Toole, focusing on his 1981 Pulitzer Prize winning novel A Confederacy of Dunces . Toole finished the novel in 1966 and, after failing to rework his manuscript to his editor’s satisfaction, he shelved the project. Following this, he displayed symptoms typical of paranoid schizophrenia and he took his own life at the age of 31. In his novel, Toole parodies both psychoanalysis and the practice of psychiatry at the time, with a strong overlap with the emerging perspectives critical of psychiatry popularised by figures such as Szasz, Laing and Foucault. Toole’s life and work have relevance for psychiatrists interested in the relationship between creativity and mental illness, attitudes towards psychiatry in the 1960s, and the interplay between societal values and judgements of mental health.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"467-469"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776557","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}
引用次数: 0
Development of foundation year 1 psychiatry posts: implications for practice 基础一年级精神病学职位的发展:对实践的影响
R. Steele, Sharon Beattie
Most literature discussing the introduction of foundation year 1 (F1) psychiatry posts has focused on recruitment. However, for F1 posts to offer a valuable learning experience and a potential recruitment boost, psychiatrists and employing organisations should be aware of general issues arising in the first postgraduate year. These include the inherently stressful student-to-doctor transition, the need for bespoke induction programmes for new graduates, F1 doctors’ specific needs for support, supervision and peer support, and the centrality of the relationship with the consultant supervisor to the new doctor. Understanding these themes will enable psychiatrists and mental health organisations to offer better F1 psychiatry experiences, which may boost recruitment and could maximise the opportunities for F1 doctors to develop skills and qualities that will be of value in their future careers, whatever specialty they end up working in.
大多数讨论引入基础一年级(F1)精神病学职位的文献都集中在招聘上。然而,为了让F1职位提供宝贵的学习经验和潜在的招聘促进,精神科医生和用人机构应该意识到研究生第一年出现的一般问题。这些挑战包括从学生到医生的转变本身就充满压力,需要为新毕业生定制入职课程,F1医生对支持、监督和同伴支持的特殊需求,以及与顾问导师的关系对新医生的中心地位。了解这些主题将使精神病学家和心理健康组织能够提供更好的F1精神病学经验,这可能会促进招聘,并可以最大限度地提高F1医生发展技能和素质的机会,这些技能和素质将对他们未来的职业生涯有价值,无论他们最终从事什么专业。
{"title":"Development of foundation year 1 psychiatry posts: implications for practice","authors":"R. Steele, Sharon Beattie","doi":"10.1192/APT.BP.112.010678","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010678","url":null,"abstract":"Most literature discussing the introduction of foundation year 1 (F1) psychiatry posts has focused on recruitment. However, for F1 posts to offer a valuable learning experience and a potential recruitment boost, psychiatrists and employing organisations should be aware of general issues arising in the first postgraduate year. These include the inherently stressful student-to-doctor transition, the need for bespoke induction programmes for new graduates, F1 doctors’ specific needs for support, supervision and peer support, and the centrality of the relationship with the consultant supervisor to the new doctor. Understanding these themes will enable psychiatrists and mental health organisations to offer better F1 psychiatry experiences, which may boost recruitment and could maximise the opportunities for F1 doctors to develop skills and qualities that will be of value in their future careers, whatever specialty they end up working in.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"410-419"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777612","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}
引用次数: 5
La interfaz entre neurología y psiquiatría: el caso de la esclerosis múltiple [translation of “The interface between neurology and psychiatry: the case of multiple sclerosis” by Rodolfo Zaratiegui] La interfaz entre neurología y psiquiatría: el caso de La esclerosis múltiple[翻译自Rodolfo Zaratiegui的“神经病学和精神病学之间的界面:多发性硬化症的案例”]
E. Wong, R. Krishnadas, J. Cavanagh
Los avances en la genética y las neuroimágenes de las últimas décadas nos han permitido entender los procesos biológicos que subyacen a muchas enfermedades que originalmente se creían puramente ‘funcionales’ (Kandel 1998). La patofisiología de enfermedades tales como el Parkinson y la epilepsia, por ejemplo – previamente entendidas como enfermedades mentales sin base física identificable para el diagnóstico o tratamiento – se entiende ahora más claramente. Sin embargo, como sucede con muchas de estas enfermedades ‘funcionales’, el manejo y tratamiento de la mayoría de los pacientes con enfermedad de Parkinson y epilepsia se tornó seguidamente la responsabilidad de neurólogos. Más recientemente, los medios de comunicación han mostrado un interés creciente en pacientes con diagnóstico de enfermedad psiquiátrica en los que subsecuentemente se encontró encefalitis producida por anticuerpos, y esto ha llegado a sugerir que una proporción de tales pacientes pudieran tener una etiopatogénesis mediada por anticuerpos (Barry 2011, Lennox 2012). El optimismo en nuestras capacidades científicas, junto con la tendencia de reclasificar las enfermedades mentales como neurológicas a medida de los avances de los conocimientos biológicos, ha provocado preocupación por la supervivencia de la Psiquiatría como especialidad por derecho propio (Oyebode 2011), y puede marcar también el comienzo de una era en la que tanto el cerebro como la mente (aun la Psiquiatría y la Neurología) sean considerados esenciales en el entendimiento de cada uno. Es sabido que hay un riesgo aumentado de desarrollar un trastorno depresivo mayor en un número de enfermedades médicas – por ejemplo, afecta a un 30% de los sobrevivientes de accidente cerebrovascular (Hackett 2005) y hasta el 17% de personas con artritis reumatoidea, con tasas similares en cáncer y enfermedad cardiovascular (Dickens 2002)En la esclerosis múltiple (EM), la prevalencia vital de la depresión mayor es de hasta un 50%, con tasas de suicidio de hasta 15% (Lo Fermo 2010). En este artículo, examinamos el proceso fisiopatológico de la depresión, particularmente en la enfermedad física, utilizando la EM como un ejemplo. El artículo está dividido en tres secciones:
过去几十年遗传学和神经成像的进步使我们能够理解许多最初被认为是纯粹“功能性”疾病背后的生物学过程(Kandel 1998)。例如,帕金森氏症和癫痫等疾病的病理生理学——以前被理解为没有可识别的物理诊断或治疗基础的精神疾病——现在得到了更清晰的理解。然而,就像许多“功能性”疾病一样,大多数帕金森病和癫痫患者的管理和治疗后来成为神经学家的责任。最近,媒体表现出越来越感兴趣在诊断精神疾病患者后来发现脑炎产生抗体,这个比例已表明这种抗体介导的病人可能有etiopatogénesis(2011年巴里,伦诺克斯(2012年)。乐观的趋势我们的科学能力,与陆地神经精神疾病如随着生物知识的进展引起了关注精神病学作为生存的特产(2011 Oyebode),就可以也是一个时代的开始,无论是大脑的头脑(即使在精神病学和神经学)每个基本不得被理解。众所周知,这是一个风险增加,开发更多抑郁症在一定数量的医疗疾病—例如,也影响到30%的中风幸存者哈克特(2005年)和17%的人患有关节炎reumatoidea类似,2002年癌症和心血管疾病(狄更斯)多发性硬化症(ms)、重要的抑郁症患病率高达50%就越高,2010 (Fermo自杀率高达15%)。在这篇文章中,我们以ms为例,考察了抑郁症的病理生理过程,特别是在身体疾病中。本文分为三个部分:
{"title":"La interfaz entre neurología y psiquiatría: el caso de la esclerosis múltiple [translation of “The interface between neurology and psychiatry: the case of multiple sclerosis” by Rodolfo Zaratiegui]","authors":"E. Wong, R. Krishnadas, J. Cavanagh","doi":"10.1192/s1355514600018770","DOIUrl":"https://doi.org/10.1192/s1355514600018770","url":null,"abstract":"Los avances en la genética y las neuroimágenes de las últimas décadas nos han permitido entender los procesos biológicos que subyacen a muchas enfermedades que originalmente se creían puramente ‘funcionales’ (Kandel 1998). La patofisiología de enfermedades tales como el Parkinson y la epilepsia, por ejemplo – previamente entendidas como enfermedades mentales sin base física identificable para el diagnóstico o tratamiento – se entiende ahora más claramente. Sin embargo, como sucede con muchas de estas enfermedades ‘funcionales’, el manejo y tratamiento de la mayoría de los pacientes con enfermedad de Parkinson y epilepsia se tornó seguidamente la responsabilidad de neurólogos. Más recientemente, los medios de comunicación han mostrado un interés creciente en pacientes con diagnóstico de enfermedad psiquiátrica en los que subsecuentemente se encontró encefalitis producida por anticuerpos, y esto ha llegado a sugerir que una proporción de tales pacientes pudieran tener una etiopatogénesis mediada por anticuerpos (Barry 2011, Lennox 2012). El optimismo en nuestras capacidades científicas, junto con la tendencia de reclasificar las enfermedades mentales como neurológicas a medida de los avances de los conocimientos biológicos, ha provocado preocupación por la supervivencia de la Psiquiatría como especialidad por derecho propio (Oyebode 2011), y puede marcar también el comienzo de una era en la que tanto el cerebro como la mente (aun la Psiquiatría y la Neurología) sean considerados esenciales en el entendimiento de cada uno. Es sabido que hay un riesgo aumentado de desarrollar un trastorno depresivo mayor en un número de enfermedades médicas – por ejemplo, afecta a un 30% de los sobrevivientes de accidente cerebrovascular (Hackett 2005) y hasta el 17% de personas con artritis reumatoidea, con tasas similares en cáncer y enfermedad cardiovascular (Dickens 2002)En la esclerosis múltiple (EM), la prevalencia vital de la depresión mayor es de hasta un 50%, con tasas de suicidio de hasta 15% (Lo Fermo 2010). En este artículo, examinamos el proceso fisiopatológico de la depresión, particularmente en la enfermedad física, utilizando la EM como un ejemplo. El artículo está dividido en tres secciones:","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66142698","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}
引用次数: 0
Achieving transparency in forensic risk assessment: a multimodal approach 实现法医风险评估的透明度:多模式方法
Amy Horstead, A. Cree
SUMMARY The Department of Health’s best practice guidelines on risk management and violence prevention in UK mental health services highlight the importance of transparency and collaboration with service users. The recovery philosophy echoes the importance of service user inclusion and empowerment in treatment. Our experience in a medium and low secure hospital was that patients were largely excluded from the risk assessment process. In this article, we describe a model for achieving inclusion and transparency in the use of risk assessment tools based on structured professional judgement.
卫生部关于联合王国精神卫生服务风险管理和暴力预防的最佳做法准则强调了透明度和与服务使用者合作的重要性。康复哲学反映了服务使用者包容和在治疗中赋予权力的重要性。我们在一家安全程度中等和较低的医院的经验是,病人基本上被排除在风险评估过程之外。在本文中,我们描述了一个基于结构化专业判断的风险评估工具在使用中实现包容性和透明度的模型。
{"title":"Achieving transparency in forensic risk assessment: a multimodal approach","authors":"Amy Horstead, A. Cree","doi":"10.1192/APT.BP.112.010645","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010645","url":null,"abstract":"SUMMARY The Department of Health’s best practice guidelines on risk management and violence prevention in UK mental health services highlight the importance of transparency and collaboration with service users. The recovery philosophy echoes the importance of service user inclusion and empowerment in treatment. Our experience in a medium and low secure hospital was that patients were largely excluded from the risk assessment process. In this article, we describe a model for achieving inclusion and transparency in the use of risk assessment tools based on structured professional judgement.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"351-357"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776966","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}
引用次数: 8
Supporting self-management in early dementia: a contribution towards ‘living well’? 支持早期痴呆患者的自我管理:对“活得好”的贡献?
Jo Cheffey, L. Hill, Glenn Roberts, R. Marlow
There has been increasing interest in how to assist people to ‘live well’ with advancing and incurable conditions late into life. This article considers the progress made in mental health services for adults of working age which promote active involvement in their care and how these principles can be applied to older adults with dementia. The concept of ‘recovery’ and its applicability to dementia care are discussed. The Wellness Recovery Action Plan (WRAP) and how it could be translated and modified to the needs of people with dementia are explored. This is especially important in light of the UK National Dementia Strategy, which emphasises early diagnosis and intervention to promote improved care and quality of life.
人们对如何帮助那些身患晚期不治之症的人“活得好”越来越感兴趣。本文考虑了在促进积极参与其护理的工作年龄成年人的心理健康服务方面取得的进展,以及如何将这些原则应用于患有痴呆症的老年人。讨论了“恢复”的概念及其对痴呆症护理的适用性。探讨了健康康复行动计划(WRAP)以及如何将其转化和修改以满足痴呆症患者的需求。鉴于英国国家痴呆症战略,这一点尤其重要,该战略强调早期诊断和干预,以促进改善护理和生活质量。
{"title":"Supporting self-management in early dementia: a contribution towards ‘living well’?","authors":"Jo Cheffey, L. Hill, Glenn Roberts, R. Marlow","doi":"10.1192/APT.BP.112.011023","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011023","url":null,"abstract":"There has been increasing interest in how to assist people to ‘live well’ with advancing and incurable conditions late into life. This article considers the progress made in mental health services for adults of working age which promote active involvement in their care and how these principles can be applied to older adults with dementia. The concept of ‘recovery’ and its applicability to dementia care are discussed. The Wellness Recovery Action Plan (WRAP) and how it could be translated and modified to the needs of people with dementia are explored. This is especially important in light of the UK National Dementia Strategy, which emphasises early diagnosis and intervention to promote improved care and quality of life.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"344-350"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777982","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}
引用次数: 10
期刊
Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1