RESUMEN
Just over 25 years have passed since the major sociopolitical changes in central and eastern Europe; our aim was to map and analyse the development of mental health-care practice for people with severe mental illnesses in this region since then. A scoping review was complemented by an expert survey in 24 countries. Mental health-care practice in the region differs greatly across as well as within individual countries. National policies often exist but reforms remain mostly in the realm of aspiration. Services are predominantly based in psychiatric hospitals. Decision making on resource allocation is not transparent, and full economic evaluations of complex interventions and rigorous epidemiological studies are lacking. Stigma seems to be higher than in other European countries, but consideration of human rights and user involvement are increasing. The region has seen respectable development, which happened because of grassroots initiatives supported by international organisations, rather than by systematic implementation of government policies.
Asunto(s)
Trastornos Mentales/psicología , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Salud Mental/tendencias , Europa (Continente) , Salud Global , Hospitales Psiquiátricos/economía , Humanos , Estigma Social , Encuestas y CuestionariosRESUMEN
We investigated the effect of electroconvulsive stimulation (ECS) on cerebral circulation in vivo using the method for measuring microcirculation in real time with the photosensitizer dye Photosense and the fiber optic spectrofluorometer LESA-01-BIOSPEC. We have found that electroconvulsive stimulation significantly improved cerebral microcirculation (fourfold higher comparing to the control cerebral perfusion) after 30 min of room-temperature cardiac arrest. Morphologic study of the brain tissue showed the absence of rouleaux formation of erythrocytes ("sludged blood") in the cerebral cortex microcirculation after the application of electrical stimulus. Electroconvulsive stimulation may be useful for improving cerebral microcirculation (blood flow) in cases of long-term brain hypoxia/anoxia after prolonged cardiac arrest.