Contribution of ethical reasoning learning sessions on medical training.

INTRODUCTION: Ethical reasoning is an important skill for all physicians who often face complex ethical dilemmas in their daily practice. Therefore, medical training should include methods for learning ethical theories and concepts, as well as how to apply them in practical situations. AIM: Assess the contribution of an Ethical Reasoning Learning session to fifth medical students' training through a comparison of results of the same objective and structured clinical examination (OSCE) in the form of simulated interview before and after sessions. METHODS: Four 45- minutes' sessions of Ethical Reasoning Learning (ERL) were implemented during a psychiatry internship for four groups of 5th-year students of the faculty of medicine of Monastir (Tunisia). Each session was divided into 7 parts: introduction, reading of a clinical vignette, brainstorming concerning the problems posed by this clinical situation, classification of the problems, identification of the principles of medical ethics, construction of the ethical matrix, and a conclusion. RESULTS: Fifty-seven students participated in the study divided into 4 groups. We found a significant difference in the means of the OSCE scores before and after the ERL session and a significant difference between the probability of respecting medical secrecy during pre and post-ethical reasoning learning sessions (p <0.001). We have found an effect of ERL sessions on the acquisition of this ethical competence by medical students. CONCLUSION: We learned that an ERL session has improved medical training in ethics applied to psychiatry. Other sessions dealing with other ethical skills are necessary to confirm these results.

Where do GPs seek help for their illnesses? / Hvor søker fastleger hjelp ved egen sykdom?

Background: Doctors generally enjoy good health, but often refrain from seeking help when they are ill. Self-treatment is widespread, and this can be an inappropriate and risky practice. Material and method: This is a registry study that compares GPs' own use of the primary and specialist health services in 2018 with a control group consisting of all others in the same age group with the same sex, level of education and health as the GPs. Morbidity in both groups was surveyed with the aid of two validated morbidity indexes in the period 2015-17. Only those who scored zero on both indexes were included. Results: While only 21.7 % of the GPs had sought help from a GP and 3.3 % had attended the emergency department, the corresponding figures for the control group were 61.6 % and 11.8 %. Of the GPs, 17.5 % consulted a contract specialist, compared to 15.5 % of the control group. Measured as a proportion of all specialist consultations, consultations with a psychiatrist constituted 35 % for GPs and 13 % for others. There were small differences in the use of somatic outpatient clinics (25.9 % of GPs and 25.7 % of the control group) and acute admission in somatic hospitals (3.8 % of GPs and 3.3 % of the control group). Interpretation: This study indicates that GPs receive medical assistance from other than their own GP.

The relevance of anti-N-methyl-D-aspartate receptor encephalitis for psychiatrists.

Psychiatrists are often the first to be consulted in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. While this disease is rare, psychiatrists need to be aware of its relevant fundamental, clinical and therapeutic aspects. We begin by reviewing the connection between anti-NMDAR encephalitis and the glutamate hypothesis of schizophrenia. Next, we focus on the profile of the patient typically afflicted with this disease. Then, we tackle the limited utility of current diagnostic criteria during the early stage of the disease. After reviewing the psychiatric features, we debate the quest for finding specific psychiatric phenotypes that could facilitate early-stage diagnosis. We conclude by discussing the treatment of psychiatric symptoms and disease outcomes. As follows, this paper presents the relevance of anti-NMDAR encephalitis for psychiatrists.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an essential differential diagnosis in Psychiatry, particularly when dealing with first-episode psychosis.Psychiatrists are often the first to be consulted in patients with NMDAR encephalitis, so they need to be aware of the relevant fundamental, clinical and therapeutic aspects of this disease.

[Transidentites : the relevance of involving psychiatrists]. / Transidentités : pertinence de l'implication des psychiatres.

Psychiatrists play a crucial role in evaluating requests and treatment indications for individuals experiencing gender incongruence, while also providing support throughout the transition process. Their work involves addressing both the psychological and somatic aspects of this journey, facilitating the profound identity changes it entails.

Les psychiatres psychothérapeutes jouent un rôle essentiel pour évaluer les demandes et les indications au traitement des personnes souffrant d'incongruence de genre, et les accompagner dans leur parcours de transition. Leur travail permet d'intégrer les enjeux psychologiques et somatiques de ce cheminement et de soutenir les remaniements identitaires profonds qu'il implique.

'Eccentricity', by DH Tuke (1892).

An astronomical concept up to the eighteenth century, 'eccentricity' started to be used to refer to behaviours considered as odd, strange, rare, extravagant, etc. Once reified into a personality trait, it gained explanatory power. This not only increased its popularity but also facilitated its links with psychopathology and neuropsychology, and, via the shared concept of madness, with the notions of genius and creativity. This Classic Text describes the process whereby Alienism (Psychiatry) medicalized eccentricity. To this day, the latter remains firmly attached to 'psychoticism' and to some personality disorders.

Lothar Kalinowsky y la llegada del electroshock a América.

Includes appreciations of the work: Shock treatments, psychosurgery and other somatic treatments in psychiatry, by Lothar Kalinowsky and Paul Hoch, Editorial Cientifica Médica, Barcelona, ​​1953.

Historia de la escritura como herramienta para la práctica de la psiquiatría y la salud mental.

La escritura como la conocemos hoy en día es un desarrollo relativamente nuevo en la historia cultural de la humanidad. Más actual aún es la masividad de la alfabetización de la población. Desde los orígenes de la psiquiatría, la escritura forma parte inherente de ésta en la bibliografía médica pero también como una herramienta aplicada en la práctica en diversos formatos, tanto con fines diagnósticos como terapéuticos. No obstante, frente a las herramientas clásicas de comunicación, como el habla, y en la psiquiatría infantil, también el juego y el dibujo, la escritura parece haber sido relegada. En esta investigación bibliográfica, que no tendría antecedentes en su tipo, se realizó un recorrido histórico de la temática desde el surgimiento de la psiquiatría como especialidad hasta nuestros días; donde hechos como las Guerras Mundiales, la evolución del concepto de discapacidad o la pandemia por COVID-19 parecen haber jugado un papel clave para delimitar variables que caracterizan, al menos, tres períodos históricos y presumir un cuarto en plena gestación. El soporte tecnológico con el que se escribe y el uso y formato dado a la escritura resultaron las principales variables de los distintos períodos. Siendo ésta una época de muy alta demanda en Salud Mental, desafiante en su accesibilidad y la masividad en el uso de la escritura a partir de tecnologías de la información, esta investigación representaría un aporte significativo al desarrollo de la escritura como herramienta para la práctica de la psiquiatría y la salud mental.

Five interdisciplinary tensions and opportunities in neurodiversity research.

Improving our understanding of autism, ADHD, dyslexia and other neurodevelopmental conditions requires collaborations between genetics, psychiatry, the social sciences and other fields of research.

Validating the knowledge represented by a self-organizing map with an expert-derived knowledge structure.

BACKGROUND: Professionals are reluctant to make use of machine learning results for tasks like curriculum development if they do not understand how the results were generated and what they mean. Visualizations of peer reviewed medical literature can summarize enormous amounts of information but are difficult to interpret. This article reports the validation of the meaning of a self-organizing map derived from the Medline/PubMed index of peer reviewed medical literature by its capacity to coherently summarize the references of a core psychiatric textbook. METHODS: Reference lists from ten editions of Kaplan and Sadock's Comprehensive Textbook of Psychiatry were projected onto a self-organizing map trained on Medical Subject Headings annotating the complete set of peer reviewed medical research articles indexed in the Medline/PubMed database (MedSOM). K-means clustering was applied to references from every edition to examine the ability of the self-organizing map to coherently summarize the knowledge contained within the textbook. RESULTS: MedSOM coherently clustered references into six psychiatric knowledge domains across ten editions (1967-2017). Clustering occurred at the abstract level of broad psychiatric practice including General/adult psychiatry, Child psychiatry, and Administrative psychiatry. CONCLUSIONS: The uptake of visualizations of published medical literature by medical experts for purposes like curriculum development depends upon validation of the meaning of the visualizations. The current research demonstrates that a self-organizing map (MedSOM) can validate the stability and coherence of the references used to support the knowledge claims of a standard psychiatric textbook, linking the products of machine learning to a widely accepted standard of knowledge.

Climate Change and Mental Health: An Interactive Educational Session.

Introduction: Climate change is the single biggest health threat facing humanity, with direct and indirect impacts on mental health, yet health impacts of climate change remain notably absent from most medical school curricula. We describe a timely interactive educational session on climate change and mental health that was implemented and studied on a medical student clinical psychiatry rotation. Methods: We developed a 1-hour introductory session on the mental health impacts of climate change and potential solutions. The session was delivered to third-year medical students on their 4-week clinical psychiatry rotation and included pre- and postsession survey questions assessing their knowledge, comfort, and readiness regarding the topic. Results: Seventy students participated in the session, with 49 students completing the pre- and postsession surveys, giving a response rate of 70%. The average score for the four Likert-scale questions on the survey increased from 2.7 presession to 3.9 postsession on a 5-point scale (1 = strongly disagree, 5 = strongly agree). All questions displayed statistically significant improvement. Qualitative analysis identified knowledge gained about the mental health impacts of climate change as the most important aspect of the session to students. Discussion: The introductory session effectively filled an urgent need in medical education curricula regarding climate change's effects on human health. Overall, distribution of and improvement upon this timely teaching content can serve a valuable role in medical student education as the effects of climate change, particularly on mental health, continue to progress throughout the century.