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1.
Artigo em Inglês | MEDLINE | ID: mdl-32730915

RESUMO

In December 2019, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) infection was reported. In only few weeks it has caused a global pandemic, with mortality reaching 3.4%, mostly due to a severe pneumonia. However, the impact of SARS-CoV-2 virus on the central nervous system (CNS) and mental health outcomes remains unclear. Previous studies have demonstrated the presence of other types of coronaviruses in the brain, especially in the brainstem. There is evidence that the novel coronavirus can penetrate CNS through the olfactory or circulatory route as well as it can have an indirect impact on the brain by causing cytokine storm. There are also first reports of neurological signs in patients infected by the SARS-Cov-2. They show that COVID-19 patients have neurologic manifestations like acute cerebrovascular disease, conscious disturbance, taste and olfactory disturbances. In addition, there are studies showing that certain psychopathological symptoms might appear in infected patients, including those related to mood and psychotic disorders as well as post-traumatic stress disorder. Accumulating evidence also indicates that the pandemic might have a great impact on mental health from the global perspective, with medical workers being particularly vulnerable. In this article, we provide a review of studies investigating the impact of the SARS-CoV-2 on the CNS and mental health outcomes. We describe neurobiology of the virus, highlighting the relevance to mental disorders. Furthermore, this article summarizes the impact of the SARS-CoV-2 from the public health perspective. Finally, we present a critical appraisal of evidence and indicate future directions for studies in this field.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Betacoronavirus , Encéfalo/virologia , Infecções por Coronavirus/complicações , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/etiologia , Doenças do Sistema Nervoso/etiologia , Pandemias , Pneumonia Viral/complicações , Resultado do Tratamento
2.
Artigo em Inglês | MEDLINE | ID: mdl-32771337

RESUMO

BACKGROUND: Psychological suffering by health professionals may be associated with the uncertainty of a safe workplace. Front-line professionals exposed and involved in the diagnosis and treatment of COVID-19 patients are more susceptible. METHOD: This review was conducted based on papers that were published at MEDLINE, BMJ, PsycINFO, and LILACS, the according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). RESULTS: Health professionals had a higher level of anxiety (13.0 vs. 8.5%, p < 0.01, OR = 1.6152; 95%CI 1.3283 to 1.9641; p < 0.0001) and depression 12.2 vs. 9.5%; p = 0.04; OR = 1.3246; 95%CI 1.0930 to 1.6053; p = 0.0042), besides somatizations and insomnia compared to professionals from other areas. CONCLUSION: Health professionals, regardless of their age, showed significant levels of mental disorders. We observed a prevalence of anxiety and depression. Insomnia was a risk factor for both.


Assuntos
Infecções por Coronavirus , Pessoal de Saúde/psicologia , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Pandemias , Pneumonia Viral , Humanos , Transtornos Mentais/epidemiologia , Doenças Profissionais/epidemiologia , Prevalência , Estresse Psicológico
3.
Artigo em Inglês | MEDLINE | ID: mdl-32777327

RESUMO

BACKGROUND: Health professionals are key personnel to containing infectious diseases like COVID-19. In the face of long work shifts (that reach 16 h per day on average), the risk of getting infected by a high-infectious disease and the lack of enough biological protection measures, mental suffering among health professionals suddenly became evident. METHOD: We carried out an updated meta-analysis to investigate the psychiatric impacts on health professionals in the face of the physical and psychological conditions to which they are subjected due to the high demands of the COVID-19 pandemic. Papers were researched in four databases from December 2019 to April 2020. In total, eight papers were included in the study. RESULTS: Health professionals working to fight COVID-19 are being more severely affected by psychiatric disorders associated with depression, anxiety, distress and insomnia, stress, and indirect traumatization than other occupational groups. No significant differences were observed in the publication bias. CONCLUSION: There is a strong association between health professionals and COVID-19 in terms of psychiatric repercussions. Our meta-analysis showed that health professionals have a higher level of indirect traumatization, in which the level of damage exceeds psychological and emotional tolerance and indirectly results in psychological abnormalities. The incidence of obsessive-compulsive traces and somatizations was higher in situations involving front-line professionals.


Assuntos
Infecções por Coronavirus , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Pandemias , Pneumonia Viral , Ansiedade/etiologia , Ansiedade/psicologia , Depressão/etiologia , Depressão/psicologia , Pessoal de Saúde , Humanos , Angústia Psicológica , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Estresse Psicológico/epidemiologia
4.
BMJ Open ; 10(9): e040229, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873685

RESUMO

INTRODUCTION: The current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders. METHODS AND ANALYSIS: With our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources. ETHICS AND DISSEMINATION: No ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020179611.


Assuntos
Infecções por Coronavirus , Transtornos Mentais , Serviços de Saúde Mental/provisão & distribução , Saúde Mental , Pandemias/estatística & dados numéricos , Pneumonia Viral , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
6.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 443-462, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886045

RESUMO

Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government Children of parents with a mental illness (COPMI) are at an increased risk to develop (severe) mental disorders (SMI) themselves. Estimates for Germany result in about 25 % of COPMI. This is thus a large and high risk group. On the other hand, prevention programs for COPMI are still scarce, especially in Germany, and central features of the transgenerational transmission of mental disorders have not been studied in conjunction to shed light on potential transmission mechanisms. The current article presents two current research projects on COPMI focusing on preventive approaches. The BMBF funded project "Children of Parents with a Mental Illness At Risk Evaluation" (COMPARE) targets parents of children aged 1.5 to 16 years of age. Parents need to fulfil a current DSM-5 based diagnosis of a mental disorder and then receive either 25-45 sessions gold standard cognitive behavioural therapy (CBT) or CBT plus 10 sessions Positive Parenting Program (PPP) to test the effects of parental therapy on the children and whether an additional parent training results in incremental effects above and beyond CBT alone. The project "The Village" is a model project in the region Tyrol, Austria, targeting the improved identification and collaborative care of COPMI.


Assuntos
Filho de Pais Incapacitados/psicologia , Terapia Cognitivo-Comportamental , Governo , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adolescente , Adulto , Áustria , Criança , Pré-Escolar , Suscetibilidade a Doenças , Alemanha , Humanos , Lactente , Transtornos Mentais/diagnóstico , Poder Familiar/psicologia
7.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 463-480, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886047

RESUMO

Mental Disorders and Parenting: Challenges and Opportunities for Adult Mental Health Services Parenting can be a key element in the psychiatric rehabilitation process, but it may come with many challenges for parents with mental health problems. Illness symptoms, together with social and sociocultural factors, can have adverse effects on family life or parenting behaviors and entail severe consequences for a child's psychosocial development. Bidirectional interactions can increase parental burden and thus worsen a parent's course of illness. This vicious circle can be broken by the provision of early and adequate support of mothers and fathers with mental health problems. Adult mental health services can make an important yet often underestimated contribution here. This article refers to parents' resources and needs and introduces both opportunities and challenges for adult mental health services when it comes to dealing with parenting needs. Mental health professionals are in a pivotal position for extending adequate support to clients on their parental needs. These professionals' skills and knowledge regarding parenting are essential for the successful implementation of family-focused practices in adult mental health services. Beyond the individual level, there is a need for policies and guidelines stipulating the integration of family and child perspectives in adult mental health services. In a broader view, a program from Finland shows how mental health professionals as well as peers can support parents and their families during the treatment process.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental , Poder Familiar/psicologia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Transtornos Mentais/prevenção & controle , Transtornos Mentais/reabilitação
8.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 426-442, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886049

RESUMO

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Humanos , Transtornos Mentais/reabilitação
9.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 405-415, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886050

RESUMO

Shared Responsibility!? Interdisciplinary Care for Children of Mentally Ill Parents From the Perspective of Child and Youth Welfare Families with at least one mentally ill parent require professional help from several support systems considering the different burdens and complex needs. When designing help and care programs, it is important to focus on the quality of interdisciplinary cooperation and communal networking. Case-related and cross-case cooperation requires binding work structures as well as an overall strategy at the local level. The recent final report to the German Bundestag by the working group "The Children of Mentally Ill Parents" emphasized the relevance of the topic while putting forward recommendations. This article outlines the current academic discussion as well as developments in the design process of interdisciplinary care programs from the perspective of child and youth welfare.


Assuntos
Bem-Estar da Criança , Filho de Pais Incapacitados/psicologia , Transtornos Mentais , Pessoas Mentalmente Doentes/psicologia , Pais/psicologia , Adolescente , Criança , Humanos , Transtornos Mentais/prevenção & controle
10.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 416-425, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886051

RESUMO

Early Childhood Intervention for Children of Parents with Mental Health Issues - Results of the Research Program of the National Center for Early Prevention In Germany, networks and measures of early childhood intervention (ECI) have been implemented nationwide. By specifically targeting families with multiple psychosocial challenges, ECI contributes to the enhancement of families' parenting skills, in order to promote equal opportunities for all children to grow up healthy and safe. In many families supported by ECI measures at least one parent shows symptoms of a mental health disorder, which poses a major challenge to ECI practitioners. Nevertheless, there is a lack of valid scientific knowledge about the proportion of young families living with symptoms of mental disorders, the degree to which parents' psychic burdens affect care in ECI measures and about the cooperation of different care providing systems. The National Center for Early Prevention (NCEP) monitors and evaluates the scaling up of ECI networks and measures in Germany. The present article compiles results of different NCEP studies focusing on parents with mental illness in Early Childhood Intervention. Results are discussed with regard to their relevance for further improving the care systems.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/prevenção & controle , Pais/psicologia , Medicina Preventiva , Criança , Suscetibilidade a Doenças , Alemanha , Humanos , Transtornos Mentais/reabilitação , Saúde Mental , Poder Familiar/psicologia
13.
Medicine (Baltimore) ; 99(33): e21484, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871994

RESUMO

BACKGROUND: The objective of this study is to investigate the effects of humanistic care and psychological counseling (HCPC) on psychological disorders (PD) in medical students after coronavirus disease 2019 (COVID-19) outbreak. METHODS: We will search randomized controlled trials or case-controlled studies of HCPC on PD in medical students after COVID-19 outbreak in the following electronic databases: PUBMED/MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED, WANGFANG, and CNKI. The time is restricted from the construction of each database to the present. All process of study selection, data collection, and study quality evaluation will be carried out by two independent authors. Any different opinions will be solved by a third author through discussion. We will employ RevMan 5.3 software to conduct statistical analysis. RESULTS: This study will provide a better understanding of HCPC on PD in medical students after COVID-19 outbreak. CONCLUSIONS: This study may offer strong evidence for clinical practice to treat PD in medical students after COVID-19 outbreak. STUDY REGISTRATION: CRD42020193199.


Assuntos
Infecções por Coronavirus/psicologia , Aconselhamento/métodos , Transtornos Mentais/terapia , Pneumonia Viral/psicologia , Psicoterapia/métodos , Estudantes de Medicina/psicologia , Adulto , Betacoronavirus , Estudos de Casos e Controles , Feminino , Humanismo , Humanos , Masculino , Transtornos Mentais/psicologia , Pandemias , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Adulto Jovem
14.
J Prim Care Community Health ; 11: 2150132720953682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865107

RESUMO

INTRODUCTION: COVID-19 is causing an enormous psychological burden for most people. This study aims to assess individual changes in mental health and health status before and after the COVID-19 outbreak, and to explore potential predictors of change. METHODS: A cross-sectional study in Germany (n = 15 037) were conducted. Demographics, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L) were assessed. Additionally, all instruments used were adapted to measure the participants' mental health and health status before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information about COVID-19 were examined. RESULTS: Overall, the participants showed a significant increase in depression and anxiety symptoms, and distress, while health status deteriorated since the COVID-19 outbreak. Impairment in mental health was predicted by COVID-19-related fear. Pre-existing mental illness predicted an increase in depression symptoms and a deterioration in health status. Trust in governmental actions and the subjective level of information predicted less increase in psychological burden. CONCLUSIONS: Our data revealed that there have been changes in mental health and health status at an individual level since the outbreak of COVID-19. In order to maintain mental health, the observed predictors should be addressed.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Surtos de Doenças , Transtornos Mentais/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Medo/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Adulto Jovem
16.
Cien Saude Colet ; 25(9): 3401-3411, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876269

RESUMO

Pandemics such as that of COVID-19 affect a relatively large number of people and impose new rules and social habits on the world population. Information about the pandemic is constant in the media. Moreover, social distancing has been adopted in Brazil to prevent the spread of COVID-19, which may have economic and psychosocial consequences. This study aimed to verify the factors associated with indicators of mental disorders symptoms in residents of Rio Grande do Sul during the initial period of the social distancing policy. The study was approved by CONEP. There were 799 participants, aged between 18 and 75 years (M = 36.56; SD = 12.88); 82.7% were women, who answered a sociodemographic questionnaire of social distancing and the Self-Report Questionnaire (SRQ-20). The results indicated that having decreased income in the period, being part of the risk group and being more exposed to information about deaths and infected, are factors that can significantly harm mental health in this pandemic period. Investigating social determinants that contribute to greater vulnerability to the mental illness of the population is vital in the field of collective health for the planning of public actions and policies.


Assuntos
Infecções por Coronavirus/epidemiologia , Transtornos Mentais/epidemiologia , Saúde Mental , Pneumonia Viral/epidemiologia , Isolamento Social/psicologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Política de Saúde , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/psicologia , Fatores de Risco , Adulto Jovem
17.
Cien Saude Colet ; 25(9): 3465-3474, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876270

RESUMO

This work aims to systematize a set of scientific evidence presented in international papers that identify the main problems affecting health professionals directly involved in coping with the COVID-19 pandemic and point out actions and strategies for the protection and healthcare of these professionals. The risk of infection is the main issue and has led to absence from work, illness, death, and intense psychological distress, expressed in generalized anxiety and sleep disorders, fear of becoming ill and infecting colleagues and relatives. In the Brazilian reality, this work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training, given the expanded hospital bed infrastructure and reorganization of the work process in primary care to face the pandemic, emphasizing the necessary measures for the protection and promotion of the physical and mental health of health professionals and workers.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/epidemiologia , Adaptação Psicológica , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Saúde Mental , Programas Nacionais de Saúde/organização & administração , Pandemias , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Estresse Psicológico/epidemiologia
18.
Epidemiol Psychiatr Sci ; 29: e164, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32883399

RESUMO

AIMS: To identify and categorise core components of effective stigma reduction interventions in the field of mental health in low- and middle-income countries (LMICs) and compare these components across cultural contexts and between intervention characteristics. METHODS: Seven databases were searched with a strategy including four categories of terms ('stigma', 'mental health', 'intervention' and 'low- and middle-income countries'). Additional methods included citation chaining of all papers identified for inclusion, consultation with experts and hand searching reference lists from other related reviews. Studies on interventions in LMICs aiming to reduce stigma related to mental health with a stigma-related outcome measure were included. All relevant intervention characteristics and components were extracted and a quality assessment was undertaken. A 'best fit' framework synthesis was used to organise data, followed by a narrative synthesis. RESULTS: Fifty-six studies were included in this review, of which four were ineffective and analysed separately. A framework was developed which presents a new categorisation of stigma intervention components based on the included studies. Most interventions utilised multiple methods and of the 52 effective studies educational methods were used most frequently (n = 83), and both social contact (n = 8) and therapeutic methods (n = 3) were used infrequently. Most interventions (n = 42) based their intervention on medical knowledge, but a variety of other themes were addressed. All regions with LMICs were represented, but every region was dominated by studies from one country. Components varied between regions for most categories indicating variation between cultures, but only a minority of studies were developed in the local setting or culturally adapted. CONCLUSIONS: Our study suggests effective mental health stigma reduction interventions in LMICs have increased in quantity and quality over the past five years, and a wide variety of components have been utilised successfully - from creative methods to emphasis on recovery and strength of people with mental illness. Yet there is minimal mention of social contact, despite existing strong evidence for it. There is also a lack of robust research designs, a high number of short-term interventions and follow-up, nominal use of local expertise and the research is limited to a small number of LMICs. More research is needed to address these issues. Some congruity exists in components between cultures, but generally they vary widely. The review gives an in-depth overview of mental health stigma reduction core components, providing researchers in varied resource-poor settings additional knowledge to help with planning mental health stigma reduction interventions.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Atenção Primária à Saúde/métodos , Discriminação Social , Estigma Social , Estereotipagem , Humanos
19.
Psychiatr Danub ; 32(Suppl 1): 29-32, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890358

RESUMO

BACKGROUND: The multidisciplinary management of disabling chronic tinnitus in the audiophonology centre demonstrates its relevance. The detection and treatment of overlapping psychiatric pathologies is a crucial issue in the work of liaison psychiatry. SUBJECTS AND METHODS: A 10-year retrospective review of the activities of a university audiophonology centre with 166 patients who consulted for disabling chronic tinnitus and who underwent a Mini International Neuropsychiatric Interview. The diagnostic criteria used were those of the DSM IV. RESULTS: Our sample shows that major depressive disorders, somatoform disorders and sleep disorders were the most frequently encountered. Alcohol misuse was also seen as the most common substance-related disorder. Thirty (30%) had prior psychiatric or psychological monitoring, and 60% were previously treated with at least one psychotropic drug. CONCLUSION: The systematic approach of liaison psychiatry appears to be essential in the treatment of disabling chronic tinnitus, given the associated psychiatric comorbidity. Beyond the detection of unrecognized or untreated disorders, patient education to attentional mechanisms and hypervigilance, which reinforce an unpleasant perception of tinnitus, as well as the management of stress and somatizations and sleep hygiene, is recommended.


Assuntos
Transtorno Depressivo Maior , Transtornos Mentais , Zumbido , Comorbidade , Transtorno Depressivo Maior/complicações , Humanos , Transtornos Mentais/complicações , Estudos Retrospectivos , Inquéritos e Questionários , Zumbido/complicações
20.
Psychiatr Danub ; 32(Suppl 1): 58-63, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890364

RESUMO

INTRODUCTION: The present retrospective study investigated clinical correlates of the revolving door (RD) phenomenon in a population of subjects affected by Bipolar Disorders (BDs). SUBJECTS AND METHODS: Medical records of subjects with BDs admitted to a psychiatric inpatient unit over a 5-year period of time were retrospectively reviewed and clinical data were extracted into an electronic dataset. "Revolving Door Subjects" (RDS) were defined as those who presented three or more "Revolving Door Hospitalizations" (RDH) during twelve months. Features of RDH were compared with non-RDH in order to identify characteristics associated with RD phenomenon and possible risk factors for readmission. To explore predictors of RDH, a stepwise backword logistic regression model was built, including the variables that were significantly associated with RDH in the bivariate analyses. RESULTS: In our sample of 176 subjects affected by BDs, 53 (19.9%) RDH were identified. In the RDH group, a higher prevalence of mixed episodes (p=0.029) and medical co-morbidities (p=0.004) was detected. Subjects with repeated hospitalizations were more often committed to psychiatric residential facilities at discharge (p=0.002). Treatment features related to RDH were represented by a higher prescription rate of atypical antipsychotics (p=0.030), benzodiazepines (p=0.001) and antidepressants (p=0.048). CONCLUSIONS: Findings from the present study suggest that the early identification and treatment of medical comorbidities and specific clinical features of BDs may help reducing the RD phenomenon in this population of subjects.


Assuntos
Antipsicóticos , Transtorno Bipolar , Transtornos Mentais , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Hospitalização , Humanos , Pacientes Internados , Estudos Retrospectivos
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