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1.
Artigo em Inglês | MEDLINE | ID: mdl-32898346

RESUMO

Objective: To investigate the impact of reminder-focused positive psychiatry (RFPP) on attention-deficit/hyperactive disorder (ADHD) and posttraumatic stress disorder (PTSD) symptoms, vascular-function, inflammation and well-being of adolescents with comorbid ADHD and PTSD. Methods: After obtaining informed-consent, 11 adolescents were randomized to RFPP (n = 5) or trauma-focused cognitive-behavioral therapy (TF-CBT) (n = 6). Eight participants (RFPP: n = 4, TF-CBT: n = 4) completed the twice-weekly intervention for a 6-week trial. The RFPP intervention was inclusive of positive psychiatry interventions on (1) traumatic reminders and (2) avoidance and negative cognition. Vascular function measured as temperature rebound, C-reactive protein, homocysteine, ADHD Swanson, Nolan, and Pelham (SNAP) Questionnaire, Clinician-Administered PTSD Scale for DSM-5-Child/Adolescent Version (CAPS-CA), and neuropsychiatric-measures were measured at baseline and 6 weeks. Subjects were followed for 12 months. The study was conducted from September 2016 to June 2018. Results: A significant improvement in CAPS-CA, SNAP scores, and vascular function of both RFPP and TF-CBT groups was noted at follow-up, but was more-robust in the RFPP group (P < .05). At the sixth week, a significant increase in PERMA, gratitude, resilience, and Posttraumatic Growth Inventory scores and a significant decrease in homocysteine and C-reactive protein levels in the RFPP group, but not the TF-CBT group, were noted (P < .05). At 12-month follow-up, there was no psychiatry hospitalization or suicide ideation reported in either group. A continuation of significant improvement in CAPS-CA and SNAP scores in both groups was noted but was more robust in the RFPP group (P < .05). Similarly, a continuation of significant increase in PERMA, gratitude, resilience and Posttraumatic Growth Inventory scores was noted in the RFPP group but not in the TF-CBT group (P < .05). Conclusions: RFPP is associated with improvement in core PTSD and ADHD symptoms, decrease in inflammation, and increase in well-being, vascular function, and posttraumatic growth, as well as a favorable long-term clinical outcome. This finding highlights the importance of the dual role of RFPP in addressing vulnerability symptoms as well as enhancing well-being in youth with comorbid ADHD and PTSD. Trial Registration: ClinicalTrials.gov identifier: NCT04336072.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Comorbidade , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Resultado do Tratamento
3.
Artigo em Alemão | MEDLINE | ID: mdl-32916737

RESUMO

Interdisciplinary multimodal pain therapy (IMPT) is based on the biopsychosocial model of pain and describes an integrated treatment for patients with chronic pain. IMPT incorporates a close cooperation of different disciplines, including physicians, psychotherapists, physiotherapists, and others. IMPT mainly aims to restore and increase patients' physical, social and psychological functional capacity. The efficacy of IMPT has been evidenced by systematic reviews and meta-analyses. A number of studies further indicate IMPT's cost-efficiency. Psychotherapy is an essential component of IMPT. Its main goal within the framework of IMPT is to identify and modify dysfunctional patterns of pain coping, and to diagnose and potentially treat psychological comorbidities. Pain psychotherapy comprises mostly cognitive-behavioral interventions which address dysfunctional coping at the three levels of the pain experience (i.e., cognitive, emotional, and behavioral). Research into the efficacy of pain psychotherapy is rather sparse and studies have mostly focused on chronic back pain, yet existing results show promising evidence both for psychotherapy within IMPT and for psychotherapy as a monotherapy. This paper aims at providing an overview of (a) commonly employed cognitive-behavioral psychotherapeutic approaches and strategies in the treatment of chronic pain, and (b) the existing empirical evidence of pain psychotherapy both within the framework of IMPT and as a monotherapy. Future research should include a wider range of pain diagnoses and also investigate the potential benefit of individually-tailored treatments.


Assuntos
Dor Crônica , Psicoterapia , Dor nas Costas , Terapia Combinada , Humanos , Metanálise como Assunto , Manejo da Dor , Revisões Sistemáticas como Assunto
4.
Z Kinder Jugendpsychiatr Psychother ; 48(5): 369-379, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32880227

RESUMO

Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.


Assuntos
Psicoterapia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adolescente , Humanos , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(33): e21451, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871992

RESUMO

BACKGROUND: Mental health is closely related to the occurrence of hypertension, particularly the prognosis of hypertension patients. The role of psychotherapy in the occurrence, development, prevention, and prognosis of hypertension, remains to be clarified. METHODS/DESIGN: We will conduct a prospective, double-blind, randomized, multiple-centers study. Eighty patients enrolled in this trial will be randomized at 1:1 ratio. The primary endpoint is will be the reduction of the patient psychological scale (PHQ-9) score. Secondary endpoints will be the drop in blood pressure, awareness of physical and mental health and self-efficacy scale. Measurements will be performed at baseline, 5-week (questionnaires only), 10-week (primary endpoint), using the Anxiety Screening Questionnaire (GAD-7) and Depression Scale (PHQ-9). Data analysis will be carried out using the SPSS v.25 software assuming a level of significance of 5%. Results will be analyzed using multilevel, regression analysis and hierarchical linear models. DISCUSSION: We hope to provide some insight in the understanding the underlying mechanism of the novel mindfulness in the management of hypertension related psychological stress/disturbance, and will enable us to develop novel approach to manage essential hypertension and its related psychological disorders. CLINICAL TRIAL REGISTRY:: http://www.chictr.org.cn (ChiCTR1900028258).


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Hipertensão/psicologia , Hipertensão/terapia , Psicoterapia/métodos , Método Duplo-Cego , Humanos , Prognóstico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Psychiatr Danub ; 32(Suppl 1): 167-171, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890384

RESUMO

BACKGROUND: Video game has become the preferred form of play among youth. Substantial research has mainly examined problems related to potential negative effects of video games ranging from sedentary screen time, exposure to violence, and excessive or problematic gaming. However, over the past two decades, the use of video games in psychotherapy has become increasingly popular with a lot of applications. SUBJECTS AND METHODS: After a review of the use and the effectiveness of commercial video games in the psychotherapy framework, we will share our experience in the use of video games in a child and adolescent psychiatric unit. We will illustrate it with the presentation of specific case reports. RESULT: As video games are highly popular among children and adolescents, they are also interesting tools in the psychotherapeutic work with them. It's a new kind of play therapy, considering the setting, the psychological material that expresses during the game, the interpersonal relationships between gamers, the projective representation within the avatars, the cognitive strategies within the game. CONCLUSIONS: Video games represent an essential tool in taking care of child psychiatric patients because of their popularity. They contribute greatly to build the patient/psychotherapist relationship. They help to approach cognitive, emotional and social patient's functioning, and also psychopathologic understanding and then psychiatric diagnosis.


Assuntos
Comportamento do Adolescente , Transtornos Mentais , Jogos de Vídeo , Adolescente , Criança , Humanos , Relações Interpessoais , Psicoterapia
7.
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
8.
FP Essent ; 495: 23-30, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32757563

RESUMO

Posttraumatic stress disorder (PTSD) has a lifetime incidence of approximately 6.1% in the US population. However, studies of patients receiving regular primary care have shown a higher point prevalence, ranging from 11.1% to 24.5%. Multiple factors have been implicated in the etiology of PTSD, including genes, epigenetic regulation, neuroendocrine factors, inflammatory markers, autonomic risk and resilience, and sleep disturbances. There are many risk factors for PTSD, including exposure to trauma at a younger age, a high number of adverse childhood experiences, and a previous diagnosis of a mental disorder. Military personnel, police officers, and first responders who experience repeated or extreme exposure to traumatic events are at increased risk of PTSD. The National Institute for Health and Care Excellence (NICE) recommends that clinicians in the primary care setting consider screening for PTSD in patients with unexplained physical symptoms that may be associated with PTSD. Multiple evidence-based screening tools are available. If the patient is willing, psychotherapy is the treatment of choice, followed by combined psychotherapy and pharmacotherapy. PTSD is associated with many significant comorbidities and mortality.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Criança , Comorbidade , Epigênese Genética , Humanos , Psicoterapia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia
9.
Artigo em Chinês | MEDLINE | ID: mdl-32842218

RESUMO

The Chinese guideline on sublingual immunotherapy(SLIT) for allergic rhinitis and asthma(English edition) has been developed by a panel of experts on behalf of the Chinese Society of Allergy, and published in December 2019. The guideline is herein organized to outline the critical items, including the epidemiology of allergic rhinitis and asthma, clinical application and mechanisms of SLIT, standardized procedure, indications and contraindications, therapeutic process, and future perspective, to guide and improve the clinical practice of SLIT.


Assuntos
Asma , Rinite Alérgica , Imunoterapia Sublingual , Humanos , Psicoterapia
10.
Lancet Psychiatry ; 7(9): 801-812, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32828168

RESUMO

Persistent depressive disorder is a chronic mood disorder that is common and often more disabling than episodic major depression. In DSM-5, the term subsumes several chronic depressive presentations, including dysthymia with or without superimposed major depressive episodes, chronic major depression, and recurrent major depression without recovery between episodes. Dysthymia can be difficult to detect in psychiatric and primary care settings until it intensifies in the form of a superimposed major depressive episode. Although information is scarce concerning the cause of persistent depressive disorder including dysthymia, the causation is likely to be multifactorial. In this narrative Review, we discuss current knowledge about the nosology and neurobiological basis of dysthymia and persistent depressive disorder, emphasising a dimensional perspective based on course for further research. We also review new developments in psychotherapy and pharmacotherapy for persistent depressive disorder, and propose a tailored, modular approach to accommodate its multifaceted nature.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Transtorno Distímico/diagnóstico , Transtorno Distímico/terapia , Antidepressivos/uso terapêutico , Doença Crônica , Terapia Combinada , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno Distímico/epidemiologia , Humanos , Psicoterapia/métodos , Recidiva
12.
Fam Process ; 59(3): 989-996, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32743795

RESUMO

This paper addresses the need for a swift transition from in-person clinical supervision to telesupervision during the time of the COVID-19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID-19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID-19; (3) the supervisee's competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees' vulnerabilities in the face of COVID-19.


Assuntos
Infecções por Coronavirus/psicologia , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Pneumonia Viral/psicologia , Psicoterapia/organização & administração , Telemedicina/organização & administração , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Terapia de Casal/métodos , Terapia Familiar/métodos , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Telemedicina/métodos
13.
PLoS Med ; 17(8): e1003262, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32813696

RESUMO

BACKGROUND: Complex traumatic events associated with armed conflict, forcible displacement, childhood sexual abuse, and domestic violence are increasingly prevalent. People exposed to complex traumatic events are at risk of not only posttraumatic stress disorder (PTSD) but also other mental health comorbidities. Whereas evidence-based psychological and pharmacological treatments are effective for single-event PTSD, it is not known if people who have experienced complex traumatic events can benefit and tolerate these commonly available treatments. Furthermore, it is not known which components of psychological interventions are most effective for managing PTSD in this population. We performed a systematic review and component network meta-analysis to assess the effectiveness of psychological and pharmacological interventions for managing mental health problems in people exposed to complex traumatic events. METHODS AND FINDINGS: We searched CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, International Pharmaceutical Abstracts, MEDLINE, Published International Literature on Traumatic Stress, PsycINFO, and Science Citation Index for randomised controlled trials (RCTs) and non-RCTs of psychological and pharmacological treatments for PTSD symptoms in people exposed to complex traumatic events, published up to 25 October 2019. We adopted a nondiagnostic approach and included studies of adults who have experienced complex trauma. Complex-trauma subgroups included veterans; childhood sexual abuse; war-affected; refugees; and domestic violence. The primary outcome was reduction in PTSD symptoms. Secondary outcomes were depressive and anxiety symptoms, quality of life, sleep quality, and positive and negative affect. We included 116 studies, of which 50 were conducted in hospital settings, 24 were delivered in community settings, seven were delivered in military clinics for veterans or active military personnel, five were conducted in refugee camps, four used remote delivery via web-based or telephone platforms, four were conducted in specialist trauma clinics, two were delivered in home settings, and two were delivered in primary care clinics; clinical setting was not reported in 17 studies. Ninety-four RCTs, for a total of 6,158 participants, were included in meta-analyses across the primary and secondary outcomes; 18 RCTs for a total of 933 participants were included in the component network meta-analysis. The mean age of participants in the included RCTs was 42.6 ± 9.3 years, and 42% were male. Nine non-RCTs were included. The mean age of participants in the non-RCTs was 40.6 ± 9.4 years, and 47% were male. The average length of follow-up across all included studies at posttreatment for the primary outcome was 11.5 weeks. The pairwise meta-analysis showed that psychological interventions reduce PTSD symptoms more than inactive control (k = 46; n = 3,389; standardised mean difference [SMD] = -0.82, 95% confidence interval [CI] -1.02 to -0.63) and active control (k-9; n = 662; SMD = -0.35, 95% CI -0.56 to -0.14) at posttreatment and also compared with inactive control at 6-month follow-up (k = 10; n = 738; SMD = -0.45, 95% CI -0.82 to -0.08). Psychological interventions reduced depressive symptoms (k = 31; n = 2,075; SMD = -0.87, 95% CI -1.11 to -0.63; I2 = 82.7%, p = 0.000) and anxiety (k = 15; n = 1,395; SMD = -1.03, 95% CI -1.44 to -0.61; p = 0.000) at posttreatment compared with inactive control. Sleep quality was significantly improved at posttreatment by psychological interventions compared with inactive control (k = 3; n = 111; SMD = -1.00, 95% CI -1.49 to -0.51; p = 0.245). There were no significant differences between psychological interventions and inactive control group at posttreatment for quality of life (k = 6; n = 401; SMD = 0.33, 95% CI -0.01 to 0.66; p = 0.021). Antipsychotic medicine (k = 5; n = 364; SMD = -0.45; -0.85 to -0.05; p = 0.085) and prazosin (k = 3; n = 110; SMD = -0.52; -1.03 to -0.02; p = 0.182) were effective in reducing PTSD symptoms. Phase-based psychological interventions that included skills-based strategies along with trauma-focused strategies were the most promising interventions for emotional dysregulation and interpersonal problems. Compared with pharmacological interventions, we observed that psychological interventions were associated with greater reductions in PTSD and depression symptoms and improved sleep quality. Sensitivity analysis showed that psychological interventions were acceptable with lower dropout, even in studies rated at low risk of attrition bias. Trauma-focused psychological interventions were superior to non-trauma-focused interventions across trauma subgroups for PTSD symptoms, but effects among veterans and war-affected populations were significantly reduced. The network meta-analysis showed that multicomponent interventions that included cognitive restructuring and imaginal exposure were the most effective for reducing PTSD symptoms (k = 17; n = 1,077; mean difference = -37.95, 95% CI -60.84 to -15.16). Our use of a non-diagnostic inclusion strategy may have overlooked certain complex-trauma populations with severe and enduring mental health comorbidities. Additionally, the relative contribution of skills-based intervention components was not feasibly evaluated in the network meta-analysis. CONCLUSIONS: In this systematic review and meta-analysis, we observed that trauma-focused psychological interventions are effective for managing mental health problems and comorbidities in people exposed to complex trauma. Multicomponent interventions, which can include phase-based approaches, were the most effective treatment package for managing PTSD in complex trauma. Establishing optimal ways to deliver multicomponent psychological interventions for people exposed to complex traumatic events is a research and clinical priority.


Assuntos
Saúde Mental , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/psicologia , Antipsicóticos/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Comorbidade , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Transtornos de Estresse Pós-Traumáticos/epidemiologia
15.
Z Kinder Jugendpsychiatr Psychother ; 48(4): 303-317, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32614281

RESUMO

Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.


Assuntos
Psiquiatria do Adolescente , Comportamento Aditivo , Psiquiatria Infantil , Internet , Psicoterapia , Sociedades Médicas , Adolescente , Psiquiatria do Adolescente/estatística & dados numéricos , Comportamento Aditivo/epidemiologia , Criança , Psiquiatria Infantil/estatística & dados numéricos , Comorbidade , Alemanha , Humanos , Mídias Sociais , Inquéritos e Questionários , Jogos de Vídeo
16.
Soins Psychiatr ; 41(326): 20-23, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32718522

RESUMO

Psychologists occupy a specific position in the care process in addictology. The basic notions of care are considered from the perspective of a professional experience in an addiction care, support and prevention unit in the Paris region. These fundamental notions offer insights into how the psychologist's psychotherapeutic methods can be integrated into the care process, as well as the potential pitfalls.


Assuntos
Medicina do Vício/organização & administração , Comportamento Aditivo/terapia , Psicologia , Humanos , Paris , Psicoterapia/métodos
17.
Med Lav ; 111(3): 232-240, 2020 Jun 26.
Artigo em Italiano | MEDLINE | ID: mdl-32624565

RESUMO

INTRODUCTION: The management of workers with mental disability is a current topic of great interest. The aim of the article is to report the experience of managing cases of employees with mental disabilities in an Italian university hospital and to describe the preventive measures adopted and the therapeutic programs carried out. METHODS: A group of 100 workers suffering from psychiatric disorders has been included in a medical surveillance program lasting at least 6 months. The workers were followed up within a protocol that included psychiatric visits, psychotherapeutic interventions, visits by the occupational physician and medico-legal evaluations. Evaluation scales of disease severity and treatment efficacy (CGI) and overall functioning (GAF) were administered at the baseline and after 6 months of follow-up. RESULTS: The sample was mainly composed of nurses (44%) and nursing assistants (24%) and the most commonly diagnosed disorders were mood and anxiety disorders. Participation in the medical surveillance program with the implementation of specific therapeutic strategies and organizational interventions resulted in a statistically significant reduction in the severity of the disease and an improvement in overall functioning and made it possible to keep the job and place of work in almost all cases. DISCUSSION: The results of this experience allow us to affirm that the integration of skills is a valid tool both for the multidisciplinary diagnostic assessment and for the monitoring and management of workers with mental disability under periodic health surveillance.


Assuntos
Transtornos Mentais , Saúde do Trabalhador , Transtornos de Ansiedade , Humanos , Itália , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Saúde Mental , Psicoterapia , Resultado do Tratamento
19.
Fam Process ; 59(3): 883-897, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32621761

RESUMO

The Witness to Witness Program (W2W), based on Weingarten's witnessing model (2000, 2003, 2004), began in July 2018 and originally was established to support healthcare workers and attorneys (our partners) who were experiencing empathic distress working with people involved in various stages of the detention process. The W2W program evolved to offer four primary components: clinician listening sessions geared to deep understanding of the person's story of their work and its challenges; an inventory of the person's current internal and external resources both in the present and in the past; help with removal of barriers to those resources; and development of a personal toolkit to handle stress. Additional services available to partners and their organizations included psycho-educational webinars, facilitated peer support groups, and organizational consultations to foster trauma-sensitive and resilience-hardy work environments. In March, after lockdowns due to the coronavirus pandemic, W2W pivoted to focus on handouts and webinars addressing how to cope with distress and moral injury, maintaining resilience, coping with grief, and dealing with multiple losses caused by the pandemic. Disaster sparked collaboration and innovation. A train the trainer model was developed to reach more community health workers providing services to the Latinx community dealing with losses similar to those experienced by the clients they serve. W2W continues to create virtual communities of support. In doing so we practice doing reasonable hope together (Weingarten, Family Process, 2010, 49, 5).


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Doenças Profissionais/terapia , Pneumonia Viral/psicologia , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Adaptação Psicológica , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Pesar , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Avaliação de Programas e Projetos de Saúde , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos/epidemiologia , Local de Trabalho/psicologia
20.
Georgian Med News ; (302): 86-92, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32672696

RESUMO

Duration of remission (DR) is the equivalent of the risk of re-hospitalization, which is considered as evidence of unsuccessful completion of the prescribed treatment. The evidence of DR informativeness as a criterion for effectiveness of prescriptions is distribution of DR values among patients with re-hospitalization during the observation period. The aim of the study is to analyse the duration of remission as a criterion for the effectiveness of prescribing atypical antipsychotic drugs and psychotherapy for patients with paranoid schizophrenia. 4 groups of patients were formed: the study group No. 1 includes patients who received atypical antipsychotic drugs; the study group No. 2 includes patients who received atypical antipsychotic drugs and psychotherapeutic cortrection (PC); the control group No. 1 includes patients receiving typical antipsychotic drugs; the control group No. 2 includes patients who received typical antipsychotic drugs and PC. The total number of examined patients was 164 people, the average age was 29.25±13.5 years, the number of patients with a diagnosis of paranoid schizophrenia was 118, with a diagnosis of acute polymorphic psychotic disorder with symptoms of schizophrenia - 46. The average duration of the disease was 2.7±2.1 years. The statistical tobit model made it possible to objectify the results of the effectiveness of the combination of antipsychotic drugs, psychotherapy, and DR by the studied patients. We used the tobit model to test the power of hypotheses, i.e., the possibility of this model to determine the existing differences in the effectiveness of the compared treatment methods (Rosenbaum and Rubin, 1983; Wooldridge, J.M., 2012). The effectiveness of the treatment was evaluated by indicators of duration of the remission period by the patients and the risk of re-hospitalization due to disease relapse. We observed a clear dynamic of some patients to re-hospitalization during the observation period with the highest hospitalization rates in the first 100 days. Evidence of the tests powers was a clear prevalence of cases of re-hospitalization by the patients taking typical antipsychotic drugs (44 cases) compared with those among patients receiving atypical ones (12). There was a clear predominance of cases of prolonged remission by the patients who took atypical antipsychotic drugs (70) compared with those who received typical ones (38) among 108 of censored ones. It was determined that patients who took typical and atypical antipsychotic drugs entered remission with the same period, but its quality was different. It was found that the indices of DR by prescription of atypical antipsychotic drugs and PC were significantly higher compared with those of typical antipsychotic drugs - the integral difference in DR per patient was 140 days. The risk of re-hospitalization due to prescription of atypical antipsychotic drugs decreases on average by 87.8% compared with prescription of the typical ones, that is, prescription of atypical antipsychotic drugs significantly increases DR compared with prescription of typical antipsychotic drugs.


Assuntos
Antipsicóticos/uso terapêutico , Transtornos Psicóticos , Adolescente , Adulto , Hospitalização , Humanos , Psicoterapia , Esquizofrenia Paranoide/tratamento farmacológico , Adulto Jovem
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