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We present a social-historical perspective on the evolution of the voice-hearing phenomenon in Western society. Based upon a systematic search from a selection of nine databases, we trace the way hearing voices has been understood throughout the ages. Originally, hearing voices was considered a gifted talent for accessing the divine, but the progressive influence of monotheistic religion gradually condemned the practice to social marginalization. Later, the medical and psychiatric professions of secular society were instrumental in attaching stigma to both voice hearers and the phenomenon itself, thereby reinforcing social exclusion. More recently, the re-integration of voice hearers into the community by health authorities in various countries appears to have provided a new, socially acceptable setting for the phenomenon.
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Alucinações , Humanos , Alucinações/história , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , Transtornos Psicóticos/história , Estigma Social , Ocidente/históriaRESUMO
BACKGROUND: Dance therapy is thought to improve mental and physical health by activating psychological and physiological processes such as motor coordination, and expression of emotions. Some currently used mind-body interventions for posttraumatic symptoms address both mental and physical health. Although some studies have evaluated the efficacy of dance therapy for posttraumatic symptoms, a systematic review of extant research has not been conducted. OBJECTIVES: To identify the effects of dance therapy in adults with psychological trauma as well as the barriers and facilitators associated with its therapeutic use. METHOD: Articles published between 2000 and March 2023 have been selected with the help of six relevant keyword combinations applied on seven databases. Two reviewers independently screened 119 titles and abstracts against inclusion and exclusion criteria. Bias evaluation has been conducted with the help of the NIH study quality assessment tools and JBI's critical appraisal tools. A report of the results has been organized with the help of a thematic analysis. RESULTS: Of the 15 articles included, only one case study directly reports a diminution of pathognomonic symptoms of trauma. Other studies present improvements in the key aspects of trauma therapy: bodily sensations and perceptions, psychological processes, and interpersonal skills. These improvements depend on the stability of the intervention, the applied method (dance as therapy or dance/movement therapy), and likely, the skill set of the therapists. However, the reviewed studies lacked uniformity in assessments of adherence and its effect on therapeutic outcomes. CONCLUSION: Dance therapy may be a useful technique for improving both psychological and physiological symptoms associated with trauma exposure, such as avoidance and dissociative phenomena. To complement the results of this qualitative systematic review, further quantitative and qualitative research on the impact of dance therapy interventions as a trauma treatment should be conducted.
Dance therapy may be a promising approach for the therapeutic management of psychological trauma as it can address both psychological and physical symptoms.Therapist skills and training may be important factors to consider in evaluating the impact of dance therapy on posttraumatic symptoms.Dance/movement therapy, a specific type of dance therapy, appears to be associated with improvements in sensory-motor perceptions and motor skills.To date, examination of dance therapy as a trauma treatment in an adult population has been limited primarily to women and people facing migration.
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Dançaterapia , Trauma Psicológico , Adulto , Humanos , Dançaterapia/métodos , Psicoterapia , EmoçõesRESUMO
INTRODUCTION: The objective of this article is to identify the factors that influence the choice of contraceptive methods in the postpartum period. METHODS: We conducted a qualitative systematic review including articles published between 2000 and 2021 on postpartum contraception and its related influential factors. Relying on Preferred Reporting Items for Systematic Reviews and Meta-Analyses and synthesis without meta-analysis checklists, the search strategy relied on a combination of 2 lists of keywords applied to 9 databases. A bias assessment was carried out with the help of the Cochrane's randomized controlled trial tool, the checklist from Downs and Black, and Consolidated criteria for reporting qualitative research (CoreQ). A thematic analysis was performed to identify categories of influential factors. RESULTS: A total of 34 studies met our inclusion criteria and enabled us to isolate 4 categories of factors: (1) demographic and economic factors (geographic and ethnic origin, age, living environment, education/wealth), (2) clinical elements (parity, evolution of pregnancy, childbirth and afterwards, contraception used previously and its mechanism, pregnancy planning), (3) health care delivery (pregnancy monitoring, sessions about contraception, health care system, place of delivery), and (4) sociocultural factors (knowledge and beliefs about contraception, religion, the influence of family and society). The decision process related to postpartum contraception is influenced by a combination of socioenvironmental factors and clinical elements. DISCUSSION: The main influential factors (parity, level of education, knowledge and beliefs about contraception, and influence of family) need to be addressed by clinicians during consultations. Further multivariate research should provide quantitative data on this topic.
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Anticoncepcionais , Período Pós-Parto , Gravidez , Feminino , Humanos , Anticoncepção/métodos , Paridade , Parto , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Sexual behavior of psychiatric inpatients is often inadequately addressed within psychiatric institutions. This systematic review aimed to identify existing policies, guidelines, and recommendations regarding inpatient sexual behavior in psychiatric units, institutions, and supported housing across Europe in existing literature. It also aimed to assess the attitudes held by mental health professionals (MHPs) and inpatients toward existing policies, guidelines, and recommendations. Nine databases were searched in seven languages for articles published between 2000 and 2020. Double-blind bias assessment was performed on 10 articles. Five thematic categories emerged from the selected studies: (1) types of policies and guidelines; (2) MHPs' and inpatients' attitudes toward inpatient sexual behavior; (3) impact and strategies related to inpatient sexual behavior; (4) barriers to inpatient sexual behavior; and (5) facilitators to inpatient sexual behavior. Most screened publications reported implicit norms addressing inpatient sexual behavior among the staff. Surveyed MHPs and inpatients typically showed opposing attitudes regarding inpatient sexual behavior, with MHPs generally deeming such behavior unsafe and inpatients emphasizing it as their human right. The aims of this systematic review were partially fulfilled as articles reported little or no policy documents and guidelines and, therefore, did not allow for the assessment of policy impact. MHPs' attitudes toward inpatient sexual behavior were addressed and trends in several countries outside of Europe addressing inpatient sexual behavior were discussed. Finally, capacity to consent with respect to inpatient sexual behavior is discussed in the context of human rights.
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Habitação , Transtornos Mentais , Humanos , Comportamento Sexual , Transtornos Mentais/psicologia , Sexualidade , Políticas , Europa (Continente) , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Depression affects approximately 27% of adults with chronic kidney disease (CKD) and end-stage kidney failure (ESKF). Depression in this population is associated with impaired quality of life and increased mortality. The extent of inflammation and the impact on depression in CKD/ESKF is yet to be established. Through a systematic literature review and meta-analysis, we aim to understand the relationship between depression and inflammation in CKD/ESKF patients. METHODS: We searched nine electronic databases for published studies until January 2022. Titles and abstracts were screened against inclusion and exclusion criteria. Data extraction and study quality assessment was carried out independently by two reviewers. A meta-analysis was carried out where appropriate; otherwise a narrative review of studies was completed. RESULTS: Sixty studies met our inclusion criteria and entered the review (9481 patients included in meta-analysis). Meta-analysis of cross-sectional associations revealed significantly higher levels of pro-inflammatory biomarkers; C-reactive protein; Interleukin 6 (IL-6) and tumour necrosis factor-alpha in patients with depressive symptoms (DS) compared to patients without DS. Significantly lower levels of anti-inflammatory cytokine IL-10 were found in patients with DS compared to patients without DS. Considerable heterogeneity was detected in the analysis for most inflammatory markers. CONCLUSION: We found evidence for an association of higher levels of pro-inflammatory and lower anti-inflammatory cytokines and DS in patients with CKD/ESKF. Clinical trials are needed to investigate whether anti-inflammatory therapies will be effective in the prevention and treatment of DS in these patients with multiple comorbidities.
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Falência Renal Crônica , Insuficiência Renal Crônica , Adulto , Humanos , Qualidade de Vida , Estudos Transversais , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/complicações , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Inflamação/complicações , Citocinas , Anti-InflamatóriosRESUMO
Background: This qualitative systematic review provides an overview of existing studies on the desire for parenthood of people with intellectual disabilities. Method: The scientific studies were identified following the Prisma protocol on 18 databases using keywords relating to sexuality and parenting. Results: Sixteen studies have been included and three categories identified: the obstacles and motivations to becoming a parent; parents' decision making during pregnancy; and the social construction of a parental identity. The results from these studies show that people with intellectual disabilities have a genuine desire for children, which is repressed because of an unfavorable social context. Conclusion: Further clinical and participatory research is needed to better understand the singular modes of expression of people's intimate desires and how to better accompany them on this issue.
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BACKGROUND: Inflammation is a risk factor for chronic physical illnesses. Evidence is building that inflammation is also a risk factor for mental illnesses making inflammation a common mechanism which could explain the high comorbidity between mental and physical illnesses. METHODS: Based on a systematic search, a review on factors associated with inflammation in the depressed chronically ill has been conducted. Relevant articles have been selected according to the methodological considerations (scope, sample size, type of analysis and bias). RESULTS: Five categories of factors mediate the association between chronic physical and mental illnesses: (1) social-demographic factors, (2) social-economic background, (3) adverse health behaviours, (4) psychological stress and (5) genetics. Psychological therapies and medication also moderate this association. A theoretical model of the interplay between inflammation, depression and chronic physical illness is then presented. DISCUSSION: Inflammation contribute to both chronic physical and mental illnesses. These conclusions support future advances in clinical and research practice, as well as training and education.
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Depressão , Inflamação , Humanos , Doença Crônica , Comorbidade , Modelos TeóricosRESUMO
Background: For more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders. Methods: Using PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected. Results: A total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented. Conclusions: Recommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders.
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The objective of this systematic review is to make an inventory of the representations of the professionals of specialized institutions on the sexuality of persons with intellectual disabilities. The scientific studies were identified according to the PRISMA protocol using 18 databases, with keywords on sexuality and parenthood. Studies were reviewed through a methodological assessment and then a thematic analysis. Twenty-four studies were reviewed and three themes were identified: professionals' representations of gender, sexuality, and consent; professionals' perceptions of their role in supporting people's sexual lives; and the ways in which professionals construct representations of people's sexual lives. This corpus highlights deep paradoxes in the representations of professionals concerning the socio-affective needs and sexuality of people with intellectual disabilities, creating what we could define as a "system of incompatibility" and leading to difficulties in positioning. Support is still too random and subject to control logics in the name of protecting users, who are perceived as vulnerable. Training and new ways of teamwork appear to be central to supporting the evolution of the representations and practices of professionals. Future research anchored in practices and involving users as well as professionals is necessary to better understand the paradoxical aspects of professionals' representations and to draw alternative ways of constructing these representations.
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Deficiência Intelectual , Pessoas com Deficiência Mental , Identidade de Gênero , Humanos , Deficiência Intelectual/psicologia , Comportamento Sexual , Sexualidade/psicologiaRESUMO
OBJECTIVES: The objective of the present study was to identify the structure and content of the Social Representation (SR) of health professionals regarding elderly subjects with mental health disorders and compare the latter to the lay Social Representation identified in the literature. METHOD: The structure and content of the SR of health professionals was examined in 790 careproviders from the 'Grand Est' region of France through the use of the free and hierarchical associations methodology of Abric and Vergés. A prototypical and categorical analysis as well as a similarity analysis and factorial correspondence analysis were applied to the results. RESULTS: Analysis of the collated data revealed that the items 'chronic', 'dependent', 'behavior disorders', 'memory disorders', 'solitude' and 'social isolation' were the characteristic components of the central core of the social representation. DISCUSSION: Only the peripheral elements were more sensitive to the field of practice of each profession. These findings thus highlight that the SR of health professionals is substantially identical to that of the all-comer SR on several dimensions.
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Transtornos Mentais , Saúde Mental , Idoso , Atitude do Pessoal de Saúde , França , Pessoal de Saúde , Humanos , Projetos PilotoRESUMO
Episiotomy use has decreased due to the lack of evidence on its protective effects from maternal obstetric anal sphincter injuries. Indications for episiotomy vary considerably and there are a great variety of factors associated with its use. The aim of this article is to describe the episiotomy rate in France between 2013 and 2017 and the factors associated with its use in non-operative vaginal deliveries. In this retrospective population-based cohort study, we included vaginal deliveries performed in French hospitals (N = 584) and for which parity was coded. The variable of interest was the rate of episiotomy, particularly for non-operative vaginal deliveries. Trends in the episiotomy rates were studied using the Cochran-Armitage test. Hierarchical logistic regression was used to identify variables associated with episiotomy according to maternal age and parity. Between 2013 and 2017, French episiotomy rates fell from 21.6 to 14.3% for all vaginal deliveries (p < 0.01), and from 15.5 to 9.3% (p < 0.01) for all non-operative vaginal deliveries. Among non-operative vaginal deliveries, epidural analgesia, non-reassuring fetal heart rate, meconium in the amniotic fluid, shoulder dystocia, and newborn weight (≥ 4,000 g) were risk factors for episiotomy, both for nulliparous and multiparous women. On the contrary, prematurity reduced the risk of its use. For nulliparous women, breech presentation was also a risk factor for episiotomy, and for multiparous women, scarred uterus and multiple pregnancies were risk factors. In France, despite a reduction in episiotomy use over the last few years, the factors associated with episiotomy have not changed and are similar to the literature. This suggests that the decrease in episiotomies in France is an overall tendency which is probably related to improved care strategies that have been relayed by hospital teams and perinatal networks.
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Episiotomia/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Episiotomia/efeitos adversos , Episiotomia/tendências , Feminino , França , Humanos , Recém-Nascido , Padrões de Prática Médica/tendências , Gravidez , Estudos Retrospectivos , Fatores de RiscoRESUMO
For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs. In this context, considering the absence of an assessment battery designed for French individuals with particularly disabling, severe, and persistent mental illness (IDSPMI), we constructed an integrative assessment model adapted to this specific population. To select the most suitable tools for this population, a literature review (inspired by the PRISMA protocol) and a systematic review were combined with a clinical assessment study. The literature review first identified the cognitive and psycho-affective functions which mainly influence the day-to-day life adaptation of individuals engaged in a PSR/deinstitutionalization program. The systematic review then gathered all of the useable French validated tools to assess the initially selected dimensions (n = 87). To finish, for each dimension, the selected 87 tools were included in a clinical assessment study performed within a French psychiatric hospital. The authors collected and verified the characteristics of each tool (validity, French norms, French version, the average speed of the test, ease of use, ability to assess other dimensions). Their suitability was also assessed when applied to IDSPMI. Based on this final clinical evaluation, the authors selected one tool per function to create the French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS). This battery is an assessment tailored to the neurocognitive and psycho-affective potentials of IDSPMI. While further validation studies of this battery are ultimately required, the practical/clinical implications of this battery are presented and discussed.
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Episiotomy practice is influenced by many factors studied in the scientific literature. Evidence-based medicine has isolated many factors that are linked to episiotomy practice, thus creating a need to group all these factors to create a relevant and useful database for scientific research. Based on the PRISMA methodology, the authors conducted a systematic literature review with the aim of covering this very need. Using 12 French and English combinations of relevant keywords, 15 databases containing publications published between 2008 and 2018 were evaluated. A total of 63 articles were identified, grouped and categorised into four main themes in the results section: (1) Individual and clinical factors related to the mother, (2) individual and clinical factors related to the child, (3) technical factors, and (4) organisation of health care and professional factors (institutional, organisational, personal and professional factors). These factors are then presented in terms of their impact on the practice of episiotomy. Then the future implications of this study on scientific research and clinical practice are discussed.
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Episiotomia , Medicina Baseada em Evidências , Técnicas de Apoio para a Decisão , Parto Obstétrico/métodos , Episiotomia/efeitos adversos , Episiotomia/estatística & dados numéricos , Episiotomia/tendências , Feminino , Idade Gestacional , Humanos , Saúde Materna , Períneo/lesões , Padrões de Prática Médica , GravidezRESUMO
Episiotomy is an enlargement of the vaginal orifice made by a surgical incision of the perineum. This review aimed to provide a socio-historical retrospective on the practice or episiotomy. Using the criteria from the PRISMA guidelines, the authors conducted a literature review, browsing twenty databases and several papers available in the gray literature. Sixty-four articles, seven reports, and fifteen books were selected. Through this study, four eras with different approaches to episiotomy practice could be identified: 1792-1920, 1920-1980, 1980-1996, and 1996-2018. This review shows that institutionalization and medicalization of birth lead to a systematic practice of episiotomy in many westernized countries until 1996. Lay questioning and evidence-based medicine may have reversed this trend into a restrictive practice. After making an inventory of the factors associated with the evolution of change in the rate of episiotomies, the review finally revealed that evolution of the practice of episiotomy has also been influenced by ideological, political, and social factors.
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Parto Obstétrico/história , Episiotomia/história , Procedimentos Cirúrgicos Minimamente Invasivos/história , Feminino , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , HumanosRESUMO
In line with previous studies on elderly with mental disorders discrimination, a concept called "Psychosocial age" has been methodologically formalized and mathematically modelized. Its aim is to support health providers and hinder stigmatization process which is influenced by social representations of our population. This article presents the construction of this indicator and its clinical implications. A literature review was therefore firstly conducted to isolate the involved cognitive functions in psychosocial adaptation. Then a second literature review isolated French-language valid tests and their retained scores for mathematical modelization on each aforementioned selected cognitive function. Nine databases were reviewed (PsychInfo and PsycArticles, ScienceDirect, Web of Science, PubMed (Medline), Taylor & Francis, the Wiley Online Library, Cairn and Google Scholar). The selected articles are both in French or English and the publication period is between 2000 and 2017. The mathematical modelization is then psychometrically presented and illustrated by too clinical illustrations. Finally, strength and limits of the psychosocial age are exposed especially highlighting its interest in the institutional decision process.
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Envelhecimento/psicologia , Transtornos Mentais/psicologia , Estigma Social , Estereotipagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Testes Neuropsicológicos , PsicometriaRESUMO
First described at the beginning of the 1970s, the concept of birth medicalisation has experienced a theoretical and ideological evolution influenced by the lines of research that have been associated with it. This evolution has given rise to different schools of thought concerning medicalisation, but also various methodologies used in different scientific fields. It seems relevant to propose a global synthesis of the various lines of thought related to birth medicalisation. To do this, the authors conducted a systematic literature review based on the PRISMA method. With a total of 38 occurrences in French and English, the authors scrutinised 17 databases with a publication period between 1995 and 2018. A total of 112 documents (107 articles, 3 book chapters, 2 books) has been identified, grouped and categorised into five main themes in the results section (1) the theoretical evolution of the concept of medicalisation, (2) factors related to the birth medicalisation, (3) the impact of the birth medicalisation, (4) the humanisation of birth and (5) experiences related to childbirth. A reasoned synthesis of the literature is therefore carried out in each part and then discussed according to the selected lines of research that require development in order to guarantee the best possible accompaniment to women who give birth.
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Medicalização/normas , Parto , Humanismo , Humanos , Medicalização/tendências , Participação do Paciente/métodosRESUMO
BACKGROUND: Since the 2000s, selective episiotomy has been systematically recommended worldwide. In France, the recommended episiotomy rate in vaginal deliveries is less than 30%. The aims of this study were to describe the evolution of episiotomy rates between 2007 and 2014, especially for vaginal deliveries without instrumental assistance and to assess individual characteristics and birth environment factors associated with episiotomy. METHODS: This population-based study included all hospital discharge abstracts for all deliveries in France from 2007 to 2014. The use of episiotomy in vaginal deliveries was identified by one code in the French Common Classification of Medical Procedures. The episiotomy rate per department and its evolution is described from 2007 to 2014. A mixed model was used to assess associations with episiotomy for non-operative vaginal deliveries and the risk factors related to the women's characteristics and the birth environment. RESULTS: There were approximately 540,000 non-operative vaginal deliveries per year, in the study period. The national episiotomy rate for vaginal deliveries overall significantly decreased from 26.7% in 2007 to 19.9% in 2014. For non-operative deliveries, this rate fell from 21.1% to 14.1%. For the latter, the use of episiotomy was significantly associated with breech vaginal delivery (aOR = 1.27 [1.23-1.30]), epidural analgesia (aOR = 1.45 [1.43-1.47]), non-reassuring fetal heart rate (aOR = 1.47 [1.47-1.49]), and giving birth for the first time (aOR = 3.85 [3.84-4.00]). CONCLUSIONS: The episiotomy rate decreased throughout France, for vaginal deliveries overall and for non-operative vaginal deliveries. This decrease is probably due to proactive changes in practices to restrict the number of episiotomies, which should be performed only if beneficial to the mother and the infant.
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Parto Obstétrico/tendências , Episiotomia/tendências , Adulto , Feminino , França , Humanos , Gravidez , Estudos Retrospectivos , Fatores de Risco , Vagina , Adulto JovemRESUMO
The authors' purpose for this article is to identify, review and interpret all publications about the episiotomy rates worldwide. Based on the criteria from the PRISMA guidelines, twenty databases were scrutinized. All studies which include national statistics related to episiotomy were selected, as well as studies presenting estimated data. Sixty-one papers were selected with publication dates between 1995 and 2016. A static and dynamic analysis of all the results was carried out. The assumption for the decline in the number of episiotomies is discussed and confirmed, recalling that nowadays high rates of episiotomy remain in less industrialized countries and East Asia. Finally, our analysis aims to investigate the potential determinants which influence apparent statistical disparities.
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Parto Obstétrico/métodos , Episiotomia/tendências , Episiotomia/estatística & dados numéricos , Feminino , Humanos , GravidezRESUMO
This paper is aimed to improve the socio-psycho-therapeutic support for older patients with heavy psychiatric disability. First, we review the literature to question the specific grounds reported by professionals regarding the orientation of these vulnerable subjects. Secondly, we emphasize that integration of these subjects within alternatives to hospitalization requires a type of support similar to that usually proposed, an accompaniment of psychosocial rehabilitation. Then, we propose to build an indicator called the psychosocial age, which reduces the weight of the chronological age for the orientation of these subjects. Ultimately, we question the health policies in psychiatry.