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1.
Rev Med Suisse ; 16(681): 301-306, 2020 Feb 12.
Artigo em Francês | MEDLINE | ID: mdl-32049450

RESUMO

In the context of liaison psychiatry, potentially traumatic somatic situations at the psychic level are frequent. They can be grouped into three broad categories: 1) psychotrauma in connection with a medical event ; 2) traumatic event at the origin of somatic management ; 3) traumatic event prior to somatic management. It is important to know the possible clinical reactions after a traumatic event. In the immediate aftermath of trauma, a clinical assessment is recommended to allow early identification of subjects at risk of developing post-traumatic stress disorder (PTSD). Pharmacological and non-pharmacological interventions should be considered to prevent or to treat the installation of PTSD with the aim of also improving the somatic prognosis.


Assuntos
Psiquiatria , Trauma Psicológico , Transtornos de Estresse Pós-Traumáticos/psicologia , Humanos , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/terapia
2.
Br J Gen Pract ; 70(691): 60, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32001459

Assuntos
Psiquiatria
4.
J Clin Psychiatry ; 81(2)2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31995679

RESUMO

Valbenazine and deutetrabenazine are FDA-approved as treatment for tardive dyskinesia (TD). Both medications are vesicular monoamine transporter type 2 (VMAT2) inhibitors, and both are effective for reducing TD symptoms. Clinicians need to be aware of the adverse effects of valbenazine and deutetrabenazine, as well as other key differences between the two, in order to individualize treatment. Using the Abnormal Involuntary Movement Scale assists clinicians in assessing progress for each patient. Treating TD effectively with these new medications will reduce the burden of the condition for patients.


Assuntos
Exame Neurológico/métodos , Discinesia Tardia , Tetrabenazina/análogos & derivados , Valina/análogos & derivados , Proteínas Vesiculares de Transporte de Monoamina/antagonistas & inibidores , Monitoramento de Medicamentos/métodos , Humanos , Conduta do Tratamento Medicamentoso , Moduladores de Transporte de Membrana/administração & dosagem , Moduladores de Transporte de Membrana/efeitos adversos , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/normas , Psiquiatria/educação , Discinesia Tardia/induzido quimicamente , Discinesia Tardia/diagnóstico , Discinesia Tardia/tratamento farmacológico , Tetrabenazina/administração & dosagem , Tetrabenazina/efeitos adversos , Resultado do Tratamento , Valina/administração & dosagem , Valina/efeitos adversos
5.
Rev Med Suisse ; 16(678): 144-147, 2020 Jan 22.
Artigo em Francês | MEDLINE | ID: mdl-31967758

RESUMO

Living in an urban environment increases the risk to develop psychosis. An interdisciplinary research project has allowed a better definition of urban stress components and the adaptation strategies applied by patients to face it. On this basis, the concept of « urban remediation ¼ has emerged as a strategy to help patients regain access to the city. Among the other new treatment approaches, we also discuss therapy through games, which, due to their flexibility and variety, can suit many different needs. These approaches allow the reinforcement of coping capacities through diverse strategies, ranging from the promotion of social interactions to cognitive restructuration or behavioral activation. In addition, the engaging nature of these games may facilitate access and adherence to treatment.


Assuntos
Psiquiatria , Transtornos Psicóticos , Adaptação Psicológica , Humanos , Relações Interpessoais , Psiquiatria/tendências
6.
Curr Psychiatry Rep ; 22(2): 8, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31989417

RESUMO

PURPOSE OF REVIEW: The purpose of this paper is to demonstrate how a remote workforce may increase access to care while reducing physician burnout. We review workforce issues and organizational and individual obstacles for implementing a telepsychiatry workforce including administrative, logistical, and clinical considerations and offer resources for how to overcome barriers that may arise in implementing a remote workforce. RECENT FINDINGS: There is an increasingly unmet demand for mental health services and a shortage in psychiatrists. Burnout may be a key factor contributing to psychiatrists working less, pursuing less acute cases, and leading to worsened outcomes for patients and the psychiatrists themselves. Telepsychiatry provides comparable patient and provider satisfaction and equal outcomes when compared with face-to-face encounters. We provided 3 case examples to demonstrate psychiatrists demonstrating successful delivery of care in a range of clinic settings and workplace configurations while optimizing their quality of life and reducing their risk of burnout.


Assuntos
Esgotamento Profissional/prevenção & controle , Psiquiatria , Telemedicina , Recursos Humanos , Humanos , Qualidade de Vida , Videoconferência
9.
J Hist Med Allied Sci ; 75(1): 54-82, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31702006

RESUMO

In wartime Harlem, liberal mental health professionals, eager to serve the black freedom struggle, sought to depict the minds of troubled black children as human without reinforcing pernicious racial stereotypes. This paper examines how psychiatrist Viola W. Bernard and the Community Service Society struggled to portray the black community as both psychologically damaged and morally beyond reproach when publicly presenting the cases of her male and female clients. As a consequence, liberals helped champion the mental health needs of delinquent black males as a matter of racial justice while rendering young unmarried mothers effectively invisible.


Assuntos
Afro-Americanos/história , Política , Psiquiatria/história , Relações Raciais/história , Feminino , História do Século XX , Humanos , Masculino , Saúde Mental/história , New York , Respeito , II Guerra Mundial
10.
Adv Exp Med Biol ; 1180: 219-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31784966

RESUMO

The goal of treatment for depressive disorders is complete remission of depressive symptoms with full recovery of social function and prevention of recurrence. However, a large proportion of patients do not experience symptomatic remission after the initial treatment, with even lower rates of remission in the longer treatment term. The main objective of individualized treatment applied in psychiatry is to improve precision in disease diagnosis, prognosis, treatment choices, and treatment response. Diverse approaches and techniques, such as genomics, epigenomics, other omics, neural circuit, and artificial intelligence are related to precision psychiatry. Using biology and computational psychiatry tools to find potential biomarkers, and based on precision psychiatry, patients considered to belong to the same endophenotype will be possible to receive biomarkers-based treatment and better prognosis. Especially in the choice of intervention, individualized treatment should be considered. In this review, we present the development of precise treatment in depressive disorders and introduce advances in several domains toward precision medicine and individualized treatment. We pay particular attention to biomarkers and the development of new technologies in depressive disorders, which will help disease complete remission and functional recovery, seek better lives for patients suffered with depressive disorders.


Assuntos
Transtorno Depressivo/terapia , Medicina de Precisão , Biomarcadores , Transtorno Depressivo/diagnóstico , Epigenômica , Humanos , Fenótipo , Psiquiatria
12.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(10): 127-133, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793554

RESUMO

The prescription of psychotropic drugs requires a thorough assessment not only of the effectiveness of pharmacotherapy, but also of its safety. It is an essential component of the rational treatment of patients with mental disorders. Most of adverse drug reactions are predictable and, accordingly, preventable. The solution to problem of adverse drug reactions prevention is feasible thanks to the interdisciplinary approach, in which the skills and methods of clinical pharmacology can be used in psychiatry. This literature review covers the current possibilities for monitoring the safety of psychopharmacotherapy.


Assuntos
Transtornos Mentais , Psicotrópicos , Humanos , Transtornos Mentais/tratamento farmacológico , Psiquiatria/tendências , Psicotrópicos/uso terapêutico
13.
J Ment Health Policy Econ ; 22(3): 85-94, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31811752

RESUMO

BACKGROUND: Since the introduction and soaring popularity of the managed behavioral healthcare (BH) "carve-out" model in the 1980s, policymakers have been concerned with their impact on access. In carve-outs, BH and medical benefits are administered separately. Earlier literature found they reduced intensity of service use while maintaining penetration rates. Recently it has become more common for employers to drop existing carve-out contracts, partly due to the Mental Health Parity and Addiction Equity Act (MHPAEA), which placed a greater administrative burden on carve-outs for parity compliance. Although prior studies focused exclusively on the impact of moving from carve-in to carve-out models, it is now more policy-relevant to understand the effects of the move from carve-out to carve-in, which may not be symmetric. Moreover, the natural experiment resulting from MHPAEA implementation may attenuate concerns about selection bias. STUDY AIMS: This study examines how specialty BH care patterns change when employees and dependents are moved from a "carve-out" plan to a "carve-in" plan. METHODS: Linked insurance claims, eligibility, plan and employer data from 2008-14 were obtained for three Optum( employers who dropped their carve-out contracts but retained their carve-in plans. A longitudinal "difference-in-differences" study design was used to compare changes in BH services use over time among individuals who were: (i) moved to carve-in plans when the employer dropped its carve-out contract (N=177,653); and (ii) enrolled in carve-in plans before and after the transition (N=58,658). Outcomes included total and inpatient expenditures, broken down by plan, patient, and total; outpatient visits for assessment, individual psychotherapy, family psychotherapy, and medication management; and days of structured outpatient care, day treatment, residential care, and acute inpatient care. We pooled person-year observations and estimated regressions including individual fixed effects, year dummies and interactions between indicators for post-transition period and whether transitioned from carve-out to carve-in. RESULTS: Relative to individuals continuously in carve-in plans, those who were transitioned experienced significant increases in inpatient utilization (beta =.02; p=.05) and patient inpatient costs (beta =2.35; p=.01) and decreases in day treatment (beta =-0.01; p=.02). Our conclusions proved robust against potential biases due to differing secular time trends and differential changes in benefits resulting from MHPAEA. DISCUSSION: The increased inpatient utilization associated with switching from carve-out to carve-in plans is consistent with previous literature. Carve-outs may use day treatment to reduce inpatient care so that increased inpatient utilization post-transition reduced demand for day treatment. Limitations include possible selection bias at the employer level; lack of data on medication and generalist use, quality, clinical endpoints and quality of life; and potential lack of generalizability. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The reduction in the use of carve-out contracts by private employers associated with MHPAEA implementation likely did not have a net negative impact and may have actually increased access to care among former carve-out enrollees in need of inpatient services. IMPLICATIONS FOR HEALTH POLICIES: Policymakers should consider and evaluate possible unintended consequences of legislation designed to improve access to care. IMPLICATIONS FOR FURTHER RESEARCH: Future work should replicate these analyses with a more representative sample.


Assuntos
Financiamento Pessoal/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/estatística & dados numéricos , Humanos , Saúde Mental , Psiquiatria , Qualidade de Vida , Estados Unidos
14.
Soins Psychiatr ; 40(325): 12-16, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31836063

RESUMO

The history and evolution of nursing practice in psychiatry provide us with some insights regarding the training needs of today's nurses. The care relationship, the central focus of practice, has been constructed as treatments have advanced and care has become more humanised. Nurses have been able to forge their professional identity on the basis of the "clinical nursing science, psychiatry and human sciences" triptych. The implementation of advanced practice, which essentially involves the delegation of medical acts, must not overshadow the need to develop nurses' specialisation in the clinical field in order to respond to patients' suffering.


Assuntos
Enfermagem Psiquiátrica , Psiquiatria , Humanos
16.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46886

RESUMO

APA has more than 38,500 members involved in psychiatric practice, research, and academia representing the diversity of the patients for whom they care. As the leading psychiatric organization in the world, APA now encompasses members practicing in more than 100 countries.


Assuntos
Psiquiatria , Saúde Mental
18.
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