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1.
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
2.
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
3.
Psychiatr Hung ; 34(4): 380-392, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31767798

RESUMO

The provision and coordination of good quality care in mental health represents a major challenge worldwide. The direct and indirect costs of psychiatric disorders, including costs due to substance use disorders are very high in the countries of the European Union. The prevalence of both mental disorders and substance use disorders is significant in Hungary. Leaders of the psychiatric profession joined forces and assembled a complex plan for the development of mental health care in Hungary. The National Programme of Mental Health represents both challenges and opportunities for this area. The main objective is a stepped care and collaborative care model for individuals with psychiatric disorders that incorporates the primary care system (general practitioners) and the community psychiatry providers. Primary care needs to develop competence to identify and treat people with common mental disorders, supported by a new care model of clinical psychologist counseling services. The tasks of these psychologists include screening (assessment interviews), giving information, leading patients to the optimal therapeutic pathways, psychoeducation and low-intensity psychological interventions. The psychologist represents a bridge between the family doctor and psychiatric care. The programme aims to shift mental health services from hospitals to community mental health facilities services. However there is a parallel organization of health and social care systems in Hungary that inhibits the complex care of patients. It is necessary to develop a closer coordination (or collaboration) of out-patient psychiatric care and the community-based services, to provide more and better facilities for reintegration of patients. Continuity of care can beestablished by psychiatrists being responsible for treatment plans and pathways, including the frequency of follow-up visits or the need for transferring patients to family doctors or to psychiatric hospitals. In some areas there is an important need for the development of specialized teams or units (for example crisis intervention service, forensic psychiatric unit, mother-child unit, psychiatric emergency rooms, high security wards). Human resources represent a major problem, the numbers of psychiatric nurses and psychiatrists are insufficient. The dysfunctional distribution of human resources leads to the deterioration of services. This is principally financial question. In the future the psychiatry should take advantage of the possibilities offered by digital technology. In this paper we present the main elements of the National Programme of Mental Health. We hope that the programme can be realized in the coming years with financial support of the Hungarian Government.


Assuntos
Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/tendências , Saúde Mental , Humanos , Hungria , Transtornos Mentais/terapia , Psiquiatria/organização & administração , Psiquiatria/tendências
4.
Psychiatr Hung ; 34(4): 403-410, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31767800

RESUMO

The fruitless fights and battles among biological psychiatry, social psychiatry and antipsychiatry represented obstacles on the road towards development in psychiatry. Psychiatry came into existence as part of medicine, although its best practices often looked over the fence of natural sciences and embraced various approaches and viewpoints from both human sciences and existentialist philosophy. In our review paper, we analyse the philosophy of sciences background of psychiatry and the latest trends such as critical psychiatry and postpsychiatry. Then, under a critical psychiatry angle, we touch on some callenges psychiatry is compelled to face today, namely:(1) limits of the validity of diagnostics and of the research of evidence-based practices; (2) the various drawbacks of the state of being a psychiatric patient; (3) the intertwining of psychiatry and marketing interests; (4) the professional challenges linked to the therapeutic effectiveness of certain illegal drugs. Finally, we will display the benefits of the postmodern approach and postpsychiatry which stem from the various viewpoints and approaches and provide positive and practical answers to challenges in psychiatry. All this together offers us, professionals, new vistas for development and changes. Similarly, postpsychiatry offers a solid theoretical basis to a number of existing good practices.


Assuntos
Psiquiatria , Humanos , Filosofia , Psiquiatria/tendências
5.
Nervenarzt ; 90(12): 1215-1220, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31748866

RESUMO

BACKGROUND: Reliable and valid diagnostics and treatment of bipolar disorders and affective episodes are subject to extensive, especially methodological limitations in the clinical practice. OBJECTIVE: The use of smartphones and mobile sensor technology for improvement in diagnostics and treatment of bipolar disorders. METHODS: Critical discussion of current research on the use of ambulatory monitoring and digital phenotyping with bipolar disorders. RESULTS: In many studies the observation periods were too short and the sensors applied were too inaccurate to enable reliable and valid detection of behavioral changes in the context of affective episodes. CONCLUSION: The clarification and operationalization of psychopathological constructs to allow for the measurement of objectively observable and ascertainable behavioral changes during depressive and (hypo)manic states are essential for the successful application of modern mobile technologies in the diagnostics and treatment of bipolar disorders.


Assuntos
Transtorno Bipolar , Monitorização Ambulatorial , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/terapia , Humanos , Psiquiatria/tendências , Smartphone
6.
Nervenarzt ; 90(12): 1207-1214, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31641793

RESUMO

The breathtaking technological progress in the field of mobile computing, smartphones and wearables offers new opportunities for psychiatric research and therapy. Wearables enable not only the objective assessment of psychiatric symptoms in real time and everyday life but using continuous monitoring and analysis of relevant parameters can also define important situations, contexts and timing during which extended assessment strategies and real-life interventions can be implemented. The momentary effect of inner city green space exposure on well-being, motivational behavior feedback and geofencing for the detection of drinking episodes are used as examples to illustrate the core benefits of real-time analyses and feedback from wearables for psychiatric research and therapy.


Assuntos
Psiquiatria , Dispositivos Eletrônicos Vestíveis , Humanos , Transtornos Mentais/diagnóstico , Psiquiatria/instrumentação , Psiquiatria/tendências
7.
Psychiatr Hung ; 34(3): 249-265, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31570657

RESUMO

A growing body of data has accumulated in the past decades about the possible role of nutritional factors in influencing the initiation and course of mental disorders as well as in the treatment of these disorders. As a result of the aggregation of this data a new field emerged - "nutritional psychiatry". In our current review paper we discuss some of those natural agents that supposedly have antidepressive properties and, accordingly, may play a role in the stand-alone and/or adjuvant treatment of major depressive disorder.


Assuntos
Transtorno Depressivo Maior/dietoterapia , Estado Nutricional , Psiquiatria/métodos , Psiquiatria/tendências , Humanos
8.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 58-66, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532592

RESUMO

The authors review current data on the role of the synthetic aspartic acid analogue N-acetyaspartate (NAA) in various biochemical metabolic reactions in the CNS. Its importance as a biomarker for neuropsychiatric disorders identified using magnetic resonance spectroscopy (MRS) is noted. The authors present their own results of the use of cogitum, a synthetic analogue of NAA, in children with the effects of traumatic brain injury, mental retardation, hyperactivity disorder and in the complex therapy of schizotypal disorder. Effects of cogitum on cognitive deficit, asthenia are evaluated. The neurotrophic effect of the drug, which specifically affects cognitive and asthenic disorders in these diseases, is shown.


Assuntos
Ácido Aspártico , Transtorno do Deficit de Atenção com Hiperatividade , Ácido Aspártico/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo , Criança , Colina , Creatina , Humanos , Espectroscopia de Ressonância Magnética , Neurologia/tendências , Psiquiatria/tendências
9.
Pathologica ; 111(2): 79-85, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31388201

RESUMO

In the conviction that a look at the past can contribute to a better understanding of the present in the field of science too, we discuss here two aspects of the relationship between early 20th century anatomic pathology and psychiatry that have received very little attention, in Italy at least. There was much debate between these two disciplines throughout the 19th century, which began to lose momentum in the early years of the 20th, with the arrival on the scene of schizophrenia (a disease histologically sine materia) in all its epidemiological relevance.The First World War also contributed to the separation between psychiatry and pathology, which unfolded in the fruitless attempts to identify a histopathological justification for the psychological trauma known as shell shock. This condition was defined at the time as a "strange disorder" with very spectacular symptoms (memory loss, trembling, hallucinations, blindness with no apparent organic cause, dysesthesias, myoclonus, bizarre postures, hemiplegia, and more), that may have found neuropathological grounds only some hundred years later.Among the doctors with a passed involvement in the conflict, Ugo Cerletti, the inventor of electroshock treatment, focused on the problem of schizophrenia without abandoning his efforts to identify its organic factors: if inducing a controlled electric shock, just like an experimentally-induced epileptic seizure, seems to allay the psychotic symptoms and heal the patient, then what happens inside the brain? In seeking histological proof of the clinical effects of electroconvulsive therapy ("the destruction of the pathological synapses"), and attempting to isolate molecules (that he called acroagonins) he believed to be synthesized by neurons exposed to strong electric stimulation, Cerletti extended a hand towards anatomic pathology, and took the first steps towards a neurochemical perspective. However his dedication to finding a microscopic explanation for schizophrenia - in the name of a "somatist" approach that, some years earlier, the psychiatrist Enrico Morselli had labelled "histomania" - was unable to prevent psychiatry from moving further and further away from anatomic pathology.


Assuntos
Eletroconvulsoterapia/tendências , Psiquiatria/tendências , Choque Traumático/psicologia , Choque Traumático/terapia , Distúrbios de Guerra/patologia , Distúrbios de Guerra/psicologia , Distúrbios de Guerra/terapia , Eletroconvulsoterapia/métodos , Eletrochoque , Humanos , Itália , Psiquiatria/métodos , Choque Traumático/patologia , I Guerra Mundial
10.
Psychiatr Danub ; 31(2): 133-140, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31291216

RESUMO

The aim of is to explore whether by observing the fetus by 4D US it is possible to enter fetal behavior, emotions, mental status, consciousness, awareness and other states connected with fetal mind and ability of self-regulation. It is well known that fetal motoric activity is enabling the development of central and peripheral nervous system and the muscles. It is 4D US which enabled to investigate fetal movement patterns from the first trimester of pregnancy throughout the whole pregnancy. Based on the evaluation of fetal spontaneous motor activity by 4D US, a prenatal neurologic scoring test named Kurjak Antenatal Neurodevelopmental Test (KANET) was created. This test has been used to assess almost 2000 fetuses and our results have indicated that KANET has an ability to recognize normal, borderline, and abnormal behavior in fetuses from normal and abnormal pregnancies. The fetus is able to process tactile, vestibular, taste, olfactory, auditory and visual sensations. The fetus responds to painful stimuli with a wide spectrum of reactions. Important external signs of emotion are facial expressions. The existence of a wide range of facial expressions, including grimacing, smiling, crying, similar to emotional expressions in adults, has been revealed by 4D sonography in the 2nd and 3rd trimesters of pregnancy. It is questionable if mental, emotional and behavioral conditions of the fetus were covered in this paper and whether we are able to perceive the fetus as the patient who may develop communication or some other psychiatric disorders which we will be hopefully able to recognize prenatally. Although it seems as the speculation from the point of view of our recent diagnostic possibilities, it is apparent that the day when this will be a reality is rapidly approaching.


Assuntos
Feto/diagnóstico por imagem , Psiquiatria/instrumentação , Psiquiatria/tendências , Ultrassonografia Pré-Natal/tendências , Emoções , Expressão Facial , Feminino , Movimento Fetal , Humanos , Gravidez
12.
Tijdschr Psychiatr ; 61(5): 335-342, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31180572

RESUMO

BACKGROUND: The digitization of society has an increasing impact on healthcare in general and, therefore, also on psychiatry.
AIM: To provide an overview of digital developments and their influence on the design of future professional psychiatric care.
METHOD: With the help of examples from literature, show how digitization will influence diagnostic procedures as well as psychiatric treatment.
RESULTS: Digitization will have a major impact on psychiatric diagnostics and treatment. For example, psychiatric diagnostics will be strengthened by continuous monitoring of behaviour with digital wearables and the collection of large amounts of personal data. How we deal with these new sources of information needs to be developed in everyday practice. Psychiatric treatments with E-health, online therapies, apps and virtual reality are being developed rapidly. There is increasing evidence concerning the efficacy of these treatments in a variety of patient groups.
CONCLUSION: The digital revolution in psychiatric health services has just begun. To maximise the benefits of digitization for psychiatry, it is necessary to connect technological possibilities with well-founded scientific knowledge, professional expertise, expectations and needs of patients, and clear legal instructions.


Assuntos
Informática/métodos , Internet , Psiquiatria/métodos , Humanos , Psiquiatria/tendências
13.
Soins Psychiatr ; 40(322): 41-43, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31229146

RESUMO

The desire to modernise the approach to psychiatric care aims to confirm the patient's place as subject and to reposition him or her in a context of empowerment. This article describes the contextualisation of the mental health dimension, through the democratic impetus given by an 'emancipatory' form of psychiatry.


Assuntos
Transtornos Mentais/terapia , França , Liberdade , Humanos , Política , Psiquiatria/tendências
14.
Psychopharmacology (Berl) ; 236(8): 2405-2412, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31230144

RESUMO

The nascent field computational psychiatry has undergone exponential growth since its inception. To date, much of the published work has focused on choice behaviors, which are primarily modeled within a reinforcement learning framework. While this initial normative effort represents a milestone in psychiatry research, the reality is that many psychiatric disorders are defined by disturbances in subjective states (e.g., depression, anxiety) and associated beliefs (e.g., dysmorphophobia, paranoid ideation), which are not considered in normative models. In this paper, we present interoceptive inference as a candidate framework for modeling subjective-and associated belief-states in computational psychiatry. We first introduce the notion and significance of modeling subjective states in computational psychiatry. Next, we present the interoceptive inference framework, and in particular focus on the relationship between interoceptive inference (i.e., belief updating) and emotions. Lastly, we will use drug craving as an example of subjective states to demonstrate the feasibility of using interoceptive inference to model the psychopathology of subjective states.


Assuntos
Simulação por Computador , Cultura , Autoavaliação Diagnóstica , Transtornos Mentais/psicologia , Modelos Psicológicos , Psiquiatria/métodos , Comportamento de Escolha , Fissura/fisiologia , Emoções/fisiologia , Feminino , Humanos , Aprendizagem/fisiologia , Masculino , Transtornos Mentais/diagnóstico , Psiquiatria/tendências
17.
Psychiatry Res ; 273: 767-769, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31207864

RESUMO

Evaluating patients' verbal fluency by counting the number of unique words (e.g., animals) produced in a short-period (e.g., 1-3 min) is one of the most widely employed cognitive tests in psychiatric research. We introduce new methods to analyze fluency output that leverage modern computational language technology. This enables moving beyond simple word counts to charting the temporal dynamics of speech and objectively quantifying the semantic relationship of the utterances. These metrics can greatly expand the current psychiatric research toolkit and can help refine clinical theories regarding the nature of putative language differences in patients.


Assuntos
Testes de Linguagem , Testes Neuropsicológicos , Psiquiatria/métodos , Fala/fisiologia , Comportamento Verbal/fisiologia , Adulto , Feminino , Humanos , Linguagem , Masculino , Psiquiatria/tendências , Semântica
18.
Nervenarzt ; 90(7): 669-674, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31073675

RESUMO

Coercion and violence in psychiatric inpatient settings represent a serious challenge. This challenge cannot be successfully met just by denying any legitimation of coercive measures or by assuming that violence from the patients' side is a fateful complication. Coercive measures are essentially approximative solutions of interpersonal and intrapersonal conflicts of autonomy, if these cannot be resolved without violence. Therefore, prevention of coercive measures can only succeed when the focus is on the needs and rights for autonomy of all subjects involved, including patients, relatives and staff. Autonomy-focused psychiatry targets transparency of conflicts of interests and aims at limiting coercive measures to the absolute minimum necessary by preventive means. A number of effective measures are available to achieve a comprehensive implementation strategy. Using these measures in clinical practice must evolve, however, during a dynamic continuous improvement process and implementation should be based on the local as well as legal, administrative and architectural situation and the available human resources. The presently widespread prioritization of opening closed psychiatric wards is insufficient to effectively minimize coercion and violence in psychiatric inpatient settings.


Assuntos
Transtornos Mentais , Psiquiatria , Coerção , Humanos , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria/normas , Psiquiatria/métodos , Psiquiatria/normas , Psiquiatria/tendências , Restrição Física
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