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1.
Medicina (Kaunas) ; 57(6)2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34204131

RESUMO

Background and Objectives: Over the past twenty years a large number of new psychoactive substances (NPS) have entered and modified the recreational drug scene. Their intake has been associated with health-related risks, especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self-injurious behavior. This paper aims at providing an overview of NPS abuse and the effects on mental health and suicidality issues, by performing a literature review of the current related knowledge, thereby identifying those substances that, more than others, are linked to suicidal behaviors. Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been undertaken. An electronic search was performed, including all papers published up to March 2021, using the following keywords "NPS" OR "new psychoactive substances" OR "novel psychoactive substances" OR "synthetic cannabinoids" OR "phenethylamines" OR "synthetic cathinones" OR "tryptamines" OR "piperazines" OR "new synthetic opioids" OR "designer benzodiazepines" AND ("suicide" OR "suicidality") NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases. Results: Suicidality and self-injurious behavior appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. The results are organized according to the substances recorded. Conclusion: The growing use of NPS has become a significant clinical issue, causing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviors, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring, and restriction of NPS.


Assuntos
Drogas Ilícitas , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Suicídio , Analgésicos Opioides , Humanos , Psicotrópicos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
2.
BMC Psychol ; 9(1): 104, 2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246318

RESUMO

BACKGROUND: Hikikomori is a phenomenon describing people who exhibit behaviors of self-secluding themselves at home for long durations of time and usually only having face-to-face social interactions with none other than family. Existing interventions for hikikomori are inconclusive and the majority are absent in using a theoretical framework to guide its components. Therefore, applicability of the psychosocial recovery framework of Connectedness, Hope and Optimism, Identity, Meaning in Life, and Empowerment (CHIME) towards hikikomori care was reviewed. METHOD: Five databases were searched in April 2020 with the search formula from a published systematic review on hikikomori combined with search terms specific to domains of the CHIME framework. Articles included in the review were of the English language, of all publication years, peer-reviewed, quantitative or qualitative research studies and case studies, included study designs that were observational or interventional in nature, and involved populations of socially withdrawn youth. RESULTS: CHIME's comprehensive structure and organized approach could guide researchers or service providers in determining areas needing assessments, measurement, and areas of focus. It is suggested that the CHIME framework is applicable after modifying a specific dimension-'meaning of mental illness experiences' into 'meaning of the hikikomori experience'. Thematic overlap occurred between the domains of connectedness, identity, and meaning. Yet, additional dimensions or domains such as trust building, non-linearity, and spatiality can be included for addressing specific limitations in this application, which would help towards catering services to help hikikomori in recovery or in increasing quality-of-life of those individuals' while entrapped in this withdrawn lifestyle. CONCLUSION: CHIME framework could be applicable towards hikikomori care after applying the suggested modifications. Additionally, many knowledge gaps were found in literature during this review that warrants further investigation to improve hikikomori care.


Assuntos
Esperança , Transtornos Mentais , Adolescente , Humanos , Otimismo , Pesquisa Qualitativa , Qualidade de Vida
3.
Int J Circumpolar Health ; 80(1): 1935133, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34210240

RESUMO

Mental health providers have rapidly pivoted their in-person practices to teletherapy and telehealth interventions to address the increased demand for mental health services during the COVID-19 crisis. The change to service delivery has emphasised challenges for mental health service providers, particularly in regions that rely on fly-in and fly-out (FIFO) mental health service providers who are no longer able to travel to their places of work. In this qualitative study, we examined the impact of COVID-19 on the delivery of mental health services in Inuit Nunangat. Using a participatory action research methodology, we conducted semi-structured interviews with eight FIFO mental health service providers to understand their experiences and implement strategies to effectively deliver mental health services in a pandemic. We identified three themes through thematic analysis: 1) Service providers identify the challenges in adapting their practices to meet individual and community needs; 2) Service providers recognise the opportunities for enhancements to service delivery; 3) Service providers identify telemental health services as a potentially effective adjunct to in-person sessions. The findings support reconceptualising post-pandemic mental health service delivery to include both face-to-face and telemental health services.


Assuntos
COVID-19/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Saúde Mental/estatística & dados numéricos , Telemedicina/organização & administração , COVID-19/terapia , Aconselhamento/organização & administração , Humanos , Pesquisa Qualitativa , Apoio Social
4.
Biochemistry (Mosc) ; 86(6): 657-666, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34225589

RESUMO

Ischemic brain injuries are accompanied by the long-term changes in gene expression in the hippocampus, the limbic system structure, involved in the regulation of key aspects of the higher nervous activity, such as cognitive functions and emotions. The altered expression of genes and proteins encoded by them may be related to the development of post-ischemic psycho-emotional and cognitive disturbances. Activation of neuroinflammation following stroke in the hippocampus has been suggested to play an essential role in induction of long-lasting consequences. Identification of changes in the gene expression patterns after ischemia and investigation of the dynamics of these changes in the hippocampus are the necessary first steps toward understanding molecular pathways responsible for the development of post-stroke cognitive impairments and mental pathologies.


Assuntos
Isquemia Encefálica/genética , Transtornos Cognitivos/etiologia , Hipocampo/metabolismo , Transtornos Mentais/etiologia , Acidente Vascular Cerebral/genética , Animais , Lesões Encefálicas , Isquemia Encefálica/complicações , Isquemia Encefálica/metabolismo , Cognição , Depressão/etiologia , Regulação da Expressão Gênica , Humanos , Inflamação , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/metabolismo
5.
Biochemistry (Mosc) ; 86(6): 773-783, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34225599

RESUMO

The review summarizes the results of our own studies and published data on the biological markers of psychiatric disorders, with special emphasis on the activity of platelet monoamine oxidase. Pharmacotherapy studies in patients with the mixed anxiety-depressive disorder and first episode of schizophrenia have shown that the activity of platelet monoamine oxidase could serve as a potential biomarker of the efficacy of therapeutic interventions in these diseases.


Assuntos
Plaquetas/enzimologia , Transtornos Mentais/sangue , Monoaminoxidase/sangue , Transtorno Depressivo/sangue , Transtorno Depressivo/tratamento farmacológico , Humanos , Transtornos Mentais/tratamento farmacológico , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento
6.
N Z Med J ; 134(1537): 128-134, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34239152

RESUMO

Structural discrimination worsens physical health inequities and significantly reduces life expectancy for people with mental health and addiction issues. Aotearoa has recently made some notable changes in health policy by formally recognising the physical health needs of people with mental health and addiction issues. The COVID-19 vaccination sequencing framework provides an important opportunity to protect and promote the health of people with addiction and mental health issues. An expert advisory group, convened as part of the Aotearoa Equally Well collaborative, considered findings of a literature review on the vulnerability of people with mental health and addiction issues of contracting and dying from COVID-19. Evidence indicates an association between mental health and addiction issues and infection risk and worse outcomes. The group concluded mental health and addiction issues should be recognised as underlying health conditions that increase COVID-19 vulnerability, and that people with these issues should be prioritised for vaccination. For too long the health system has failed to address the life expectancy gap of people with addiction and mental health issues. Now is an opportunity to change the korero. People with mental health and addiction issues experience significant physical health inequities. Addressing these inequities must be integral in modern health policy-including our COVID-19 pandemic response.


Assuntos
COVID-19 , Disparidades em Assistência à Saúde , Transtornos Mentais/terapia , Discriminação Social , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Política de Saúde , Acesso aos Serviços de Saúde , Humanos , Saúde Mental , Nova Zelândia , Pandemias , SARS-CoV-2 , Estigma Social
7.
J Consult Clin Psychol ; 89(6): 537-550, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264701

RESUMO

OBJECTIVE: To determine if the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) improves functional impairment, psychiatric symptoms, and sleep and circadian functioning. METHOD: Adults diagnosed with serious mental illness (SMI) and sleep and circadian dysfunction (N = 121) were randomly allocated to TranS-C plus usual care (TranS-C + UC; n = 61; 8 individual weekly sessions) or 6 months of Usual Care followed by Delayed Treatment with TranS-C (UC-DT; n = 60). Schizophrenia (45%) and anxiety disorders (47%) were common. Blind assessments were conducted pre-treatment, post-treatment, and 6 months later (6FU). The latter two were the post-randomization points of interest. The location was Alameda County Behavioral Health Care Services (ACBHCS), a Community Mental Health Center (CMHC) in California. RESULTS: For the primary outcomes, relative to UC-DT, TranS-C + UC was associated with reduction in functional impairment (b = -3.18, p = 0.025, d = -0.58), general psychiatric symptoms (b = -5.88, p = 0.001, d = -0.64), sleep disturbance (b = -5.55, p < .0001, d = -0.96), and sleep-related impairment (b = -9.14, p < .0001, d = -0.81) from pre-treatment to post-treatment. These effects were maintained to 6-month follow-up (6FU; d = -0.42 to -0.82), except functional impairment (d = -0.37). For the secondary outcomes, relative to UC-DT, TranS-C + UC was associated with improvement in sleep efficiency and on the Sleep Health Composite score from pre-treatment to 6FU. TranS-C + UC was also associated with reduced total wake time and wake time variability from pre-treatment to post-treatment, as well as reduced hallucinations and delusions, bedtime variability, and actigraphy measured waking activity count variability from pre-treatment to 6FU. CONCLUSIONS: A novel transdiagnostic treatment, delivered within a CMHC setting, improves selected measures of functioning, symptoms of comorbid disorders, and sleep and circadian outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Centros Comunitários de Saúde Mental , Transtornos Mentais/terapia , Psicoterapia/métodos , Transtornos do Sono do Ritmo Circadiano/terapia , Transtornos do Sono-Vigília/terapia , Adulto , Ansiedade/terapia , Transtornos de Ansiedade/terapia , California , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Pessoa de Meia-Idade , Esquizofrenia/terapia , Sono , Transtornos do Sono do Ritmo Circadiano/complicações , Transtornos do Sono-Vigília/complicações , Resultado do Tratamento
8.
Curr Psychiatry Rep ; 23(8): 46, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34196826

RESUMO

PURPOSE: To examine mental health outcomes of unaccompanied refugee minors during global policy shift. Additionally, to consider mental health service delivery and placement type for this group. METHODS: A rapid systematic search of research published since 2018 which related to mental health outcomes of unaccompanied refugee minors. Data extracted, risk of bias assessed and outcomes reviewed qualitatively. RESEARCH FINDINGS: We found 181 papers, of which 14 met inclusion criteria. This review found consistently high levels of PTSD and PTSS among URMs in various contexts. Exposure to trauma, being unaccompanied (compared to accompanied), being female and being older are associated with poor outcomes. Depression and anxiety were consistently high among URMs and associated with discrimination, limited language attainment and daily hassles. High rates of mental illness and symptoms among unaccompanied refugee minors were consistent across national and settlement contexts but the quality of the evidence is variable with significant heterogeneity of assessment. We relate persistence of poor mental health outcomes with problems accessing mental health services and discuss the role of key post-migration factors influencing outcomes-in particular placement type and the use of detention centres.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Refugiados , Transtornos de Estresse Pós-Traumáticos , Feminino , Humanos , Transtornos Mentais/epidemiologia , Menores de Idade , Avaliação de Resultados em Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia
9.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205403

RESUMO

Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study is to determine changes in the intake of F&V and motivation to do so among people with SMDs after participating in a food education programme. A community-based randomized controlled trial was conducted in Spain, with the intervention group (IG) participating in a food education programme based on the stages of change model to promote consumption of F&V and the control group (CG) receiving three informative sessions on basic healthy eating. The main outcomes were related to the intake of F&V and stages of change. Data collection was performed at baseline, post intervention, and 12-month follow-up. Seventy-four participants enrolled in the study and sixty completed the 12-month follow-up. An increase in motivation towards the intake of F&V was observed in the IG but not in the CG (McNemar's test p = 0.016, p = 0.625). No significant difference was observed for the intake of fruit, vegetables, or F&V. Basing food education strategies on the stages of change model shows positive results, increasing the awareness and disposition of people with SMD towards the intake of F&V. More research is needed to identify the most appropriate eating intervention to increase the intake of F&V.


Assuntos
Frutas , Educação em Saúde/métodos , Transtornos Mentais/dietoterapia , Modelo Transteórico , Verduras , Adulto , Aconselhamento , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Ciências da Nutrição/educação , Estado Nutricional , Espanha
10.
Artigo em Inglês | MEDLINE | ID: mdl-34205491

RESUMO

Internationally, mental health service developments are increasingly informed by the principles of recovery, and the availability of arts and creative activities are becoming more common as part of provision. Mental health service users' experiences, reflecting on the complex nature of using music participation in recovery are, however, limited. This essay considers literature that explores how music can support mental health service users in a recovery process. We have selected studies that include a broad spectrum of music activities, as well as literature considering various concepts about recovery. The conceptual recovery framework CHIME, that includes five important components in the recovery process, is used as the backdrop for exploring music activities as a contribution to recovery-oriented practice and services in mental health care. Eleven key components are identified in which music can support the recovery process: Feelings of equality; Social and emotional wellbeing; Tolerance; Hope and social agency; Triggering encounters; Redefining and reframing; A social practice; Moments of flow and peak experiences; Moments of meaning; Continuity; and Potentials instead of limitations. This essay concludes that the experiential knowledge of music activities from service users' perspectives is essential knowledge when developing and using music activities in mental health recovery services. While this essay acknowledges that music activities can also produce unintended negative outcomes, the focus is on the positive contributions of music to mental health recovery processes.


Assuntos
Coloboma , Transtornos Mentais , Recuperação da Saúde Mental , Serviços de Saúde Mental , Música , Humanos , Transtornos Mentais/terapia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34207211

RESUMO

Sexting is generally known as creating, sending and/or forwarding of sexual content using electronic devices. When such content is non-consensually disseminated, it becomes a criminally relevant behavior. To date, very few empirical studies have examined the prevalence of non-consensual dissemination of sexting, and none of them have analyzed the relationship with psychopathology and further victimization outcomes. Therefore, the aims of this study were (1) to examine the prevalence of non-consensual dissemination of sexual content, (2) to analyze the prevalence of further victimization as a result of non-consensual dissemination of sexting and (3) to investigate the association between secondary victimization as a result of non-consensual dissemination of sexting and psychopathology. The sample comprised 1370 Spanish college students (73.6% female; mean age = 21.4 years; SD = 4.85) who answered an online survey about their engagement in sexting behaviors, online sexual victimization and psychopathology, measured by a sexting scale and the Listado de Síntomas Breve (LSB-50), respectively. Overall, 43 participants (3.14) were victims of non-consensual dissemination of sexting, and results showed those participants who had suffered further victimization reported higher psychopathology scores than those who were not victimized and that being victimized by an ex-partner was associated with poorer mental health outcomes in the victim. Further implications are discussed.


Assuntos
Vítimas de Crime , Transtornos Mentais , Envio de Mensagens de Texto , Adulto , Feminino , Humanos , Masculino , Comportamento Sexual , Estudantes , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-34207855

RESUMO

Knowledge on user experiences from mentally disordered offenders (MDOs) is still limited in a Danish context, especially regarding recovery from offences, severe mental illness, long-term admissions and often involuntarily contact with hospital psychiatry. The study is based on 34 semi-structured interviews with nine forensic patients exploring their experiences with personal recovery processes. The MDOs point out a significant number of elements and factors enhancing, supporting and limiting personal recovery processes. Long-term recovery processes for MDOs involve coming to terms with mental disorders as well as offences. Working with offender recovery implies addressing and understanding the index offence leading to psychiatric measurement as well as addressing risk and prevention of future crime. This coming to terms is an individual and deeply personal process and it often involves several and changing narratives. According to the informants, professionals play a crucial role in supporting recovery processes and maintaining hope and optimism over time. MDOs experience structural barriers limiting recovery potential, especially stigma or limited areas of participation. It is important not to focus solely on personal recovery as a one-dimensional individual process or responsibility, but as a process also marked by structural and organisational challenges.


Assuntos
Criminosos , Transtornos Mentais , Crime , Medicina Legal , Psiquiatria Legal , Humanos
13.
Transl Psychiatry ; 11(1): 370, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34226495

RESUMO

Is engaging with music good for your mental health? This question has long been the topic of empirical clinical and nonclinical investigations, with studies indicating positive associations between music engagement and quality of life, reduced depression or anxiety symptoms, and less frequent substance use. However, many earlier investigations were limited by small populations and methodological limitations, and it has also been suggested that aspects of music engagement may even be associated with worse mental health outcomes. The purpose of this scoping review is first to summarize the existing state of music engagement and mental health studies, identifying their strengths and weaknesses. We focus on broad domains of mental health diagnoses including internalizing psychopathology (e.g., depression and anxiety symptoms and diagnoses), externalizing psychopathology (e.g., substance use), and thought disorders (e.g., schizophrenia). Second, we propose a theoretical model to inform future work that describes the importance of simultaneously considering music-mental health associations at the levels of (1) correlated genetic and/or environmental influences vs. (bi)directional associations, (2) interactions with genetic risk factors, (3) treatment efficacy, and (4) mediation through brain structure and function. Finally, we describe how recent advances in large-scale data collection, including genetic, neuroimaging, and electronic health record studies, allow for a more rigorous examination of these associations that can also elucidate their neurobiological substrates.


Assuntos
Transtornos Mentais , Musicoterapia , Música , Ansiedade , Humanos , Transtornos Mentais/terapia , Saúde Mental , Qualidade de Vida
14.
Artigo em Inglês | MEDLINE | ID: mdl-34198659

RESUMO

Depression is a common mental health disease, which has great harm to public health. At present, the diagnosis of depression mainly depends on the interviews between doctors and patients, which is subjective, slow and expensive. Voice data are a kind of data that are easy to obtain and have the advantage of low cost. It has been proved that it can be used in the diagnosis of depression. The voice data used for modeling in this study adopted the authoritative public data set, which had passed the ethical review. The features of voice data were extracted by Python programming, and the voice features were stored in the format of CSV files. Through data processing, a big database, containing 1479 voice feature samples, was generated for modeling. Then, the decision tree screening model of depression was established by 10-fold cross validation and algorithm selection. The experiment achieved 83.4% prediction accuracy on voice data set. According to the prediction results of the model, the patients can be given early warning and intervention in time, so as to realize the health management of personal depression.


Assuntos
Transtornos Mentais , Saúde Mental , Algoritmos , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Saúde Pública
15.
Int J Mol Sci ; 22(11)2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34200240

RESUMO

The term neuroinflammation refers to inflammation of the nervous tissue, in general, and in the central nervous system (CNS), in particular. It is a driver of neurotoxicity, it is detrimental, and implies that glial cell activation happens prior to neuronal degeneration and, possibly, even causes it. The inflammation-like glial responses may be initiated in response to a variety of cues such as infection, traumatic brain injury, toxic metabolites, or autoimmunity. The inflammatory response of activated microglia engages the immune system and initiates tissue repair. Through translational research the role played by neuroinflammation has been acknowledged in different disease entities. Intriguingly, these entities include both those directly related to the CNS (commonly designated neuropsychiatric disorders) and those not directly related to the CNS (e.g., cancer and diabetes type 2). Interestingly, all the above-mentioned entities belong to the same group of "complex disorders". This review aims to summarize cumulated data supporting the hypothesis that neuroinflammation is a common denominator of a wide variety of complex diseases. We will concentrate on cancer, type 2 diabetes (T2DM), and neuropsychiatric disorders (focusing on mood disorders).


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Inflamação/complicações , Transtornos Mentais/etiologia , Neoplasias/etiologia , Neurônios/patologia , Animais , Diabetes Mellitus Tipo 2/patologia , Humanos , Transtornos Mentais/patologia , Neoplasias/patologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-34200986

RESUMO

Evidence indicates that stigma impedes an individual's chance of seeking professional help for a mental health crisis. Commonly reported aggregate-level results for stigma-reduction efforts obfuscate how much stigma reduction is needed to incur a practically meaningful change within an individual, defined here as an attitudinal shift and openness towards seeking mental health for oneself and/or support for others. When basing conclusions and recommendations about stigma-reducing interventions on aggregate scales, it is unclear how much stigma reduction is needed to incur meaningful change within an individual. We explored the impact of reductions in stigma of help-seeking scores in response to an online suicide prevention video among young adults in the United States, using online surveys to collect qualitative and quantitative data. We compared mean changes in the stigma scores from pre- to post-test (video exposure) of 371 young U.S. adults using standard t-tests and individual level analysis. A separate thematic analysis of free-text responses was also conducted from a smaller, randomly-selected subgroup, capturing individuals' attitudes towards help-seeking for mental health problems. Great attention was given to participants to ensure that they were in a campus setting where counseling services were available. Four main themes emerged: (1) small changes in stigma scores were associated with individual reports of meaningful reductions in their attitudes towards professional counseling; (2) increased empathy towards victims of suicide and other mental health problems sometimes indicated increased empathy for victims of suicide and decreased openness in professional help; (3) empathy towards victims sometimes took the form of increased scores and grief or sadness, possibly thwarting the potential for help-seeking; and (4) self-reports of decreased stigma were not always associated with increased openness towards help-seeking. Results also indicated that small stigma score charges, not meeting statistical significance, were often associated with increased openness towards seeking help. These findings, discovered using mixed-methods, contribute to the body of literature regarding stigma towards suicide and help-seeking by demonstrating deficits in the aggregate-only analysis of stigma-reducing interventions specifically aimed at suicide prevention. Such individuation in stigma experiences indicates that public education on how to reduce the stigma of help-seeking for suicide prevention needs to consider individual-level analyses for improving target populations. Recommendations for future research include additional studies prior to releasing suicide prevention videos to public forums where they may be seen by individuals without access to help.


Assuntos
Transtornos Mentais , Suicídio , Humanos , Saúde Mental , Aceitação pelo Paciente de Cuidados de Saúde , Estigma Social , Suicídio/prevenção & controle , Adulto Jovem
17.
Z Kinder Jugendpsychiatr Psychother ; 49(4): 295-306, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34240621

RESUMO

Objective: This study investigates whether adolescents' adherence to psychotropic medication is associated with demographic and socioeconomic factors, and to what extent parents' assessments of their offspring's attitudes toward treatment correspond with the adolescents' self-report. Methods: This study is part of the multicenter SEMA study (Subjective Experience and Medication Adherence in Adolescents with Psychiatric Disorders). Adolescents' subjective attitudes toward medication and their adherence were assessed using the patient and parent versions of the QATT (Questionnaire on Attitudes Toward Treatment) and the MARS (Medication Adherence Rating Scale). Furthermore, we collected socioeconomic and demographic data. Results: Of the n = 75 adolescents included in the study, n = 45 (60 %) were classified as completely adherent. Patients receiving monotherapy were more often completely adherent than those receiving a combination of different medications. There was no statistically significant association between adherence and demographic or socioeconomic factors. Consensus between adolescents and their parents regarding adolescents' attitudes toward treatment ranged from slight (κ = 0.157) to fair (κ = 0.205). Conclusion: Incomplete medication adherence in adolescents with psychiatric disorders is a common phenomenon and still poorly understood. Demographic and socioeconomic factors do not seem to be relevant in this respect. However, adolescents' subjective attitudes towards medication, which parents are presumably unable to adequately assess, warrant more careful consideration in future research.


Assuntos
Transtornos Mentais , Adolescente , Humanos , Adesão à Medicação , Transtornos Mentais/tratamento farmacológico , Pais , Psicotrópicos/efeitos adversos , Inquéritos e Questionários
18.
Z Kinder Jugendpsychiatr Psychother ; 49(4): 284-294, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34240622

RESUMO

ADHS - Disorder concepts and the beginnings of pharmacotherapy in the Federal Republic of Germany and the German Democratic Republic Abstract. After sporadic references before 1900, the concept of attention deficit/hyperactivity disorder became established in the 20th century. The hyperactive and inattentive child then became the focus of neuropediatrics in the wake of the encephalitis lethargica epidemic by clinical presentations of postencephalitic residual conditions. From these patients, physicians distilled a subgroup with an blank neurological history but impressive clinical symptoms. Child psychiatry, which emerged in the middle of the last century, studied these minimally brain-damaged patients, searching for both causes and therapies. The disorder concepts of Reinhart Lempp and Gerhard Göllnitz are significant contributions from the Federal Republic of Germany and the GDR, respectively, which provide revealing insights into the establishment of pharmacotherapy with stimulants in the 1970s.


Assuntos
Transtornos Mentais , Criança , Alemanha , Alemanha Oriental , Alemanha Ocidental , História do Século XX , Humanos
19.
Medicina (Kaunas) ; 57(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208694

RESUMO

Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.


Assuntos
Coriorretinopatia Serosa Central , Transtornos Mentais , Coriorretinopatia Serosa Central/diagnóstico , Humanos , Personalidade
20.
Clin Interv Aging ; 16: 1315-1325, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34285476

RESUMO

Purpose: The purpose of this case series is to illustrate the complexity of considerations across health (physical and mental), ethical, human rights and practical domains when an older adult with chronic symptoms of mental illness refuses treatment for a serious medical comorbidity. A broad understanding of these considerations may assist health care professionals in navigating this challenging but common aspect of clinical practice. Case Presentation: Three detailed case reports are described. Participants were older adults with an acute presentation of a chronic mental illness, admitted to a specialized older persons mental health inpatient unit (OPMHU) in an Australian metropolitan hospital. Significant comorbid medical issues were detected or arose during the admission and the patient refused the recommended medical intervention. Data extracted from patients' medical records were analyzed and synthesized into detailed case reports using descriptive techniques. Each patient was assessed as lacking capacity for healthcare and treatment consent and did not have relatives or friends to assist with supported decision-making. Multifaceted aspects of decision-making and management are highlighted. Conclusion: There are multiple complex issues to consider when an older adult with chronic symptoms of mental illness refuses treatment for serious comorbid medical conditions. In addition to optimizing management of the underlying mental illness (which may be impairing capacity to make healthcare decisions), clinicians should adopt a role of advocacy for their patients in considering the potential impact of ageism and stigma on management plans and inequities in physical healthcare. Consultation with specialist medical teams should incorporate multifaceted considerations such as potentially inappropriate treatment and optimum setting of care. Equally important is reflective practice; considering whether treatment decisions may infringe upon human rights or cause trauma.


Assuntos
Pessoal de Saúde/psicologia , Transtornos Mentais/terapia , Relações Profissional-Paciente , Recusa do Paciente ao Tratamento , Idoso , Idoso de 80 Anos ou mais , Austrália , Doença Crônica , Feminino , Direitos Humanos , Humanos , Masculino , Competência Mental
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