Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 36.744
Filtrar
1.
Transl Psychiatry ; 10(1): 337, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009366

RESUMO

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Transtornos Mentais , Pandemias , Pneumonia Viral , Psicotrópicos , China/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Prognóstico , Escalas de Graduação Psiquiátrica , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
3.
Psychiatr Serv ; 71(10): 1088-1090, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32998660

RESUMO

Specific guidance on how to manage COVID-19 in forensic psychiatric institutions is necessary because these settings differ substantially from both acute-care psychiatric hospitals and correctional institutions. The challenges raised by COVID-19 in these settings are unique, given the nature of the patients treated, length of stay, and need to collaborate with various partners in the criminal justice system during both the admission and discharge planning processes. This column outlines these specific challenges, which are likely to recur in subsequent epidemics, and suggests potential strategies to address them.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Psiquiatria Legal/métodos , Hospitais Psiquiátricos , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Pneumonia Viral/complicações , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle
4.
Soins Psychiatr ; 41(328): 12-15, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039084

RESUMO

We need to go back to the time of alienist doctors to understand the interest of the care programme established in 2011. In fact, the psychiatric clinic requires professionals to accompany the patient over time, while accepting the variability of suffering. In this context, this system proposes an alternative to full in-patient care while preserving the aspect of compulsory treatments. Caring for the patient, acquiring their consent while preserving their rights is a real challenge for the psychiatrist and their team.


Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Consentimento Livre e Esclarecido , Transtornos Mentais/terapia , Psiquiatria , Humanos
5.
Soins Psychiatr ; 41(328): 23-25, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039087

RESUMO

Psychiatric compulsory community treatment programmes are widely and heterogeneously used measures of coercion. The recovery oriented mental health service 59G21 used them to minimize violating the rights of persons under compulsory care. Based on a clinical situation of failing this objective, we discuss their place in the health system and the reasons why we chose to move towards a "zero recourse" objective.


Assuntos
Serviços Comunitários de Saúde Mental , Transtornos Mentais/terapia , Humanos , Direitos do Paciente
6.
Soins Psychiatr ; 41(328): 19-22, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039086

RESUMO

The act of 5 July 2011 pertaining to the rights and the protection of persons under psychiatric care presents the possibility for compulsory care, without the need for full hospitalisation. Patients can be cared for through partial hospitalisation (day hospital and part-time therapeutic clinic) or in a medical-psychological centre. Treatments and all care are detailed in a care programme. This programme is sent, like all certificates, to the regional health agency and the prefecture in the case of psychiatric care by decision of the State representative, or to the hospital director for psychiatric care at the request of a third party. We propose two clinical vignettes.


Assuntos
Assistência Ambulatorial , Transtornos Mentais/terapia , Hospital Dia , Humanos , Direitos do Paciente/legislação & jurisprudência
7.
Soins Psychiatr ; 41(328): 26-29, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039088

RESUMO

The care programmes are medical-legal and therapeutic systems that showcase different spaces, the law, the patient's clinic, their freedom and their rights. In this context, the patient preserves their freedom to come and go. In applying the care programme, the doctor must acquire their approval, not to say consent. Outside hospitalisation, the care programmes bring patients and teams together within the city. The matter of social and community psychiatry, a vector of catchment-area psychiatry, then makes full sense.


Assuntos
Transtornos Mentais/terapia , Psiquiatria Comunitária , Liberdade , Humanos , Direitos do Paciente
8.
Soins Psychiatr ; 41(328): 30-31, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039089

RESUMO

Claude Finkelstein, president of the Fédération nationale des associations d'usagers en psychiatrie, has drawn up an inventory of care programmes, nine years after their establishment. In particular, she highlights the experience of patients and their familes regarding this system. The pitfalls concern the systematic search for the healthcare proxy and some application methods in the follow-up. Prospects for improvement should be discussed to give value to the interest of such programmes for the subjects.


Assuntos
Consentimento Livre e Esclarecido , Transtornos Mentais/terapia , Humanos
9.
Soins Psychiatr ; 41(328): 34-40, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33039091

RESUMO

Ethical questioning and reflection are a requirement for the psychiatric caregiver, a particular discipline which is both clinical and political. Ethics is a safeguard that allows the professional to refocus on the core of their profession. It is not synonymous with morality and is situational. It is a combat sport against oneself and against those who reduce the patient to a human-machine to be repaired.


Assuntos
Transtornos Mentais/terapia , Psiquiatria/ética , Internação Compulsória de Doente Mental/ética , Empatia/ética , Humanos
10.
Rev Med Suisse ; 16(707): 1737-1740, 2020 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-32969608

RESUMO

This article presents the construction of a chain of care of perinatal psychiatric situations within the University Service of Child and Adolescent Psychiatry, which evolved within the framework of the departmentalization of this service. This chain of care includes the psychiatry of the liaison, the outpatient clinics as well as and day hospital care and extends from the prenatal period to the child's five years, with a focus on the relationship between child and caregivers, as well as an individual perspective on the child. Herein, we present and describe the different units and their functioning emphasizing the synergies and collaborations put in place that ensure the best possible continuity for patients and their families by promoting as much as possible the therapeutic alliance in this chain of care.


Assuntos
Psiquiatria do Adolescente/organização & administração , Psiquiatria Infantil/organização & administração , Adolescente , Cuidadores , Criança , Saúde da Família , Feminino , Humanos , Transtornos Mentais/terapia , Gravidez , Universidades
11.
Medicine (Baltimore) ; 99(33): e21484, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871994

RESUMO

BACKGROUND: The objective of this study is to investigate the effects of humanistic care and psychological counseling (HCPC) on psychological disorders (PD) in medical students after coronavirus disease 2019 (COVID-19) outbreak. METHODS: We will search randomized controlled trials or case-controlled studies of HCPC on PD in medical students after COVID-19 outbreak in the following electronic databases: PUBMED/MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED, WANGFANG, and CNKI. The time is restricted from the construction of each database to the present. All process of study selection, data collection, and study quality evaluation will be carried out by two independent authors. Any different opinions will be solved by a third author through discussion. We will employ RevMan 5.3 software to conduct statistical analysis. RESULTS: This study will provide a better understanding of HCPC on PD in medical students after COVID-19 outbreak. CONCLUSIONS: This study may offer strong evidence for clinical practice to treat PD in medical students after COVID-19 outbreak. STUDY REGISTRATION: CRD42020193199.


Assuntos
Infecções por Coronavirus/psicologia , Aconselhamento/métodos , Transtornos Mentais/terapia , Pneumonia Viral/psicologia , Psicoterapia/métodos , Estudantes de Medicina/psicologia , Adulto , Betacoronavirus , Estudos de Casos e Controles , Feminino , Humanismo , Humanos , Masculino , Transtornos Mentais/psicologia , Pandemias , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Adulto Jovem
13.
Hu Li Za Zhi ; 67(5): 26-32, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-32978763

RESUMO

The popularization of smart technology is a global phenomenon. The increasing ubiquity of smartphones offers the potential to apply smart technology in areas such as healthcare and behavioral change interventions. Mobile health services may enhance the effectiveness and resolve the shortcomings of traditional medical services, which cannot continuously and instantly track changes in disease symptoms. The popularity of mobile phones has led to the emergence of mobile health applications. Mobile health applications use active and passive methods to collect data and transmit information. Studies have confirmed the feasibility and acceptance of these applications in assessing and detecting diseases and in mental health interventions. In this article, the limitations of traditional psychiatric medical diagnosis and the opportunity to develop mobile health using information and communication technology are discussed, and related empirical research on using smart technology to evaluate and detect symptoms is explored using the example of bipolar disorders. In addition, the benefits and future prospects of onset alert and the development of healthcare models for action are highlighted. In the future, we look forward to developing mobile health applications that meet the needs of healthcare in Taiwan. Furthermore, we recommend more research and investment in related fields to accumulate more extensive empirical evidence.


Assuntos
Transtornos Mentais/terapia , Aplicativos Móveis , Smartphone , Telemedicina/métodos , Humanos , Taiwan
14.
BMJ Open ; 10(9): e040229, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873685

RESUMO

INTRODUCTION: The current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders. METHODS AND ANALYSIS: With our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources. ETHICS AND DISSEMINATION: No ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020179611.


Assuntos
Infecções por Coronavirus , Transtornos Mentais , Serviços de Saúde Mental/provisão & distribução , Saúde Mental , Pandemias/estatística & dados numéricos , Pneumonia Viral , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
15.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 443-462, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886045

RESUMO

Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government Children of parents with a mental illness (COPMI) are at an increased risk to develop (severe) mental disorders (SMI) themselves. Estimates for Germany result in about 25 % of COPMI. This is thus a large and high risk group. On the other hand, prevention programs for COPMI are still scarce, especially in Germany, and central features of the transgenerational transmission of mental disorders have not been studied in conjunction to shed light on potential transmission mechanisms. The current article presents two current research projects on COPMI focusing on preventive approaches. The BMBF funded project "Children of Parents with a Mental Illness At Risk Evaluation" (COMPARE) targets parents of children aged 1.5 to 16 years of age. Parents need to fulfil a current DSM-5 based diagnosis of a mental disorder and then receive either 25-45 sessions gold standard cognitive behavioural therapy (CBT) or CBT plus 10 sessions Positive Parenting Program (PPP) to test the effects of parental therapy on the children and whether an additional parent training results in incremental effects above and beyond CBT alone. The project "The Village" is a model project in the region Tyrol, Austria, targeting the improved identification and collaborative care of COPMI.


Assuntos
Filho de Pais Incapacitados/psicologia , Terapia Cognitivo-Comportamental , Governo , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adolescente , Adulto , Áustria , Criança , Pré-Escolar , Suscetibilidade a Doenças , Alemanha , Humanos , Lactente , Transtornos Mentais/diagnóstico , Poder Familiar/psicologia
16.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 463-480, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886047

RESUMO

Mental Disorders and Parenting: Challenges and Opportunities for Adult Mental Health Services Parenting can be a key element in the psychiatric rehabilitation process, but it may come with many challenges for parents with mental health problems. Illness symptoms, together with social and sociocultural factors, can have adverse effects on family life or parenting behaviors and entail severe consequences for a child's psychosocial development. Bidirectional interactions can increase parental burden and thus worsen a parent's course of illness. This vicious circle can be broken by the provision of early and adequate support of mothers and fathers with mental health problems. Adult mental health services can make an important yet often underestimated contribution here. This article refers to parents' resources and needs and introduces both opportunities and challenges for adult mental health services when it comes to dealing with parenting needs. Mental health professionals are in a pivotal position for extending adequate support to clients on their parental needs. These professionals' skills and knowledge regarding parenting are essential for the successful implementation of family-focused practices in adult mental health services. Beyond the individual level, there is a need for policies and guidelines stipulating the integration of family and child perspectives in adult mental health services. In a broader view, a program from Finland shows how mental health professionals as well as peers can support parents and their families during the treatment process.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental , Poder Familiar/psicologia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Transtornos Mentais/prevenção & controle , Transtornos Mentais/reabilitação
17.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 426-442, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886049

RESUMO

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.


Assuntos
Filho de Pais Incapacitados/psicologia , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adulto , Criança , Suscetibilidade a Doenças , Humanos , Transtornos Mentais/reabilitação
18.
Cochrane Database Syst Rev ; 9: CD013458, 2020 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-32885850

RESUMO

BACKGROUND: Migrants who have been forced to leave their home, such as refugees, asylum seekers, and internally displaced persons (IDP), are likely to experience stressors which may lead to mental health problems. The efficacy of interventions for mental health promotion, prevention, and treatment may differ in this population. OBJECTIVES: With this overview of systematic reviews, we will map the characteristics and methodological quality of existing systematic reviews and registered systematic review protocols on the promotion of mental health and prevention and treatment of common mental disorders among refugees, asylum seekers, and IDPs. The findings from this overview will be used to prioritise and inform future Cochrane reviews on the mental health of involuntary migrants. METHODS: We searched Ovid MEDLINE (1945 onwards), Ovid Embase (1974 onwards), Ovid PsycINFO, ProQuest PTSDpubs, Web of Science Core Collection, Cochrane Database of Systematic Reviews, NIHR Journals Library, CRD databases (archived), DoPHER, Epistemonikos, Health Evidence, 3ie International Initiative for Impact Evaluation, and PROSPERO, to identify systematic reviews of mental health interventions for involuntary migrants. We did not apply any restrictions on date, language, or publication status to the searches. We included systematic reviews or protocols for systematic reviews of interventions aimed at refugees, asylum seekers, and internally displaced persons. Interventions must have been aimed at mental health promotion (for example, classroom-based well-being interventions for children), prevention of mental health problems (for example, trauma-focussed Cognitive Behavioural Therapy to prevent post-traumatic stress disorder), or treatment of common mental disorders and symptoms (for example, narrative exposure therapy to treat symptoms of trauma). After screening abstracts and full-text manuscripts in duplicate, we extracted data on the characteristics of the reviews, the interventions examined in reviews, and the number of primary studies included in each review. Methodological quality of the included systematic reviews was assessed using AMSTAR 2. MAIN RESULTS: The overview includes 23 systematic reviews and 15 registered systematic review protocols. Of the 23 published systematic reviews, meta-analyses were conducted in eight reviews. It was more common for the search strategy or inclusion criteria of the reviews to state that studies involving refugees were eligible for inclusion (23/23), than for asylum seekers (14/23) or IDPs (7/23) to be explicitly mentioned. In most reviews, study eligiblity was either not restricted by participant age (9/23), or restricted to adults (10/23). Reviews commonly reported on studies of diagnosis or symptoms of post-traumatic stress disorder or trauma (11/23) and were less likely to report on depression or anxiety (6/23). In 15 reviews the intervention of interest was focused on/ specific to psychological therapy. Across all 23 reviews, the interventions most commonly identified from primary studies were general Cognitive Behavioural Therapy, Narrative Exposure Therapy, and a range of different integrative and interpersonal therapies. Even though many reviews included studies of participants without a diagnosis of a mental health problem, they often assessed mental health treatments and did not usually distinguish between promotion, prevention, and treatment in the review aims. Together the 23 systematic reviews included 336 references, of which 175 were unique primary studies. Limitations to the methodological quality of reviews most commonly related to reporting of selection criteria (21/23), absence of a protocol (19/23), reporting of study design (20/23), search strategy (22/23), and funding sources of primary studies (19/23). AUTHORS' CONCLUSIONS: Gaps exist in the evidence on mental health interventions for refugees, asylum seekers, and internally displaced persons. Most reviews do not specify that internally displaced persons are included in the selection criteria, even though they make up the majority of involuntary migrants worldwide. Reviews specific to mental health promotion and prevention of common mental disorders are missing, and there is more evidence available for adults or mixed populations than for children. The literature is focused on post-traumatic stress disorder and trauma-related symptoms, with less attention for depression and anxiety disorders. Better quality systematic reviews and better report of review design and methods would help those who may use these reviews to inform implementation of mental health interventions.


Assuntos
Promoção da Saúde , Transtornos Mentais/terapia , Saúde Mental , Refugiados/psicologia , Revisões Sistemáticas como Assunto , Humanos , Transtornos Mentais/prevenção & controle , Metanálise como Assunto , Refugiados/classificação , Transtornos de Estresse Pós-Traumáticos/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA