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1.
Rev Med Suisse ; 15(663): 1657-1660, 2019 Sep 18.
Artigo em Francês | MEDLINE | ID: mdl-31532116

RESUMO

Old age with its succession of losses is a vulnerable phase in life for developing or exacerbating mental illnesses. Pragmatically, we can identify three types of senior patients: patients presenting behavioral and psychological symptoms of dementia, patients affected by a chronic mental illness, patients experiencing a first major psychiatric syndrome in later life. The purpose of this article is to describe the specific programs developed by the day care hospital of the Geriatric Psychiatry Service, Geneva University Hospitals, to respond to the need of these groups of patients as well as their relatives. This community psychiatric care intends to provide a better psychological adaption in order to support functional and social recovery.


Assuntos
Hospital Dia , Psiquiatria Geriátrica , Transtornos Mentais , Doença Crônica , Hospital Dia/psicologia , Demência/terapia , Psiquiatria Geriátrica/métodos , Psiquiatria Geriátrica/tendências , Hospitais Universitários , Humanos , Transtornos Mentais/terapia
3.
Soins Psychiatr ; 40(323): 17-20, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402034

RESUMO

As part of a 'Culture in hospital' initiative, street art was displayed in the grounds of Théophile-Roussel hospital, a public mental healthcare facility in Montesson. Professional graffiti artists organised a street art festival, aimed at patients, children, teenagers, adults and the medical and educational staff. This article describes this innovative initiative and the role of cultural and artistic projects in care.


Assuntos
Terapia pela Arte , Transtornos Mentais/terapia , Difusão de Inovações , França , Hospitais , Humanos
4.
Soins Psychiatr ; 40(323): 12-16, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402033

RESUMO

The distinction between therapeutic activities and occupational activities seems obvious. On what is this difference based? How can we predict whether an activity will or will not be therapeutic? Using the question of the meaning of our activities as a basis, we can consider what care in psychiatry entails.


Assuntos
Transtornos Mentais/terapia , Humanos , Terapia Ocupacional
5.
Soins Psychiatr ; 40(323): 25-28, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402036

RESUMO

Art therapy is starting to find its place in psychiatric units. However, depending on the facility, it is seen either as an occupational activity, or as a real therapy. While, in both cases, art therapy provides a form of care, it is essential that it is carried out in specific conditions to be truly effective as part of a therapeutic project.


Assuntos
Terapia pela Arte , Transtornos Mentais/terapia , Humanos , Unidade Hospitalar de Psiquiatria
6.
Soins Psychiatr ; 40(323): 29-34, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402037

RESUMO

Art is used as a form of mediation in care units. In addition to its benefit as an occupational activity, it is rooted in the tangible which can help combat apragmatism and anxiety.While this practice helps patients give meaning to their existence, the group approach and the help of a therapist form part of personalised care projects. Work around the self-portrait is an illustration of this practice, between the occupational and the therapeutic.


Assuntos
Terapia pela Arte/métodos , Transtornos Mentais/terapia , Psicoterapia de Grupo , Autoavaliação , Ansiedade/prevenção & controle , Humanos , Transtornos Mentais/psicologia
7.
Soins Psychiatr ; 40(323): 35-38, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402038

RESUMO

A plastic arts workshop makes no claims to provide therapeutic benefits. Patients are invited to attend without any clear objectives. This occupational activity soon becomes rooted in the care approach. Supported by the nurse, patients draw on their creativity and express a shared pleasure for artistic production. The story of Cyrille conveys a real journey, a vehicle for mental reconstruction, towards the path of possibilities.


Assuntos
Terapia pela Arte/métodos , Transtornos Mentais/terapia , Criatividade , Humanos , Transtornos Mentais/psicologia , Plásticos , Prazer
8.
Soins Psychiatr ; 40(323): 41-43, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402039

RESUMO

A new type of patient has been arriving in psychiatry over recent years, migrants, with complex psychological, social, cultural and political issues. How and with what means can we, as caregivers, take this complexity on board? What do these patients make of their healthcare experience and how do they deal with the pathway imposed by hospitalisation?


Assuntos
Transtornos Mentais/terapia , Migrantes/psicologia , Humanos , Psiquiatria
9.
Tijdschr Psychiatr ; 61(7): 487-497, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31372970

RESUMO

BACKGROUND: Although the evidence is expanding, in mental health care shared decision making (SDM) is not widely applied. Moreover, little is known about the use of routine outcome monitoring (ROM) and eHealth in SDM.
AIM: PhD research on the added value of SDM using ROM and eHealth for patients and clinicians in mental health care.
METHOD: Three studies: 1. a literature research and a cross-sectional study on decisional conflict; 2. ROM implementation research and a cluster randomised trial on shared decision making using ROM (Breakthrough program); 3. a cluster randomised trial on shared decision making during the intake (regional).
RESULTS: The interventions did not lead to reduced decisional conflict for all patient groups. Decisional conflict gives insight into the patient's perspective on the quality of the decision making process and decisions being made. Only patients with depression, who participated in the national trial, reported less decisional conflict. This trial did not show a higher level of SDM, but did show increased usage of rom in clinical practice. Although the regional trial showed no results on decisional conflict, the application of SDM and treatment outcomes improved.
CONCLUSION: SDM in mental health care needs further improvement. We recommend investigating how to support patients better, taking into account the role that suits them.


Assuntos
Tomada de Decisões , Transtornos Mentais , Conflito (Psicologia) , Humanos , Transtornos Mentais/terapia , Saúde Mental , Participação do Paciente
10.
Stud Health Technol Inform ; 262: 228-231, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349309

RESUMO

Conversational agents are being used to help in the screening, assessment, diagnosis, and treatment of common mental health disorders. In this paper, we propose a bootstrapping approach for the development of a digital mental health conversational agent (i.e., chatbot). We start from a basic rule-based expert system and iteratively move towards a more sophisticated platform composed of specialized chatbots each aiming to assess and pre-diagnose a specific mental health disorder using machine learning and natural language processing techniques. During each iteration, user feedback from psychiatrists and patients are incorporated into the iterative design process. A survival of the fittest approach is also used to assess the continuation or removal of a specialized mental health chatbot in each generational design. We anticipate that our unique and novel approach can be used for the development of conversational mental health agents with the ultimate goal of designing a smart chatbot that delivers evidence-based care and contributes to scaling up services while decreasing the pressure on mental health care providers.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Interface Usuário-Computador , Comunicação , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Saúde Mental , Processamento de Linguagem Natural
11.
Stud Health Technol Inform ; 262: 292-295, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349325

RESUMO

Mental health indicators are essential for monitoring people's mental health status, developing mental health policies, and evaluating the performance of such policies. The aim of this paper is to describe the development of a web-based tool for mental health indicators capable to support the management of Brazilian mental health care networks. The SISAM is a web information system responsible for management and provision of mental health information in Brazil and it was chosen as the use case of this study. The indicators were developed as a decision support web tool for public health managers. The tool is able to calculate 11 indicators related to inpatient care. A descriptive analysis of all indicators is presented using SISAM data from 2017. The results generated by the tool are promising and could provide improvements on care monitoring, evaluation of possible trends and investments in prevention and promotion in mental health care.


Assuntos
Assistência à Saúde , Internet , Transtornos Mentais , Saúde Mental , Brasil , Política de Saúde , Indicadores Básicos de Saúde , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia
12.
Stud Health Technol Inform ; 261: 303-308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156135

RESUMO

BACKGROUND: Using mobile applications in health is progressing rapidly; hence, assessing them is essential to ensure their quality and standards. The present study was designed to critically evaluate the quality of existing applications in the field of mental health. METHODS: In this is review the related keywords "Health and Mental health" were used in Persian and English to search in 4 application platforms: App Store, Google Play, Bazar (Persian version of Google Play), Sib app (Persian version of App Store). Inclusion criteria for the applications were either in Persian or English language and compatible with Android or IOS. The exclusion criteria were any application downloaded less than 100 times and those that were one dimensional such as only focusing on sleep disorder. A team of researchers reviewed each app in terms of two sets of criteria: 1) Mobile App Rating Scale (MARS) subdomain scores for reviewing engagement, functionality, esthetics, and information; and 2) personalization level. RESULT: The search resulted in 958 apps, of which 61 had the inclusion criteria. Most of them (n=59, 97%) were rated as appropriate for all age groups and only two were designed for children. In MARS score, thirty-three percent (n=5) of the Persian apps received the rating of 2.5 or higher, while this score was 53 percent (n=27) for English applications. Eight application (13%) used dialogue boxes for personalization and 11 (18%) had feedback capability. None of the Persian apps could be personalized. CONCLUSION: Although numerous apps are available, there are only few apps with personalization features, which should be considered as one of the key features when developing this type of apps.


Assuntos
Transtornos Mentais , Saúde Mental , Aplicativos Móveis , Adulto , Criança , Humanos , Transtornos Mentais/terapia
13.
Nervenarzt ; 90(7): 700-704, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31165211

RESUMO

The Wedding model is a recovery-orientated treatment model that was implemented in 2010 as part of a complex change project in the Department of Psychiatry of the Charité at the St. Hedwig Hospital (PUK-SHK). According to this model, all ward structures were changed in order to promote transparency, participation, trialogue and multiprofessional work. A strong focus was also laid on therapeutic attitudes and the opening of acute psychiatric wards. The relevance of the Wedding model as a possible tool to implement a recovery-orientated, person-centered approach of care and its possible role in the reduction of coercion are the subject of this article.


Assuntos
Atitude do Pessoal de Saúde , Transtornos Mentais , Modelos Psicológicos , Psiquiatria , Coerção , Humanos , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria , Psiquiatria/métodos , Psiquiatria/normas
14.
Nervenarzt ; 90(7): 680-689, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31165212

RESUMO

BACKGROUND: Currently, it is a topic of debate whether psychiatric hospitals can and should be managed with a full open door policy. The revised legislation of public law for involuntary commitment explicitly allows or even encourages such practice in several German federal states. In parts of Austria, open doors are required for legal reasons. A systematic literature search was conducted for articles providing empirical data related to this issue. METHOD: Literature search in PubMed augmented by a manual search in references of retrieved papers and reviews with similar objectives. RESULTS: A total of 26 articles reporting empirical data could be identified. Most of these articles came from Germany or Switzerland. The majority were published within the past 5 years. The definition of "open doors" ranged from an only vaguely defined open door policy up to explicit set time periods with open doors. Some studies reported a decrease in coercive interventions. No study reported any associated adverse events resulting from open doors in psychiatric wards. DISCUSSION: Generally, all studies had methodological weaknesses. Prospective randomized controlled studies or quasi-experimental studies are missing in the context of European healthcare systems. The risk of bias was considerable in most studies. A final conclusion regarding the possible extent of psychiatry with open doors and the associated risks is currently not possible. There is an urgent need for future high-quality prospective studies.


Assuntos
Hospitais Psiquiátricos , Transtornos Mentais , Psiquiatria , Europa (Continente) , Hospitais Psiquiátricos/normas , Humanos , Transtornos Mentais/terapia , Estudos Prospectivos , Psiquiatria/métodos , Psiquiatria/organização & administração , Psiquiatria/normas
15.
Nervenarzt ; 90(7): 695-699, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31175380

RESUMO

In connection with the UN Convention on the Rights of Persons with Disabilities, mental healthcare concepts increasingly focus on the prevention of violence and coercion. Hospital care with an open-door policy is linked with a reduction in violence and coercive measures. The authors describe a specific therapeutic milieu aiming to promote social resources and to reduce institutional exclusion. Open-door policies can be extended to and tied in with outreach community mental health work. Model projects according to § 64b of the German Social Code (SGB V) on interdisciplinary care enable flexible needs-based care including home treatment for severe mental illness.


Assuntos
Serviços de Saúde Comunitária , Transtornos Mentais , Serviços de Saúde Mental , Psiquiatria , Coerção , Serviços de Saúde Comunitária/ética , Serviços de Saúde Comunitária/legislação & jurisprudência , Serviços de Saúde Comunitária/normas , Pessoas com Deficiência/legislação & jurisprudência , Pessoas com Deficiência/psicologia , Alemanha , Humanos , Transtornos Mentais/terapia , Serviços de Saúde Mental/ética , Serviços de Saúde Mental/legislação & jurisprudência , Serviços de Saúde Mental/normas , Psiquiatria/ética , Psiquiatria/legislação & jurisprudência , Psiquiatria/normas , Violência/prevenção & controle
16.
Prax Kinderpsychol Kinderpsychiatr ; 68(5): 402-418, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31250720

RESUMO

Having an Eye for Families? - Standardized Family Diagnostics in Socialpediatric Centres In socialpediatric centres (SPZ) children and adolescents with mental and/or physical disorders/impairments are diagnosed and treated together with their families. This cross-sectional study researches to what extent standardized family diagnostic questionnaires are used in this context. One third of the 152 German SPZ participated in this questionnaire study (N = 50). While nearly all SPZ use intelligence tests (98 %) and symptom questionnaires (100 %) (s. Sydow u. Homes, in prep.), family diagnostic is applied remarkably seldom in German socialpediatric centres up to now: Only 14 of 28 family questionnaires whose use we had evaluated systematically, ever were used by the participating SPZs. Implications for research and clinical practice are derived.


Assuntos
Saúde da Família , Transtornos Mentais/diagnóstico , Inquéritos e Questionários , Adolescente , Criança , Estudos Transversais , Pessoas com Deficiência/psicologia , Alemanha , Humanos , Testes de Inteligência , Transtornos Mentais/terapia
17.
Prax Kinderpsychol Kinderpsychiatr ; 68(5): 419-437, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31250723

RESUMO

Family Psychiatry - The Attachment-Focused, Systemic-Oriented, Integrative Concept of the Family Therapy Centre (FaTC), an Acute Multi-Family Day Clinic Up to three quarters of the children of mentally ill parents develop a mental disorder during their lifetime. The transmission occurs essentially through dysfunctional interaction and disturbed attachment. Parent-child interaction is characterized by a vicious circle of escalating symptoms in the child and increasing helplessness in the parents. For this family psychiatric approaches are helpful, which address the interaction in addition to the individual disorders. The Family Therapy Centre (FaTC) Neckargemünd offers family psychiatric, integrated therapy for parents and children in an acute day clinic multi-family setting. The basic therapeutic principles are attachment orientation, mentalisation and systemic perspective with a multi-family therapy approach. Typical family psychiatric case constellations are presented, for which the concept seems particularly helpful: (1) Early childhood regulatory disorders in interaction with mentally ill parents, (2) mother with PTSD and expansive-aggressive preschool child and (3) adolescents with separation anxiety and depressive-anxious mother. The previous experiences are reflected by a moderated focus group of the entire FaTC team. The FaTC concept was evaluated as very helpful. It was positively judged that the family system is visibly present on site (and not only virtually). The focus is on interaction, therefore causal therapy can be offered rather than symptomatic treatment. Limitations of the concept are therapy of severely aggressive adolescents or parents who do not want to participate. The concept of the FaTC is currently being scientifically evaluated.


Assuntos
Filho de Pais Incapacitados/psicologia , Terapia Familiar/métodos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Relações Pais-Filho , Pais/psicologia , Psiquiatria/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Familiar/organização & administração , Feminino , Grupos Focais , Humanos , Masculino , Psiquiatria/organização & administração
19.
Rev Infirm ; 68(250): 28-30, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31147072

RESUMO

Isolation and restraint both aim to protect the patient. Their practice, monitored and assessed, must meet ethical, legal, clinical and organisational requirements. It has its advantages (pacification) and its limits (loss of freedom to make choices about one's care).


Assuntos
Transtornos Mentais , Isolamento de Pacientes , Psiquiatria , Restrição Física , Humanos , Transtornos Mentais/terapia
20.
Soins Pediatr Pueric ; 40(308): 30-32, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31171297

RESUMO

The question of "child witches" is a tropism of the transcultural clinic. Caring for these children is a real clinical challenge. It goes beyond the subjectivity of the teenager to include the adults around him or her and the cultural representations which inhabit them. It also addresses the effects of migration, the psychological frailties of the adults and their traditional theories. This reflection shows the decentering work which clinicians need to do.


Assuntos
Contratransferência (Psicologia) , Características Culturais , Transtornos Mentais/terapia , Bruxaria , Criança , Humanos
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