The context and historical correlations of the origin and development of the oldest continually existing residential alcohol treatment model ("Apolinar model") in Central Europe from 1948 to 1960.

Building upon the tradition of the oldest specialized programs, the "Apolinar model" of alcohol treatment influenced the emergence and development of residential treatment programs in what is now the Czech Republic and Slovakia. Similarly to the socialist concept of unitary economy, this approach was applied in all emerging treatment programs until the Velvet Revolution. To identify and describe the key factors determining the origin and development of residential alcohol treatment and what became known as the Apolinar model in the context of the development of the addiction-specific institutional infrastructure. Qualitative content analysis of retrieved historical documents was used to identify and establish the sources and data. The relevant documents were identified and compiled according to their thematic relationship with the focus of the research in terms of their place and time of origin and authorship. The Apolinar model represented a compact and unique treatment approach. This was owed to both foreign and local experience, ideas and inspiration, which the program drew on. The key figure behind the Apolinar model was Jaroslav Skála. In addition to achieving the maximum that was possible at the time and creating a homogeneous, original, and successful residential alcohol treatment model, Skála succeeded in establishing valuable international links and kept his facility and the emerging Czechoslovak addiction professional community in contact with the latest international trends and leading institutions.

[The emotional issue at the heart of the therapeutic link]. / La question des émotions au cœur du lien thérapeutique.

Within the caregiver-patient relationship, the emotional burden and internal psychological tensions are central. If the desire to care leads to an encounter with the patient, a whole professional "growth" is to be built in order to learn how to relate to emotions and affects that accompany care situations. This "step sideways" allows for caring thinking. The avoidance of this acceptance can lead the caregiver to a psychic economy, to an overly framed posture, at the risk of not welcoming the patient's suffering. Finally, the managerial ideology, if present in the hospital today, represents a brake on the capacity to think the clinic.

[The home visit: "If it were only work at the level of the daisies, not much would happen there"]. / Visite à domicile : de l'importance de la supervision.

The home visit is a nursing practice more particularly developed within the framework of the medico-psychological centre. Going to the patient's home to ensure continuity of care is not an easy task. Although approached in a nursing training institute, it cannot be learned. Clinical situations are sometimes explosive or disconcerting, undermining the helpless and inadequately prepared nurse. Supervision of nursing practices can be life-saving and allow everyone to make sense of clinical situations. Feedback from experience.

[Care programmes, to respond to the breakdown of care and lack of consent in psychiatry]. / Programmes de soins, pour répondre à la rupture de soins et au défaut de consentement en psychiatrie.

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.

[From geriatric psychology to old age psychiatry]. / De la psychogériatrie à la psychiatrie de la personne âgée.

The story of the old age psychiatry unit François-Rabelais at the hospital in Quimperlé shows the need for practices to evolve, the optimisation of care as well as a specific patient pathway approach. The patient as a player in his or her care remains a focal point. A personalised care project aims to ensure the continuous improvement of the quality of care. In practice, a shift towards ambulatory care shows that 'real life is not hospital' but home.

Ego States of nurses working in psychiatric clinics according to transactional analysis theory.

OBJECTIVE: An effective interpersonal communication is an essential nursing skill required to help provide quality health care and meet the treatment objectives. The aim of this study was to investigate the communication between the psychiatric nurses and the patients in terms of Transactional Analysis Theory ego states. METHODS: The quantitative and qualitative research methods were used. The descriptive statistics (frequency, percentage, mean, standard deviation) were used in the data analysis and Kendall's Tau-c coefficient was used to assess the agreement among the observers. RESULTS: Of the psychiatric nurses, 66.7% (n = 14) had served as a psychiatric nurse for 1-10 years. Among the nurses, 52.4% (n=11) had received training about communication from any institution/organization. The agreement among the opinions of the nurses, the researcher and the charge nurses about the psychiatric nurses' ego states showed that there was a significant relationship between the researcher's opinion of the nurses' ego states and the charge nurses' opinion of the nurses' ego states in terms of Critical Parent, Nurturing Parent, Adult, Adapted Child and Natural Child ego states. CONCLUSION: It is suggested that training be offered in regards to raising awareness about ulterior transactions that can affect communication negatively, patient autonomy and therapeutic communication in particular, and patients requiring the use of special communication methods.

Neuropsychiatric symptoms of patients two years after experiencing severe COVID-19: A mixed observational study.

BACKGROUND: The impact of SARS-CoV-2 infection (COVID-19) on mental health has not been extensively studied in the medium and long term. This study assessed how clinical, biological, and social factors affect mental health in patients who recovered from severe COVID-19. The evaluation was done 90 days after hospital discharge and followed up at 12 and 24 months. METHODS: A retrospective-prospective cohort mixed observational study was conducted on patients over 18 years of age who required hospitalization in Internal Medicine or ICU for severe COVID-19 pneumonia during 2020 and 2021. Demographic information, clinical variables, and data for the scales were obtained from electronic medical records and telephone interviews. For comparisons of the different variables in each clinical variable (insomnia, depression, anxiety), the Student's t-test for independent samples has been used (normal distribution); otherwise, the Mann-Whitney test will be used. All tests and intervals will be performed with a confidence level of 95. Fisher's exact or Pearson's Chi-square test has been used as appropriate for qualitative variables. RESULTS: 201 patients were recruited. 37.3% presented insomnia, 22.4% anxiety, and 21.4% depressive symptoms. A direct association was established between female sex and depressive symptoms. Psychotropic history, fatigue, and C-reactive protein levels (CRP) were correlated with depression. Anosmia and ageusia, CRP, cognitive symptoms, and dyspnea predicted insomnia. Sex, orotracheal intubation (OTI), pain, fatigue, mental health history, and academic level were independent predictors of anxiety. High percentages of depressive, anxiety, and insomnia symptoms were detected in the second month after discharge and persisted at 12 and 24 months. The fatigue variable maintained a significant relationship with depressive symptoms at 2, 12 and 24 months. A possible limitation could be recall bias in retrospective data collection. CONCLUSIONS: This is a novel study to follow up on mental health for two years in patients with severe COVID-19. Clinical, biological, and psychosocial variables could be predictors of depressive symptoms, anxiety, and insomnia. The psychiatric symptoms persisted throughout the 2-year follow-up. These findings are critical for the follow-up of these patients and open the possibility of further studies in the medium and long term.

The effects of care management on depression treatment in a psychiatric clinic: a randomized controlled trial.

OBJECTIVE: This study aims to examine whether care management has an effect on adherence to depression treatment in a psychiatric clinic in Korea. METHODS: Fifty-seven patients with depression aged 60 years or over participated in the study. They were all low-income patients screened in the community and treated in a psychiatric clinic. The study design was a double-blind randomized controlled trial. The patients were randomly assigned to intervention (n = 29) or usual care (n = 28) groups. Intervention patients received depression care management for 6 months. Primary endpoint was an increase in remission rate as assessed using the 17-item Hamilton Depression Rating Scale score at 6 months. Secondary endpoints included improvement in treatment adherence, improvement in health-related quality of life, and a reduction in feelings of hopelessness. RESULTS: Patients in the care management intervention group showed a higher remission rate than those in the usual care group (55% vs. 29%, p = 0.0421). Intervention patients were significantly more likely to adhere to the treatment (59% vs. 18%, p = 0.0016). The hopelessness score at the 6-month assessment was significantly lower in the intervention group than the usual care group (23.5 vs. 25.7, p = 0.0443). However, there was not a significant group difference in the quality of life. CONCLUSIONS: We found that care management not only contributed to reducing depressive symptoms in geriatric patients suffering from depression but also increased the treatment adherence rate, which in turn increased the remission rate. Care management intervention is both feasible and effective in psychiatric clinics in Korea.

Social, Motivational, and Symptomatic Diversity: An Analysis of the Patient Population of the Phipps Psychiatric Clinic at Johns Hopkins Hospital, 1913-1917.

In the five years after the Phipps Psychiatric Clinic opened in 1913 at Johns Hopkins, its 88 beds were consistently in high demand. Exploiting the biographical information and the particularly descriptive medical narratives in the hospital records of Phipps patients, this study explores the social composition of the patient population, the various avenues by which patients were admitted, and the decision-making processes of families and communities confronting the vicissitudes of mental illness. Quantitative and qualitative analyses of all admissions between 1913 and 1917 reveal that, contrary to scholarly myth, this population was highly diverse socially, motivationally, and symptomatically.

Effects of media portrayals of alleged malpractice in psychiatry and response strategies to mitigate reputational damage: Randomized controlled trial.

Media allegations about malpractice in psychiatry are not uncommon, but little is known about their effects and how clinic management can effectively mitigate reputational damage. This study explored the impact of footage from a TV documentary raising allegations against a psychiatric clinic and assessed the effectiveness of different public response strategies from clinic management. N = 615 adults were randomized to one of four intervention groups watching allegations of malpractice in a psychiatric clinic or unrelated footage (control). Each intervention group further included one specific fictitious public response from clinic management: Denial, attack the accuser, apology, or decline to respond. The primary outcome was attitudes toward psychiatry, assessed before and after the intervention. Secondary outcomes (attitudes toward the staff of the clinic, intentions to recommend the clinic) were measured post-intervention. There was a decrease of favorable attitudes toward psychiatry across intervention groups (F = 14.46, p < .001, ηp2 = .102). Favorable attitudes toward the clinic staff (MD = 0.49, 95% CI = 0.02-0.96, p < .05) and intentions to recommend the clinic to a friend (MD = 0.42, 95% CI = 0.02-0.81, p < .05) were greater when accusations were denied as compared to no response. Media portrayals featuring allegations of psychiatric malpractice cause reputational damage not only to the specific clinic facing allegations, but also to the entire field. Public responses can partially mitigate the reputational damage and are preferable to no response.

Is it possible to implement community care based on mental health in Japan? A comparison between decade ago and present on Duration of Untreated Psychosis (DUP).

INTRODUCTION: In recent years, the early detection and treatment of the first episode of schizophrenia (FES) has attracted worldwide attention. In Japan, psychiatric care has changed to an open and accessible framework over the past decade. Therefore, the duration of untreated psychosis (DUP) is thought to have been shortened. The purposes of this study were to investigate whether recent DUP periods are shorter than they were 10 years ago and whether the DUP at present differs among psychiatric facilities. We investigated the recent DUP at a psychiatric hospital and its satellite clinic. MATERIAL AND METHODS: We examined the differences in DUP, age, sex, referral pathway, living companions, social participation, and schooling history among 3 groups of FES patients: (i) a psychiatric hospital during 1999-2001 and (ii) during 2009-2011, and (iii) a psychiatric clinic during 2009-2011. RESULTS: The average DUP was 14.3 (SD = 17.5) months for the psychiatric hospital during 1999-2001, 16.0 (SD = 18.7) months for the psychiatric hospital during 2009-2011, and 24.4 (SD = 30.0) months for the psychiatric clinic during 2009-2011. No significant differences were found in the DUP for each facility and during this decade. Also, the differences in the DUP could not be attributed to factors such as living companions or social participation. DISCUSSION: Increases in the numbers of patients and psychiatric clinics have not led to the early detection of FES. To shorten the DUP in the future, closer cooperation among the medical field, the educational field, and the health and welfare will be needed.

Mobile Health Apps in OB-GYN-Embedded Psychiatric Care: Commentary.

This paper explores the potential benefits of the use of mobile health (mHealth) apps in obstetrician-gynecologist (OB-GYN)-embedded psychiatric clinics in the United States. First, we highlight the increasing trend of integrating mental health care within the OB-GYN context. Second, we provide examples of successful uses of mHealth in the global health context and highlight the dearth of available research in the United States. Finally, we provide a summary of the shortcomings of currently available apps and describe the upcoming trial of a novel app currently underway at the Mother-Child Wellness Clinical and Research Center at Boston Medical Center.

Price elasticity of demand for psychiatric consultation in a Nigerian psychiatric service.

OBJECTIVE: This paper addresses price elasticity of demand (PED) in a region where most patients make payments for consultations out of pocket. PED is a measure of the responsiveness of the quantity demanded of goods or services to changes in price. The study was done in the context of an outpatient psychiatric clinic in a sub -Saharan African country. METHODS: The study was performed at the University College Hospital (UCH), Ibadan, Nigeria. Aggregate data were collected on weekly clinic attendance over a 24-month period October 2008 - September 2010 representing 12 months before, to 12months after a 67% increase in price of outpatient psychiatric consultation. The average weekly clinic attendance prior to the increase was compared to the average clinic attendance after the price increase. Arc-PED for consultation was also estimated. RESULTS: Clinic attendance dropped immediately and significantly in the weeks following the price increase. There was a 34.4% reduction in average weekly clinic attendance. Arc-PED for psychiatric consultation was -0.85. CONCLUSION: In comparison to reported PED on health care goods and services, this study finds a relatively high PED in psychiatric consultation following an increase in price of user fees of psychiatric consultation.

Prevalence of xerostomia in an adolescent inpatient psychiatric clinic: a preliminary study.

OBJECTIVE: Adolescents with psychiatric conditions may be at risk for xerostomia. In this preliminary study, we estimated xerostomia prevalence in adolescents ages 9 to 17 years from an inpatient psychiatric clinic (N = 25) and examined whether: (1) gender and age were associated with xerostomia and (2) xerostomia was associated with self-reported cavities. METHODS: We used a modified 11-item Xerostomia Index to identify xerostomia (no/yes) and asked if adolescents ever had or currently have cavities (no/yes). RESULTS: The mean age was 14 years (SD = 2.3) and 72% were male. Sixty percent reported xerostomia (SD = 50). There were no significant associations between xerostomia and gender (p = 0.99) or age (p = 0.66), or between xerostomia and past (p = 0.26) or current cavities (p = 0.11). Larger proportions of adolescents with xerostomia reported previous and current cavities. CONCLUSIONS: Sixty percent of adolescents from an inpatient psychiatric clinic reported having xerostomia, which may lead to increased caries risk over time. Additional research should examine the prevalence and consequences of xerostomia in high-risk adolescents.

The need for information and training among staff of psychiatric clinics / Монголын Анагаах Ухаан

Background@#Information and technology knowledge is important for the medical and non-medical staff of hospitals, regardless of their position. @*Aim@#To study needs for information and advanced training among medical professionals. @*Material and Method@#Using a survey questionnaire, the need for information of medical professionals, as well as the ability to independently receive and process the information received, was studied. Data was collected anonymously and obtained informed consent. @*Results@#A high need for up-to-date information among doctors was revealed; the willingness to work with information varied significantly depending on the age of the respondents. When assessing the possibility of satisfying the information, it was found that the available information support does not meet the modern requirements of medical workers in reference books and convenient mobile applications. The lack of commitment of doctors to the principles of evidence-based medicine, most often due to the difficulty in finding sources, was revealed. The possibilities of training doctors of different age groups are evaluated. @*Conclusion@#Organizational solutions are proposed to enhance the professional competencies of psychiatrists regarding the practical application of legislation.

Analysis of patients attending a private psychiatric clinic.

BACKGROUND: Private psychiatric clinics provide help for the bulk of our population, but they have not been evaluated systematically. It is time that we analyze the functioning of these set-ups to improve functioning. This paper is a modest attempt to analyze one such clinic. AIMS: To analyze the diagnostic distribution of the clients attending the clinic and to study the pattern of follow-up. MATERIALS AND METHODS: All records from April 1(st) 1997 to 31(st) March 1999 were analyzed. This is a descriptive study. RESULTS AND CONCLUSIONS: A total of 3077 new patients visited the clinic in this period. The male:female ratio was 54:46. Diagnostic distribution revealed the following: schizophrenia 20%, affective disorders 40%, OCD 8%, dissociative disorders 5.5% and anxiety disorders around 4.5%. The pattern of visits revealed that 50% of the patients dropped out after the first visit. Another 25% did so in next the two visits.

La clínica psicológica y clínica de niños argentina: diagnósticos y tratamientos (1929-1955) / The psychological and psychiatric clinic of children in argentina: diagnostics and treatments (1929-1955)

El presente trabajo analiza el desarrollo de la clínica psicológica y psiquiátrica de niños en Argentina entre los años 1929 y 1955. Para ello se privilegia el estudio de dos instituciones paradigmáticas: el Instituto Psiquiátrico de Rosario, ubicado en la provincia de Santa Fe, y el Centro de Psicología y Psiquiatría del Hospital de Clínicas José de San Martín, en Buenos Aires. En el marco de un estudio ex post facto retrospectivo (Montero & León, 2007), se analiza la correlación entre dos variables: los diagnósticos utilizados y los tipos de tratamiento administrados al niño. El objetivo es determinar cómo se aborda al niño en cada institución (tratamiento psicológico y/o psiquiátrico) a fin de establecer encuentros y desencuentros en el desarrollo que sigue la clínica psicológica de niños.

This paper analyzes the development of psychological and psychiatric clinic of children in Argentina between 1929 and 1955. For this, two paradigmatic institutions are privileged: the Psychiatric Institute of Rosario (Santa Fe), and the Center of Psychology and Psychiatry of the Hospital de Clínicas José de San Martin (Buenos Aires). As part as a retrospective ex post facto study (Montero & León, 2007), the correlation between two variables is analyzed: the diagnostics used and the types of treatment applied to the child. The aim is to determine how the child is approached in each institution (with psychological and/or psychiatric treatment) to document agreements and disagreements in the development that follows the psychological clinic of children.