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Psychiatry guidelines

X Jégouzo, M Desbordes, S Delègue, G Le Vacon, M Patrick, S Mouchabac
OBJECTIVES: Behavioral and psychological symptoms have a high prevalence in dementia. They include mood disorders, psychotic disorders and behavioral disorders such as aggression or screaming. Despite a number of side effects and an increased mortality, antipsychotic drugs are widely prescribed for treatment of this disorder. In France, this increased risk of mortality led in 2009 to the adoption of guidelines concerning all antipsychotics. The guidelines propose a sensible use of antipsychotics after the establishment of non-pharmacological measures...
October 12, 2016: L'Encéphale
Martin Knapp, Derek King, Renée Romeo, Jessica Adams, Ashley Baldwin, Clive Ballard, Sube Banerjee, Robert Barber, Peter Bentham, Richard G Brown, Alistair Burns, Tom Dening, David Findlay, Clive Holmes, Tony Johnson, Robert Jones, Cornelius Katona, James Lindesay, Ajay Macharouthu, Ian McKeith, Rupert McShane, John T O'Brien, Patrick P J Phillips, Bart Sheehan, Robert Howard
OBJECTIVE: Most investigations of pharmacotherapy for treating Alzheimer's disease focus on patients with mild-to-moderate symptoms, with little evidence to guide clinical decisions when symptoms become severe. We examined whether continuing donepezil, or commencing memantine, is cost-effective for community-dwelling, moderate-to-severe Alzheimer's disease patients. METHODS: Cost-effectiveness analysis was based on a 52-week, multicentre, double-blind, placebo-controlled, factorial clinical trial...
October 13, 2016: International Journal of Geriatric Psychiatry
M Kölch, P L Plener
Pharmacotherapeutic interventions are available for most psychiatric disorders in children. Evidence for these interventions varies, depending on the targeted disorders. For attention-deficit/hyperactivity disorder, a sound database on efficacy and safety of medication exists. For other common disorders or psychopathological phenomena like disruptive behavior, anxiety disorders, depressive disorders, or autism, data on efficacy and safety are much scarcer. This selective review aims to provide an overview about current psychopharmacological interventions in child and adolescent psychiatry...
October 13, 2016: Pharmacopsychiatry
S Döpfmer, M C Münchmeyer, T Natschke, W Herrmann, F Holzinger, R Burian, A Berghöfer, C Heintze
BACKGROUND: The aim of this study was to compare the approach of general practitioners (GP) and outpatient specialists for psychiatry, neurology or psychosomatic medicine to patients with somatically unexplained complaints. METHODS: Qualitative interviews were conducted with general practitioners in Berlin and with outpatient specialists. Interviews were analyzed by qualitative content analysis. RESULTS: Both GPs and specialists rarely used structured diagnostic instruments...
October 5, 2016: Der Nervenarzt
Elisa Schröder, Hendrik Kajosch, Paul Verbanck, Charles Kornreich, Salvatore Campanella
Event-related potentials (ERPs) bimodal oddball task has disclosed increased sensitivity to show P300 modulations to subclinical symptoms. Even if the utility of such a procedure has still to be confirmed at a clinical level, gathering normative values of this new oddball variant may be of the greatest interest. We specifically addressed the challenge of defining the best location for the recording of P3a and P3b components and selecting the best reference to use by investigating the effect of an offline re-reference procedure on recorded bimodal P3a and P3b...
2016: Frontiers in Psychology
Javier Rivera, Miguel A Vallejo
The objectives of this study are to describe appropriateness and drug treatment of comorbidities in fibromyalgia (FM). Cross-sectional study of a group of patients. Number of drugs, indication, duration and appropriateness of prescriptions were evaluated. Patients were classified as: group 1, (FM/FM) previous FM diagnosis and fulfilling criteria; group 2, (noFM/noFM) other diagnosis and not fulfilling criteria; and group 3, (noFM/FM) other diagnosis but fulfilling criteria. Drugs were classified into drugs for nervous system, analgesics/NSAID and drugs for other comorbidities...
September 23, 2016: Rheumatology International
Gregory Carter, Andrew Page, Matthew Large, Sarah Hetrick, Allison Joy Milner, Nick Bendit, Carla Walton, Brian Draper, Philip Hazell, Sarah Fortune, Jane Burns, George Patton, Mark Lawrence, Lawrence Dadd, Jo Robinson, Helen Christensen
OBJECTIVE: To provide guidance for the organisation and delivery of clinical services and the clinical management of patients who deliberately self-harm, based on scientific evidence supplemented by expert clinical consensus and expressed as recommendations. METHOD: Articles and information were sourced from search engines including PubMed, EMBASE, MEDLINE and PsycINFO for several systematic reviews, which were supplemented by literature known to the deliberate self-harm working group, and from published systematic reviews and guidelines for deliberate self-harm...
October 2016: Australian and New Zealand Journal of Psychiatry
Shareefa Dalvie, Nastassja Koen, Nathaniel McGregor, Kevin O'Connell, Louise Warnich, Raj Ramesar, Caroline M Nievergelt, Dan J Stein
Mental disorders represent a major public health burden worldwide. This is likely to rise in the next decade, with the highest increases predicted to occur in low- and middle-income countries. Current psychotropic medication treatment guidelines focus on uniform approaches to the treatment of heterogeneous disorders and achieve only partial therapeutic success. Developing a global precision medicine approach in psychiatry appears attractive, given the value of this approach in other fields of medicine, such as oncology and infectious diseases...
October 2016: Omics: a Journal of Integrative Biology
K Radenbach, J Retzlik, S H Meyer-Rötz, C Wolff-Menzler, J Wolff, H Esselmann, F Godemann, M Riemenschneider, J Wiltfang, F Jessen
BACKGROUND: Dementia is of increasing medical and societal relevance. Hospitalization of dementia patients is mostly due to behavioral and psychological symptoms of dementia (BPSD). There is a need for sufficient qualified personnel in hospitals in order to be able to effectively treat these symptoms. OBJECTIVES: This study aims at identifying the personnel requirements for guideline-conform, evidence-based inpatient treatment concepts for patients with BPSD and to compare these with the resources defined by the German psychiatric personnel regulations (Psych-PV)...
August 31, 2016: Der Nervenarzt
Lucia Tomas-Aragones, Silla M Consoli, Sylvie G Consoli, Francoise Poot, Klaus-Michael Taube, M Dennis Linder, Gregor B E Jemec, Jacek C Szepietowski, John de Korte, Andrey N Lvov, Uwe Gieler
The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new psychotherapies and psychotropic drugs without forgetting the most important relational characteristics required for dealing with people with these disorders. The management of self-inflicted skin lesions necessitates empathy and a doctor-patient relationship based on trust and confidence...
August 26, 2016: Acta Dermato-venereologica
Peter Aitken, Geoffrey Lloyd, Richard Mayou, Christopher Bass, Michael Sharpe
Aims and method To record the development of liaison psychiatry in the UK and to summarise the current levels of activity. We also highlight the challenges the specialty may face if it is to develop further. History since the 1970s is reviewed by early pioneers and those involved in the present day, with a focus on the key role played by members of the Royal College of Psychiatrists. Results We describe the development of training guidelines, the publication of joint documents with other Royal Colleges, establishing international collaborations and defining service specifications...
August 2016: BJPsych Bulletin
Uta Gühne, Thomas Becker, Steffi Riedel-Heller
The Psychiatry Enquête turned 40 years old last year. The S3 guideline "Psychosocial therapies for severe mental illness" is considered to be the last milestone of the reform to date. This paper highlights new impulses resulting from the S3 guideline for psychiatric care and provides an outlook on the update, expected in 2017. Many of the interventions reported in the S3 guideline are now supported by a broader evidence base.
August 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Sophie Walsh, Eoin Golden, Stefan Priebe
OBJECTIVES: To review systematically the literature on patients' experiences of, and participation in, technology-based monitoring of mental health symptoms. This practice was defined as patients monitoring their mental health symptoms, emotions or behaviours outside of routine clinical appointments by submitting symptom data using technology, with feedback arising from the data (for example, supportive messages or symptom summaries, being sent to the patient, clinician or carer). DESIGN: Systematic review following PRISMA guidelines of studies evaluating technology-based symptom monitoring...
2016: BMJ Open
Kaoru Arai, Ayumi Takano, Takako Nagata, Naotsugu Hirabayashi
BACKGROUND: Most structured assessment tools for assessing risk of violence were developed in Western countries, and evidence for their effectiveness is not well established in Asian countries. AIMS: Our aim was to examine the predictive accuracy of the Historical-Clinical-Risk Management-20 (HCR-20) for violence in forensic mental health inpatient units in Japan. METHODS: A retrospective record study was conducted with a complete 2008-2013 cohort of forensic psychiatric inpatients at the National Center Hospital of Neurology and Psychiatry, Tokyo...
June 13, 2016: Criminal Behaviour and Mental Health: CBMH
Malik Nassan, Wayne T Nicholson, Michelle A Elliott, Carolyn R Rohrer Vitek, John L Black, Mark A Frye
Antidepressants are commonly prescribed medications in the United States, and there is increasing interest in individualizing treatment selection for more than 20 US Food and Drug Administration-approved treatments for major depressive disorder. Providing greater precision to pharmacotherapeutic recommendations for individual patients beyond the large-scale clinical trials evidence base can potentially reduce adverse effect toxicity profiles and increase response rates and overall effectiveness. It is increasingly recognized that genetic variation may contribute to this differential risk to benefit ratio and thus provides a unique opportunity to develop pharmacogenetic guidelines for psychiatry...
July 2016: Mayo Clinic Proceedings
Karsten Ebbing
Behavioral and psychological symptoms of dementia (BPSD) are frequent and represent a challenge for an optimal care of patients. They must be investigated systematically and if necessary analyzed with specialized teams in the domain of old age Psychiatry so that these disorders are optimally addressed and complications are prevented. A precise analysis of potential causes of BPSD in concertation with both family members and caring team allows clinicians to avoid the use of drugs that may appear to solve the immediate issue but happen to have serious side effects or even toxicity over time...
April 20, 2016: Revue Médicale Suisse
M Bohus, C Schmahl, S C Herpertz, K Lieb, M Berger, S Roepke, A Heinz, J Gallinat, L Lyssenko
BACKGROUND: Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure...
July 2016: Der Nervenarzt
A Pfennig, J Conell, P Ritter, D Ritter, E Severus, T D Meyer, M Hautzinger, J Wolff, F Godemann, A Reif, M Bauer
In this article the guideline-adherent psychiatric psychotherapeutic treatment of patients with bipolar disorders is outlined and the required resources are estimated. Based on the core recommendations of the S3 guidelines for diagnostics and treatment of bipolar disorders published in 2012, inpatient treatment needs in hours per week and per patient are determined for both manic and bipolar depressive episodes. The resulting staffing requirements are estimated on this basis. In summary, for guideline-adherent inpatient psychiatric psychotherapeutic treatment the additional needs regarding the physician/psychotherapeutic domain add up to 44 min per patient and week during a manic episode and 88 min for patients with bipolar depression when compared to current psychiatry staffing regulations...
May 24, 2016: Der Nervenarzt
Fiona J Charlson, Amanda J Baxter, Hui G Cheng, Rahul Shidhaye, Harvey A Whiteford
BACKGROUND: China and India jointly account for 38% of the world population, so understanding the burden attributed to mental, neurological, and substance use disorders within these two countries is essential. As part of the Lancet/Lancet Psychiatry China-India Mental Health Alliance Series, we aim to provide estimates of the burden of mental, neurological, and substance use disorders for China and India from the Global Burden of Disease Study 2013 (GBD 2013). METHODS: In this systematic analysis for community representative epidemiological studies, we conducted systematic reviews in line with PRISMA guidelines for community representative epidemiological studies...
July 23, 2016: Lancet
Helena Tenkanen, Helena Taskinen, Raija Kontio, Eila Repo-Tiihonen, Jari Tiihonen, Juha Kinnunen
Forensic psychiatric nurses are key in implementing the core interventions outlined in the clinical practice guideline on schizophrenia. This study endeavors to ascertain how these were implemented in routine practice in forensic psychiatry by measuring how nurses use their time. Data were collected from registered nurses and practical mental nurses in all forensic psychiatric facilities in Finland using self-report diary forms for 1 week. In total, nurses used 20% of their weekly working hours on core interventions...
April 2016: Journal of Forensic Nursing
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