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Guideline And Psychiatry

M Elzain, I Elimam, S Barry
While suicide and injury account for increased mortality, a large volume of premature deaths in psychiatry are due to medical conditions. The Royal College of Psychiatrists recommend that every new psychiatric admission should have a thorough physical examination within 24 hours of their admission. We randomly reviewed charts of 50 new admission to the Acute Psychiatric Unit to check the adherence to these guidelines. Forty patients (80%) had complete physical examination, nine patients (18%) had incomplete physical examination, and one patient (2%) had no physical examination in the Re Audit...
September 10, 2018: Irish Medical Journal
Erfan Soliman, Sarujan Ranjan, Tianyou Xu, Carol Gee, Aidan Harker, Alvaro Barrera, John Geddes
There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition...
2018: Bio-design and manufacturing
Alkomiet Hasan, Borwin Bandelow, Lakshmi N Yatham, Michael Berk, Peter Falkai, Hans-Jürgen Möller, Siegfried Kasper
This manuscript reviews sources of data typically used in guideline development, available grading systems, their pros and cons, and the methods for evaluating risks of bias in publications, and proposes a revised method for grading evidence and recommendations for use in development of clinical treatment guidelines. The new World Federation of Societies of Biological Psychiatry (WFSBP) grading system allows guideline developers to follow a multi-step approach of defining Levels of Evidence (LoE), applying criteria for grading (define the acceptability) and the Grading of Recommendations (GoR)...
December 11, 2018: World Journal of Biological Psychiatry
Stacey D Espinet, Sandra Gotovac, Sommer Knight, Merrick Zwarenstein, Lorelei Lingard, Margaret Steele
Background: Primary care providers (PCPs) are increasingly called upon to assist in meeting the growing demand for paediatric mental health care in Canada, yet they report inadequate training and confidence to do so. The Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program was designed to fill this gap by teaching PCPs the skills needed to provide frontline care themselves, particularly in rural/remote regions where specialist resources are limited. This innovative educational intervention may improve paediatric mental health care capacity, but a pilot study is needed...
November 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
Tomoya Hirota, Anthony Guerrero, Norman Sartorius, Daniel Fung, Bennett Leventhal, Say How Ong, Hitoshi Kaneko, Suporn Apinuntavech, Abang Bennett, Jegannathan Bhoomikumar, Keun-Ah Cheon, Oyunsuren Davaasuren, Susan Gau, Brian Hall, Evgeny Koren, Tuan van Nguyen, Tin Oo, Susan Tan, Masaru Tateno, Manivone Thikeo, Tjhin Wiguna, Mark Wong, Yi Zheng, Norbert Skokauskas
AIM: Data pertaining to Child and Adolescent Psychiatry (CAP) training systems are limited as extant research was mostly derived from a one-time data collection. This 5-year follow-up survey collects updated information on CAP training systems in the Far East, allowing for the tracking of system changes over the past 5 years. METHODS: Data were obtained from 18 countries, or functionally self-governing areas, in the Far East, 17 of which were also included in the original study...
November 24, 2018: Psychiatry and Clinical Neurosciences
J-P Lang, N Jurado, C Herdt, F Sauvanaud, L Lalanne
CONTEXT: Psychoeducation and therapeutic patient education can be effectively included in treatments for patients with psychiatric disorders. These two effective educational therapies have the common purpose of improving disorder-related morbidity, compliance with treatment and patients' quality of life. While they have different methods of application, both teach patients to play an active role in their own care. However, it is still critical to combine them for care of patients with psychiatric and addiction disorders in a manner that allows for specificity...
November 17, 2018: Revue D'épidémiologie et de Santé Publique
Stefan Unterecker, Gudrun Hefner, Pierre Baumann, Gerd Gründer, Niels Bergemann, Hans-Willi Clement, Andreas Conca, Jürgen Deckert, Katharina Domschke, Gabriel Eckermann, Karin Egberts, Manfred Gerlach, Christine Greiner, Ekkehard Haen, Ursula Havemann-Reinecke, Renate Helmer, Ger Janssen, Eveline Jaquenoud, Gerd Laux, Thomas Messer, Rainald Mössner, Matthias J Müller, Michael Paulzen, Bruno Pfuhlmann, Peter Riederer, Alois Saria, Bernd Schoppek, Georgios Schoretsanitis, Markus Schwarz, Margarethe Silva Gracia, Benedikt Stegmann, Werner Steimer, Julia C Stingl, Manfred Uhr, Sven Ulrich, Roland Waschgler, Gerald Zernig, Gabriele Zurek, Christoph Hiemke
Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood serum or plasma to optimize pharmacological therapy. TDM is an instrument with which the high interindividual variability of pharmacokinetics of patients can be identified and therefore enables a personalized pharmacotherapy. In September 2017 the TDM task force of the Working Group for Neuropsychopharmacology and Pharmacopsychiatry (AGNP) published an update of the consensus guidelines on TDM published in 2011...
November 16, 2018: Der Nervenarzt
Deborah S Johnson
A significant challenge related to nurse practitioner (NP) training is the shortage of clinical sites with qualified faculty to precept NP interns. The problem is compounded in rural communities with provider shortages, restricting their opportunities to train (and potentially recruit) new APRNs. Consequently, these underserved communities have difficulty accessing specialty providers, such as Psychiatric Mental Health Nurse Practitioners (PMHNPs). Combined with geographic distance from urban communities and generally lower pay, many rural and/or remote communities struggle with the disparity in contrast to more populated regions...
October 30, 2018: Issues in Mental Health Nursing
Krithika Chennapan, Samuel Mullinax, Eric Anderson, Mark J Landau, Kimberly Nordstrom, Rawle A Seupaul, Michael P Wilson
BACKGROUND: Patients presenting to the emergency department (ED) with psychiatric complaints often require medical screening to evaluate for a medical cause of their symptoms. OBJECTIVE: We sought to evaluate the existing literature on the medical screening of psychiatric patients and establish recommendations for ideal screening practices in Western-style EDs. METHODS: PubMed, PsycINFO, and were searched for clinical studies examining the medical screening of adult psychiatric patients in the ED or inappropriate referrals to psychiatry...
October 10, 2018: Journal of Emergency Medicine
Fiona Judd, Stephanie Lorimer, Richard H Thomson, Angela Hay
OBJECTIVE: The aim of the study was to explore the range of psychiatric diagnoses seen in pregnant women who score above the 'cut-off' on the Edinburgh Postnatal Depression Scale when this is used as a routine screening instrument in the antenatal period. METHOD: Subjects were all pregnant women referred to and seen by the Perinatal Consultation-Liaison Psychiatry Team of a tertiary public hospital over a 14-month period. Edinburgh Postnatal Depression Scale score at maternity 'booking-in' visit, demographic and clinical data were recorded and diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders (5th ed...
October 12, 2018: Australian and New Zealand Journal of Psychiatry
Chad Bousman, Abdullah Al Maruf, Daniel J Müller
PURPOSE OF REVIEW: The implementation of pharmacogenetic testing in psychiatry is underway but is not yet standard protocol. Barriers to pharmacogenetics becoming standard practice are the lack of translation of evidence-based recommendations and standardization of genetic testing panels. As for the latter, there are currently no regulatory standards related to the gene and allele content of testing panels used to derive medication selection and dosing advice. To address these barriers, we summarize the current gene-drug interaction knowledgebase and proposed a minimum gene and allele set for pharmacogenetic testing in psychiatry...
October 5, 2018: Current Opinion in Psychiatry
Jerry C Middleton, Christopher Kalogeropoulos, Jason A Middleton, Martin Drapeau
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPGs) endeavour to incorporate the best available research evidence together with the clinically informed opinions of leading experts in order to guide clinical practice when dealing with a given condition. There has been increased interest in CPGs that are evidence based and that promote best practice, a central component of which is incorporating the best available research predicated on strong study designs. Despite this soaring interest, there remains heterogeneity in the methodological quality of many CPGs, which may have an effect on the quality of services that clinicians offer...
September 17, 2018: Journal of Evaluation in Clinical Practice
Miro Jakovljevic, Fran Borovecki
Personalized or precision medicine is a relatively new promising concept which is gaining momentum in all branches of medicine including psychiatry and neurology. Psychiatry and neurology are medical specialties dealing with diagnosis, prevention and treatment of brain disorders which are the main causes of years lived with disability worldwide as well as shortened life. Despite a huge progress in clinical psychopharmacology and neuropharmacology, the treatment outcome for many psychiatric disorders and neurologic diseases has remained unsatisfactory...
September 2018: Psychiatria Danubina
Ahlem Houidi, Saeeda Paruk, Benn Sartorius
Background: Individuals who were charged with a serious offence may be referred by courts for forensic psychiatric assessment. The court may declare them as state patients if they are found unfit to stand trial or not criminally responsible because of mental illness or defect.In forensic psychiatry practice, there may be challenges in the forensic psychiatric observation process, and discrepancies may occur between the clinician report and the court's decision. Objectives: To describe elements of the forensic psychiatric observation and discuss the legal correlates associated with the admission of state patients...
2018: South African Journal of Psychiatry: SAJP: the Journal of the Society of Psychiatrists of South Africa
Tamsyn E Van Rheenen, Kathryn E Lewandowski, Jessica M Lipschitz, Katherine E Burdick
Cognitive dysfunction is common in many psychiatric disorders. While it has long been described as a core feature in schizophrenia, more recent data suggest qualitatively similar impairments in patients with bipolar disorder and major depressive disorder. There is compelling evidence to suggest that cognitive impairment contributes directly to functional disability and reduced quality of like across these disorders. As current treatments focus heavily on "primary" symptoms of mood and psychosis, the standard of care typically leaves cognitive deficits unmanaged...
September 24, 2018: CNS Spectrums
Abdulmohsen Alhumoud, Muhammad Zahid, Sameh Ibrahim, Talal Syed, Ahmed Naguy
INTRODUCTION: The offending behavior arising from a mental disorder invokes criminal responsibility doctrines or insanity defenses and calls for legislative framework ensuring availability of care and treatment for the patient and protection of the public from harm from the offender. The conviction of mentally disordered offenders varies depending upon the local legislation and its socio-cultural context, so do the principles, procedures and guidelines for forensic assessments between different countries...
September 2018: International Journal of Law and Psychiatry
Jan Scott, Bruno Etain, Frank Bellivier
Clinical practice guidelines identify lithium as a first line treatment for mood stabilization and reduction of suicidality in bipolar disorders (BD); however, most individuals show sub-optimal response. Identifying biomarkers for lithium response could enable personalization of treatment and refine criteria for stratification of BD cases into treatment-relevant subgroups. Existing systematic reviews identify potential biomarkers of lithium response, but none directly address the conceptual issues that need to be addressed to enhance translation of research into precision prescribing of lithium...
2018: Frontiers in Psychiatry
Narayana Manjunatha, Channaveerachari Naveen Kumar, Suresh Bada Math, Jagadisha Thirthalli
Background: Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value...
April 2018: Indian Journal of Psychiatry
Massimiliano Murgia, Rosanna Izzo, Alessandra Bettinelli, Chiara Di Maggio, Martina De Angelis, Massimiliano Mangone, Marco Paoloni, Andrea Bernetti, Andrea Torquati, Vincenzo Leuzzi, Valter Santilli
BACKGROUND: The Non-Communicating Children Pain Check List-Revised (NCCPC-R) is a clinical assessment tool used to assess and measure pain in children aged 3 to 18 years, with mental and intellectual disabilities, incapable to speaking. AIM: Aim of our study was to test the validity and reliability of the Italian version of the NCCPC- R in children with cognitive impairment, in order to obtain a valid tool for pain assessment in these children. DESIGN: Prospective observational study...
August 29, 2018: European Journal of Physical and Rehabilitation Medicine
K Stengler, M Frank, S G Riedel-Heller, T Becker, I Steinhart, G Gerlinger, I Hauth, A Deister
For most people living with mental illnesses, participating in society is of existential importance; however, psychosocial care often fails to recognize its significance and therefore rarely includes the patient's interaction with society in the course of treatment. The reasons for this are both substantial and organizational in nature. The endless opportunities for participating in society, current areas as well as ways of taking part in social life even beyond the terms of the social legislative definition are, in addition to institutional variety and regional differences, all too often barriers to providing the very urgently needed support...
November 2018: Der Nervenarzt
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