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Guideline And Psychiatry

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...
August 24, 2018: Der Nervenarzt
Anita Thapar
The 21st century has witnessed the discovery of multiple rare and common gene variants associated with attention deficit hyperactivity disorder (ADHD), and these discoveries have already provided a starting point for the investigation of the biology of the disorder and novel treatments. The purpose of this selective review is to examine genetic findings from the past 5 years and consider their implications for the conceptualization of ADHD and future clinical practice. Recent discoveries reveal the strong genetic overlaps between ADHD and autism spectrum disorder (ASD) as well as intellectual disability...
August 16, 2018: American Journal of Psychiatry
Christian Jagsch, Alex Hofer
BACKGROUND: The number of people with diseases of the schizophrenia spectrum in old age will increase significantly in the coming years. In the literature the topics of schizophrenia and delusional disorders in older and old people are inadequately represented. AIM: This article gives an overview of the most important diagnostic and differential diagnostic characteristics. Another important aspect is the pharmacological and non-pharmacological treatment options in old age...
August 14, 2018: Zeitschrift Für Gerontologie und Geriatrie
Kenji Sugiyama, Takao Nozaki, Tetsuya Asakawa, Tetsuro Sameshima, Schinichiro Koizumi, Hisaya Hiramatsu, Hiroki Namba
Deep brain stimulation (DBS) is used to treat symptoms by modulating the cortico-striato-thalamo-cortical (CSTC) loop in the central nervous system (CNS), and attempts to research loop circuit disorders have been globally initiated among the intractable neurological and psychiatric disorders. DBS treatment has been evaluated for all these newly found CNS loop circuit disorders. In 2011, neurosurgical treatments for psychiatric disorders were renamed from "psychosurgery" to "neurosurgery for psychiatric disorders (NPD)" by the World Society for Stereotactic and Functional Neurosurgery (WSSFN)...
September 15, 2018: Neurologia Medico-chirurgica
Robert Waltereit, Martha Feucht, Magdalena C de Vries, Julia Huemer, Veit Roessner, Petrus J de Vries
Neuropsychiatric manifestations in Tuberous Sclerosis Complex (TSC): diagnostic guidelines, TAND concept and therapy with mTOR inhibitors Abstract. Tuberous sclerosis complex (TSC), albeit a rare autosomal-dominant multisystem disease with an incidence of 1:6,000, is one of the most important monogenetic disorders in child and adolescent psychiatry. In up to 90 % of patients, neurological disorders such as epilepsy and psychiatric disorders such as autism spectrum disorder, ADHD, affective disorders, and intellectual disability are observed...
August 6, 2018: Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie
Kevin P Brazill, Stephen Warnick, Christopher White
Family medicine physicians are often the first providers to encounter and identify mental illness in their patients. Having a solid understanding of three landmark studies-Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), Sequenced Treatment Alternatives to Relieve Depression (STAR*D), and Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)-can significantly improve a family medicine physician's approach to mental illness and treatment choices, ultimately improving patient outcomes...
November 2018: International Journal of Psychiatry in Medicine
Helena J Teede, Marie L Misso, Michael F Costello, Anuja Dokras, Joop Laven, Lisa Moran, Terhi Piltonen, Robert J Norman
STUDY QUESTION: What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise and consumer preference? SUMMARY ANSWER: International evidence-based guidelines, including 166 recommendations and practice points, addressed prioritized questions to promote consistent, evidence-based care and improve the experience and health outcomes of women with PCOS. WHAT IS KNOWN ALREADY: Previous guidelines either lacked rigorous evidence-based processes, did not engage consumer and international multidisciplinary perspectives, or were outdated...
September 1, 2018: Human Reproduction
Charles Alezrah, Marielle Lafont, Roland Bouet, Anne Depaigne-Loth, Cédric Paindavoine, Michel Laurence, Marie-Hélène Rodde-Dunet, Jean-Louis Senon
Over recent years, the psychiatric sector has endeavoured to develop community-based care. Paradoxically, the number of compulsory hospitalisations is increasing. At the same time, the legal framework is evolving and measures relating to the deprivation of liberty in the context of psychiatric care have given rise to extensive guidelines. The work of the French National Health Authority represents, in this context, a certain continuity, with regard to the legal, ethical and social discussions around restriction of liberty practices within psychiatric units...
July 2018: Soins. Psychiatrie
Peer Briken, Daniel Turner, Flaurence Thibaut, John Bradford, Paul Cosyns, Safiye Tozdan
Guidelines for pharmacological treatment of patients with paraphilic disorders have been developed by a working group of the World Federation of Societies of Biological Psychiatry (Thibaut et al. 2010 ). With an increasing duration of experience and number of treated patients as well as aging patients, change of or withdrawal from testosterone lowering medications (TLM) has become an important issue. The current study aimed to assess the quality of a structured professional judgement procedure that helps switching or discontinuing especially TLM in patients with paraphilic disorders...
July 24, 2018: Journal of Sex & Marital Therapy
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