Narrative psychiatry

Bipolar disorder (BD) is a heritable mood disorder characterized by episodes of mania and depression. Although genomewide association studies (GWAS) have successfully identified genetic loci contributing to BD risk, sample size has become a rate-limiting obstacle to genetic discovery. Electronic health records (EHRs) represent a vast but relatively untapped resource for high-throughput phenotyping. As part of the International Cohort Collection for Bipolar Disorder (ICCBD), we previously validated automated EHR-based phenotyping algorithms for BD against in-person diagnostic interviews (Castro et al...

OBJECTIVES: Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents' adherence to care. METHOD: We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED...

This paper looks at the relationship between fiction and psychiatry. Specifically, the idea of psychiatrists as fiction writers is explored, and reference is made to various fictional texts to illustrate the problems of stigma and negative imagery. These two main areas of focus are highlighted as ones that the practice of writing fiction might address, and some potential pitfalls are discussed. The paper suggests how psychiatrists might ameliorate the present problems by incorporating their unique clinical skills and knowledge into fictional narratives...

A fictional journey was planned and carried out in a time machine, to know and understand the glorious past of Central Institute of Psychiatry (CIP), Ranchi. As Dr. Anand, the protagonist, went through different periods in the history of CIP, he narrated his experiences while meeting different peoples in different clinical settings. In this journey, he met Lt. Col Berkeley-Hill at European Mental Hospital, as it was in the 1930s. He tried to understand the relevance of Professor Mapother's report and its essence in relation to European and Indian psychiatric scenario during inter-war period, the significance of Moore-Taylor's report, and the direction of psychiatric training and teaching during postindependence era under Major RB Davis as the superintendent of Hospital for Mental Diseases (HMD)...

Personalised psychiatry is the promise that biological stratification and analysis of 'big' data will enable clinical prediction.<br/> AIM: To analyse promises and problems regarding personalised medicine in the psychiatry.<br/> METHOD: Analysis of current challenges.<br/> RESULTS: Essential challenges are: 1. Biological psychiatry yields weak findings and clinically negligible diagnostic likelihood ratios. 2. The impact of biological stratification in medicine is relatively small yet may result in explosive health care costs...

Very little has been published on the rise and fall of psychosurgery in Australia. In the mid-twentieth century, Western Australia was the largest but most sparsely-populated of the six Australian States, and its local psychiatry practice was, as one commentator put it, 'backward'. Nonetheless, electroconvulsive therapy was introduced in 1945, and leucotomy in 1947. This paper will explore the introduction of leucotomy to Western Australia in the context of wider national and international trends in psychiatry, and posit some reasons for its decline and abandonment in the 1970s...

INTRODUCTION: Vaccines are one of the newer therapeutic modalities being researched in psychiatric illnesses with limited role of pharmacological interventions. Preclinical studies on vaccines have shown favorable results in conditions like Substance use Disorders and Alzheimer's Dementia. However, the utility of Mumps Measles Rubella vaccine has been overshadowed by controversy linked to causation of Autism. With this background, the current narrative review aimed to comprehensively and critically evaluate the current status of vaccines in Psychiatric illnesses...

INTRODUCTION: Bipolar disorder is a chronic and recurrent mood disease that includes symptoms that fluctuate from euphoria to depression. As a mood disorder, itis one of the main contraindications for transplantation procedures. The case is presented of a patient with bipolar disorder who had a heart transplant after a cardiac arrest. Heart transplantation is the treatment of choice in patients with heart failure and arrhythmias that do not respond to conventional treatment. METHODS: Case report and narrative review of literature...

The Munchausen syndrome and Munchausen syndrome by proxy are factitious disorders characterized by fabrication or induction of signs or symptoms of a disease, as well as alteration of laboratory tests. People with this syndrome pretend that they are sick and tend to seek treatment, without secondary gains, at different care facilities. Both syndromes are well-recognized conditions described in the literature since 1951. They are frequently observed by health teams in clinics, hospital wards and emergency rooms...

The authors present a narrative review from the diagnostic and nosologic viewpoints of mood disorders (bipolar and depressive ones) by revisiting the revision from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision to DSM-5, including the following: the separation of the bipolar and depressive sections; the addition of increased energy and continuation of symptoms to the hypo/manic criteria; the elimination of mixed episodes; the creation of new categories and specifiers ("other specified bipolar and related disorder", "disruptive mood dysregulation disorder", "with anxious distress", "with mixed features", "with peripartum onset"); the categorization of hypo/manic episodes during antidepressant treatment into bipolar disorder; the elimination of the "bereavement exclusion"; the ambiguous separation between bipolar I and II; the insufficient distinction between "other specified bipolar and related disorders" and major depressive disorder; the differentiation regarding borderline personality disorder; agitation; premenstrual dysphoric disorder; and society and psychiatry...

An ambition of depression biomarker research is to augment psychometric and cognitive assessment of clinically relevant phenomena with neural measures. Although such applications have been slow to arrive, we observe a steady evolution of the idea and anticipate emerging technologies with some optimism. To highlight critical themes and innovations in depression biomarker research, we take as our point of reference a specific research narrative. We begin with an early model of frontal-limbic dysfunction, which represents a conceptual shift from localized pathology to understanding symptoms as an emergent property of distributed networks...

INTRODUCTION: Although classical randomized clinical trials (RCTs) are the gold standard for proof of drug efficacy, randomized discontinuation trials (RDTs), sometimes called "enriched" trials, are used increasingly, especially in psychiatric maintenance studies. METHODS: A narrative review of two decades of experience with RDTs. RESULTS: RDTs in psychiatric maintenance trials tend to use a dependent variable as a predictor: treatment response...

This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness...

OBJECTIVES: We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. METHODS: Narrative review of published English-language articles. RESULTS: After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers...

Objective: This manuscript reviews medical literature published pertaining to the management of chronic pain with medical marijuana therapy (MMJ), with an emphasis on the social, medical, and legal aspects of therapy. Design: Narrative review of peer-reviewed literature. Methods: The 3rd Symposium on Controlled Substances and Their Alternatives for the Treatment of Pain was held in Boston on February 27, 2016, with a focus on MMJ for the treatment of chronic pain...

OBJECTIVES: The aim of this study was to explore medical students' learning experiences from the didactic teaching formats using either text-based patient cases or video-based patient cases with similar content. The authors explored how the two different patient case formats influenced students' perceptions of psychiatric patients and students' reflections on meeting and communicating with psychiatric patients. METHODS: The authors conducted group interviews with 30 medical students who volunteered to participate in interviews and applied inductive thematic content analysis to the transcribed interviews...

Dissociative Identity Disorder (DID) is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition...

INTRODUCTION: The collaborative care model is an approach providing care to those with mental health and addictions disorders in the primary care setting. There is a robust evidence base demonstrating its clinical and cost-effectiveness in comparison with usual care; however, the transitioning to this new paradigm of care has been difficult. While there are efforts to train and prepare healthcare professionals, not much is known about the current state of collaborative care training programmes...

BACKGROUND AND AIMS: It has been well established that long-term antipsychotic treatment prevents relapse, lowers number of rehospitalisations, and also effectively reduces violent behaviour. Although violent behaviour is not a typical manifestation of schizophrenia or other psychotic disorders, the diagnosis of psychosis increases the overall risk of violence. One of the few modifiable factors of violence risk is adherence with medication. In contrast, non-adherence with drug treatment and subsequent relapse increases risk of violent acts...

PURPOSE: In an effort to provide medical students with opportunities for accurate grading, some psychiatry clerkship directors allow for grade appeals. The authors examined the appeals process from the clerkship directors' perspective. METHODS: A 23-item survey, consisting of multiple choice and narrative questions, was sent to allopathic and osteopathic accredited schools in North America. Questions included information about the medical school, the clerkship director, and the grade appeal processes...