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Integrative psychiatry

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https://www.readbyqxmd.com/read/28427766/evaluation-of-a-model-of-integrated-care-for-patients-with-chronic-medical-and-psychiatric-illness
#1
Aghaegbulam Uga, Shreedhar Kulkarni, Vineka Heeramun, Kathy Bottum
BACKGROUND: Chronic illnesses are prevalent in general medical and psychiatric practices, causing significant disease burden to care givers and providers. Systems of care that treat individuals with mental illness are often separate from general medical systems of care. OBJECTIVE: This study sought to compare the quality of life, satisfaction with care, and utilization of care in patients with comorbid chronic medical and mental illnesses. METHODS: A total of 64 participants from an integrated medicine and psychiatry clinic (med/psych), were compared with 52 patients from separate internal medicine and psychiatry clinics (within the same institution) for quality of life, satisfaction with care, and utilization of care...
February 20, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28426332/buprenorphine-treatment-and-patient-use-of-health-services-after-the-affordable-care-act-in-an-integrated-health-care-system
#2
Cynthia I Campbell, Sujaya Parthasarathy, Kelly C Young-Wolff, Derek D Satre
The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258)...
April 20, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28419586/a-review-of-the-nutritional-challenges-experienced-by-people-living-with-severe-mental-illness-a-role-for-dietitians-in-addressing-physical-health-gaps
#3
REVIEW
S B Teasdale, K Samaras, T Wade, R Jarman, P B Ward
People experiencing a severe mental illness (SMI), such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic features, have a 20-year mortality gap compared to the general population. This 'scandal of premature mortality' is primarily driven by preventable cardiometabolic disease, and recent research suggests that the mortality gap is widening. Multidisciplinary mental health teams often include psychiatrists, clinical psychologists, specialist mental health nurses, social workers and occupational therapists, offering a range of pharmacological and nonpharmacological treatments to enhance the recovery of clients who have experienced, or are experiencing a SMI...
April 17, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28413369/evaluation-of-quality-indicators-of-integrated-care-in-a-regional-psychiatry-budget-a-pre-post-comparison-by-secondary-data-analysis
#4
Anne Berghöfer, Svenja Hubmann, Thomas Birker, Torsten Hejnal, Felix Fischer
The Regional Psychiatry Budget (RPB), as a special arrangement within the German Federal Hospital Refund Regulation, is based on the capitation principle. A lump sum is allocated to a major inpatient care provider in a large region on a yearly basis. Under this model, the provider is free to offer all forms of treatment and to construct individual models of integrated care that specifically suit the region and the needs of community members. The present study aimed to evaluate selected aspects that represent a change in the psychiatric health status of patients in the covered region under the conditions of the RPB...
December 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28403846/the-new-field-of-precision-psychiatry
#5
Brisa S Fernandes, Leanne M Williams, Johann Steiner, Marion Leboyer, André F Carvalho, Michael Berk
BACKGROUND: Precision medicine is a new and important topic in psychiatry. Psychiatry has not yet benefited from the advanced diagnostic and therapeutic technologies that form an integral part of other clinical specialties. Thus, the vision of precision medicine as applied to psychiatry - 'precision psychiatry' - promises to be even more transformative than in other fields of medicine, which have already lessened the translational gap. DISCUSSION: Herein, we describe 'precision psychiatry' and how its several implications promise to transform the psychiatric landscape...
April 13, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28400963/psychiatry-and-the-geriatric-syndromes-creating-constructive-interfaces
#6
EDITORIAL
Simon Thacker, Mike Skelton, Rowan Harwood
Integrating mental and physical healthcare is difficult to achieve because of professional and organisational barriers. Psychiatrists recognise the problems resulting from fragmentation of services and want continuity of care for patients, but commissioning and service structures perpetuate these problems. One way forward may be to follow the syndromic model employed by geriatricians as a means of avoiding over-emphasis on diagnosis above the pragmatics of implementing multi-component, coordinated care. Commissioners need to be made aware of the overlap and complementarity of skills possessed by old age psychiatry and geriatric medicine to create joint services for people vulnerable to dementia and delirium...
April 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28399107/-exogenous-organic-disease-of-the-brain-is-a-paradoxical-problem-of-clinical-psychiatry
#7
B N Piven
The author considers an important issue of clinical psychiatry - mental or exogenous organic disorders. An analysis of publications of 9 Russian psychiatric journals for the period 2011-2015 and program reports of the XV and XVI Russian psychiatric congresses shows that very small attention is given to this pathology. According to the author's opinion, many aspects of this problem are unexplored or controversial. Some different interpretations of the term 'exogenous organic' makes it uninformative. There are not clear ideas about the structure of the clinical exogenous-organic disorders; their prevalence in different populations is not well studied; their combination with other mental illnesses requires further studies...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28397842/structural-alterations-within-cerebellar-circuitry-are-associated-with-general-liability-for-common-mental-disorders
#8
A L Romer, A R Knodt, R Houts, B D Brigidi, T E Moffitt, A Caspi, A R Hariri
Accumulating mental-health research encourages a shift in focus toward transdiagnostic dimensional features that are shared across categorical disorders. In support of this shift, recent studies have identified a general liability factor for psychopathology-sometimes called the 'p factor'- that underlies shared risk for a wide range of mental disorders. Identifying neural correlates of this general liability would substantiate its importance in characterizing the shared origins of mental disorders and help us begin to understand the mechanisms through which the 'p factor' contributes to risk...
April 11, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28390442/a-first-step-toward-integrating-schema-theory-in-geriatric-psychiatry-a-delphi-study
#9
M J H Legra, F R J Verhey, S P J van Alphen
BACKGROUND: Schematherapy (ST) is an effective therapy for personality disorders (PD's) in adults, however, empirical research into ST in older adults is limited. The manifestation of schemas over the life course is unclear. Besides, long-term patterns of schemas in old age and whether schemas change during the aging process remain unknown. METHODS: We performed a Delphi study involving a group meeting of nine experts in the field of ST in older adults. RESULTS: Full consensus was achieved that schemas vary later in life, and that this is due to biopsychosocial factors...
April 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28373692/a-missense-mutation-in-katnal1-underlies-behavioural-neurological-and-ciliary-anomalies
#10
G Banks, G Lassi, A Hoerder-Suabedissen, F Tinarelli, M M Simon, A Wilcox, P Lau, T N Lawson, S Johnson, A Rutman, M Sweeting, J E Chesham, A R Barnard, N Horner, H Westerberg, L B Smith, Z Molnár, M H Hastings, R A Hirst, V Tucci, P M Nolan
Microtubule severing enzymes implement a diverse range of tissue-specific molecular functions throughout development and into adulthood. Although microtubule severing is fundamental to many dynamic neural processes, little is known regarding the role of the family member Katanin p60 subunit A-like 1, KATNAL1, in central nervous system (CNS) function. Recent studies reporting that microdeletions incorporating the KATNAL1 locus in humans result in intellectual disability and microcephaly suggest that KATNAL1 may play a prominent role in the CNS; however, such associations lack the functional data required to highlight potential mechanisms which link the gene to disease symptoms...
April 4, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28367993/perceived-dangerousness-as-related-to-psychiatric-symptoms-and-psychiatric-service-use-a-vignette-based-representative-population-survey
#11
Julia F Sowislo, Franca Gonet-Wirz, Stefan Borgwardt, Undine E Lang, Christian G Huber
Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either depicted psychiatric symptoms of a fictitious character or a psychiatric service institution the fictitious character had been admitted to...
April 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28355326/soul-butterfly-mythological-nymph-psyche-in-philosophy-and-neuroscience
#12
Elena I Antonakou, Lazaros C Triarhou
The term "psyche" and its derivatives - including "Psychology" and "Psychiatry" - are rooted in classical philosophy and in mythology. Over the centuries, psyche has been the subject of discourse and contemplation, and of fable; it has also come to signify, in entomology, the order of Lepidoptera. In the current surge of research on brain and mind, there is a gradual transition from the psyche (or the "soul") to the specified descriptors defined by the fields of Behavioral, Cognitive and Integrative Neuroscience...
March 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28348383/prefrontal-gray-matter-volume-mediates-genetic-risks-for-obesity
#13
N Opel, R Redlich, C Kaehler, D Grotegerd, K Dohm, W Heindel, H Kugel, A Thalamuthu, N Koutsouleris, V Arolt, A Teuber, H Wersching, B T Baune, K Berger, U Dannlowski
Genetic and neuroimaging research has identified neurobiological correlates of obesity. However, evidence for an integrated model of genetic risk and brain structural alterations in the pathophysiology of obesity is still absent. Here we investigated the relationship between polygenic risk for obesity, gray matter structure and body mass index (BMI) by the use of univariate and multivariate analyses in two large, independent cohorts (n=330 and n=347). Higher BMI and higher polygenic risk for obesity were significantly associated with medial prefrontal gray matter decrease, and prefrontal gray matter was further shown to significantly mediate the effect of polygenic risk for obesity on BMI in both samples...
March 28, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28348379/genetic-evidence-for-role-of-integration-of-fast-and-slow-neurotransmission-in-schizophrenia
#14
A Devor, O A Andreassen, Y Wang, T Mäki-Marttunen, O B Smeland, C-C Fan, A J Schork, D Holland, W K Thompson, A Witoelar, C-H Chen, R S Desikan, L K McEvoy, S Djurovic, P Greengard, P Svenningsson, G T Einevoll, A M Dale
The most recent genome-wide association studies (GWAS) of schizophrenia (SCZ) identified hundreds of risk variants potentially implicated in the disease. Further, novel statistical methodology designed for polygenic architecture revealed more potential risk variants. This can provide a link between individual genetic factors and the mechanistic underpinnings of SCZ. Intriguingly, a large number of genes coding for ionotropic and metabotropic receptors for various neurotransmitters-glutamate, γ-aminobutyric acid (GABA), dopamine, serotonin, acetylcholine and opioids-and numerous ion channels were associated with SCZ...
March 28, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28344933/precision-medicine-the-golden-gate-for-detection-treatment-and-prevention-of-alzheimer-s-disease
#15
H Hampel, S E O'Bryant, J I Castrillo, C Ritchie, K Rojkova, K Broich, N Benda, R Nisticò, R A Frank, B Dubois, V Escott-Price, S Lista
During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer's disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy...
December 2016: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/28338845/computational-psychiatry-and-the-challenge-of-schizophrenia
#16
John H Krystal, John D Murray, Adam M Chekroud, Philip R Corlett, Genevieve Yang, Xiao-Jing Wang, Alan Anticevic
Schizophrenia research is plagued by enormous challenges in integrating and analyzing large datasets and difficulties developing formal theories related to the etiology, pathophysiology, and treatment of this disorder. Computational psychiatry provides a path to enhance analyses of these large and complex datasets and to promote the development and refinement of formal models for features of this disorder. This presentation introduces the reader to the notion of computational psychiatry and describes discovery-oriented and theory-driven applications to schizophrenia involving machine learning, reinforcement learning theory, and biophysically-informed neural circuit models...
May 1, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28336492/looking-into-the-brain-through-the-retinal-ganglion-cells-in-psychiatric-disorders-a-review-of-evidences
#17
REVIEW
Thomas Schwitzer, Raymund Schwan, Emanuel Bubl, Laurence Lalanne, Karine Angioi-Duprez, Vincent Laprevote
Psychiatry and neuroscience research need novel approaches to indirectly investigate brain function. As the retina is an anatomical and developmental extension of the central nervous system (CNS), changes in retinal function may reflect neurological dysfunctions in psychiatric disorders. The last and most integrated retinal relay before visual information transfer to the brain is the ganglion cell layer. Here, based on collected arguments, we argue that these cells offer a crucial site for indirectly investigating brain function...
March 20, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28331503/integrating-smartphone-technology-at-the-time-of-discharge-from-a-child-and-adolescent-inpatient-psychiatry-unit
#18
Jonathan M Gregory, Javeed Sukhera, Melissa Taylor-Gates
OBJECTIVE: As smartphone technology becomes an increasingly important part of youth mental health, there has been little to no examination of how to effectively integrate smartphone-based safety planning with inpatient care. Our study sought to examine whether or not we could effectively integrate smartphone-based safety planning into the discharge process on a child and adolescent inpatient psychiatry unit. METHOD: Staff members completed a survey to determine the extent of smartphone ownership in a population of admitted child and adolescent inpatients...
2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28322275/oxidative-stress-driven-parvalbumin-interneuron-impairment-as-a-common-mechanism-in-models-of-schizophrenia
#19
P Steullet, J-H Cabungcal, J Coyle, M Didriksen, K Gill, A A Grace, T K Hensch, A-S LaMantia, L Lindemann, T M Maynard, U Meyer, H Morishita, P O'Donnell, M Puhl, M Cuenod, K Q Do
Parvalbumin inhibitory interneurons (PVIs) are crucial for maintaining proper excitatory/inhibitory balance and high-frequency neuronal synchronization. Their activity supports critical developmental trajectories, sensory and cognitive processing, and social behavior. Despite heterogeneity in the etiology across schizophrenia and autism spectrum disorder, PVI circuits are altered in these psychiatric disorders. Identifying mechanism(s) underlying PVI deficits is essential to establish treatments targeting in particular cognition...
March 21, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28314165/exploring-the-use-of-routine-outcome-monitoring-in-the-treatment-of-patients-with-a-psychotic-disorder
#20
M Tasma, E J Liemburg, H Knegtering, P A E G Delespaul, A Boonstra, S Castelein
BACKGROUND: Routine Outcome Monitoring (ROM) has become part of the treatment process in mental health care. However, studies have indicated that few clinicians in psychiatry use the outcome of ROM in their daily work. The aim of this study was to explore the degree of ROM use in clinical practice as well as the explanatory factors of this use. METHODS: In the Northern Netherlands, a ROM-protocol (ROM-Phamous) for patients with a psychotic disorder has been implemented...
December 28, 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
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