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Integrative psychiatry

Wanjiku F M Njoroge, Cody A Hostutler, Billie S Schwartz, Jennifer A Mautone
There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home...
December 2016: Current Psychiatry Reports
Soteri Polydorou, Stephen Ross, Peter Coleman, Laura Duncan, Nichole Roxas, Anil Thomas, Sonia Mendoza, Helena Hansen
OBJECTIVES: This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS: This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
John Torous, Ryan O'Connor, Jamie Franzen, Caitlin Snow, Robert Boland, Robert Kitts
BACKGROUND: While medical students and residents may be utilizing websites as online learning resources, medical trainees and educators now have the opportunity to create such educational websites and digital tools on their own. However, the process and theory of building educational websites for medical education have not yet been fully explored. OBJECTIVE: To understand the opportunities, barriers, and process of creating a novel medical educational website. METHODS: We created a pilot psychiatric educational website to better understand the options, opportunities, challenges, and processes involved in the creation of a psychiatric educational website...
November 5, 2015: JMIR Med Educ
Sube Banerjee, Nicolas Farina, Stephanie Daley, Wendy Grosvenor, Leila Hughes, Molly Hebditch, Sophie Mackrell, Ramin Nilforooshan, Chris Wyatt, Kay de Vries, Inam Haq, Juliet Wright
OBJECTIVES: Traditional healthcare education, delivered through a series of time-limited clinical placements, often fails to deliver an understanding of the experiences of those with long-term conditions, a growing issue for healthcare systems. Responses include longitudinal integrated clerkships and senior mentor programmes allowing students' longer placements, continuity of contact and opportunities to learn about chronic illness and patient experience. We review their development and delivery in dementia and present the Time for Dementia (TFD) Programme, a novel 2-year interdisciplinary educational programme...
October 10, 2016: International Journal of Geriatric Psychiatry
D M Baguley, T E Cope, D J McFerran
There are a number of auditory symptom syndromes that can develop without an organic basis. Some of these, such as nonorganic hearing loss, affect populations similar to those presenting with functional somatosensory and motor symptoms, while others, such as musical hallucination, affect populations with a significantly different demographic and require different treatment strategies. Many of these conditions owe their origin to measurably abnormal peripheral sensory pathology or brain network activity, but their pathological impact is often due, at least in part, to overamplification of the salience of these phenomena...
2017: Handbook of Clinical Neurology
Heather S Anderson, William F Gabrielli, Anthony Paolo, Anne Walling
OBJECTIVE: This study was undertaken to assess any impact on National Board of Medical Examiners (NBME) neurology and psychiatry subject examination scores of changing from an integrated neuropsychiatry clerkship to independent neurology and psychiatry clerkships. METHODS: NBME psychiatry and neurology subject examinations scores were compared for all 625 students completing the required neuropsychiatry clerkship in academic years 2005-2006 through 2008-2009 with all 650 students completing the independent neurology and psychiatry clerkships in academic years 2009-2010 through 2012-2013...
October 7, 2016: Academic Psychiatry
Ayşen Esen Danacı, Kuzeymen Balıkçı, Orkun Aydın, Cengiz Cengisiz, A Burak Uykur
OBJECTIVE: It has been widely acknowledged that the community and health professionals hold negative attitudes toward patients with impaired mental health. This constitutes a majör obstacle for those patients in coping with their disease, managing their care, and hence regulating their lives. Although studies carried out in Turkey document the presence of stigma, they provide limited information about the ways for solving this problem. Drawing on the litrature, the present study investigated the effect of medical education on stigmatization...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
Stephanie L Schnorr, Harriet A Bachner
Over the past decade, research has shown that diet and gut health affects symptoms expressed in stress related disorders, depression, and anxiety through changes in the gut microbiota. Psycho-behavioral function and somatic health interaction have often been ignored in health care with resulting deficits in treatment quality and outcomes. While mental health care requires the professional training in counseling, psychotherapy and psychiatry, complimentary therapeutic strategies, such as attention to a nutritional and diverse diet and supplementation of probiotic foods, may be integrated alongside psychotherapy treatment models...
September 2016: Yale Journal of Biology and Medicine
Krzysztof Maria Wilczyński, Elżbieta Mazgaj, Oleg Fedyk, Dominika Wizner, Krzysztof Krysta
BACKGROUND: In modern psychiatry, deinstitutionalization of mentally ill became an essential part of improving state of being of those affected. Integration in community, despite obvious benefits, led to increase in social distance and rejection towards mentally ill. Social stigma affects different life domains of those afflicted, and therefore it is crucial to introduce methods to deal with it. Our objective was to assess and compare psychiatrists' and public attitudes and beliefs about mentally ill people...
September 2016: Psychiatria Danubina
Christophe Clesse, Isabelle Dumand, Émeline Nassau, Cécile Prudent, Michel Decker, Christine Savini, Joëlle Lighezzolo-Alnot, Martine Batt
This paper is aimed to improve the socio-psycho-therapeutic support for older patients with heavy psychiatric disability. First, we review the literature to question the specific grounds reported by professionals regarding the orientation of these vulnerable subjects. Secondly, we emphasize that integration of these subjects within alternatives to hospitalization requires a type of support similar to that usually proposed, an accompaniment of psychosocial rehabilitation. Then, we propose to build an indicator called the psychosocial age, which reduces the weight of the chronological age for the orientation of these subjects...
September 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
K Stengler, J Rauschenbach, S G Riedel-Heller, T Becker, I Steinhart, G Gerlinger, I Hauth
Working and living for persons with mental illnesses are a major concern of rehabilitative psychiatry. In Germany the definition of rehabilitation for persons with mental illnesses is closely linked to different sectors of social welfare and to the strongly organized supply chain of prevention, acute treatment, rehabilitation and care. In successfully supporting people with mental health problems in terms of vocational integration, professionals face various obstacles. Besides finding the correct content, structural and organizational difficulties can also arise...
September 20, 2016: Der Nervenarzt
Ilina Singh
Eighteen months ago, I left a permanent professorship in a generously interdisciplinary department of sociology and took an impermanent, lower-paying job at a university where I had to apply to something called the "Committee on Distinction" to retain the title of "Professor." Some people say, "That's what happens when Oxford calls." But it wasn't just that. It was the opportunity to engage in a groundbreaking experiment: to embed and integrate ethics within the Oxford Department of Psychiatry and Neuroscience...
September 2016: Hastings Center Report
Steven Pennybaker, Patrick Hemming, Durga Roy, Blair Anton, Margaret S Chisolm
OBJECTIVE: A systematic review was conducted of the biomedical literature regarding pastoral care (PaC) providers on inpatient psychiatric units with the aim of answering 3 questions: (1) What are the risks and benefits of PaC providers' presence on inpatient psychiatric units? (2) What are current recommendations for integration of PaC providers into a psychiatric team? and (3) What gaps exist in the literature? METHODS: PubMed, PsycInfo, Embase, CINAHL, and Scopus were searched from the start of each database to July 9, 2014 using terms related to PaC providers and inpatient psychiatry...
September 2016: Journal of Psychiatric Practice
D Leguay
This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention...
September 9, 2016: L'Encéphale
Golan Shahar
An integrative-psychodynamic theory of criticism in self and relationships is presented (Shahar, 2015). My theoretical starting point is the tension between Authenticity (A; our inherited potential, tantamount to Winnicott's True Self) and Self-Knowledge (SK; what we [think] we know about ourselves). Self-criticism, a formidable dimension of vulnerability to a wide array of psychopathologies, is construed as a distorted form of self-knowledge, reducing internal confusion at the expense of widening the gap between A and SK...
2016: Psychodynamic Psychiatry
Patricia Rubí G, Luis De la Barra V, Hardy Schaefer A
UNLABELLED: In Medical Education, feedback is an instrument that informs the trainees about their learning process and how to make the necessary changes. Feedback enables learners to monitor their progress and provides direction for improvement. Effective feedback is useful to improve the performance, clinical skills, communication skills, and treatment of patients. It is essential when teaching clinical interview skills to psychiatry residents. Feedback necessarily involves social interaction between teachers and trainees...
June 2016: Revista Médica de Chile
Rachelle Ashcroft, Jose Silveira, Kwame Mckenzie
BACKGROUND: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. METHOD: A qualitative pilot study using semi-structured interviews with thematic analysis...
August 2016: Healthcare Policy, Politiques de Santé
Muhammad Ashar Malik, Murad Moosa Khan
BACKGROUND: The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings. AIM: To estimate economic burden of mental illnesses in Pakistan...
September 2016: Journal of Mental Health Policy and Economics
Diana Botero-Franco, Juan David Palacio-Ortíz, Pilar Arroyave-Sierra, Sandra Piñeros-Ortíz
The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and related health problems (ICD) integrate the diagnostic criteria commonly used in psychiatric practice, but the DSM-IV-TR was insufficient for current clinical work. The DSM-5 was first made public in May at the Congress of the American Psychiatric Association, and it includes changes to some aspects of Child Psychiatry, as many of the conditions that were at the beginning in chapter of infancy, childhood and adolescence disorders have been transferred to other chapters and there are new diagnostic criteria or new terms are added...
July 2016: Revista Colombiana de Psiquiatría
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
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