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Clinical decision making in Psychiatry

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https://www.readbyqxmd.com/read/29674774/-psychiatrist-burnout-or-psychiatric-assistance-burnout
#1
Vincenzo Manna, Francesca Dicuonzo
In recent years, mature industrial countries are rapidly changing from production economies to service economies. In this new socio-economic context, particular attention has been paid to mental health problems in the workplace. The risk of burnout is significantly higher for certain occupations, in particular for health workers. Doctors and psychiatrists, in particular, quite frequently have to make quick decisions by dealing with a huge amount of requests, which often require considerable assumptions of responsibility...
March 2018: Rivista di Psichiatria
https://www.readbyqxmd.com/read/29614851/the-make-biomarker-discovery-for-enhancing-antidepressant-treatment-effect-and-response-study-design-and-methodology
#2
Hee-Ju Kang, Ju-Wan Kim, Seon-Young Kim, Sung-Wan Kim, Hee-Young Shin, Myung-Geun Shin, Jae-Min Kim
Objective: Depression is associated with a major disease burden, and many individuals suffer from depressive symptoms due to an insufficient response to ostensibly adequate antidepressant treatment. Therefore, it is important to identify reliable treatment response predictors for use in developing personalized treatment strategies. Methods: The MAKE Biomarker discovery for Enhancing anTidepressant Treatment Effect and Response (MAKE BETTER) study was performed to identify predictors of antidepressant response using a 2-year naturalistic prospective design...
April 5, 2018: Psychiatry Investigation
https://www.readbyqxmd.com/read/29601060/revealing-neurocomputational-mechanisms-of-reinforcement-learning-and-decision-making-with-the-hbayesdm-package
#3
Woo-Young Ahn, Nathaniel Haines, Lei Zhang
Reinforcement learning and decision-making (RLDM) provide a quantitative framework and computational theories with which we can disentangle psychiatric conditions into the basic dimensions of neurocognitive functioning. RLDM offer a novel approach to assessing and potentially diagnosing psychiatric patients, and there is growing enthusiasm for both RLDM and computational psychiatry among clinical researchers. Such a framework can also provide insights into the brain substrates of particular RLDM processes, as exemplified by model-based analysis of data from functional magnetic resonance imaging (fMRI) or electroencephalography (EEG)...
October 2017: Comput Psychiatr
https://www.readbyqxmd.com/read/29588829/the-effectiveness-of-clinical-teaching-of-mental-health-courses-in-nursing-using-clinical-supervision-and-kirkpatrick-s-model
#4
Maryam Maddineshat, Mitra Hashemi, Reza Besharati, Sepideh Gholami, Fatemeh Ghavidel
Background: Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. Objective: To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29588046/meta-analyses-in-child-and-adolescent-psychiatry-getting-closer-to-clinical-practice
#5
EDITORIAL
Samuele Cortese
Rigorously conducted meta-analyses provide evidence synthesis that has the potential to inform daily clinical decision making and development of clinical guidelines. In the past decade, there has been an increasing number of studies on pharmacologic and non-pharmacologic treatments for childhood and adolescent psychiatric disorders. Given this large body of research, busy clinicians might tend to rely on meta-analyses, rather than individual trials, to keep abreast of the evidence base supporting intervention strategies in child and adolescent psychiatry...
April 2018: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29415803/ethical-considerations-in-bipolar-disorders
#6
S Richa, R Chammay, A Dargél, C Henry, M Masson
The implications of biomedical ethics principles extend to both medical care and biomedical research. They are particularly relevant for psychiatry in which pathologies are often chronic and disabling. Bipolar disorders impact the ability to make judgements and to take decisions during mood episodes and remain a stigmatised condition. Early interventions, even those in the prodromal phase, pose ethical questions for both clinicians and researchers. The degree of patients' autonomy in their clinical care must also now be considered from a biomedical ethics perspective...
February 4, 2018: L'Encéphale
https://www.readbyqxmd.com/read/29401044/machine-learning-approaches-for-clinical-psychology-and-psychiatry
#7
Dominic B Dwyer, Peter Falkai, Nikolaos Koutsouleris
Machine learning approaches for clinical psychology and psychiatry explicitly focus on learning statistical functions from multidimensional data sets to make generalizable predictions about individuals. The goal of this review is to provide an accessible understanding of why this approach is important for future practice because of its potential to augment decisions associated with the diagnosis, prognosis, and treatment of people suffering from mental illness using clinical and biological data. To this end, the limitations of current statistical paradigms in mental health research are critiqued, and an introduction is provided to the critical machine learning methods used in clinical studies...
January 29, 2018: Annual Review of Clinical Psychology
https://www.readbyqxmd.com/read/29355640/cannabinoids-induce-apathetic-and-impulsive-patterns-of-choice-through-cb1-receptors-and-trpv1-channels
#8
Zahra Fatahi, Zahra Reisi, Gregor Rainer, Abbas Haghparast, Abbas Khani
Despite evidence from psychiatry and psychology clinics pointing to altered cognition and decision making following the consumption of cannabis, the effects of cannabis derivatives are still under dispute and the mechanisms of cannabinoid effects on cognition are not known. In this study, we used effort-based and delay-based decision tasks and showed that ACEA, a potent cannabinoid agonist induced apathetic and impulsive patterns of choice in rats in a dose-dependent manner when locally injected into the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC), respectively...
May 1, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29304845/testing-decision-making-competency-of-schizophrenia-participants-in-clinical-trials-a-meta-analysis-and-meta-regression
#9
Sorin Hostiuc, Mugurel Constantin Rusu, Ionut Negoi, Eduard Drima
BACKGROUND: The process of assessing the decision-making capacity of potential subjects before their inclusion in clinical trials is a legal requirement and a moral obligation, as it is essential for respecting their autonomy. This issue is especially important in psychiatry patients (such as those diagnosed with schizophrenia). The primary purpose of this article was to evaluate the degree of impairment in each dimension of decision-making capacity in schizophrenia patients compared to non-mentally-ill controls, as quantified by the (MacCAT-CR) instrument...
January 5, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29298748/from-ehealth-to-ihealth-transition-to-participatory-and-personalized-medicine-in-mental-health
#10
Sofian Berrouiguet, Mercedes M Perez-Rodriguez, Mark Larsen, Enrique Baca-García, Philippe Courtet, Maria Oquendo
Clinical assessment in psychiatry is commonly based on findings from brief, regularly scheduled in-person appointments. Although critically important, this approach reduces assessment to cross-sectional observations that miss essential information about disease course. The mental health provider makes all medical decisions based on this limited information. Thanks to recent technological advances such as mobile phones and other personal devices, electronic health (eHealth) data collection strategies now can provide access to real-time patient self-report data during the interval between visits...
January 3, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29202428/factors-influencing-participation-of-psychiatry-inpatients-in-clinical-trials
#11
Nandeeshwar Reddy Mopuru, Sam Padamadan Jose, Biju Viswanath, C Naveen Kumar, Suresh Bada Math, Jagadisha Thirthalli
Serious concerns have arisen in recent years regarding the unethical and illegal practices resorted to during clinical trials. Clinical trials in psychiatry are further complicated by issues such as 'validity of consent' and 'decision making capacity' of patients. This study was planned to explore the factors determining patient participation in clinical trials. A random sample of 123 consenting psychiatry inpatients were provided the information and consent-form of a hypothetical clinical drug trial. They were interviewed regarding their decision, the decision maker and factors that led to the decision...
February 2018: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29193265/substance-use-disorder-and-compulsory-commitment-to-care-a-care-ethical-decision-making-framework
#12
Marie Nicolini, Joris Vandenberghe, Chris Gastmans
In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision-making in CCC...
November 29, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29173196/person-fit-feedback-on-inconsistent-symptom-reports-in-clinical-depression-care
#13
Rob B K Wanders, Rob R Meijer, Henricus G Ruhé, Sjoerd Sytema, Klaas J Wardenaar, Peter de Jonge
BACKGROUND: Depressive patients can present with complex and different symptom patterns in clinical care. Of these, some may report patterns that are inconsistent with typical patterns of depressive symptoms. This study aimed to evaluate the validity of person-fit statistics to identify inconsistent symptom reports and to assess the clinical usefulness of providing clinicians with person-fit score feedback during depression assessment. METHODS: Inconsistent symptom reports on the Inventory of Depressive Symptomatology Self-Report (IDS-SR) were investigated quantitatively with person-fit statistics for both intake and follow-up measurements in the Groningen University Center of Psychiatry (n = 2036)...
November 27, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/29122225/-web-visit-patterns-for-the-clinical-practice-guidelines-for-management-of-depressive-disorder-and-alcohol-abuse-dependence
#14
Fernando Suárez-Obando, Carlos Gómez Restrepo
INTRODUCTION: Clinical practice guidelines (CPG) are a set of recommendations for professionals, patients, and families, in order to make decisions about health care. The CPG respond to the need for concise, accurate, practical, and up to date information. In the field of mental health, Colombia has developed three GPC; alcohol (GPC-OH), depression (GPC-TDA), and schizophrenia. OBJECTIVES: To describe the Web Portal traffic related to psychiatry guidelines, with emphasis on the number of visits, distribution throughout Colombian cities, and estimating user behaviour patterns...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29110776/psychiatric-syndromes-other-than-dementia
#15
Karl Bechter, Florian Deisenhammer
There is wide variability in how psychiatry guidelines and textbooks address the question of cerebrospinal fluid (CSF) diagnostics in the screening of psychiatric disorders. A United States-based textbook confirms that there is no consensus about which laboratory investigation should be routinely performed in psychiatric patients, but with respect to CSF diagnostics, the differences are even more striking. A survey among European experts showed a wide variety of opinions regarding clinical use and criteria in various countries of Europe and worldwide: some psychiatrists, mostly university hospital-based, recommended performing CSF diagnostics in every patient first experiencing severe mental illness (SMI), but especially in patients from the schizophrenia spectrum, whereas others almost never perform CSF examinations themselves and usually refer patients to neurology departments if necessary...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29052262/diversion-evaluations-a-specialized-forensic-examination
#16
Virginia Barber-Rioja, Merrill Rotter, Faith Schombs
Diversion programs screen justice-involved individuals for the presence of psychiatric disorders, and after negotiations take place with attorneys and treatment providers, these programs link participants with community-based treatment programs in lieu of incarceration. As the number of diversion programs, including mental health courts, continues to rapidly grow, so does the need for "diversion evaluations". Diversion evaluations are a type of forensic mental health assessment (FMHA) conducted to assist the courts in making decisions regarding diversion eligibility...
September 2017: Behavioral Sciences & the Law
https://www.readbyqxmd.com/read/29017332/shared-decision-making-in-mental-health-the-importance-for-current-clinical-practice
#17
Victoria Alguera-Lara, Michelle M Dowsey, Jemimah Ride, Skye Kinder, David Castle
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...
December 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28983797/clinical-factors-associated-with-decision-to-recommend-methylphenidate-treatment-for-children-with-adhd-in-france
#18
Elodie Courtabessis, Florence Pupier, Laurie Surig, Marie-Christine Picot, Erika Nogué, Valérie Macioce, Elizabeth Stein, Diane Purper-Ouakil
European guidelines advise on best practices for the diagnosis and non-pharmacological and pharmacological treatment of attention-deficit hyperactivity disorder (ADHD). This study aimed to (1) assess whether clinician's decisions to initiate methylphenidate treatment in children diagnosed with ADHD are in accordance with European guidelines and (2) identify clinical factors associated with the decision to recommend methylphenidate prescription. 5 to 13-year-old patients with an ADHD diagnosis were consecutively evaluated in an outpatient child and adolescent psychiatry clinic in France...
March 2018: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28967349/the-revolution-of-personalized-psychiatry-will-technology-make-it-happen-sooner
#19
G Perna, M Grassi, D Caldirola, C B Nemeroff
Personalized medicine (PM) aims to establish a new approach in clinical decision-making, based upon a patient's individual profile in order to tailor treatment to each patient's characteristics. Although this has become a focus of the discussion also in the psychiatric field, with evidence of its high potential coming from several proof-of-concept studies, nearly no tools have been developed by now that are ready to be applied in clinical practice. In this paper, we discuss recent technological advances that can make a shift toward a clinical application of the PM paradigm...
April 2018: Psychological Medicine
https://www.readbyqxmd.com/read/28966147/understanding-psychiatric-disorder-by-capturing-ecologically-relevant-features-of-learning-and-decision-making
#20
REVIEW
Jacqueline Scholl, Miriam Klein-Flügge
Recent research in cognitive neuroscience has begun to uncover the processes underlying increasingly complex voluntary behaviours, including learning and decision-making. Partly this success has been possible by progressing from simple experimental tasks to paradigms that incorporate more ecological features. More specifically, the premise is that to understand cognitions and brain functions relevant for real life, we need to introduce some of the ecological challenges that we have evolved to solve. This often entails an increase in task complexity, which can be managed by using computational models to help parse complex behaviours into specific component mechanisms...
September 28, 2017: Behavioural Brain Research
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