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psychiatric medical management

Arjun Sethi, Valerie Voon, Hugo D Critchley, Mara Cercignani, Neil A Harrison
Computational models of reinforcement learning have helped dissect discrete components of reward-related function and characterize neurocognitive deficits in psychiatric illnesses. Stimulus novelty biases decision-making, even when unrelated to choice outcome, acting as if possessing intrinsic reward value to guide decisions toward uncertain options. Heightened novelty seeking is characteristic of attention deficit hyperactivity disorder, yet how this influences reward-related decision-making is computationally encoded, or is altered by stimulant medication, is currently uncertain...
March 13, 2018: Brain: a Journal of Neurology
John Gunderson, Sara Masland, Lois Choi-Kain
Borderline personality disorder (BPD) has moved from being an untreatable disorder to a disorder with multiple evidence-based psychotherapies. When a second generation of research showed that less intensive, easier-to-learn therapies could be nearly as effective, they offered an approach that would be responsive to the persisting unmet needs of these patients. This paper describes good psychiatric management (GPM), a once-weekly, generalist model that medicalizes the disorder, emphasizes psychoeducation, and focuses on social adaptation...
January 5, 2018: Current Opinion in Psychology
Debasish Basu, Aniruddha Basu, Abhishek Ghosh
A large proportion of patients with substance use disorders have clinical comorbidities, either medical or psychiatric. An initial assessment is necessary initially for prompt identification and management of any psychiatric or medical emergency, and thereafter a more detailed assessment for the comprehensive understanding of the individual. This should be done keeping in mind the goals of both immediate and long term assessment so that a comprehensive but individualized, context and culture sensitive, reality based, recovery-oriented management plan can be formulated...
February 2018: Indian Journal of Psychiatry
Lakshmi N Yatham, Sidney H Kennedy, Sagar V Parikh, Ayal Schaffer, David J Bond, Benicio N Frey, Verinder Sharma, Benjamin I Goldstein, Soham Rej, Serge Beaulieu, Martin Alda, Glenda MacQueen, Roumen V Milev, Arun Ravindran, Claire O'Donovan, Diane McIntosh, Raymond W Lam, Gustavo Vazquez, Flavio Kapczinski, Roger S McIntyre, Jan Kozicky, Shigenobu Kanba, Beny Lafer, Trisha Suppes, Joseph R Calabrese, Eduard Vieta, Gin Malhi, Robert M Post, Michael Berk
The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments...
March 14, 2018: Bipolar Disorders
Sharon Ashong, Irene A Kretchy, Barima Afrane, Ama de-Graft Aikins
Background: Patients with schizophrenia are managed with antipsychotics and other psychotropic medications. Objectives: This study aimed to assess the commonly prescribed psychotropic medications for patients with schizophrenia, explore the types of therapeutic monitoring that were performed, and find out whether the side effects experienced by the patients played any role in their adherence behaviour. Methods: This hospital-based cross-sectional study enrolled 259 patients with schizophrenia from Accra Psychiatric Hospital and Pantang Psychiatric Hospital...
2018: Psychiatry Journal
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Cynthia Cheng, Fatima Mithoowani, Thomas Ungar, Monica Lee
Background: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. Objectives: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information...
January 2018: Canadian Journal of Hospital Pharmacy
S Kalyana Sundaram, Sneha Kumar
Mental illness and mental health are concepts that have existed from time immemorial. In India, the Atharvaveda and Vedic texts and traditional medical systems such as Siddha, Unani, and Ayurveda have described mental health and disorders, in detail. The advent of the mental hospital brought in the 'chemical revolution' in psychiatric management. The early nineties witnessed the birth of psychiatric rehabilitation in India. These developments saw a shift from a biological to a biopsychosocial model. It embraced the individual, family, community and society into the treatment process...
February 2018: Indian Journal of Psychiatry
C Vallée, A Biraben, A Nica, M Loiseau
OBJECTIVES: The occurrence of depression in people with epilepsy is almost twice as common as in the general population. Furthermore, depression is the first cause of lower quality of life among those patients. Which is why the main goal of this study was to assess the epidemiology of depression and its associated factors among the patients from the tertiary department of epileptology in Rennes. METHODS/RESULTS: The subjects were included prospectively and consecutively at the moment of their consultation or hospitalisation in the department...
March 7, 2018: L'Encéphale
Luke E Grzeskowiak, Catherine Leggett, Lynn Costi, Claire T Roberts, Lisa H Amir
AIMS: To examine the association between late pregnancy exposure to serotonin reuptake inhibitor (SRI) antidepressants and difficulties in achieving an adequate breast milk supply in women who gave birth to preterm infants, while accounting for the potential impacts of underlying maternal psychiatric illness. METHODS: Retrospective cohort study of 3,024 women delivering liveborn preterm infants (<37 weeks' gestation) between January 2004 and December 2008. The primary outcome was postnatal domperidone use, considered a valid proxy for presence and pharmacological management of low milk supply...
March 9, 2018: British Journal of Clinical Pharmacology
Kingsley O Abode-Iyamah, Hsiu-Yin Chiang, Royce W Woodroffe, Brian Park, Francis J Jareczek, Yasunori Nagahama, Nolan Winslow, Loreen A Herwaldt, Jeremy D W Greenlee
OBJECTIVE Deep brain stimulation is an effective surgical treatment for managing some neurological and psychiatric disorders. Infection related to the deep brain stimulator (DBS) hardware causes significant morbidity: hardware explantation may be required; initial disease symptoms such as tremor, rigidity, and bradykinesia may recur; and the medication requirements for adequate disease management may increase. These morbidities are of particular concern given that published DBS-related infection rates have been as high as 23%...
March 9, 2018: Journal of Neurosurgery
Jessica Mandrioli, Laura Ferri, Antonio Fasano, Elisabetta Zucchi, Nicola Fini, Cristina Moglia, Christian Lunetta, Kalliopi Marinou, Nicola Ticozzi, Gianluca Drago Ferrante, Carlo Scialo, Gianni Sorarù, Francesca Trojsi, Amelia Conte, Yuri M Falzone, Rosanna Tortelli, Massimo Russo, Valeria Ada Sansone, Gabriele Mora, Vincenzo Silani, Paolo Volanti, Claudia Caponnetto, Giorgia Querin, Maria Rosaria Monsurrò, Mario Sabatelli, Adriano Chiò, Nilo Riva, Giancarlo Logroscino, Sonia Messina, Andrea Calvo
BACKGROUND: Only a few studies considered the role of comorbidities on ALS prognosis and provided conflicting results. METHODS: our multicenter, retrospective study included patients diagnosed from 1/1/2009 to 31/12/2013 in 13 Referral Centers for ALS located in 10 Italian Regions. Caring neurologists collected a detailed phenotypic profile and follow-up data until death into an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role on ALS prognosis...
March 7, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Omar T Sims, Pamela A Melton, Shaonin Ji
This study describes clinical characteristics of poor and uninsured patients living with hepatitis C virus (HCV) who received care from a multidisciplinary HCV clinic, reports treatment completion and cure rates, and estimates the cost of HCV medications provided at no cost to uninsured patients. A retrospective chart review was performed and identified 69 uninsured HCV patients who received medical care at Mercy Health Center, a small non-profit community clinic, between January 2008 and March 2015. Three-fourths of the patients were unemployed, a third had multiple HCV exposures, nearly half acquired HCV due to illicit drug use, and more than half had active psychiatric disorders...
March 6, 2018: Journal of Community Health
Clinton G Lauritsen, Abigail L Chua, Stephanie J Nahas
PURPOSE OF REVIEW: Menopause is a life-changing event in numerous ways. Many women with migraine hold hope that the transition to the climacteric state will coincide with a cessation or improvement of migraine. This assumption is based mainly on common lay perceptions as well as assertions from many in the healthcare community. Unfortunately, evidence suggests this is far from the rule. Many women turn to a general practitioner or a headache specialist for prognosis and management. A natural instinct is to manipulate the offending agent, but in some cases, this approach backfires, or the concern for adverse events outweighs the desire for a therapeutic trial, and other strategies must be pursued...
March 6, 2018: Current Treatment Options in Neurology
Yvette Low, Sajita Setia, Graca Lima
Psychiatric and physical conditions often coexist, and there is robust evidence that associates the frequency of depression with single and multiple physical conditions. More than half of patients with depression may have at least one chronic physical condition. Therefore, antidepressants are often used in cotherapy with other medications for the management of both psychiatric and chronic physical illnesses. The risk of drug-drug interactions (DDIs) is augmented by complex polypharmacy regimens and extended periods of treatment required, of which possible outcomes range from tolerability issues to lack of efficacy and serious adverse events...
2018: Neuropsychiatric Disease and Treatment
Brian Wilkinson, James Garwood, Stephen Langford
OBJECTIVE: Patients can be transferred many hundreds of kilometers with acute mental health disturbance for specialist mental health services in Western Australia. METHODS: A retrospective notes review of Royal Flying Doctor Service Western Operations records was undertaken over a 4-month period. Patients were identified from the transfer database by mental health diagnosis. Benzodiazepine and antipsychotic doses were converted into a reference drug per class for comparison...
March 2018: Air Medical Journal
C E Lloyd, A Nouwen, N Sartorius, H U Ahmed, A Alvarez, S Bahendeka, D Basangwa, A E Bobrov, S Boden, V Bulgari, L Burti, S K Chaturvedi, L C Cimino, W Gaebel, G de Girolamo, T M Gondek, M Guinzbourg de Braude, A Guntupalli, M G Heinze, L Ji, X Hong, A Khan, A Kiejna, A Kokoszka, T Kamala, N M Lalic, D Lecic Tosevski, B Mankovsky, M Li, A Musau, K Müssig, D Ndetei, G Rabbani, S S Srikanta, E G Starostina, M Shevchuk, R Taj, O Vukovic, W Wölwer, Y Xin
AIMS: To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. METHODS: People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. RESULTS: A total of 2783 people with Type 2 diabetes (45...
February 25, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Maeva Jego, Julien Abcaya, Diana-Elena Ștefan, Céline Calvet-Montredon, Stéphanie Gentile
BACKGROUND: Homeless people have poorer health status than the general population. They need complex care management, because of associated medical troubles (somatic and psychiatric) and social difficulties. We aimed to describe the main characteristics of the primary care programs that take care of homeless people, and to identify which could be most relevant. METHODS: We performed a literature review that included articles which described and evaluated primary care programs for homeless people...
February 10, 2018: International Journal of Environmental Research and Public Health
Nicole Baumer, Sarah J Spence
PURPOSE OF REVIEW: Autism spectrum disorder is a neurodevelopmental disorder defined by deficits in social communication and the presence of restricted and repetitive behaviors and interests. This article provides the tools to diagnose and manage patients with autism spectrum disorder. RECENT FINDINGS: Autism spectrum disorder is a heterogeneous condition with varying presentations, multiple etiologies, and a number of comorbidities that impact the course and management of the disorder...
February 2018: Continuum: Lifelong Learning in Neurology
Steven A House, Eric L Fisher
Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered. The initial evaluation begins with a targeted history and physical examination, while also looking for signs of potential systemic etiologies...
December 1, 2017: American Family Physician
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