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Risk management in Psychiatry

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https://www.readbyqxmd.com/read/29232248/endocarditis-in-the-setting-of-idu-multidisciplinary-management
#1
Bobby Yanagawa, Anees Bahji, Wiplove Lamba, Darrell H Tan, Asim Cheema, Ishba Syed, Subodh Verma
PURPOSE OF REVIEW: The purpose of this article is to provide a brief overview of the medical and surgical management of infective endocarditis secondary to IDU, with a focus on the underlying substance use disorder. RECENT FINDINGS: Patients with infective endocarditis secondary to IDU are often young with unique comorbidities including mental illness, chronic hepatitis C, HIV infection, which are often compounded by limited social and familial supports. The focus of management has been treatment of endocarditis using IV antibiotics alongside surgery...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29223515/-patients-assaulted-in-psychiatric-institutions-literature-review-and-clinical-implications
#2
A Ladois-Do Pilar Rei, S Chraïbi
BACKGROUND: The psychiatric ward is a place where all forms of violence are treated. Occasionally, this violence involves acts of aggression between patients in emergency psychiatric units or hospital wards. Such events can lead to the development or worsening of posttraumatic stress disorder. METHODS: To establish the context, we first examined the epidemiology data concerning posttraumatic stress disorder in psychiatric patients who were frequently exposed to assaults...
December 6, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/29158581/improved-ethical-guidance-for-the-return-of-results-from-psychiatric-genomics-research
#3
G Lázaro-Muñoz, M S Farrell, J J Crowley, D M Filmyer, R A Shaughnessy, R C Josiassen, P F Sullivan
There is an emerging consensus that genomic researchers should, at a minimum, offer to return to individual participants clinically valid, medically important and medically actionable genomic findings (for example, pathogenic variants in BRCA1) identified in the course of research. However, this is not a common practice in psychiatric genetics research. Furthermore, psychiatry researchers often generate findings that do not meet all of these criteria, yet there may be ethically compelling arguments to offer selected results...
November 21, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/29098597/smart-r-a-prospective-cohort-study-of-a-resilience-curriculum-for-residents-by-residents
#4
Deanna Chaukos, Emma Chad-Friedman, Darshan H Mehta, Laura Byerly, Alper Celik, Thomas H McCoy, John W Denninger
OBJECTIVE: This study aimed to determine the feasibility of a resident-led resiliency curriculum developed by residents, for residents. METHODS: The Stress Management and Resiliency Training Program for Residents (SMART-R) is a 6-h group-based curriculum that teaches meditation, behavioral skills, and positive perspective-taking strategies. SMART-R was implemented for all medicine and psychiatry interns at a large US teaching hospital during the first 6 months of internship...
November 2, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/29072182/social-challenges-of-contemporary-psychiatry
#5
N Bouras
Psychiatry and society are interrelated and the biopsychosocial model continues to dominate the clinical psychiatric practice. Some doubts have been expressed in recent years about the value and the wide acceptance of the biopsychosocial model. Ghaemi (2009)1 considers it to be anti-humanistic and advocates the use of less eclectic, less generic, and less vague alternatives. The fundamental changes that have been witnessed in our times across the spectrum of biology, psychology and sociology have made necessary that a conceptual clarity should prevail...
July 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29061403/neuroleptic-malignant-syndrome-a-neuro-psychiatric-emergency-recognition-prevention-and-management
#6
REVIEW
Raj Velamoor
Neuroleptic Malignant Syndrome (NMS) is a life threatening complication of antipsychotic therapy. It is often assumed to be rare. Observations suggest that rather than overestimating its frequency, we are more likely to underestimate it (Pope et al., 1986). It is a rare but potentially fatal disorder characterized by four principal symptoms. These are mental status changes, muscle rigidity, hyperthermia, and autonomic dysfunction. The diagnosis of NMS often presents a challenge because several medical conditions generate similar symptoms...
October 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29026329/pharmacogenomic-testing-aiding-in-the-management-of-psychotropic-therapy-for-adolescents-with-autism-spectrum-disorders
#7
Seuli Bose-Brill, Jinming Xing, Debra J Barnette, Christopher Hanks
Adolescents with autism have higher rates of anxiety than the general adolescent population. They often struggle to express psychological symptoms verbally where their symptoms may manifest as withdrawal and agitation. Adolescent patients with autism have higher rates of polypharmacy and high-risk psychiatric medication use (eg, atypical antipsychotics) than other patients with psychiatric illness. Primary care pediatricians are at the front lines of psychiatric management for patients with autism. Yet, they have inadequate access to pediatric psychiatry for complex medication management...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28983641/-suicidality-in-german-speaking-school-psychiatry-thematization-in-textbooks-from-1803-until-the-present
#8
REVIEW
M Gnoth, H Glaesmer, H Steinberg
BACKGROUND: This chronology gives an overview about continuities and changes in the perception of suicidality in German-speaking school psychiatry over the past 200+ years. QUESTIONS: This study was guided by the following questions: has suicidality been perceived as regularly being connected to certain mental illnesses? Which other possible causes have been discussed by psychiatrists from the nineteenth century to the beginning of the twenty-first century? What approaches have major psychiatrists adopted towards suicidal patients and threatened suicide? What treatment and preventive strategies have been suggested? METHODOLOGY: First, we compiled a list of the, in our view, most influential textbooks on psychiatry of German-speaking school psychiatry from 1803 until the present...
October 5, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28953852/prescription-of-sodium-valproate-as-a-mood-stabiliser-in-pregnancy
#9
Kate Womersley
This essay was submitted for the Royal College of Psychiatry's perinatal psychiatry medical student essay prize in 2017. The essay considers the choices available to women with bipolar disorder who become pregnant while taking sodium valproate to treat mania or for mood stabilisation. The implications of three options are considered: to stop all treatment, to switch to a different mood stabiliser or to continue on sodium valproate. The implications for the fetus, on the mother's wellbeing and the ethics of patient choice are discussed...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28953837/emotionally-responsive-wearable-technology-and-stress-detection-for-affective-disorders
#10
Jenny Tillotson
As humans, we are born with no knowledge of odour. Our sense of smell is linked directly to the limbic system, the emotional part of our brain responsible for memory and behaviour, and therefore, our individual sense of smell is based purely on life's deep experiences and impressions. The roots of "Aromatherapy" can be traced back more than 3,500 years, to a time when essential oils were first recorded in human history for their therapeutic and medicinal properties. However, in the 21(st) century, it remains one of the most controversial complementary therapies applied in medicine because of its pseudoscience connotations and limited available data on health benefits, despite the importance of smell on human health...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28937004/suicide-in-india-part-perceptions-partial-insights-and-inadequate-solutions
#11
K S Jacob
Suicide is a complex phenomenon, often linked to environment. Despite the identification of many social, cultural, economic and political correlates and risk factors, psychiatry continues to argue for curative solutions based on the reductionistic biomedical model, rather than support public health measures to manage the larger sociocultural, economic and political context. While psychiatry and curative medicine help many people, survival of the human body is best explained by the materialist explanation that locates the variation in health and longevity to tangible resources...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28910997/paediatric-nuclear-medicine-imaging
#12
Lorenzo Biassoni, Marina Easty
Background: Nuclear medicine imaging explores tissue viability and function by using radiotracers that are taken up at cellular level with different mechanism. This imaging technique can also be used to assess blood flow and transit through tubular organs. Nuclear medicine imaging has been used in paediatrics for decades and this field is continuously evolving. Sources of data: The data presented comes from clinical experience and some milestone papers on the subject...
September 1, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28886752/protocol-for-the-management-of-psychiatric-patients-with-psychomotor-agitation
#13
Eduard Vieta, Marina Garriga, Laura Cardete, Miquel Bernardo, María Lombraña, Jordi Blanch, Rosa Catalán, Mireia Vázquez, Victòria Soler, Noélia Ortuño, Anabel Martínez-Arán
BACKGROUND: Psychomotor agitation (PMA) is a state of motor restlessness and mental tension that requires prompt recognition, appropriate assessment and management to minimize anxiety for the patient and reduce the risk for escalation to aggression and violence. Standardized and applicable protocols and algorithms can assist healthcare providers to identify patients at risk of PMA, achieve timely diagnosis and implement minimally invasive management strategies to ensure patient and staff safety and resolution of the episode...
September 8, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28869705/long-acting-injectable-antipsychotics-for-prevention-and-management-of-violent-behaviour-in-psychotic-patients
#14
REVIEW
Pavel Mohr, Pavel Knytl, Veronika Voráčková, Anna Bravermanová, Tomáš Melicher
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...
September 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28869006/amisulpride-augmentation-in-clozapine-unresponsive-schizophrenia-amicus-a-double-blind-placebo-controlled-randomised-trial-of-clinical-effectiveness-and-cost-effectiveness
#15
Thomas Re Barnes, Verity C Leeson, Carol Paton, Louise Marston, Linda Davies, William Whittaker, David Osborn, Raj Kumar, Patrick Keown, Rameez Zafar, Khalid Iqbal, Vineet Singh, Pavel Fridrich, Zachary Fitzgerald, Hemant Bagalkote, Peter M Haddad, Mariwan Husni, Tim Amos
BACKGROUND: When treatment-refractory schizophrenia shows an insufficient response to a trial of clozapine, clinicians commonly add a second antipsychotic, despite the lack of robust evidence to justify this practice. OBJECTIVES: The main objectives of the study were to establish the clinical effectiveness and cost-effectiveness of augmentation of clozapine medication with a second antipsychotic, amisulpride, for the management of treatment-resistant schizophrenia...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28851471/a-systematic-evaluation-of-impulsive-aggressive-behavior-in-psychogeriatric-inpatients-using-the-staff-observation-aggression-scale-revision-soas-r
#16
Myrella Paschali, Daniel Kamp, Claudia Reichmann, Michaela Jaenner, Christian Lange-Asschenfeldt, Tillmann Supprian
BACKGROUND: Impulsive-aggressive behavior is a significant challenge in geriatric psychiatry and requires professional evaluation and management. METHODS: SOAS-R scales (Staff Observation Aggression Scale-Revision) completed by medical staff on three secure psychiatric wards were analyzed during a period of 12 months. Patients were subdivided into the following two diagnostic subgroups: dementia and other diagnoses. RESULTS: A total of 146 aggressive incidents involving 66 patients were reported (8...
August 30, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28817488/risk-management-of-hospitalized-psychiatric-patients-taking-multiple-qtc-prolonging-drugs
#17
Eline Vandael, Bert Vandenberk, Rik Willems, Johan Reyntens, Joris Vandenberghe, Veerle Foulon
PURPOSE/BACKGROUND: Drug-related QTc prolongation has been linked with Torsade de Pointes and sudden cardiac death. The objective of this study was to investigate the impact of starting an additional QTc-prolonging drug on the QTc interval of psychiatric inpatients. METHODS: An observational study was performed between May 2011 and December 2014 in 6 Belgian psychiatric hospitals. Inpatients who were already taking 1 QTc-prolonging drug or more could be included in the study when an additional QTc-prolonging drug was started...
August 16, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28805175/outcomes-of-a-psycho-education-and-monitoring-programme-to-prevent-compulsory-admission-to-psychiatric-inpatient-care-a-randomised-controlled-trial
#18
B Lay, W Kawohl, W Rössler
BACKGROUND: There is a need for interventions that effectively reduce compulsory admission to psychiatry. We conducted a randomised controlled trial to investigate whether an innovative intervention programme prevents compulsory re-admission in people with serious mental illness. METHODS: The programme addresses primarily patients' self-management skills. It consists of individualised psychoeducation focusing on behaviours prior to and during illness-related crises, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring...
August 14, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28801871/pediatric-delirium-evaluation-management-and-special-considerations
#19
REVIEW
Nasuh Malas, Khyati Brahmbhatt, Cristin McDermott, Allanceson Smith, Roberto Ortiz-Aguayo, Susan Turkel
Delirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation...
August 12, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28800809/legal-and-ethical-challenges-in-emergency-psychiatry-part-2-management-of-inmates
#20
REVIEW
Andrew Foote, Britta Ostermeyer
Psychiatrists and clinicians encounter unique situations, challenges, and requirements in the treatment of jail and prison inmates in the emergency department. This article reviews the historical legal highlights pertaining to medical and psychiatric care of inpatients, as well as the professional, ethical, and legal aspects that allow clinicians to evaluate, treat, and properly disposition their inmate patients. In particular, this article discusses the specific suicide risk factors related to inmates and correctional facilities that should be ascertained and managed in a clinician's suicide risk assessment and intervention planning in this special high suicide risk patient population...
September 2017: Psychiatric Clinics of North America
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