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Risk management in Psychiatry

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https://www.readbyqxmd.com/read/28646744/systematic-biobanking-novel-imaging-techniques-and-advanced-molecular-analysis-for-precise-tumor-diagnosis-and-therapy-the-polish-mobit-project
#1
Jacek Niklinski, Adam Kretowski, Marcin Moniuszko, Joanna Reszec, Anna Michalska-Falkowska, Magdalena Niemira, Michal Ciborowski, Radoslaw Charkiewicz, Dorota Jurgilewicz, Miroslaw Kozlowski, Rodryg Ramlau, Cezary Piwkowski, Miroslaw Kwasniewski, Monika Kaczmarek, Andrzej Ciereszko, Tomasz Wasniewski, Robert Mroz, Wojciech Naumnik, Ewa Sierko, Magdalena Paczkowska, Joanna Kisluk, Anetta Sulewska, Adam Cybulski, Zenon Mariak, Boguslaw Kedra, Jacek Szamatowicz, Paweł Kurzawa, Lukasz Minarowski, Angelika Edyta Charkiewicz, Barbara Mroczko, Jolanta Malyszko, Christian Manegold, Lothar Pilz, Heike Allgayer, Mohammed L Abba, Hartmut Juhl, Frauke Koch
Personalized and precision medicine is gaining recognition due to the limitations by standard diagnosis and treatment; many areas of medicine, from cancer to psychiatry, are moving towards tailored and individualized treatment for patients based on their clinical characteristics and genetic signatures as well as novel imaging techniques. Advances in whole genome sequencing have led to identification of genes involved in a variety of diseases. Moreover, biomarkers indicating severity of disease or susceptibility to treatment are increasingly being characterized...
June 21, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28641817/-preventing-violence-in-schizophrenia-with-cognitive-remediation
#2
C Darmedru, C Demily, N Franck
OBJECTIVES: The association between schizophrenia and violence represents an important issue in psychiatry. Often highly publicized, violent acts raise the question of their detection, prevention, management and treatment. There is no single, direct and exclusive link between aggressiveness and the underlying psychiatric disorder. On the contrary, the processes underlying this violence are multiple and interlinked. In addition to static and dynamic risk factors, cognitive deficits play an important role in the genesis and maintenance of violent and aggressive behavior...
June 19, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28637535/routine-hospital-management-of-self-harm-and-risk-of-further-self-harm-propensity-score-analysis-using-record-based-cohort-data
#3
S Steeg, R Emsley, M Carr, J Cooper, N Kapur
BACKGROUND: The care received by people presenting to hospital following self-harm varies and it is unclear how different types of treatment affect risk of further self-harm. METHOD: Observational cohort data from the Manchester Self-Harm Project, UK, included 16 456 individuals presenting to an Emergency Department with self-harm between 2003 and 2011. Individuals were followed up for 12 months. We also used data from a smaller cohort of individuals presenting to 31 hospitals in England during a 3-month period in 2010/2011, followed up for 6 months...
June 22, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28623183/phone-based-interventions-in-adolescent-psychiatry-a-perspective-and-proof-of-concept-pilot-study-with-a-focus-on-depression-and-autism
#4
Robert Yuzen Chen, Jordan Robert Feltes, William Shun Tzeng, Zoe Yunzhu Lu, Michael Pan, Nan Zhao, Rebecca Talkin, Kavon Javaherian, Anne Glowinski, Will Ross
BACKGROUND: Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed...
June 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#5
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28541169/imagining-moral-bioenhancement-practices-drawing-inspiration-from-moral-education-public-health-ethics-and-forensic-psychiatry
#6
Jona Specker, Maartje H N Schermer
In this article, we consider contexts or domains in which (future) moral bioenhancement interventions possibly or most likely will be implemented. By looking closely at similar or related existing practices and their relevant ethical frameworks, we hope to identify ethical considerations that are relevant for evaluating potential moral bioenhancement interventions. We examine, first, debates on the proper scope of moral education; second, proposals for identifying early risk factors for antisocial behaviour; and third, the difficult balancing of individual freedom and third party concerns in (forensic) psychiatry...
July 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28476249/-therapeutic-restraint-and-freedom-of-movement-changing-practices
#7
Annick Perrin-Niquet
From confinement to the philosophy of care in the community, the history of psychiatry testifies to the evolution of practices in the matter of the restriction of freedom. The French National Health Authority still too often recommends practices based on restraint. Caregivers, in relation to the clinical aspect of the patients, need clearly identified therapeutic projects. While training can be vital for them, risk management policies can prove to be a hindrance to patients' freedom.
May 2017: Soins. Psychiatrie
https://www.readbyqxmd.com/read/28365002/national-survey-on-pediatric-acute-agitation-and-behavioral-escalation-in-academic-inpatient-pediatric-care-settings
#8
Nasuh Malas, Linden Spital, Jason Fischer, Yu Kawai, David Cruz, Patricia Keefer
BACKGROUND: Pediatric acute agitation and behavioral escalation (PAABE) is common and disruptive to pediatric inpatient health care. There is a paucity of literature on PAABE in noncritical care inpatient pediatric care settings with little consensus on its evaluation and management. METHODS: In January 2016, a 34-question survey was e-mailed to pediatric hospitalists and consultation-liaison psychiatrists through their respective professional listservs. Excluded responses included incomplete surveys, and surveys from providers in community care settings...
January 27, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28318493/-bipolar-disorders-in-oncology-characteristics-and-management
#9
Michel Reich, Nuria Kotecki
Bipolar disorders belong to the spectrum of mood disorders and represent a serious psychiatric comorbidity. Behaviors adopted by bipolar patients can foster cancer occurrence but also impact its management, especially during acute depressive or manic episode. Oncologists must adapt their protocols in order to obtain the best compliance for treatment and avoid any possible mood destabilization, with the inherent risk of suicidal attempt. Potential interactions between mood-stabilizing agents (lithium, divalproate, atypical antipsychotics, and anticonvulsivants) and oncologic treatment (chemotherapy, targeted therapy, immunotherapy, corticotherapy) will be particularly watched...
March 15, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28302702/predictive-accuracy-of-risk-scales-following-self-harm-multicentre-prospective-cohort-study
#10
Leah Quinlivan, Jayne Cooper, Declan Meehan, Damien Longson, John Potokar, Tom Hulme, Jennifer Marsden, Fiona Brand, Kezia Lange, Elena Riseborough, Lisa Page, Chris Metcalfe, Linda Davies, Rory O'Connor, Keith Hawton, David Gunnell, Nav Kapur
BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm...
June 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28284362/-reorganising-a-department-of-psychiatry-according-to-recovery-principles-a-pilot-study-with-mixed-method-design
#11
Gisbert Eikmeier, Luciana Degano Kieser, Mirjam Paap, Jörg Utschakowski, Angelika Lacroix
Considering the impact of mental disorders, control and evaluation of treatment programs are important topics. Here, we report on a pilot study composed of a qualitative and a quantitative part to monitor the recovery-oriented reorganisation of a psychiatric department. For this purpose 13 and 15, respectively, stakeholders of the change management were interviewed between 2012 (T1) and 2014 (T2). Moreover, patients and staff were asked to complete a German version of the Recovery Self Assessment (RSA) questionnaire...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28284098/harm-reduction-as-a-strategy-for-supporting-people-who-self-harm-on-mental-health-wards-the-views-and-experiences-of-practitioners
#12
Karen James, Isaac Samuels, Paul Moran, Duncan Stewart
BACKGROUND: Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. METHODS: We explored practitioners' views of harm reduction as a strategy for supporting people who self-harm. The Self Harm Antipathy Scale (SHAS) was administered to a random sample of 395 mental health practitioners working on 31 wards in England, semi-structured interviews were then conducted with 18 survey respondents...
May 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28220082/synaptic-and-neuronal-autoantibody-associated-psychiatric-syndromes-controversies-and-hypotheses
#13
Adam Al-Diwani, Thomas A Pollak, Alexander E Langford, Belinda R Lennox
Autoimmune encephalitis (AE) mediated by antibodies against synaptic and neuronal surface targets frequently presents with a psychiatric syndrome. In these patients, removal of autoantibodies treats the disease and outcomes are closely linked to early intervention. The discovery of these autoantibodies in isolated psychiatric syndromes has raised the possibility that these patients may derive similar benefits from immunotherapy, a potentially transformational approach to the treatment of mental illness. Although open-label case series suggest impressive therapeutic outcomes, the pathological relevance of these autoantibodies outside of canonical presentations is debated...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28191035/the-prevalence-of-suicidal-ideation-and-depression-among-primary-care-patients-and-current-management-in-south-korea
#14
Yoon-Joo Choi, Weon-Young Lee
BACKGROUND: Primary care in South Korea has no effective screening system to identify high-risk suicide patients despite to the possibility of hidden patients. The present study examined the prevalence of suicidal ideation and depression among primary care patients and investigated rates of recognition and management strategies of physicians as they encountering patients with suicidal ideation and depression in primary care settings. METHODS: This study was conducted as a two-part survey of patients visiting primary care clinics and their physicians...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28120116/urine-drug-screen-findings-among-ambulatory-oncology-patients-in-a-supportive-care-clinic
#15
Sherri Rauenzahn, Adam Sima, Brian Cassel, Danielle Noreika, Teny Henry Gomez, Lynn Ryan, Carl E Wolf, Luke Legakis, Egidio Del Fabbro
PURPOSE: Professional organizations provide no guidelines regarding assessment and management of opioid abuse risk in cancer. Universal precautions (UP) developed for non-cancer pain, include assessments for aberrant behavior, screening questionnaires, and urine drug screens (UDS). The role of UDS for identifying opioid abuse risk in cancer is uncertain. Our aim is to characterize inappropriate UDS, and identify a potential role for UDS in therapeutic decision-making. METHODS: An observational retrospective chart review of 232 consecutive supportive care clinic patients were seen during the study...
June 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28119350/a-systematic-review-of-management-strategies-for-children-s-mental-health-care-in-the-emergency-department-update-on-evidence-and-recommendations-for-clinical-practice-and-research
#16
Amanda S Newton, Lisa Hartling, Amir Soleimani, Scott Kirkland, Michele P Dyson, Mario Cappelli
OBJECTIVE: Children with mental health crises require access to specialised resources and services which are not yet standard in general and paediatric EDs. In 2010, we published a systematic review that provided some evidence to support the use of specialised care models to reduce hospitalisation, return ED visits and length of ED stay. We perform a systematic review to update the evidence base and inform current policy statements. METHODS: Twelve databases and the grey literature were searched up to January 2015...
January 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28103871/a-descriptive-survey-study-of-violence-management-and-priorities-among-psychiatric-staff-in-mental-health-services-across-seventeen-european-countries
#17
Seamus Cowman, Anna Björkdahl, Eric Clarke, Georgina Gethin, Jim Maguire
BACKGROUND: In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach. METHODS: The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG)...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28044943/forgotten-but-not-gone-new-developments-in-the-understanding-and-treatment-of-tardive-dyskinesia
#18
Jonathan M Meyer
The broad use of atypical antipsychotics was expected to dramatically reduce the prevalence and incidence of tardive dyskinesia (TD), but data show that TD remains an important challenge due the persistent nature of its symptoms and resistance to numerous treatment modalities, including antipsychotic discontinuation. Recent insights on genetic risk factors and new concepts surrounding pathophysiology have spurred interest in the possibility of targeted treatment for TD. As will be reviewed in this article, the number of evidence-based strategies for TD treatment is small: only clonazepam, amantadine, ginkgo biloba extract, and the vesicular monoamine transporter 2 (VMAT2) inhibitor tetrabenazine have compelling data...
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28007050/an-adverse-drug-event-manager-facilitates-spontaneous-reporting-of-adverse-drug-reactions
#19
Siri Vinther, Pia Klarskov, Hanne Borgeskov, Perle Darsø, Anette Kvindebjerg Christophersen, Bille Borck, Catrine Christensen, Melissa Voigt Hansen, Natalie Monica Løvland Halladin, Mikkel Bring Christensen, Kirstine Moll Harboe, Marie Lund, Espen Jimenez-Solem
INTRODUCTION: Spontaneous reporting of adverse drug reactions (ADRs) is used for continuous risk-benefit evaluation of marketed pharmaceutical products and for signal detection. The Adverse Drug Event Manager (ADEM) is a service offered to clinicians employed at hospitals in the Capital Region of Denmark. The ADEM assists healthcare professionals in reporting suspected ADRs to the Danish Health Authority. The aim of this retrospective observational study was to quantify and describe ADRs reported via the ADEM in 2014...
January 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28005647/the-ethical-use-of-mobile-health-technology-in-clinical-psychiatry
#20
REVIEW
John Torous, Laura Weiss Roberts
The rapid rise of mobile health technologies, such as smartphone apps and wearable sensors, presents psychiatry with new tools of potential value in caring for patients. Novel diagnostic and therapeutic applications of these technologies have been developed in private industry and utilized in mental health, although these methods do not yet constitute standard of care. In this article, we provide an ethical perspective on the practical use of this novel modality by psychiatrists. We propose that in the present context of limited scientific research and regulatory oversight, mobile technologies should serve to enhance the psychiatrist-patient relationship, rather than replace it, to minimize potential clinical and ethical harm to vulnerable patients...
January 2017: Journal of Nervous and Mental Disease
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