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Risk management in Psychiatry

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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
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27965330/approach-to-risk-identification-in-undifferentiated-mental-disorders
#5
REVIEW
José Silveira, Patricia Rockman, Casey Fulford, Jon Hunter
OBJECTIVE: To provide primary care physicians with a novel approach to risk identification and related clinical decision making in the management of undifferentiated mental disorders. SOURCES OF INFORMATION: We conducted a review of the literature in PubMed, CINAHL, PsycINFO, and Google Scholar using the search terms diagnostic uncertainty, diagnosis, risk identification, risk assessment/methods, risk, risk factors, risk management/methods, cognitive biases and psychiatry, decision making, mental disorders/diagnosis, clinical competence, evidence-based medicine, interviews as topic, psychiatry/education, psychiatry/methods, documentation/methods, forensic psychiatry/education, forensic psychiatry/methods, mental disorders/classification, mental disorders/psychology, violence/prevention and control, and violence/psychology...
December 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27880971/the-risk-factors-of-postoperative-delirium-after-total-knee-arthroplasty
#6
Lih Wang, Sangyun Seok, Sungsoo Kim, Kyungtaek Kim, Seunghyun Lee, Kyungho Lee
We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27819619/-nicht-von-schlechten-eltern-nische-a-family-orientated-collaborative-care-approach-to-support-children-in-families-with-mentally-ill-parents
#7
Pascal Wabnitz, Klaus-Thomas Kronmüller, Erwin Wieskus-Friedemann, Sabine Kliem, Johannes Hoppmann, Monika Burek, Michael Löhr, Ulrich Kemper, André Nienaber
"Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents The present work describes the setting- and multi-professional offer "NischE" in Gütersloh, a systemic approach for the care of children and their mentally ill parents. Children of mentally ill parents are a special risk group for developing their own mental illness. The aim of the collaborative care model between child and adolescent psychiatry, youth services and adult psychiatry is to enable affected families in terms of family-focused practice a low threshold access to different services...
November 2016: Praxis der Kinderpsychologie und Kinderpsychiatrie
https://www.readbyqxmd.com/read/27794549/clinicians-use-of-prescription-drug-monitoring-programs-in-clinical-practice-and-decision-making
#8
Gillian J Leichtling, Jessica M Irvine, Christi Hildebran, Deborah J Cohen, Sara E Hallvik, Richard A Deyo
OBJECTIVES:  Little is known about clinicians' use of prescription drug monitoring program (PDMP) profiles in decision-making. The objective of this qualitative study was to understand how clinicians use, interpret, and integrate PDMP profiles with other information in making clinical decisions. DESIGN : Qualitative interviews of clinician PDMP users. SETTING:  Oregon registrants in the state's PDMP. SUBJECTS:  Thirty-three clinicians practicing in primary care, emergency medicine, pain management, psychiatry, dentistry, and surgery...
October 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27788673/immuno-psychiatry-an-agenda-for-clinical-practice-and-innovative-research
#9
EDITORIAL
Marion Leboyer, Michael Berk, Robert H Yolken, Ryad Tamouza, David Kupfer, Laurent Groc
BACKGROUND: The diagnostic scheme for psychiatric disorders is currently based purely on descriptive nomenclature given that biomarkers subtypes and clearly defined causal mechanisms are lacking for the vast majority of disorders. The emerging field of "immuno-psychiatry" has the potential to widen the exploration of a mechanism-based nosology, possibly leading to the discovery of more effective personalised treatment strategies. DISCUSSION: Disturbances in immuno-inflammatory and related systems have been implicated in the aetiology, pathophysiology, phenomenology and comorbidity of several psychiatric disorders, including major mood disorders and schizophrenia...
October 28, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27732772/the-use-of-long-acting-injectable-antipsychotics-in-schizophrenia-evaluating-the-evidence
#10
Christoph U Correll, Leslie Citrome, Peter M Haddad, John Lauriello, Mark Olfson, Stephen M Calloway, John M Kane
Long-acting injectable antipsychotics (LAIs) are among the most effective treatments in psychiatry, yet they remain underutilized in clinical practice. Although LAIs are typically used to maintain treatment adherence in patients with chronic schizophrenia, recent research has suggested that they may also provide an effective treatment strategy for patients with early-phase or first-episode disease. In October 2015, a group of 8 experts on the management of schizophrenia and LAIs met to evaluate the evidence surrounding the efficacy, safety, and cost-effectiveness of LAIs and to develop practical recommendations regarding the clinical use, education, and unmet needs related to LAIs...
2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27637873/-attention-deficit-hyperactivity-disorder-in-forensic-psychiatry-a-review
#11
D Galland, I Tisserant, L Notardonato
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is one of the most common and challenging childhood neurobehavioral disorders. ADHD may have behavioral consequences and involvements in minor and serious crimes. Our work aims to establish links between ADHD and forensic psychiatry. METHODS: A review of international scientific literature concerning the relationship between ADHD and forensic psychiatry was conducted using the PudMed electronic database...
September 13, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27623121/-advocacy-for-the-establishment-of-a-comprehensive-strategy-to-reduce-the-burden-of-schizophrenic-disorders
#12
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...
October 2016: L'Encéphale
https://www.readbyqxmd.com/read/27605915/risk-factors-for-problematic-behaviors-among-forensic-outpatients-under-the-medical-treatment-and-supervision-act-in-japan
#13
Kumiko Ando, Takahiro Soshi, Kanako Nakazawa, Takamasa Noda, Takayuki Okada
The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27587328/aspree-d-aspirin-for-the-prevention-of-depression-in-the-elderly
#14
Michael Berk, R L Woods, M R Nelson, R C Shah, C M Reid, E Storey, S M Fitzgerald, J E Lockery, R Wolfe, M Mohebbi, A M Murray, B Kirpach, R Grimm, J J McNeil
BACKGROUND: Not only is depression associated with increased inflammation but inflammation is a risk factor for the genesis of depression. Many of the environmental risk factors for depression are transduced through inflammatory signaling. Anti-inflammatory agents show promise for the management of depression in preclinical, epidemiological, and early clinical studies. This opens the door to the potential for anti-inflammatory agents to treat and prevent depression. There are no evidence-based pharmacotherapies for depression prevention...
October 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27555554/innovative-strength-based-care-in-child-and-adolescent-inpatient-psychiatry
#15
Deanna P Sams, David Garrison, Joanne Bartlett
PROBLEM: Child and adolescent psychiatric units serve the highest risk, most vulnerable populations in the mental health delivery system. This article describes the integration of a strength-based approach with a traditional, medical model of psychiatric care on an acute inpatient unit. A strength-based framework allows for increased focus on exploring patients' goals, strengths, relationships, skills, and family communication within the hospital setting. METHODS: The process of integration of strength-based care is described, followed by discussion of the implementation and evaluation of interventions, including mindfulness, family movie, narrative, and animal-assisted therapies...
August 2016: Journal of Child and Adolescent Psychiatric Nursing
https://www.readbyqxmd.com/read/27512583/opening-the-black-box-liaison-psychiatry-services-and-what-they-actually-do
#16
Elspeth Guthrie, Aaron McMeekin, Rachel Thomasson, Sylvia Khan, Sally Makin, Ben Shaw, Damien Longson
Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service. Results Three hundred and forty-four patients were referred to the service over a 12-month period. Ten different types of liaison interventions were identified, with the most common interventions being diagnosis (112 patients, 32...
August 2016: BJPsych Bulletin
https://www.readbyqxmd.com/read/27480874/a-pharmacist-physician-collaboration-to-optimize-benzodiazepine-use-for-anxiety-and-sleep-symptom-control-in-primary-care
#17
Shannon M L Furbish, Miranda E Kroehl, Danielle F Loeb, Huong Mindy Lam, Carmen L Lewis, Jennifer Nelson, Zeta Chow, Katy E Trinkley
INTRODUCTION: Benzodiazepines are prescribed inappropriately in up to 40% of outpatients. The purpose of this study is to describe a collaborative team-based care model in which clinical pharmacists work with primary care providers (PCPs) to improve the safe use of benzodiazepines for anxiety and sleep disorders and to assess the preliminary results of the impact of the clinical service on patient outcomes. METHODS: Adult patients were eligible if they received care from the academic primary care clinic, were prescribed a benzodiazepine chronically, and were not pregnant or managed by psychiatry...
August 1, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27473529/the-role-of-boundary-spanners-in-delivering-collaborative-care-a-process-evaluation
#18
Carianne M Hunt, Michael Spence, Anne McBride
BACKGROUND: On average, people with schizophrenia and psychosis die 13-30 years sooner than the general population (World Psychiatry 10 (1):52-77, 2011). Mental and physical health care is often provided by different organisations, different practitioners and in different settings which makes collaborative care difficult. Research is needed to understand and map the impact of new collaborative ways of working at the primary/secondary care interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the Community Mental Health Team, Community in the title CPHC refers to Community Mental Health) and Multi-Disciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of mental and physical health care for service users with Severe Mental Illness (SMI)...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27450328/palliative-psychiatry-for-severe-persistent-mental-illness-as-a-new-approach-to-psychiatry-definition-scope-benefits-and-risks
#19
Manuel Trachsel, Scott A Irwin, Nikola Biller-Andorno, Paul Hoff, Florian Riese
BACKGROUND: As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. DISCUSSION: Based on the WHO definition of palliative care, a, a working definition of palliative psychiatry is proposed...
July 22, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27400856/genome-wide-common-and-rare-variant-analysis-provides-novel-insights-into-clozapine-associated-neutropenia
#20
S E Legge, M L Hamshere, S Ripke, A F Pardinas, J I Goldstein, E Rees, A L Richards, G Leonenko, L F Jorskog, K D Chambert, D A Collier, G Genovese, I Giegling, P Holmans, A Jonasdottir, G Kirov, S A McCarroll, J H MacCabe, K Mantripragada, J L Moran, B M Neale, H Stefansson, D Rujescu, M J Daly, P F Sullivan, M J Owen, M C O'Donovan, J T R Walters
The antipsychotic clozapine is uniquely effective in the management of schizophrenia; however, its use is limited by its potential to induce agranulocytosis. The causes of this, and of its precursor neutropenia, are largely unknown, although genetic factors have an important role. We sought risk alleles for clozapine-associated neutropenia in a sample of 66 cases and 5583 clozapine-treated controls, through a genome-wide association study (GWAS), imputed human leukocyte antigen (HLA) alleles, exome array and copy-number variation (CNV) analyses...
July 12, 2016: Molecular Psychiatry
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