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Risk management in Psychiatry

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https://www.readbyqxmd.com/read/28365002/national-survey-on-pediatric-acute-agitation-and-behavioral-escalation-in-academic-inpatient-pediatric-care-settings
#1
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
#2
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
#3
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...
March 16, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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