Behavior In Psychotic Patients Research Articles

Restraints Practices on Patients of the Psychiatric Wards in a Selected Hospital, Mangalore

Abstract Background Restraints are one of the common procedures performed in various medical settings, especially intensive care units, and psychiatric wards. There are various forms of restraints, including chemical, physical, and mixed restraints. The primary reasons for using restraints are to prevent injury to the patient and others, and to reduce violent behavior in psychotic patients. Objectives The aim of this article was to identify the types of restraints used for psychiatric patients and current restraint practices for patients in psychiatric wards of selected mental health facilities. Methods This was a descriptive cross-sectional study conducted among 100 psychiatric patients selected using purposive sampling techniques. An observational checklist was used to assess restraint practice in patients who met study criteria. Results The majority of patients (44%) received chemical restraints, some (28%) received physical restraints, but a minority (28%) used mixed restraints. In terms of practice, most patients (91%) received reasonably safe restraint care. An association was found between practice of restraints and restraints type with a p-value (0.001) less than 0.05 at a significance level of 0.05. Conclusions The development of mandatory practice protocols is critical for better nursing care.

Global DNA methylation in suicidal ideation and suicide attempt in schizophrenia.

Suicidal behavior is influenced by many risk factors such as childhood trauma, stressful life events, genetic factors, and severe mental illnesses. Suicidal ideation is present in 50% of schizophrenia patients and is associated with an elevated risk of suicide attempt. Studies have shown that epigenetic mechanisms are associated with suicidal behavior in schizophrenia. Although several studies have suggested the importance of epigenetic factors in suicidal ideation and behavior, no studies have investigated global methylation in association with these two phenotypes. This study investigated global methylation level/change in association with current and emergent suicidal ideation and also with suicide attempt. Forty-seven schizophrenia patients were assessed for the association between global methylation and suicide attempt, and a subsample of these patients (n = 27) was assessed for current suicidal ideation. Afterwards, we performed a longitudinal analysis in which global methylation changes during a 3-month follow-up were compared between patients with and without emergent suicidal ideation. This methylation analysis did not find evidence for a significant association between global methylation and suicidal ideation or suicide attempt. To date, there are no robust biomarkers predicting suicidal ideation or behavior in psychotic patients. This study is the first to investigate global methylation in predicting suicidal ideation and behavior. Although we did not find evidence for an association between global methylation and these phenotypes, our findings may offer novel insights into the molecular mechanisms linked to suicide. Future investigation may measure global methylation in association with suicidal ideation or behavior in larger samples.

Nursing intervention of impulsive behavior in psychotic patients during treatment

Nursing intervention of impulsive behavior in psychotic patients during treatment

Psychiatrists’ View on the Risk Factors for Aggressive Behavior in Psychotic Patients

In meta-analytic studies it was found that patients diagnosed with a psychotic disorder are at increased risk for displaying violent behavior. However, it remains largely unclear which specific factors contribute to the heightened risk for aggression in this patient group, nor what the views of psychiatrists are on this issue. A cross-sectional survey study was carried out and a survey questionnaire was developed to investigate the view of 652 psychiatrists on the relative contributions of various factors (e.g., illness related, personality, social influences) that might explain aggression in psychosis. It was found that psychiatrists generally view illness-related features as the most important determinant of aggression in these patients, followed by impulsivity/lack of insight and social influences, whereas personality characteristics are considered as least relevant. Latent class cluster analysis revealed that there are several subgroups of psychiatrists who attach different levels of importance to various types of risk factors. In these subgroups, two cluster contrasts were found: one representing differences in response style, and one representing differences in the evaluation of personality characteristics. Overall, psychiatrists seem to adopt a medical model when interpreting aggression in psychotic patients, although several subgroups of psychiatrists can be identified who have different opinions of such behavior.

Threat/Control-Override Symptoms and Emotional Reactions to Positive Symptoms as Correlates of Aggressive Behavior in Psychotic Patients

This cross-sectional multicenter study was carried out to examine whether the experience of threat/control-override symptoms and emotional reactions to positive symptoms (e.g., anger, anxiety) are related to aggressive behavior. Patients diagnosed with schizophrenia, delusional disorder, psychotic disorder not otherwise specified, or a schizoaffective disorder (N = 124) were interviewed and filled out self-report questionnaires. Results indicated that, in particular, threat/control-override symptoms were significantly related to aggressive behavior in psychotic patients. Further analysis revealed that the threat symptoms especially, but not the control-override symptoms, carried this effect. Anger disposition also accounted for a significant and unique proportion of the variance in the aggressive behavior of psychotic patients, whereas state anger and anxiety in reaction to positive symptoms did not. These results seem to suggest that feeling threatened by positive psychotic symptoms and anger disposition play a role in the origins of aggressive behavior of psychotic patients.

39-166 - Sexual interest and behavior of psychotic patients

39-166 - Sexual interest and behavior of psychotic patients

The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD):

The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD) is a rating scale constructed for the assessment of psychotic patients in relation to 29 situations or interactions. The instrument is used to rate the potential of these situations/interactions for precipitating aggressive behavior in psychotic patients. These assessments result in a profile of situational vulnerability that describes a patient's potential for aggressive behavior in relation to the 29 situations or interactions. In this pilot study, 10 psychotic patients at a special secure unit were assessed by means of this scale. After the completion of the PAD ratings, systematic observations of episodes involving verbal, threatened, and physical aggression were made throughout a 2-year follow-up period. The results indicate that the PAD was able to predict the patients' potential for aggression and, to some extent, the situations that were the most potent precipitants of aggressive behavior.

Serum creatine phosphokinase levels and assaultive behaviour of psychotic patients.

Serum creatine phosphokinase (CPK) levels were compared with assaultive behaviour by 46 psychiatric patients. Significant relationships were found between CPK level and violent behaviour prior to admission and CPK level and seclusion as a danger to others while in hospital. No relationship was found between CPK level and assaultiveness while in hospital.

Work-flow Influences on the Interaction of Schizophrenics

Methodological considerations involved in studying the impact of the sheltered workshop setting on the behavior of psychotic patients are discussed within the framework of a pilot study designed to examine the effects of work-flow variations on interaction in small work groups. An observational technique for measuring behavior through systematic sampling and the problems associated with analysis of quantitative behavioral data are presented. Analysis of the pilot study revealed that increases in the amounts of interaction among schizophrenics working in a ward-sheltered workshop may result from relatively simple variations in the ways in which the jobs are structured.

Effects of frequent hospitalization on behavior of psychotic patients in multiple family therapy program.

Effects of frequent hospitalization on behavior of psychotic patients in multiple family therapy program.

METHOTRIMEPRAZINE FOR CONTROL OF THE ACUTELY DISTURBED.

Our conclusion is that methotrimeprazine is clinically useful in controlling marked disturbances of behavior in psychotic patients when administered muscularly. It is more hypnotic than chlorpromazine, and it is possibly less anti-psy-chotic. But it is free of the untoward effects to the tissues as no signs or symptoms of tissue damage were observed. It is very helpful in controlling the acutely disturbed patient, including the aged, if the few basic precautions are observed for parenteral use.

Effects of isonicotinic acid hydrazide in mentally ill patients.

Isonicotinic acid hydrazide was administered to a group of 51 mentally ill tuberculous patients in an effort to assist in determining whether toxic effects to the liver, kidney and blood forming organs would be encountered during the course of treatment. Two patients had to be discontinued because of the lack of cooperation and one with severe pulmonary and superimposed renal tuberculosis died after a short period of treatment. All treated had known active tuberculosis at the time administration of the drug was begun. The conclusions reached as a result of this study are as follows: 1) There was no demonstrable damage to the liver, kidney or blood forming organs after 90 days of treatment and it was not thought that those patients showing damage prior to treatment had any significant increase in impairment of function which could be related directly to the action of the drug. 2) Increase in appetite and weight and reduction in sedimentation rate were in keeping with findings as reported elsewhere but did not parallel in degree those published by other investigators. This probably is related in some way to the type of patient treated in this series. 3) Study of chest x-ray films and gastric washings after 90 days of treatment showed no consistent x-ray improvement but 22.9 per cent of cases treated showed change in sputum status. 4) An improvement in the mental behavior of psychotic patients under treatment with this drug was noted in a reasonably high percentage of cases.

Modified sedation with secondary butyl-ethyl barbituric acid in the psychosis

1. Secondary butyl-ethyl barbituric acid may be used for the production of prolonged sleep without toxic effect in cases having no cardiac or kidney lesions. 2. During the eight-day period tolerance for the drug did not appear. 3. In the ten cases in which this drug was used the effect obtained did not indicate that it was of particular value in altering the trend or behavior of psychotic patients.