Psychiatry Clinic Research Articles

The impact of shelter-in-place during the COVID-19 pandemic on social support for mental health recovery: A prescribing-oriented qualitative study of patient perspectives.

The COVID-19 pandemic created unprecedented challenges for social connectivity and mental health, especially during mandated shelter-in-place periods. For patients engaged in mental health treatment, the social impact of their shelter-in-place experience remains an area of active investigation. This is particularly relevant in the context of social prescribing, a growing area of clinical intervention where healthcare providers actively refer patients to local social resources or activities to enhance mental health and wellbeing. Here, we investigated patient perspectives on their social supports during shelter-in-place, with an eye toward informing future social prescribing and counseling steps that mental health clinicians can take to foster social resiliency of patients. We conducted semi-structured phone interviews with 12 participants receiving mental health treatment at Kaiser Permanente San Jose Adult Psychiatry clinics. Interviews were transcribed and analyzed for themes. The sample consisted of 8 female and 4 male participants between the ages of 21 to 44, who received services including outpatient medication management, outpatient therapy, and/or outpatient group therapy. Analysis revealed two thematic categories that participants identified: (A) Specific ways that shelter-in-place impacted their social experience and (B) specific types of social relationships that participants felt were important to their mental health and wellbeing. In the first category, thematic factors that affected the social experience included (1) COVID-19-related health concerns, (2) participants' baseline socialization patterns (degree of introversion/extroversion) and (3) the use of online and social media communication channels. For the second category of themes, specific functions of social relationships identified included those centered around (a) instrumental support, (b) emotional support, (c) community connection. Many relationships served more than one function during shelter-in-place, and many participants cited perceived community connection as a particularly important element in their mental health recovery. These themes highlight key contributors to the social experience of the shelter-in-place period for individuals in mental health recovery and inform future ways that clinicians can structure social prescribing practices to better assist the needs of patients.

Assessing Health Technology Literacy and Attitudes of Patients in an Urban Outpatient Psychiatry Clinic: Cross-Sectional Survey Study.

Digital health technologies are increasingly being integrated into mental health care. However, the adoption of these technologies can be influenced by patients' digital literacy and attitudes, which may vary based on sociodemographic factors. This variability necessitates a better understanding of patient digital literacy and attitudes to prevent a digital divide, which can worsen existing health care disparities. This study aimed to assess digital literacy and attitudes toward digital health technologies among a diverse psychiatric outpatient population. In addition, the study sought to identify clusters of patients based on their digital literacy and attitudes, and to compare sociodemographic characteristics among these clusters. A survey was distributed to adult psychiatric patients with various diagnoses in an urban outpatient psychiatry program. The survey included a demographic questionnaire, a digital literacy questionnaire, and a digital health attitudes questionnaire. Multiple linear regression analyses were used to identify predictors of digital literacy and attitudes. Cluster analysis was performed to categorize patients based on their responses. Pairwise comparisons and one-way ANOVA were conducted to analyze differences between clusters. A total of 256 patients were included in the analysis. The mean age of participants was 32 (SD 12.6, range 16-70) years. The sample was racially and ethnically diverse: White (100/256, 38.9%), Black (39/256, 15.2%), Latinx (44/256, 17.2%), Asian (59/256, 23%), and other races and ethnicities (15/256, 5.7%). Digital literacy was high for technologies such as smartphones, videoconferencing, and social media (items with >75%, 193/256 of participants reporting at least some use) but lower for health apps, mental health apps, wearables, and virtual reality (items with <42%, 108/256 reporting at least some use). Attitudes toward using technology in clinical care were generally positive (9 out of 10 items received >75% positive score), particularly for communication with providers and health data sharing. Older age (P<.001) and lower educational attainment (P<.001) negatively predicted digital literacy scores, but no demographic variables predicted attitude scores. Cluster analysis identified 3 patient groups. Relative to the other clusters, cluster 1 (n=30) had lower digital literacy and intermediate acceptance of digital technology. Cluster 2 (n=50) had higher literacy and lower acceptance. Cluster 3 (n=176) displayed both higher literacy and acceptance. Significant between-cluster differences were observed in mean age and education level between clusters (P<.001), with cluster 1 participants being older and having lower levels of formal education. High digital literacy and acceptance of digital technologies were observed among our patients, indicating a generally positive outlook for digital health clinics. Our results also found that patients of older age and lower formal levels of educational attainment had lower digital literacy, highlighting the need for targeted interventions to support those who may struggle with adopting digital health tools.

Evaluating Adverse Drug Reactions, Their Reporting Rates and Their Impact on Attitudes Toward Pharmacotherapy Among Female Patients with Schizophrenia: Insights and Implications from a Cross-Sectional Study

Background/Objectives: Schizophrenia is a chronic psychiatric disorder usually managed with antipsychotics, which can cause adverse drug reactions (ADRs) that may impact patients’ attitudes toward their treatment, as well as treatment adherence. This study aimed to assess the influence of ADRs and other factors on treatment attitudes among female patients with schizophrenia. Methods: A cross-sectional study was conducted at the Vrapče Psychiatry Clinic with 109 female schizophrenia patients. The DAI-10 (Drug Attitude Inventory) questionnaire was used to assess attitudes toward treatment. Data on their demographic details, pharmacotherapy, ADR occurrence and ADR reporting rates were collected. Multiple regression analyses were used to identify predictors of DAI-10 scores. Results: Patients using more medications and those experiencing ADRs had lower DAI-10 scores, indicating less favorable attitudes (F (2, 106) = 7.364, p = 0.001, R2 = 0.105). ADRs, primarily extrapyramidal symptoms and weight gain, were reported by 43.1% of patients; however, only one patient formally reported them. First-generation antipsychotics were associated with a higher prevalence of ADRs (χ2 = 4.969, df = 1, p = 0.022). Conclusion: Negative experiences with ADRs significantly impact patients’ attitudes and adherence. Low ADR reporting rates highlight the need for better pharmacovigilance education. Enhancing patient awareness may foster more positive attitudes and adherence, potentially improving patient outcomes.

Evaluation of Ocular Parameters in Newly Diagnosed Obsessive-Compulsive Disorder Children With Eye-Rubbing Compulsion.

To determine the ocular structural changes in obsessive-compulsive disorder (OCD) children with eye-rubbing compulsion. Participants recruited at the child and adolescent psychiatry clinic were evaluated for the OCD diagnosis. All patients underwent imaging with Scheimpflug corneal topography (Sirius, CSO, Italy), Tomey EM-4000 specular microscopy (Nagoya, Japan), and Lenstar LS 900 (Haag-Streit AG, Switzerland) optical biometry. Both naive OCD and healthy control groups consisted of 40 patients. Mean cylindric diopter, coma, and trefoil values were significantly higher in the right eyes of OCD children. (P = .043, .024, and .028, respectively). Besides, lens thickness, total ocular aberrations, and high ocular aberrations (P = .014, .040; .027, .038; and.020, .013, in right and left eyes, respectively) were bilaterally higher in OCD children. Eye rubbing and mechanical trauma were proposed as risk factors for ocular structural changes. Early evaluation of corneal topographic parameters such as CylD, coma, and trefoil aberrations in newly diagnosed OCD children might assist in preventing future corneal ectatic diseases.

The Frequency of Certain Genetic Polymorphisms and Their Influence on the Therapeutic Response of Patients Treated with Olanzapine

Abstract Olanzapine is an atypical antipsychotic that serves as the first line of schizophrenia treatment. The metabolism of olanzapine takes place with the leading participation of two enzymes, CYP1A2 and CYP2D6. The CYP450 enzyme activity can be changed under the influence of many drugs, which results in potentially significant interactions in which one drug can increase the toxicity (inhibition of cytochrome) or reduce the second drug's therapeutic effect. The aim of this study was to examine the frequency of certain genetic polymorphisms and their impact on the therapeutic response of patients treated with olanzapine. This research was conducted according to the design of a prospective, interventional, clinical study of phase IV by type of case series, where the stratification of the subjects was performed according to the obtained types of tested genotypes. Patients (N=120) were recruited at the Clinic of Psychiatry, University Clinical Center Kragujevac, in Serbia. The primary endpoint to assess the therapeutic response in this study was PANSS. In our study, the presence of the investigated gene variations (UGT1A4, CYP1A2, FMO3, and CYP2D6) does not affect the clinical response to olanzapine therapy in patients suffering from schizophrenia, compared to patients who are carriers of the wild-type gene. The presence of genes of CYP1A2*1C (rs2069514, −3860G&gt;A), CYP1A2 (rs2472297, 74735539C&gt;T), FMO3 E158K (rs2266782, 15167G&gt;A), FMO3 V257M (rs1736557, 18281G&gt;A), FMO3 E308G (rs2266780, 21443A&gt;G), CYP2D6*3 (rs35742686, 2549delA), CYP2D6*4 (rs3892097, 1846G&gt;A), CYP2D6*6 (rs5030655, 1707delT) does not change the clinical response to olanzapine therapy in patients suffering from schizophrenia, compared to patients who are carriers of the wild-type gene.

Participation in the Clinic for Child and Adolescent Psychiatry and Psychotherapy. Do Personality Traits Affect the Difference Between the Desire and Experience of Participation?

Participation in the Clinic for Child and Adolescent Psychiatry and Psychotherapy. Do Personality Traits Affect the Difference Between the Desire and Experience of Participation? Abstract: Objective: Participation and codetermination are important rights of children and adolescents. The present study examined discrepancies between the desire and experience of participation, their relationship with treatment satisfaction, and which patient-related variables are associated with the reported discrepancies. Method: Forty adolescents from the inpatient unit or the day clinic of the university clinic of Ruppin-Brandenburg answered a questionnaire concerning their desire for and experience of participation. Additionally, we assessed sociodemographic data and personality traits. Results: Patients experienced less participation than desired. The highest discrepancy was found in items concerning communication with family and friends. Two personality traits had significant positive effects on the discrepancy of desired and experienced participation: "suspicious schizotypical" and "loyal-dependent." Conclusion: Minors want more participation than they actually experience. We need flexible concepts, especially concerning communication with family and friends, to reduce the discrepancy between the desire and the experience of participation. Giving patients the possibility to participate and encouraging them to do so should be emphasized, especially with patients with the personality traits "suspicious-schizotypical" and "loyal-dependent."

Community Psychiatry Clinic’s Impact on Dementia Care: Insight from Rythm Community Mental Healthcare Program

Community Psychiatry Clinic’s Impact on Dementia Care: Insight from Rythm Community Mental Healthcare Program

Perception of Internalized Stigma in Parents of Children With Autism Spectrum Disorder: Investigating the Effects of Depression, Anxiety, and Family Functioning.

Introduction Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder that impacts communication, behavior, and social interaction. It is well-documented that parents of children with ASD often experience psychiatric conditions like anxiety and depression. Nevertheless, research on the perception of internalized stigma, family functioning, and their interconnections is scarce. The main objective of our study was to analyze the internalized stigma perceptions, depression, anxiety, and family functioning among parents or caregivers of children diagnosed with ASD. Methods This study was conducted on 102 cases and 101 healthy controls in a cross-sectional case-control study involving patients aged 3-12 years. The research was carried out at the Child Psychiatry Clinic of Adana City Training and Research Hospital and three Family Health Centers in Adana from October 15 to December 15, 2022. Sociodemographic data, family history, families' knowledge levels about autism, and information about their social lives were collected using a face-to-face structured questionnaire. The Internalized Stigma of Mental Illness (ISMI), Hospital Anxiety and Depression (HAD), and Family APGAR scales were administered. Results The mean ISMI score of the case group was 67.31±8.91. According to the HAD Anxiety scale score, 60.8% of the case group and 14.9% of the control group were at high risk (p<0.001). According to the HAD Depression Scale, 52% of the case group participants and 25.7% of the control group were at high risk (p<0.001). The rate of severe familial dysfunction was 18.6% in the case group and 3.0% in the control group (p<0.001). Conclusion Stigma, anxiety, depression, and family functioning in parents of children diagnosed with ASD lead to various adverse outcomes. Further studies are necessary to prevent these negative experiences for families of children with ASD and to facilitate the integration of these children into society.

Telehealth Brief Cognitive Behavioral Therapy for Suicide Prevention

Suicide rates continue to increase in the US. Evidence-based treatments for suicide risk exist, but their effectiveness when delivered via telehealth remains unknown. To test the efficacy of brief cognitive behavioral therapy (BCBT) for reducing suicide attempts and suicidal ideation among high-risk adults when delivered via telehealth. This 2-group parallel randomized clinical trial comparing BCBT with present-centered therapy (PCT) was conducted from April 2021 to September 2023 with 1-year follow-up at an outpatient psychiatry and behavioral health clinic located in the midwestern US. Participants reporting suicidal ideation during the past week and/or suicidal behavior during the past month were recruited from clinic waiting lists, inpatient service, intermediate care, research match, and direct referrals from clinicians. A total of 768 participants were invited to participate, 112 were assessed for eligibility, and 98 were eligible and randomly assigned to a treatment condition. Data analysis was from April to September 2024. Participants received either BCBT, an evidence-based suicide-focused treatment that teaches emotion regulation and reappraisal skills, or PCT, a goal-oriented treatment that helps participants identify adaptive responses to stressors. Participants were randomized using a computerized stratified randomization algorithm with 2 strata (sex and history of suicide attempts). The primary outcome was suicide attempts as measured by the Self-Injurious Thoughts and Behaviors Interview-Revised. The secondary outcome was severity of suicidal ideation as measured by the Scale for Suicide Ideation. Participants included 96 adults (mean [SD] age, 31.8 [12.6] years; 64 female [66.7%] and 32 male [33.3%]), with 51 receiving BCBT and 45 receiving PCT. Of all participants, 85 (88.5%) completed at least 1 session. From baseline to 12 months, 12 participants receiving PCT (estimated percentage, 35.6%) made 56 suicide attempts and 11 participants receiving BCBT (estimated percentage, 30.0%) made 36 suicide attempts. Participants randomized to BCBT made significantly fewer suicide attempts than participants randomized to PCT (mean [range], 0.70 [0.00-8.00] attempts per participant vs 1.40 [0.00-10.00] per participant) and had a 41% reduced risk for suicide attempts (hazard ratio, 0.59; 95% CI, 0.36-0.96; P = .03). Severity of suicidal ideation significantly decreased in both treatments (F4,330 = 50.1; P < .001) but did not differ between groups (F4,330 = 0.2; P = .91). The findings of this randomized clinical trial suggest that BCBT delivered via video telehealth is effective for reducing suicide attempts among adults with recent suicidal thoughts and/or behaviors. ClinicalTrials.gov Identifier: NCT04844294.

Teletherapy and Medication Management of Attention-Deficit/Hyperactivity Disorder with Co-occurring Internalizing Symptoms and Suicidality During the Pandemic.

Sam (he/him) is an 11-year-old cisgender white male with previous diagnoses of attention-deficit/hyperactivity disorder, anxiety, and major depressive disorder who was referred to an outpatient psychiatry clinic after hospitalization for suicidal ideation and agitation. Family history is significant for bipolar disorder, depression, anxiety, substance use/abuse, and suicidality. Sam started a trial of atomoxetine 10 mg po QAM in December 2019 due to increasing inattention in the backdrop of worsening anxiety. Sam received school-based counseling through his IEP, which Sam declined due to embarrassment from being pulled out of the classroom, and services were quickly discontinued. In January 2020, obsessive-compulsive symptoms emerged, specifically obsessions about cleanliness with related compulsions. He started biweekly cognitive behavioral therapy with an outpatient provider to target obsessive-compulsive disorder symptoms. Concomitantly, a developmental-behavioral pediatrician who diagnosed obsessive-compulsive disorder started Sam on fluoxetine 10 mg po QAM. Atomoxetine was also increased to 25 mg po QAM for 4 weeks and built up to 40 mg po QAM in February 2020.Depressive symptoms emerged in Spring 2020, around the time of the COVID-19 pandemic, despite ongoing treatment with fluoxetine. There was a significant increase in aggression, agitation, and compulsive cleaning, which did not respond to the addition of lorazepam 0.5 mg po daily. Owing to concerns that medication was exacerbating his presentation, his prescriber began to wean him off both atomoxetine and fluoxetine.Sam presented to the Emergency Department in the summer of 2020 due to worsening symptoms, including suicidal ideation and aggression, in the context of medication adjustment, social isolation, and academic difficulty with virtual schooling. He completed a 3-week inpatient hospitalization followed by a 2-week virtual partial hospitalization program, during which Sam struggled with attention and engagement. As part of his discharge plan, he was referred to the outpatient psychiatry department to continue outpatient therapy and medication management.During the virtual transfer appointment to outpatient therapy, his parents reported persistent concerns for ongoing attention-deficit/hyperactivity disorder, depression, anxiety, and obsessive-compulsive symptoms, along with a fear of a resurgence of suicidal thinking. Sam reported exhaustion from virtual partial hospitalization program sessions he attended earlier in the day and was eager to leave the appointment. He minimized concerns, denied suicidal ideation or intent, and reported a strong disinterest in doing "another virtual therapy." In-person sessions would be ideal for Sam, given his history of attention difficulties, clinical complexity, and acuity and his self-identified dislike for virtual settings. However, services needed to be done virtually due to the quarantine shutdown. How would you proceed with treating Sam?

Internal Validation of the Latvian Version of 16-Item Prodromal Questionnaire in A Help-Seeking Adolescent Population: Psychometric Analysis and Associated Factors.

The prodromal phase of a psychotic disorder is a period of altered functioning before the onset of the acute state; several interviews have been developed to determine whether individuals present with prodromal symptoms. The 16-item Prodromal Questionnaire (PQ-16) is a screening tool for evaluating those at risk of developing a psychotic disorder. The study aimed to evaluate the psychometric properties of the Latvian version of the PQ-16 in a sample of help-seeking adolescents referred for diagnostic assessment and look for possible associated socio-demographic and health-related factors. A cross-sectional study included patients admitted for evaluation between November 2022 and February 2023 in Riga's Children's Clinical University Hospital Child Psychiatry clinic. The data were collected during outpatient consultations by mental health professionals. We used the Latvian translation of PQ-16 and the socio-demographic and health-related factors questionnaire. Data were analysed with IBM SPSS 28; the scale's diagnostic accuracy and internal validity were examined. The study involved 107 adolescents aged 12% to 17%, 80.5% female, with a mean age of 14.98 (CI 14.70-15.26). Socio-demographic data and health-related variables did not significantly differ between the sexes (p > 0.05). The Latvian PQ-16 demonstrated excellent internal reliability with a Cronbach's alpha of 0.890. All 16 items were found to be valid with p < 0.001. A significant number of participants (73.8%) scored above the current cut-off of ≥ 6 with a mean of 9.17 (95% CI 8.41-9.93). Certain socio-demographic factors, such as female gender (p < 0.001), fair school performance (p = 0.048) and recent changes in school performance (p < 0.001), demonstrated a significant association with higher scores. Additionally, there were found significant associations between positive screening and health-related factors such as obstetric complications (p = 0.044), smoking (p = 0.002), alcohol consumption (p = 0.021), history of bullying in school (p < 0.001) and emotional abuse at home (p = 0.011). Latvian translation of PQ-16 showed high internal reliability and validity levels. Positive PQ-16 screening was associated with female gender, worsened school performance, obstetric complications, substance abuse and experienced emotional violence. The average score of 9.17 positive answers and 73.8% of participants screening positive for attenuated psychotic symptoms is significantly higher than in recent studies under similar conditions.

Cortical localization and the nerve cell: Freud's work in Meynert's psychiatry clinic.

Sigmund Freud's pioneering early work on individuated nerve cells, later termed "neurons," has long been recognized by the history of psychology. Yet, relatively little has been written about the influence of Freud's then mentor, Theodor Meynert, on Freud's 1884-1885 neuroanatomical research, or the monumental conceptual shift embodied in the project itself. Focusing on Freud's 1884 "Die Struktur der Elemente des Nervensytems" (The Structure of the Elements of the Nervous System) as his first true effort to describe individuated nerve cells, this article identifies Meynert as highly influential on Freud's turn to representative schema, further suggesting that Freud's brief foray in clinical neurology at Meynert's clinic aligns with Freud's move from the laboratory to the mind. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Thoughtful program: a randomized controlled study of a mentalization-based mental health education intervention in a psychiatric outpatient population

Background P-factor and mentalizing theory and research set perspectives for transdiagnostic psychiatric treatments. Aims To test the effects of a low-cost mentalization-based health education program (the Thoughtful program) in an unselected waiting list population, from a psychiatric outpatient clinic in North Norway. Methods Waiting list patients were randomized (1:1 allocation): 79 patients in the control group were offered standard individual assessment and treatment. Seventy-nine patients in the intervention group were offered a one-day (six-hour) group-based Thoughtful course, plus individual assessment, and treatment. Results During a 6-month follow-up period, the number of patients in active assessment and treatment was 66% higher in the control group than in the intervention group. Self-reported patient questionnaire scores on mentalizing, well-being and suicidal ideation scores showed no significant changes in the control group. In the intervention group, significant changes were reported: Mentalizing scores improved by 72% and well-being scores improved by 55%. Suicidal ideation scores were not significantly changed. No adverse effects were registered. Limitations The results from this study should be interpreted with caution because of a small population size and low questionnaire response rate. The follow up period was limited to 6 months. Transfer of program information from intervention group patients to control group patients could not be guaranteed. It may be considered a limitation that diagnostic pattern analysis was not included in the study. Conclusions A low-cost transdiagnostic mentalization-based educational program in an outpatient psychiatry clinic may improve patient mentalizing and wellbeing without adverse effects and reduce the use of hospital services.

Clinical and Sociodemographic Characteristics that May Affect Delays in Child Sexual Abuse Disclosures: Ten Years in Practice.

This study covers Child Sexual Abuse (CSA) survivors who had never disclosed the abuse until their psychiatric interview. There is a clear lack of understanding of which factors contribute to delays in the disclosure of CSA. Thus, we aimed to examine the risk factors and sociodemographic variables that may inhibit CSA disclosures. We retrospectively analyzed the files of patients who presented to a child and adolescent psychiatry clinic with diferent complaints between 2010 and 2020 in a tertiary hospital. All of these sexual assaults were ofcially reported by a child and adolescent psychiatrist to the competent authorities. The mean period of time from abuse to disclosure was 28.4 ± 32.5 months. The time from abuse to disclosure was significantly negatively correlated with mothers' education years (r=-.430, P < .01) and with the age of onset of sexual abuse (r=-.589, P < .001). Results of multiple linear regression showed that female sex and the earlier age of onset of sexual abuse were significant predictors of increased duration from abuse to disclosure. Our results provide insights into several risks that may afect the time from abuse to disclosure for CSA survivors. Studies with larger samples are needed to understand the factors afecting the time from abuse to disclosure.

Efficacy of a Telephone-Intervention on Caregiving Burden and Mental Health among Family Caregivers of Persons with Dementia in Malaysia: A Randomized Controlled Trial.

Identifying effective and accessible interventions for family caregivers of persons with dementia (PWD) is crucial as the prevalence of dementia increases in Asia. This study investigated the efficacy of a telephone-intervention on the reduction in caregiver burden, as well as depressive and anxiety symptoms among family caregivers (FCs) of PWD in Malaysia. A single-blinded randomized controlled trial was carried out with 121 FCs of PWD selected from memory or psychiatry clinics in three tertiary hospitals in Malaysia, who were randomly allocated into the intervention or control group. The intervention group received the psychoeducational intervention delivered by healthcare staff via telephone for 10 sessions over 12 weeks. The outcome of the intervention was measured by the Malay version of the Zarit Burden Interview and the Hospital Anxiety and Depression Scale at baseline and post-intervention. An intention to treat analysis shows that caregiver burden, anxiety symptoms, and psychological distress among FCs in the intervention group decreased by 7.57 units (p < 0.001), 2.46 units (p < 0.001), and 2.98 units (p = 0.011), respectively, at post-intervention, compared to the differences from baseline to post-intervention in the control group. Policies aimed at integrating the telephone-intervention into memory/psychiatry clinics in Malaysia may help FCs of PWD to reduce their caregiver burden and stress while caring for a family member with dementia.

Managing the risk of suicide in a psychiatry clinic: An ethnographic study on the work atmosphere of nurses during the Covid-19 pandemic

The aim of this study was to describe the approaches of nurses working in an inpatient psychiatry clinic during the pandemic period to managing suicide risk in the context of their work atmosphere. This ethnographic research design used a sample of 13 psychiatric nurses in a psychiatric clinic in Ankara, Turkey. Data were collected with in-depth interviews and 612h of observation. Qualitative thematic analysis was used for data analysis. Two themes emerged from the data analysis, including ‘De-prioritizing the uniqueness of the patient in managing suicide risk’ and ‘A condition that remains important for uniqueness: personality disorders’. The current risk assessment methods for suicide, pandemic measures, and past inadequacies in the approach to patients with personality disorders have revealed the risk of alienating from the individual risk factors as well as the patients' history in risk management. Risk management practices that consider the psychosocial assets of patients at risk of suicide, addressing the risk level with a safe measurement scale and performing triage according to this grading system can provide an atmosphere that allows nurses to make risk assessments greater self-confidence.

Perceived Parenting Styles and Parental Bonding among a Sample of Adolescents Attending Adolescents’ Psychiatry Clinic at Ain Shams University Hospital

Abstract Background Although family history of mental disorders is one of the most consistent and potent risk factors for mental disorders in offspring, both familial and non-familial environmental factors are thought to play a role in etiology. Many aspects of parenting, ranging from daily interactions to potentially traumatic experiences such as abuse and inter-parental conflict, may be not only mechanisms through which parental disorders confer increased risk to offspring but also independent risk factors for mental disorders. Aim of the Work Our study aimed to study perceived parenting styles among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder, study both maternal and paternal bonding among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder. Patients and Methods Our study was conducted in Ain Shams university hospital, precisely in the outpatient clinic of Okasha institute of psychiatry. We compared 50 adolescents diagnosed with different psychiatric disorders to 50 healthy adolescents. Participants were recruited from the outpatient clinic while a matched group of adolescents without psychiatric disorders was recruited from adolescents of employee working in Okasha institute of psychiatry. Results adolescents with different psychiatric disorders perceived their parents as more authoritarian, less authoritative. they also perceived their mothers as less permissive, while there was no significant difference between both groups regarding father's permissiveness. Low level of care and high level of overprotection were significantly correlated with all psychiatric disorders in the study group. Conclusion Pathogenic parenting styles characterized by high level of control and overprotection and low level of care are associated with wide range of psychiatric disorders in adolescents, while parenting styles characterized by high level of care seem to be protective against psychiatric disorders in adolescents.

Assessment of Depressive Symptoms and Coping Patterns in a Sample of Mothers of ADHD Children

Abstract Background Attention-deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that affects children and adults. Aim and Objectives To identify the rate of occurrence and severity of depressive symptoms in a sample of mothers with children having ADHD and to assess different coping strategies with stress used by those mothers. Subjects and Methods This cross sectional comparative study was conducted on 100 mothers. The study sample collected from the outpatient clinic of child psychiatry, Okasha Institute of psychiatry, Ain Shams University Hospital and rehabilitation unit, and the outpatient clinic of child psychiatry at El-Maamoura Psychiatric Hospital (during the proposed study period from September 2021 to the first of March 2022). Result Mothers of ADHD children had higher levels of depressive symptoms than the control group. There was statistically significant difference between the score of less useful in mild depressed Mean ±SD (35.29±4.23), moderate depressed Mean ±SD (34.71 ± 4.57) non-depressed mothers Mean ± SD (25.90±5.17). There was statistically significant relation between Beck Score and hyperactive and combined ADHD types. While there was no statistically significant relation between Beck Score and inattentive ADHD type. There was no statistically significant difference between the score of problem focused, emotional focused and humor in depressed and non- depressed mothers. Conclusion The depressive complaints of the mothers of the study sample were higher than the controls. There was statistically significant positive correlation between severity of depression and some coping styles.

Quality of life (QOL) of patients with schizophrenia and epilepsy attending an outpatient clinic in a tertiary care hospital in Sri Lanka

Background: Schizophrenia and epilepsy are chronic relapsing disorders, that share common disadvantages that affects QOL.Methods: A cross-sectional descriptive study was conducted on 68 patients with schizophrenia and 68 patients with epilepsy, presenting to psychiatry and neurology clinics of the Colombo South Teaching Hospital (CSTH). The validated Sinhala and Tamil version of the WHO QOL 100 was used to assess the QOL.Results: Schizophrenia group had poorer QOL in physical (p&lt;0.05), social (p&lt;0.01), independence (p&lt;0.05) and environmental (p&lt;0.05) domains, compared to epilepsy. Longer duration of illness (&gt; 5 years) was associated with poorer QOL in the independence (p&lt;0.05) and social domains (p&lt;0.05) and longer duration of untreated illness was associated with lower QOL in the physical (p&lt;0.01) and social domains (p&lt;0.01) in schizophrenia group.Conclusions: Patients with schizophrenia had poorer QOL compared to patients with epilepsy. Longer duration of untreated illness was associated with poorer QOL in both groups.

Predictors of No-Shows and Cancellations in an Outpatient Neuropsychology Clinic in a Large Healthcare System.

The purpose of this study was to evaluate potential predictors of no-shows and late cancellations in an outpatient clinic within a large healthcare system serving vulnerable communities. Demographic data and appointment status were recorded for 537 consecutive patients scheduled for neuropsychological evaluation in an outpatient psychiatry clinic. Patients include 220 males and 317 females with an average formal education of 11.01 years (SD = 3.87) and age of 55.64 years (SD = 16.20). The overall rate of no-shows or late cancellations was 20%. Of the 106 patients who no-showed/late cancelled, 41% rescheduled, and of those, 23% missed or late cancelled their second appointment. No-shows and late cancellations were associated with historical/prior no-show rate, while race/ethnicity and activation of MyChart had slight impacts. These data suggest that prior no-show rates and MyChart access may be targets for interventions to improve show rates. This is important for the patients' gaining access to care as well as minimizing financial strains for the system and increasing wait times/delays to care for other patients.