Management Of Psychiatric Disorders Research Articles

Gender differences in the management of acute psychiatric episodes in the emergency department: a cross-sectional analysis of the 2017-2019 triennium.

There is growing evidence that gender is an important determinant of mental health and well-being. In this sense, both biological and socio-economic factors play a key role in how people experience psychological disturbances. This study examine whether there were sex- and gender-based differences in the management of psychiatric disorders in the emergency department (ED). A cross-sectional retrospective study was conducted in the ED over the 2017-2019 period. Sex was codified as female/male and socio-economic deprivation index was compiled to address the impact of social determinants. Episodes were reclassified according to four major clusters. Psychotropic drug prescription was categorized according to the ATC classification. Poisson regression models, adjusted for age and socioeconomic status, were used. A total of 9789 episodes (53.9% females) of individuals who required an acute-related psychiatric intervention were retrieved. Age distribution and socioeconomic quintiles revealed gender differences. Anxiety-related consultations accounted for up to 50% of all episodes. Female gender was found to be overrepresented in anxiety and stress-related disorders, mood disorders, and personality disorders. In contrast, Males accounted for 70% of all psychoactive substance use disorders. Considering main clinical syndromic clusters, analysis showed that female patients were more likely to be prescribed with anxiolytic treatment in ED treatment than men in the categories of "Common mental disorders" (PR = 1.122 [1.014-1.242; p = 0.025), "Severe Mental Disorders" (PR = 1.217[1.054-1.406] p = 0.007) and "Personality disorders" (PR = 1.398 (1.038 - 1.884); p = 0.028). This study highlights the relevance of considering sex and gender as potential determinants in both the clinical presentation and management of psychiatric emergencies.

Guide de prescription psychiatrique pendant la grossesse, le postpartum et l’allaitement

Perinatal psychopharmacology is an emerging specialty that is gradually developing alongside perinatal psychiatry. The management of psychiatric disorders during the perinatal period is a challenge for perinatal practitioners due to the multiple changes occurring during this crucial period. This little-known specialty still suffers from inappropriate considerations on the impact of psychotropic treatments on the mother and the infant during pregnancy and postpartum, which can promote a deficiency in perinatal psychic care. However, the risks associated with insufficient management of mental health are major, impacting both the mental and physical health of the mother and the infant. In this paper, we propose a perinatal psychopharmacology prescription guide based on available scientific evidence and international and national recommendations. We thus propose a decision-making process formalized on simple heuristics in order to help the clinician to prescribe psychotropic drugs during the perinatal period.

The place of EMDR in children: a review of the literature

IntroductionEMDR therapy is a brief form of trauma-focused therapy for PTSD. This therapeutic technique was first used by Francine Shapiro in the United States in 1987. EMDR combines exposure imagination, cognitive and psychoanalytical techniques. Designed to treat psychological trauma, emotional shock and grief, EMDR can also be used to treat neurotic problems such as phobias, anxiety and depression.EMDR therapy can be used at any age and can be adapted to children, adolescents, adults and the elderly unless contraindicated.In the pediatric population, several studies have shown that EMDR therapy has a remarkable effectiveness on several pathologies and particularly on PTSD.Translated with www.DeepL.com/Translator (free version)EMDR therapy is a brief form of trauma-focused therapy for PTSD. This therapeutic technique was first used by Francine Shapiro in the United States in 1987. EMDR combines exposure imagination, cognitive and psychoanalytical techniques. Designed to treat psychological trauma, emotional shock and grief, EMDR can also be used to treat neurotic problems such as phobias, anxiety and depression. EMDR therapy can be used at any age and can be adapted to children, adolescents, adults and the elderly unless contraindicated.In the pediatric population, several studies have shown that EMDR therapy has a remarkable effectiveness on several pathologies and particularly on PTSD. Translated with www.DeepL.com/Translator (free version)ObjectivesPresent the indications of EMDR therapy in children and demonstrated its effectiveness in the management of psychiatric disorders in this population.MethodsThis is a systematic review of the literature. The databases used are “PubMed” and “Google Scholar”. No language restrictions were applied.The following keywords were entered: EMDR, Child. Recent articles published in English or “systematic reviews, meta-analyses or reviews” were included.ResultsFrom this review of the literature, we note that:EMDR is a psychotherapy that has been shown to be effective in improving the symptoms of various pathologies in children, including PTSD, major depressive disorders, intellectual disability, anxiety disorders, as well as behavioral disordersHowever, the studies are still few in number and also have methodological limitations: they were exploratory studies of relatively small samples.ConclusionsEMDR therapy is mentioned in the described guidelines as “promising”, as the fact that it yields positive results in a short period of time and that these results continue in follow-up studies has increased the interest in using EMDR in children.Nevertheless, larger sample sizes are recommended in future studies to better establish the effectiveness of EMDR therapy in children.Disclosure of InterestNone Declared

Role of Yoga and Pranayama in Anxiety: A Review Article

In India, rates of anxiety are quite high in the general population with women, young adults and the elderly particularly vulnerable. In recent years, Holistic approaches are gaining increasing popularity in the management of psychiatric disorders. Yoga is among the oldest sciences with a holistic approach and hence, has been studied extensively in psychiatry. This increase in popularity is partly due to interest in how this practice, with its aspects of mindfulnessand meditation, can reduce anxiety. In yoga, physical postures and breathing exercises improve muscle strength, flexibility, blood circulation and oxygen uptake as well as hormone function. In addition, the relaxation induced by meditation helps to stabilize the autonomic nervous system with a tendency towards parasympathetic dominance. Physiological benefits which follow, help yoga practitioners become more resilient to stressful conditions.

Social theories of mental illness and its relevance in prevention of psychiatric disorder

Sociological concept of mental illness is based on assumption that outer environment is directly connected with inner psyche of individuals. Any change in outer environment directly affects the people’s psychological milieu by changing itself. Hence destabilize the environment-psyche ecosystem. Sociological theories play a pivotal role in genesis and management of psychiatric disorders. These theories provide the basic framework for treatment and prevention of mental illness. These theories are foundation for various governments and non-government based preventive programmes for mental illness. Overall, there is need of better understanding of sociological theories and its implication in current day practice for prevention and management of mental disorder.

A Systematic Review on the Effect of Nutraceuticals on Antidepressant-Induced Sexual Dysfunctions: From Basic Principles to Clinical Applications

Sexual dysfunctions are common side effects reported by patients during antidepressant treatment. When they occur, patients often discontinue psychopharmacological therapy, with a negative impact on the underlying psychiatric disease. Recently, great attention has been paid to the use of nutraceuticals in the management of psychiatric disorders, although a systematic review on their effects as a treatment option for antidepressant-induced sexual dysfunctions (AISD) is lacking. Here, we conducted a systematic search in the following databases: MEDLINE (through PubMed), EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and Web of Science. We searched eligible studies among parallel or crossover randomized controlled trials (RCTs) in adult populations. After this process, a total of 10 articles that evaluated the effect of six different nutraceuticals versus placebo were included: Maca Root, S-adenosyl-L-methionine (SAMe), Rosa Damascena, Ginkgo Biloba, Saffron, and Yohimbine. Overall, a high dose of Maca Root and the use of SAMe or Saffron may improve AISD. Additionally, the administration of Rosa Damascena seemed to be more effective in men than in women, whereas no evidence of effects emerged for Gingko Biloba and Yohimbine. Given the mixed results still available, future RCTs should consider larger samples and confounding factors, such as depressive status and individual vulnerability.

Assessment of nurses’ knowledge about management of psychiatric patients in emergency unit

The Emergency Department is a fast-paced setting where nurses must deal with crucial situations such as psychologically disturbed patients. Nurses in emergency rooms are frequently presented with patients who exhibit physical symptoms associated with psychiatric disorder, which might impair nurses' ability to make an accurate diagnosis and manage their patients. A descriptive analytic design was conducted on measurement of the Nurses' Knowledge regarding management of psychiatric disorders at emergency units in Babylon governorate for the period of (December 12th, 2021 to march 14th, 2022). The study instrument was designed to meet the objectives of the current study, which was consisting of two parts: the first part includes the demographical data for nurses; the second part includes the knowledge management Scale 32 items (KMS). The results showed that nurses are young with age (27.89±6.291 year) in which 75.8% of them are seen with age group of 20-29 year. The study shows nurses have a good level of knowledge for items related to knowledge about the treatment of psychiatric disorders at emergency units as seen among 89.4%. The study concluded that most nurses have a good level of knowledge ' about the treatment of psychiatric disorders at emergency units.

Use of Mobile and Wearable Artificial Intelligence in Child and Adolescent Psychiatry: Scoping Review.

BackgroundMental health disorders are a leading cause of medical disabilities across an individual’s lifespan. This burden is particularly substantial in children and adolescents because of challenges in diagnosis and the lack of precision medicine approaches. However, the widespread adoption of wearable devices (eg, smart watches) that are conducive for artificial intelligence applications to remotely diagnose and manage psychiatric disorders in children and adolescents is promising.ObjectiveThis study aims to conduct a scoping review to study, characterize, and identify areas of innovations with wearable devices that can augment current in-person physician assessments to individualize diagnosis and management of psychiatric disorders in child and adolescent psychiatry.MethodsThis scoping review used information from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of several databases from 2011 to June 25, 2021, limited to the English language and excluding animal studies, was conducted. The databases included Ovid MEDLINE and Epub ahead of print, in-process and other nonindexed citations, and daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; Web of Science; and Scopus.ResultsThe initial search yielded 344 articles, from which 19 (5.5%) articles were left on the final source list for this scoping review. Articles were divided into three main groups as follows: studies with the main focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, and internalizing disorders such as anxiety disorders. Most of the studies used either cardio-fitness chest straps with electrocardiogram sensors or wrist-worn biosensors, such as watches by Fitbit. Both allowed passive data collection of the physiological signals.ConclusionsOur scoping review found a large heterogeneity of methods and findings in artificial intelligence studies in child psychiatry. Overall, the largest gap identified in this scoping review is the lack of randomized controlled trials, as most studies available were pilot studies and feasibility trials.

Survey of Primary Care Provider Comfort in Treating Psychiatric Patients in 2 Community Clinics: A Pilot Study.

Context: Patients with mental health needs are often treated by primary care providers (PCPs). Little is known about current PCP attitudes and comfort level with mental health disorders and treatments despite their role in managing these illnesses.Objective: To quantify PCP comfort with the management of psychiatric disorders and treatments.Methods: PCPs in 2 community clinics were given a survey of psychiatric disorders, treatments, and perceived benefit of assistance from a mental health professional (data were collected during provider meetings in May 2017 and February 2021). Questions were ranked using a Likert scale from 1 to 5 with 1 being "least comfortable," 3 being "neutral," and 5 being "very comfortable." Survey responses about medications and disorders were averaged (ie, mean values were calculated) to approximate PCP comfort with providing psychiatric care with and without support.Results: A total of 71 surveys were sent, and 54 were completed. Overall, respondents indicated comfort greater than neutral in 4 of the 14 disorder-related questions (ie, for anxiety disorders, unipolar depression, attention-deficit/hyperactivity disorder [ADHD], and sleep disorders) and 7 of the 19 treatment-related questions (ie, for selective serotonin reuptake inhibitors [SSRIs]/serotonin-norepinephrine reuptake inhibitors [SNRIs], second-generation antipsychotics, other sleep medications, other antidepressants, stimulants, non-stimulant treatments for ADHD, and tricyclics). SSRIs/SNRIs were the only item with average comfort greater than 4. Mean overall PCP comfort was 2.73 without support. PCP comfort increased significantly with support from a therapist (3.24) or a psychiatrist (4.11) (P < .001), with backup from a psychiatrist providing significantly more comfort than a therapist (P < .001).Discussion: These data show ongoing low comfort levels of PCPs in treating psychiatric conditions, suggesting a need for ongoing educational and collaborative approaches to address this critical unmet need.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Management of Psychiatric Disorders in Patients with Chronic Kidney Diseases.

Management of Psychiatric Disorders in Patients with Chronic Kidney Diseases.

Management of Psychiatric Disorders in Patients of Epilepsy.

Psychiatric disorders co-occur very frequently with epilepsy. This guideline covers the etiopathogenesis, presentation, evaluation and management of various psychiatric disorders in epilepsy such as mood, anxiety, psychotic and substance use disorders. It also provides an approach to important special issues in this population.

Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases.

Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases.

Management of Psychiatric Disorders in Patients with Endocrine Disorders.

The neuropsychiatric symptoms and disorders among endocrine disorders are discussed in the context of current global and local epidemiological data. Neuropsychiatric symptoms, clinical differentials in hypothyroidism, hyperthyroidism, and parathyroid disorders, and relevant management protocols are described. HPT axis and its interaction with psychotropic usage are mentioned. Stress diathesis, depression, anxiety disorders, and severe mental illnesses and their respective association with diabetes, the relevant mechanisms, and management protocols are stated. The metabolic syndrome, its definition, and its relationship to psychotropic usage are laid out. Moreso, best clinical practices for scenarios such as hyperprolactinemia and psychiatric illnesses, and steroid-induced psychosis are mentioned.

Role of deep brain stimulation in management of psychiatric disorders.

Nowadays, most of patients affected by psychiatric disorders are successfully treated with conservative therapies. Still, a variable percentage of them demonstrate resistance to conventional treatments, and alternative methods can then be considered. During the last 20 years, there is a progressive interest in use of deep brain stimulation (DBS) in mental illnesses. It has become clear nowadays, that this modality may be effectively applied under specific indications in some patients with major depressive disorder, obsessive-compulsive disorder, anorexia nervosa and other eating disorders, Tourette syndrome, schizophrenia, substance use disorder, and even pathologically aggressive behavior. Despite the fact that the efficacy of neuromodulation with DBS, as well as of various lesional interventions, in cases of mental illnesses is still not fully established, there are several premises for wider applications of such "unclassical" psychiatric treatments in the future. Novel technologies of DBS, developments in non-invasive lesioning using stereotactic radiosurgery and transcranial magnetic resonance-guided focused ultrasound, and advances of neurophysiological and neuroimaging modalities may bolster further clinical applications of psychiatric neurosurgery, improve its results, and allow for individually selected treatment strategies tailored to specific needs of the patient.

Management of Psychiatric Disorders in Patients with Parkinson's Diseases.

Parkinson’s disease (PD) is a heterogeneous progressive neurodegenerative disorder, with a triad of motor symptoms with akinesia/bradykinesia, resting tremor (4–6 Hz), and rigidity. It is the second most common neurodegenerative disease after Alzheimer’s disease. The overall management of PD depends on the status of symptoms, functioning of the patients, impairment, disability, and its impact on quality of life. Depression, anxiety disorders, apathy, anhedonia, psychosis, cognitive impairments, dementia, and impulse control disorders (ICDs) are the common psychiatric symptoms/disorders comorbid with PD. Depression remains the most common psychiatric disorder reported to be comorbid with PD. Several pharmacological and nonpharmacological management strategies are used for the treatment of comorbid psychiatric disorders in PD. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors are used to treat depression in patients with PD. The best evidence of efficacy in PD psychosis is for clozapine and pimavanserin. The treatment for cognitive impairments in PD remains poorly researched. Rivastigmine is the only approved treatment for PD as per the Food and Drug Administration. Pramipexole, a dopamine agonist (DA), is reported to cause improvement in the symptoms of decreased willingness in apathy. The treatment approaches for different sleep disorders in PD are different. Identifying the cause, reviewing the patient’s ongoing medications, and evaluating the impact of comorbid medical conditions and sleep hygiene are common to all conditions related to sleep disorders. The first approach for treating ICD symptoms is the reduction or discontinuation of DAs. The psychiatric symptoms in patients with PD are highly prevalent, and their management should be included in the basic treatment algorithm for PD. This paper summarizes common psychiatric symptoms/disorders in PD and their management approaches.

BPSS Award

BPSS Award

Management of psychiatric disorders in patients with cancer.

Management of psychiatric disorders in patients with cancer.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

Management of Psychiatric Disorders during the Perinatal Period.

Management of Psychiatric Disorders during the Perinatal Period.