Patients In Psychiatric Hospital Research Articles

Hyperhomocysteinemia is associated with the risk of venous thromboembolism in patients with mental illness: a case-control study

ObjectiveThe risk of venous thromboembolism in patients with mental illness has been insufficiently addressed. This study aimed to assess the correlation between hyperhomocysteinemia and venous thromboembolism prevalence among this population.MethodsPatients with a diagnosis of mental illness and concurrent venous thromboembolism, admitted to Sir Run Run Shaw Hospital at Zhejiang University School of Medicine between January 2014 and December 2021, were included in the venous thromboembolism group. The control group, approximately twice the size, comprised individuals with mental illness but without venous thromboembolism. Basic clinical data were gathered for both cohorts.ResultsIn psychiatric patients, elevated D-dimer levels(OR=5.60,95% CI 3.28–10.00), hyperhomocysteinemia (OR=2.37,95% CI 1.10–5.14), and hyperprolactinemia(OR= 2.68,95% CI 1.12–6.42)were significant risk factors for venous thromboembolism. According to further subgroup analyses, hyperhomocysteinemia is a significant risk factor associated with pulmonary embolism, with an OR of 5.08 (95% CI 1.20–21.48). An interaction effect between gender and homocysteine level was found, with a p-interaction of 0.022. A subsequent analysis confirmed the association between hyperhomocysteinemia and venous thromboembolism in female psychiatric patients, with an OR of 3.34 (95% CI 1.68–6.65), indicating that hyperhomocysteinemia is a significant risk factor for venous thromboembolism in women.ConclusionPatients with psychiatric disorders were found to have an elevated risk of venous thromboembolism, which was associated with increased levels of D-dimer, hyperprolactinemia, and hyperhomocysteinemia. A strong correlation between hyperhomocysteinemia and pulmonary embolism was identified in patients with mental illnesses. Furthermore, the study revealed that female psychiatric patients with hyperhomocysteinemia constituted a high-risk group for venous thromboembolism. This finding holds significant clinical implications, suggesting that early preventative measures could be implemented for this high-risk population to reduce the incidence of thromboembolic events during hospitalization for psychiatric patients.

COVID-19로 인한 정신간호사의 코호트 격리 경험

Objectives This study aimed to explore the experiences of psychiatric nurses who were quarantined in cohorts to prevent the spread of infection during the COVID-19 pandemic. Methods Data were collected from July 19 to December 28, 2021 through in-depth interviews with psychiatric nurses who were in cohort isolation for more than 3 weeks until the data was saturated through the snowball sampling method. Through one-on-one in-depth interviews with psychiatric nurses, the meaning of experiences in cohort isolation was analyzed according into themes, sub-themes, and categorization stages according to Colaizzi's phenomenological method. Results The experience of nurses in cohort isolation, such as patients in psychiatric hospitals, was derived into six themes. The six themes were ‘anxious due to unpredictable situations’, ‘re-awareness of the ward environment’, ‘need a support system’, ‘do activities to cope with anxiety’, ‘think about changing jobs’, ‘ self-esteem improved as a psychiatric nurse.’ These results showed that cohort isolation was a problem under unilateral hospital instructions, without having any prior explanation or opportunity to judge cohort isolation. During cohort isolation, psychiatric nurses experienced the conflict of turnover and the meaning of their professional role as mental nurses while analyzing the causes of cohort isolation and working to cope with them. Conclusions Based on the results of psychiatricl nurses' cohort isolation experience, it can be used as basic data for developing strategies to support psychiatric nurses who are cohort- isolated in the event of a new infectious disease in the future, developing manuals for work efficiency, and maintenance education.

Purpose in life, loneliness and depression among patients with substance use disorders in the psychiatric hospitals in Ghana.

Substance use disorder is a global mental health issue. Purpose in life, Loneliness and depression are key indicators of poor mental health, and people with substance use disorder are more likely to experience low purpose in life, depression, and loneliness. This study aims to further the understanding of purpose in life, depression and loneliness among substance use disorders (SUD) patients in three hospitals in Ghana. It uses a cross-sectional survey design. A total of 425 SUD inpatients were screened. Beck Depression Inventory-II, the revised UCLA Loneliness Scale, and the Purpose in Life Test were utilised to measure depression, loneliness, and purpose in life respectively. Data were analysed using the SPSS version 23 for Windows. Data from 378 participants were collected for this study using a cross sectional survey design; after data cleaning, frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarise the demographics and the three outcome variables depression, purpose in life, and loneliness. Our findings indicate that overall, participants are more likely to experience low sense of purpose in life, depression, and loneliness compared to the general population. There was no statistically significant relationship between depression and loneliness (r = 0.030, p = 0.567). There was a statistically significant negative relationship between depression and purpose in life (r = -0.514, p < 0.001). There was a statistically significant positive relationship between purpose in life and loneliness (r = 0.147, p = 0.004). There was no gender difference in depression, purpose in life, and loneliness among SUDs patients in psychiatric hospitals. There were no significant differences in purpose in life, depression and loneliness based on marital status. It is anticipated that the findings of this study will inform policies and clinical practice regarding service provision for patients with SUDs.

Healthcare Professionals Perspectives on Discharge Planning for Patients with Mental Illness

Introduction: Discharge planning is transferring a patient to a different level of care to improve continuity of care by bridging the gap between hospital and community care. This study aimed to explore the perspectives of healthcare professionals involved in discharge planning for patients with mental illness. Method: This research used qualitative methods with a phenomenological approach. Ten participants were selected using a purposive sampling method, with inclusion criteria healthcare professionals involved in the discharge planning process for patients in psychiatric hospitals, had worked in the service for at least 5 years, and provided direct or indirect services to patients. Data were collected through in-depth interviews using interview guides, recording devices, and field notes. Data were analyzed using thematic analysis. Results: The study identified four themes related to discharge planning preparation for patients with mental illness perceptions of roles and experiences in discharge planning, internal and external barriers in discharge planning, internal and external support in discharge planning and expectations for the continuity of discharge planning. Conclusions: The findings indicate that there are still significant disparities in the way that discharge planning for patients with mental illness is implemented in different mental health service settings. These study findings are intended to serve as a further source of information to develop a discharge planning system that integrates patients with mental illnesses from the hospital into the community.

Jenis Intervensi Pada Pasien Dengan Perilaku Kekerasan Di Rumah Sakit Jiwa Scoping Review

Violence behaviour poses a potential risk of physical harm to oneself or others. Violence behaviour must be promptly addressed by providing intervention to avoid detrimental impacts on the patient, others, or the surrounding environment. This research aims to identify the types of interventions for patients with violent behaviour in psychiatric hospitals. This review adopts a scoping review approach, following the analysis procedure by Arksey and O'Malley. Articles were identified using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) method. Inclusion criteria for this review article include English or Indonesian language articles, original articles, articles using quantitative, qualitative, and mixed research methods published within the last 5 years. From the review results of 1.128 articles, 8 articles met the inclusion criteria. The analysis results indicate various types of interventions proven to be effective in reducing violent behaviour in patients in psychiatric hospitals. Treatments involving physical, psychological, and belief-based activities are suitable for reducing violent behaviour in patients in psychiatric hospitals. Furthermore, to determine the real impact of reducing violent behaviour, supplemental research is needed to develop interventions in patients in psychiatric hospitals.

Prevalence and Major Risk Factors of Type 2 Diabetes Mellitus Among Adult Psychiatric Patients in Taif Mental Hospital in Saudi Arabia

Background: Patients who suffer from psychiatric disorders have a higher likelihood of developing Type 2 Diabetes Mellitus (T2DM). Determining the prevalence of T2DM among individuals with psychiatric disorders is challenging due to the underdiagnosis of diabetes among this population. Objective: This study aimed to investigate the prevalence and risk factors of T2DM among adult psychiatric patients in Taif Mental Hospital, Saudi Arabia. Method: A cross-sectional study was conducted among adult psychiatric patients from June to November 2023 using a data collection sheet comprised of socio-demographic characteristics, the prevalence of T2DM, and the factors that may contribute to T2DM. Results: A study was conducted on 138 patients with psychiatric orders, most of whom (95.7%) were Saudi nationals, with 60.9% of them being female. Patients had a mean (Standard deviation [SD]) age of 42.7 (13.45) years old and a mean (SD) body mass index (BMI) of 29.3 (6.59) kg/m2. The patients had been suffering from psychiatric disorders for a mean (SD) of years of 10.3 (9.34) years. The prevalence of T2DM among patients with psychiatric disorders was 23.2%. The psychiatric patients aged more than 40 years (37.5%) had a significantly higher prevalence of T2DM compared to those aged less than or equal to 40 years (7.6%) (p&lt;0.001). The patients with anxiety disorders (42.1%) had a significantly higher prevalence of T2DM compared to those who had other psychotic disorders (20.2%) (p=0.044). Psychiatric patients with complications (47.2%) had a significantly higher prevalence of T2DM compared to those who had not (7.3%) (p&lt;0.001). Conclusion: Our study provides further evidence of the association between psychiatric disorders and an increased risk of T2DM. Implementing regular screening programs, managing anxiety disorders, promoting a healthy lifestyle, and providing comprehensive care are recommended for psychiatric patients with T2DM and comorbidities.

Features of cultural work and ideological education of disabled people of the Great Patriotic War in 1945–1955 (based on materials from the Tambov Psychiatric Hospital)

Importance. The study of certain aspects of cultural work among disabled people of the Great Patriotic War who are being treated in psychiatric hospitals allows not only to clarify the features of the treatment process in medical organizations, but also to carry out a systematic detail of the socialization and rehabilitation of military veterans in the 40–50s of the twentieth century.Materials and Methods. The methodological features of the study of the stated problems are based on the author’s concept of involving the works of contemporaries, primarily specialists in the field of psychiatry, practitioners of the Tambov region, as well as the actual case histories and anamnesis of mental illness. Materials from state and party archives of the Tambov region and memoirs of contemporaries were used, many of which were introduced into scientific circulation for the first time.Results and Discussion. In fact, patients in psychiatric hospitals, to one degree or another, were involved in mass cultural events, ideologically verified political and cultural activities, which reflected the mentality of not only the party elite and nomenklatura, but also completely coexisted in the perception and understanding of the overwhelming majority of the population of the Soviet Union. The results of studying the problem made it possible to assess these processes, viewed through the prism of the development of regional healthcare, to identify not only the vectors and trends in the formation of Soviet psychiatry in the first post-war decade, but also to clarify the features of the relationship between government and society, the individual and the state, individual consciousness and the collective Soviet (“communist”) worldview.Conclusion. The results of the study allow us to draw a very obvious conclusion that cultural work, as well as political education in general, was not only an integral part of the ideological concept of the era of socialism, which lowered the entire structure of Soviet society, but also an important component of the treatment and preventive work of medical institutions of various profiles. These medical and social work activities were carried out very successfully in the Tambov region. However, in general, it should be noted that the lack of trained personnel and resources, including logistics, musical instruments, etc., often contributed to the formation of a superficial approach in organizing cultural work in psychiatric clinics. It is important to note that these shortcomings are fully preserved in the modern healthcare system in the Russian Federation. In fact, the traditions of budgetary residual financing of medical institutions are stable in the worldview of officials from different historical eras. But it is still worth noting that the general messages of ideological education consistently covered the entire population of the country, including patients in psychiatric hospitals. For these war veterans, political information, reading newspapers, and watching movies were quite common, which inevitably helped their rapid socialization, inclusion in normal communication, and ensured stable remissions during mental disorders.

Forensic Psychiatric Patients' Experiences of Personal Recovery: A Wilsonian Concept Analysis.

Psychiatric patients' recovery processes have been studied rather extensively, and a relatively clear consensus on what recovery is already exists. We examined whether the personal recovery of forensic psychiatric patients varies from this definition. We conducted a concept analysis to assess the personal recovery of patients in forensic psychiatric hospitals based on 21 articles and then evaluated how our results compared with existing definitions on psychiatric and forensic recovery. On the basis of this comparison, we concluded that the personal recovery of forensic psychiatric patients does differ from that of other psychiatric patients. The recovery process of forensic psychiatric patients can be described through five themes: personal development and autonomy, social inclusion and normality, redemption and overcoming, future orientation and hope, and advancing process. The burden of a psychiatric disorder causes similar challenges, yet a criminal history and long hospitalization periods are distinctive issues for forensic patients, both of which can lead to severe alienation from society and deterioration of skills needed in life outside an institution. The results suggest that processing the criminal offense should be part of the care; furthermore, institutions should support forensic psychiatric patients in their reintegration into society and personal development. Identifying special recovery challenges can be useful when designing effective care and promoting the recovery of forensic patients. Thus, our results suggest that certain features of forensic psychiatric patients' recovery should be considered when planning their psychiatric care.

Influence of Alcohol Dependence on the Clinical and Dynamic Characteristics of Bipolar Disorder with Their Comorbidity in Psychiatric Hospital Patients

Background: numerous studies indicate a high level of comorbidity of bipolar disorder with other psychiatric disorders. Alcohol dependence is one of the most common comorbid pathologies, along with anxiety disorders and personality disorders. Objective: determination of the frequency of comorbidity of BAR with alcohol dependence in patients of a specialized psychiatric hospital and identiашcation of clinical and dynamic features of BAR with this comorbidity. Patients and methods: in the psychiatric unit, 188 patients with bipolar disorder diagnosed according to ICD-10 (136 women and 52 men) were examined. The age of female patients was 41.6 ± 14.4 years, male — 39.4 ± 14.0 years. Depending on the current affective disorder, patients were distributed as follows: a depressive episode — 62.2 % (n = 117), a hypomanic episode — 2.7 % (n = 5), a manic episode (ME) — 1.6 % (n = 3), mixed episode — 33.5 % (n = 63). A comparative assessment of the clinical and dynamic characteristics of bipolar disorder was carried out in 2 groups of patients: with bipolar disorder and comorbid alcohol dependence — 30 individuals (14 women and 16 men), aged 43 years [29; 55] and without comorbidity with alcohol dependence — 59 individuals (39 women and 20 men), age 36 years [29; 50]. During the study, clinical-psychopathological, clinical-catamnestic, psychometric, statistical methods were used. Results and discussion: the level of comorbidity of bipolar disorder with alcohol dependence was determined — 15.9 %. It was found that in BD with comorbid alcohol dependence, compared with BD without alcohol dependence, patients have an early onset age of BD, more often have mixed episodes during an affective disorder. In addition, such patients have a higher risk of suicidal behavior, bipolar-I, and exacerbation of affective symptoms. It has also been shown that alcohol dependence makes it difficult to recognize bipolar disorder during the primary visit to specialized psychiatric care. Conclusion: addition of alcohol dependence to bipolar disorder affects negatively its main clinical and dynamic parameters and delays the terms of its diagnostics.

A service evaluation of passive remote monitoring technology for patients in a high-secure forensic psychiatric hospital: a qualitative study

BackgroundTechnology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients’ perspectives on using passive remote monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders’ perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation.MethodsSemi-structured interviews were conducted with staff and patients with experience of using Oxehealth technology face-to-face within a private room in Broadmoor Hospital. We applied thematic analysis to the data of each participant group separately. Themes and sub-themes were integrated, finalised, and presented in a thematic map. Design, management, and analysis was meaningfully informed by both staff and patients.ResultsTwenty-four participants were interviewed (n = 12 staff, n = 12 patients). There were seven main themes: detecting deterioration and improving health and safety, “big brother syndrome”, privacy and dignity, knowledge and understanding, acceptance, barriers to use and practice issues and future changes needed. Oxehealth technology was considered acceptable to both staff and patients if the technology was used to detect deterioration and improve patient’s safety providing patient’s privacy was not invaded. However, overall acceptance was lower when knowledge and understanding of the technology and its camera was limited. Most patients could not understand why both physical checks through bedroom windows, and Oxehealth was needed to monitor patients, whilst staff felt Oxehealth should not replace physical checks of patients as reassures staff on patient safety.ConclusionsOxehealth technology is considered viable and acceptable by most staff and patients but there is still some concern about its possible intrusive nature. However, more support and education for new patients and staff to better understand how Oxehealth works in the short- and long-term could be introduced to further improve acceptability. A feasibility study or pilot trial to compare the impact of Oxehealth with and without physical checks may be needed.

ПРИЧИНЫ УДАЛЕНИЯ ЗУБОВ У ПАЦИЕНТОВ ПСИХИАТРИЧЕСКОГО СТАЦИОНАРА

According to the literature, in a mentally healthy population, the main cause of tooth extraction is complications of caries and periodontitis, mainly in elderly and senile patients. In patients with psychiatric pathology, many authors note the high prevalence of dental diseases and emphasize the need for tooth extraction.&#x0D; The aim of the investigation was to study the structure of dental diseases requiring tooth extraction in psychiatric hospital patients.&#x0D; Material and methods of research. Information was copied from 1812 dental records of patients who were on inpatient treatment at the V.N. Bekhterev RCPB in the period from 2014 to 2016 at the age of 16 to 82 years (879 men and 933 women). The main reason for hospitalization of most patients was the diagnosis of schizophrenia (59%). The statistical software package SPSS 13.0 (1999) was used for statistical processing of the results.&#x0D; The results of the study. During the study period, the dental surgeons of the RCPB received 1812 patients who had 2187 teeth removed. Mostly, the tooth extraction operation was performed for chronic periodontitis (47.2%). The greatest number of removals for periodontitis was observed in elderly patients (57.1%). The smallest number of teeth removed due to periodontitis was observed in the group of middle-aged patients (45–59 years) and amounted to 36.3% of the total number of teeth removed. This is due to the predominance of chronic periodontitis in these patients, which is comparable to the indicators in patients without psychiatric pathology. In the group of elderly and senile patients, tooth extraction surgery for chronic periodontitis was performed in 49.3% of cases.&#x0D; Conclusions. The main reason for tooth extraction in mentally ill patients was chronic periodontitis and its exacerbation – 47.2%. The average age of these patients was 59.16 ± 14.33 years in men and 52.91 ± 11.85 years in women. The predominance of chronic periodontitis in the structure of the causes of tooth extraction in patients of the middle age group indicates an early clinical manifestation of inflammatory and destructive changes in the periodontium.

Unsupervised short leave in forensic addiction treatment: Is there an influence on treatment progress?

Abstract Short leave is an integral part of forensic addiction treatment in Germany. Individuals with addiction problems who have offended can be admitted to forensic addiction treatment institutions to receive treatment for their addiction disorder and reduce their risk of reoffending. During this treatment, short leave is implemented to allow the practising of an abstinent lifestyle, enhance treatment motivation, and enable the individual to stay connected with the community. A critical step is the unsupervised short leave, which comes with benefits but also risks for the individual and the community. Short leave (especially unsupervised short leave) bears the risk of incidents such as new offences, drug relapses or absconding. This study examines the influence of unsupervised short leave on treatment progress. It builds on the methodology from a previous study of patients in forensic psychiatric hospitals and uses a pre-post design with follow-up. Furthermore, the impact of incidents during short leave on treatment progress is analysed. The sample consists of 157 patients in forensic addiction treatment in Germany. The results suggest that unsupervised short leave can enhance the treatment progress of patients in forensic addiction treatment. However, incidents during short leave can have a negative effect on treatment progress.

Restriction of the Rights and Coercion of Patients in a Psychiatric Hospital: The Opinion of People With Mental Disorders and Psychiatrists

Objectives: Restriction of the rights of patients in a psychiatric hospital, isolation and fixation, compulsory treatment, and round-the-clock monitoring are negatively perceived by them, contribute to the stigma of a psychiatric hospital, and prevent timely access to psychiatric help We assessed the opinions of patients in psychiatric hospitals and psychiatrists about coercion and violence in the provision of psychiatric care for recommendations on their prevention. Methods: An anonymous survey of psychiatrists and patients was conducted in psychiatric hospitals in three regions. Data were analyzed using descriptive and non-parametric statistical methods. Results: Psychiatrists and patients were positive about the coercive measures in the psychiatric hospital. Physical restraint was considered the prerogative of orderlies by 64.5% of psychiatrists and 35.4% of patients. According to 19.6% of doctors and 28.4% of patients, a psychiatrist can independently apply physical restraint to aggressive patients. Injections of sedative drugs by a psychiatrist personally were considered justified by 81.3% of physicians and 64.6% of patients. Most patients and physicians noted that the psychiatrist needed to be involved in the application of physical restraint to an aggressive patient. Discussion: Psychiatry is currently dominated by an archaic paternalistic model of doctor-patient relations and the delegation of additional functions of social control to psychiatrists. The introduction of a contractual model is required for more effective interaction between the psychiatrist and the patient.

Types of action orientation of primary nurses in building relationships with their patients in forensic psychiatric hospitals

Types of action orientation of primary nurses in building relationships with their patients in forensic psychiatric hospitals Abstract. Background: Building interpersonal relationships with patients is one of the most elementary tasks of mental health nurses in forensic psychiatric hospitals and should be considered as the core of their professional identity. The attitude of forensic psychiatric nurses has a substantial impact on building relationships even though this is often not immediately obvious as an implicit concept. Research question: Which types of action orientation of primary nurses characterize the building of relationships with their patients in forensic psychiatric hospitals? Methodology: To record the collective orientations of nurses, two group discussions were held with eight participants. The evaluation was carried out based on the documentary method. Results: Four types of orientations could be grouped into a generalizable basic typology. The focus is set on the relationship as a necessary precondition for successful cooperation with the patient. Honesty and mutual trust are significant features. Conversations about everyday topics facilitate relationship building. Openness and a genuine interest in the patient are equally as important as the definition and maintenance of personal boundaries. Conclusion: Implicit, action-oriented attitudes of forensic psychiatric nurses should be reflectively accessed in order to define professional relationships and maintain their boundaries. To achieve this, nurses need to have a structured framework to facilitate self-reflection and self-awareness. The goal is the systematic development of personal and interactional competences.

Homelessness and associated factors over a 13-year period among psychiatric in-patients in Berlin, Germany: routine data analysis.

Homeless patients in psychiatric hospitals are a scarcely studied and there is lack of knowledge about factors associated with homelessness and in-patient treatment. To determine the change over time in the number of homeless psychiatric in-patients and to examine factors associated with homelessness. Retrospective data analysis of 1205 selected electronic patient files on psychiatric in-patient treatment in a university psychiatric hospital in Berlin, Germany. The rate of patients experiencing homelessness over a 13-year period (2008-2021) and the sociodemographic and clinical factors associated with homelessness are analysed over time. Our study revealed a 15.1% increase in the rate of homeless psychiatric in-patients over the 13-year period. Of the whole sample, 69.3% people lived in secure private housing, 15.5% were homeless and 15.1.% were housed in sociotherapeutic facilities. Homelessness was significantly associated with being male (OR = 1.76 (95% CI 1.12-2.76), born outside of Germany (OR = 2.22, 95% CI 1.47-3.34), lack of out-patient treatment (OR = 5.19, 95% CI 3.35-7.63), psychotic disorders (OR = 2.46, 95% CI 1.16-5.18), reaction to severe stress (OR = 4.19, 95% CI 1.71-10.24), personality disorders (OR = 4.98, 95% CI 1.92-12.91), drug dependency (OR = 3.47, 95% CI 1.5-8.0) and alcohol dependency (OR = 3.57, 95% CI 1.67-7.62). The psychiatric care system is facing an increasing number of patients in precarious social situations. This should be considered in resource allocation planning in healthcare. Individual solutions for aftercare, along with supported housing, could counteract this trend.

Analysis of the Serie of Cases of Neuroleptic Malignant Syndrome (Cross-Sectional Observational Study)

Background: neuroleptic malignant syndrome (NMS) is the most dangerous complication of therapy with neuroleptics with high mortality. The publications on MNS are the reviews articles or case reports.The aim of study: an identification of the frequency of occurrence of NMS harm in patients of the city psychiatric hospital over a 4-year period, a clarification of the clinical manifestations of this complication, an analysis of the effectiveness of the treatment and rate of deaths.Patients and methods: 19 cases with a confirmed diagnosis of NMS who were treated for 4 years in one of the clinical psychiatric hospitals in Moscow with 1158 beds. All patients met the criteria for the diagnosis of NMS according to DSM-5 (333.92). The severity of extrapyramidal disorders was assessed on the Simpson–Angus Rating Scale (SAS). The Bush–Francis Catatonia Rating Scale (BFCRS) was used to assess the features and severity of catatonic symptoms. All patients underwent a study of the general clinical analysis and biochemical analysis of blood with the determination of the number of leukocytes and the activity of the enzyme creatine phosphokinase (CPK).Results: the incidence of NMS was 0.035% of all treated patients, mortality— 10.5%. Most often, NMS develops during treatment with haloperidol and much less frequently with the appointment of atypical antipsychotics risperidone and clozapine in patients with schizophrenia, acute polymorphic mental disorder, organic mental disorders, including dementia. The influence of such factors as gender, age, type of disease on the development of NMS has not been established. The age of patients with a fatal outcome was higher than the average for the group. The clinical picture of NMS was characterized by a combination of catatonic, extrapyramidal and somato-vegetative disorders with hyperthermia, leukocytosis and increased activity of CPK.Conclusion: today NMS remains a relatively rare, but extremely dangerous complication of antipsychotic therapy, with a high risk of death and can develop both in the treatment with first and second generation antipsychotics in patients with schizophrenia and acute polymorphic mental disorder and in organic mental disorders, including dementia.

Ressentis des professionnels de santé sur la sexualité des patients hospitalisés en psychiatrie : une étude qualitative

ObjectivesQuestions concerning the sexuality of patients in psychiatric hospitals have come to light, particularly since the introduction of mixed gender patients in these institutions in the 1960s. Although the concerns about mixed gender are less topical, there are questions about the approach used toward sexuality in psychiatric hospitals. Today, even in a desire to protect patients, it is no longer acceptable to prohibit sexual relations on the wards in general, without considering the patient's clinical condition. A global study of the sexuality of patients in psychiatric hospitals is necessary. Initially, our study will focus on the attitudes of caregivers about the sexuality of patients. The main objective of this article is to present a thematic analysis of the discourse of health care professionals interviewed about the sexuality of adult patients hospitalized in psychiatry wards, focusing particularly on their feelings. The secondary objectives are to understand the problems encountered in daily practice by health professionals and to identify possible areas for improvement. MethodsThe study was carried out in three centers, and a total of 18 caregivers were included. The criteria for participation were to be a health professional who cared for or had treated adult patients on psychiatric wards. For this study, we favored qualitative research because it focuses on the subject's discourse, which will allow us to concentrate on the feelings of the caregivers interviewed. ResultsFirst of all, the theme of persistent taboos that we initially encountered must be qualified. In fact, although sexuality is often discussed only if the health care team is confronted with it in the department, it appears that it is increasingly possible to discuss it. Second, we noted the prevalence of the themes of vulnerability and consent in the discourse of health professionals. These themes are directly linked to those of difficulty and anxiety, which were also highlighted during the data analysis. This suggests that it is difficult for health care providers to assess whether a patient has consented to engage in sexual activity, especially for those hospitalized under duress. Sexual violence is a major concern for caregivers. How best can they protect vulnerable patients while respecting their privacy and rights? Furthermore, we found a certain heterogeneity in the way care was provided. There are differences within the same institution, but also within the same department, depending on the caregivers. The study also allowed us to identify variations in the way patients are treated and the way they feel, depending on their gender, with men often being considered as predators and women as victims. Among the subjects interviewed, there was an unanimous desire to have access to training concerning the sexuality of patients. Finally, the subject of sexuality raises other issues such as the rights of hospitalized patients and restrictions of freedom imposed during hospitalization and also the position of the health care team with respect to a patient's intimacy and communication between the medical and paramedical teams. Many aspects of this issue where there is a need for improvement must be studied, particularly training, which seems essential to enable caregivers to feel more comfortable and to offer better quality care to patients. The training on dealing with sexuality is inseparable from the training on the rights of hospitalized patients. Other areas for improvement have been identified, such as the implementation of workshops on sexuality in the wards or the development of multidisciplinary protocols in the event of a reported sexual assault or significant doubt on the part of the health care team regarding possible violence where the victim is not able to call the health care team or notify the competent authorities. ConclusionIn this qualitative approach to the sexuality of patients hospitalized in psychiatry, we have seen that the attitudes of health care providers concerning sexuality have evolved considerably because of new legislation and a change in the way society views this issue. Nevertheless, professionals seem to have difficulty in assessing the capacity to consent to sexual intercourse in patients who present a significant degree of vulnerability due to the psychological disorders they may be suffering from. In addition, we feel it is important to emphasize the need for training in the promotion of sexual and emotional health, the prevention of sexual violence and the management of sexual violence. Also, the establishment of multi-professional discussion forums on the issue of sexuality in patients with psychiatric disorders should be supported. Finally, we believe that this study should be supplemented by a qualitative analysis of the discourse of patients hospitalized in psychiatric institutions to better understand the areas of care that should be developed in the future, from the perspective of a global approach to the person suffering from mental disorders.

Antipsychotic-Induced Parkinsonism and Dyskinesia in a 43- years Old Male with Schizophrenia: Clinical Case

The development of neurological adverse drug reactions (ADRs) from the extrapyramidal system while taking antipsychotics (APs) is well known. The common forms of neurological ADRs from the side of the extrapyramidal system are AP-induced parkinsonism (AIP) with a frequency of about 36% and AP-induced tardive dyskinesia (AITD) with an incidence of about 25%. Patients with AIP and AITD make up a significant proportion of patients in psychiatric hospitals and neuropsychiatric dispensaries with AP-induced extrapyramidal disorders requiring neurological care. These ADRs make a significant contribution to the structure of the overall morbidity and mortality of the population around the world. We presented a clinical example of 43 years old male, who developed acute AIP and AITD while taking APs. This condition was resolved with amantadine 200 mg/day after several unsuccessful attempts. It is also known that the patient had a father with Parkinson's disease in his anamnesis. The patient underwent pharmacogenetic testing of SNV rs1800497 of the DRD2 gene. According to the results the patient was a homozygous carrier of the major allele. These results did not show a positive association. At the same time, such a patient needs to undergo pharmacogenetic testing using a complete genetic risk panel for developing AIP, AITD, and Parkinson's disease.

The Impact of the COVID-19 Pandemic on the Management of Mental Health Services for Hospitalized Patients in Sibiu County-Central Region, Romania.

The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania. Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic. We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased. The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.

Medication adherence and associated factors among psychiatry patients at Asella Referral and Teaching Hospital in Oromia, Ethiopia: Institution based cross sectional study.

Medication adherence is the first and main determinant of treatment success. It is defined by world health organization as "the degree to which the person's behavior corresponds to the agreed recommendations from a health care provider". Non-adherence is a multi-factorial phenomenon that can result from five major interacting factors. These are health team and health system-related factors; patient-related factors; therapy-related factors; socio-economic factors; and condition-related factors. The prevalence of non-adherence in mental illness was found to be 40% to 60% world wide. In developing countries, the magnitude of poor adherence is expected to increase. So this study aimed to assess medication adherence status and its associated factors among psychiatric patients in Asella Referral and Teaching Hospital in Oromia, Ethiopia. An institution-based cross-sectional study was conducted from March 18, 2022 to May 25, 2022, with a total sample of 422 patients. Medication adherence was measured by a modified version of the medication adherence rating scale in the psychiatric setting to determine treatment adherence status, and unstructured questionnaires were assessed by interviewing the patient. Additional data concerning the medication-taking behavior of the patient was collected from caregivers. Bivariate logistic regression was performed to see the association between each explanatory variable and the outcome variable. The odds ratio and 95% confidence interval were used to see the association between treatment adherence and the strength of the link. A total of 395 study participants were interviewed, making a response rate of 93.6%. The prevalence of treatment adherence was 246(62.3%). Medication adherence show high association with lifetime alcohol use [AOR: 3.18, 95% CI:1.31-7.72] compared to those who had no alcohol use histroy, and perceived stigma [AOR (95% CI: 2.31 (1.01-5.31)] compared with those who had no perceived stigma, where as adherence show low association with having slight or superficial insight about illness [AOR (95% CI: 0.25 (0.12-0.53)] compared to those who reported cured off their illness and belief in medication [AOR: 0.36, 95% CI: 0.16-0.81)] compared to those who didn't belief in the medication they are taking. The prevalence of mediation adherence was found to be lower. In this study, factors such as having the slight insight or poor insight about their illness and belief in the medication decreased medication adherence, whereas having an alcohol use history in their lifetime and perceived stigma increased medication adherence. For a better health outcome, awareness creation at an insight level needs to be worked on by psychiatric professionals working on the follow-up psychiatric patients at psychiatry clinic of Assela Referral and Teaching Hospital to enable them to well adhere to their medication.