Psychiatric Aspects Research Articles

Bentuk Pengungkapan Citraan pada Aspek Kejiwaan dalam Sajak Penyair Jambi Dimas Arika Miharja

This research is included in the type of descriptive research with a content analysis approach to documents in the form of poetry literary works. The purpose of this study is to describe the type of image revealing psychological aspects contained in the poems of Jambi poet Dimas Arka Mihardja. The primary data in this study are words or sentences in the form of expressions contained in poems by Jambi poet Dimas Arka Mihardja which are related to the image of revealing psychological aspects. While the source of data in this study is the Anthology of Jambi Poetry Poems by Dimas Arka Mihardja. Research data were collected using documentation study techniques. The research data were analyzed using document analysis techniques that rely on rhyme discourse containing psychiatric aspects. From the results of the study, it was found that the poems of Jambi poet Dimas Arka Mihardja contained many forms of imaging revealing psychological aspects in the form of visual images, auditory images, olfactory images, taste images and motion images. Psychiatric aspects found include depression, obsession, irritation, fear, frustration, hope, attention, and anxiety.

Hospice and Palliative Medicine Fellowship Training in Mental Health: A Survey of Program Directors.

Psychological and psychiatric care is a core domain of palliative care. Despite a high burden of mental health comorbidity among individuals with serious illness, the Accreditation Council of Graduate Medical Education gives little guidance about training hospice and palliative medicine (HPM) fellows in this domain of care. Currently, there is a lack of empiric data on HPM physician fellowship training in mental health topics. To characterize HPM physician fellowship training practices in the psychological and psychiatric aspects of palliative care. A cross-sectional survey study querying HPM fellowship training directors nationally. A total of 95 programs participated (51% response rate). A total of 98% programs offered didactics on mental health topics. Topics universally deemed as important by program directors were commonly taught, but there was variability in both the perceived importance and the didactic coverage of several topics. Only 15% of programs offered core rotations in psychiatry. Most programs offered psychiatry electives, but such electives were only rarely utilized by fellows. Interdisciplinary team (IDT) rounds infrequently included doctoral mental health clinicians. Beyond a few commonly identified and taught key topics, there is variability in clinical and didactic exposure to mental health training among HPM fellowships. Standardizing key learning objectives and guiding educators in how to achieve these objectives could improve the preparedness of the physician workforce in HPM to meet the mental health needs of patients with serious illness.

Evaluating the Efficacy of Awareness Campaigns in Addressing Psychiatric Aspects of Drug Addiction: A Tertiary Level Hospital in Bangladesh

Evaluating the Efficacy of Awareness Campaigns in Addressing Psychiatric Aspects of Drug Addiction: A Tertiary Level Hospital in Bangladesh

The historic saga of deteriorating cares of lunatic and need for women caretakers a retrospective view of Origin of Psychiatric Nurses

Early conditions of lunatics started with the myths of treatment of Greek physicians. The use of massage, food, specialized bath has been mentioned in earlier written records. The conditions of lunatics remained to be pathetic with chains. The churches gave a possession by spirit aspect to the insane. Barely hospitals existed for admission of lunatic and those which existed believed in chaining. By the time reform started for care of insane de-chaining was the first welcome move. The need for female care takers came up for those admitted insane. Better results were felt worth appointing trainees female caretakers for insane. Prominent physicians advocated training for female caretakers with a psychiatric aspect. Courses were designed and upgraded for psychiatric nursing and inclusion of public domain in that. The path was ever evolving with a lot more to added from the eighteenth century.

Sexual Violence against Minors: A Study of 35 Cases

Sexual violence refers to any contact or interaction (visual, verbal, or psychological) where an adult uses a child or adolescent for sexual stimulation, either for their own satisfaction or that of a third party. It represents a fairly common, urgent, and challenging situation to diagnose, while avoiding any underestimation or overestimation. Hence, the relevance of our study, which aims to describe and analyze the psychological and social aspects of sexual abuse in minors under the age of 18 who were seen at the pediatric psychiatry department of Arrazi Hospital in Salé. The identified risk factors were as follows: an average age of 10 years, male gender, and a conflicted family dynamic. The only factor associated with the occurrence of post-traumatic stress disorder (PTSD) after sexual assault was having a stay-at-home mother. Furthermore, it was observed that the higher the age of the first sexual assault, the greater the risk of developing depressive disorders. Victims from families marked by domestic violence had a 25.5 times higher risk of developing this disorder after a sexual assault. Compared to victims with parents in a couple, those who were divorced had a higher number of comorbid PTSD diagnoses, while widowhood was associated with a decrease in the number of comorbid diagnoses. Lastly, it was found that justice intervention in response to sexual assault was associated with a higher number of comorbid psychiatric disorders with PTSD. To ensure the care of children who are victims of abuse and family violence, it is essential to involve professionals from various disciplines. A comprehensive and multidisciplinary evaluation must be conducted, taking into account medical, psychological, psychiatric, and social aspects. Thus, this information provides valuable foundations for developing strategies for the prevention and early detection of child abuse.

The Ignored Psychiatric Aspect of Chloroquine in the COVID-19 Outbreak Period: A Narrative Review Study

Context: Several studies have shown that chloroquine can effectively diminish the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As such, other studies have also supported this statement, but the psychiatric side effects of chloroquine have not been taken into account. Objectives: The current study aimed to briefly review and discuss the safety of chloroquine. Evidence Acquisition: A narrative literature search on databases was carried out on studies without time limitations. A combination of the two main keywords of “Chloroquine” and “Psychiatric Side Effects” was used to search databases. A manual search was performed to find the relevant articles, and finally, 15 studies were reviewed. Data were shown in the table and then summarized by narrative synthesis. Results: The literature review revealed the pharmaceutical characteristics of chloroquine, the safety of chloroquine, and the management of chloroquine's side effects. Also, the studies showed that chloroquine had psychiatric symptoms varying from insomnia to catatonia, toxic psychosis, and suicidal attempts, as well as behavioral manifestations, including most frequently extreme irritability, restlessness, abusiveness, distractibility, pressured speech, flight of ideas, grandiosity delusion, and auditory and visual hallucinations. Conclusions: Given the probability of a wide range of possible psychiatric symptoms following chloroquine, physicians should cautiously prescribe antiviral agents, and healthcare workers should also notice any psychiatric symptoms after administrating the chloroquine.

Precision Medicine Approaches for Psychosis Treatment

Precision Medicine Approaches for Psychosis Treatment

Psychiatric aspects of healthcare workers during COVID-19 pandemic in Surabaya, Indonesia: prevalence of anxiety, resilience, burnout, and their correlations to stress markers

Link of Video Abstract: https://youtu.be/nI_6kXZ0cSw Introduction: The coronavirus disease (COVID-19) pandemic severely affected healthcare services, including causing negative impacts on healthcare workers’ mental health. An observational study was conducted at Dr. Soetomo General Hospital aimed to measure the prevalence of anxiety, resilience, burnout and their correlations to stress biomarkers amongst healthcare workers in Surabaya, Indonesia, during the COVID-19 pandemic. Methods: Participants were residents who managed COVID-19 patients, chosen using random sampling. All participants had a 1-week shift working with COVID-19 patients in an isolation ward. The study used online questionnaires and laboratory data at the shift’s beginning and end. Along with collecting sociodemographic characteristics, State-Trait Anxiety Inventory (STAI), Brief Resiliency Scale (BRS), and Maslach Burnout Inventory (MBI) scales were administered online. At the same time, laboratory markers such as Neutrophil to lymphocyte ratio (NLR), Interleukin-6 (IL-6), cortisol, and CD4 values were studied. Results: 61 participants were included in the study. At the beginning of the shift, 59% of participants had moderate to severe anxiety, and 83.62% had normal to high resilience. The early proportion of the participants having burnout from combined MBI measures was 88.52%. MBI-EE median scores were lower in the married group (6.50 vs. 9.50, p-value=0.030). NLR value was significantly related to STAI-S and BRS (p-value=0.007 and 0.049, respectively). Conclusions: Most healthcare workers had anxiety and burnout, with normal levels of resilience. Our study found that NLR might be useful as a marker for anxiety and resilience.

Psychiatric aspect of suicide in a sample of Iraqi people

Abstract Background: Suicide is a major public health concern worldwide. To identify risk factors for prevent suicide, it is essential to understand the demographic and clinical characteristics of individuals with suicidal ideation and behavior. Objectives: This study seeks to assess suicide symptoms in people of Babylon City and assesses the effect of factors that increase the suicide rate and to find sociodemographic and psychological factors that may influence the act of suicide and whether they differ from other suicide intensions prevailing in the world. Materials and Methods: Cross-sectional study of 57 patients with suicidal behavior who were admitted to at Al-Sadiq Teaching Hospital in Babylon City, Iraq between 2021 and 2023. Demographic and clinical characteristics were compared between suicide attempters and completers, and a correlation matrix was used to explore relationships between these characteristics. Results: The mean age of the patients was 34.2 years, and the majority were women (63.2%) and single (56.1%). Previous suicide attempts were reported by 50 patients (87.7%). Hanging and poisoning were the most common methods of attempted suicide, whereas firearms were the most common method of completed suicide. Depression and anxiety were the most common co-morbid psychiatric conditions, and chronic pain was the most common co-morbid medical condition. Conclusions: These findings highlight the importance of screening for suicide risk factors and providing appropriate treatment for co-morbid psychiatric and medical conditions. The results also suggest that suicide prevention efforts may benefit from targeting younger individuals, for those who are single or have lower education levels, and those with a history of suicide attempts.

Innate immune activation and aberrant function in the R6/2 mouse model and Huntington's disease iPSC-derived microglia.

Huntington's disease (HD) is an inherited autosomal dominant neurodegenerative disease caused by CAG repeats in exon 1 of the HTT gene. A hallmark of HD along with other psychiatric and neurodegenerative diseases is alteration in the neuronal circuitry and synaptic loss. Microglia and peripheral innate immune activation have been reported in pre-symptomatic HD patients; however, what "activation" signifies for microglial and immune function in HD and how it impacts synaptic health remains unclear. In this study we sought to fill these gaps by capturing immune phenotypes and functional activation states of microglia and peripheral immunity in the R6/2 model of HD at pre-symptomatic, symptomatic and end stages of disease. These included characterizations of microglial phenotypes at single cell resolution, morphology, aberrant functions such as surveillance and phagocytosis and their impact on synaptic loss in vitro and ex vivo in R6/2 mouse brain tissue slices. To further understand how relevant the observed aberrant microglial behaviors are to human disease, transcriptomic analysis was performed using HD patient nuclear sequencing data and functional assessments were conducted using induced pluripotent stem cell (iPSC)-derived microglia. Our results show temporal changes in brain infiltration of peripheral lymphoid and myeloid cells, increases in microglial activation markers and phagocytic functions at the pre-symptomatic stages of disease. Increases in microglial surveillance and synaptic uptake parallel significant reduction of spine density in R6/2 mice. These findings were mirrored by an upregulation of gene signatures in the endocytic and migratory pathways in disease-associated microglial subsets in human HD brains, as well as increased phagocytic and migratory functions of iPSC-derived HD microglia. These results collectively suggest that targeting key and specific microglial functions related to synaptic surveillance and pruning may be therapeutically beneficial in attenuating cognitive decline and psychiatric aspects of HD.

Psychiatric Aspects of Chemical Warfare

The Article Abstract is not available.

Meta-model of Human Recognition-behavioral Adaptation System

Scientific modeling is a syllogistic system of definitive premise, sound inference and consistent explanation to understand, define, quantify, visualize or simulate feature of the target. Single-model is defined to an informative representation for identifying a property of a target object/phenomenon, and meta-model integrates the relevant single-models to explain phenomenological realities. Human recognition-behavioral adaptation is an information-metabolism system to maintain homeostasis of human-self, and that has been investigated in neurological, psychiatric and psychological aspects. I analyzed human recognition-behavioral adaptation-system via scientific modeling. Neurological meta-model of human recognition-behavioral adaptation system was synthesized as complex-network of the functional neuronal modules, and the meta-model was integrated to Mentality-model in the psychiatric aspect, and to Personality-model in the psychological aspect. The integrated meta-models successfully explained phenomenological realities in the aspects. From the above, I comprehended that the meta-model of human recognition-behavioral adaptation-system has been developed to Biopsychosocial model integrating the biological, psychological and socio-environmental factors.

Pain-depression relationship, quality of life and acceptance of illness among patients with Chiari malformation type I: A cross-sectional study.

Chiari malformation type I (CM-I) is a congenital anomaly of the hindbrain. The most common symptoms include suboccipital tussive headache, dizziness and neck pain. Recently there has been growing interest in the psychological and psychiatric aspects of functioning in patients with CM-I, which have a significant effect on treatment outcomes and quality of life (QoL). The aim of the study was to assess the severity of depressive symptoms and the QoL in patients with CM-I and to identify the main factors responsible for these phenomena. A total of 178 people participated in the study and were divided into 3 groups: patients with CM-I who had undergone surgery (n = 59); patients with CM-I who had not undergone surgery (n = 63); and healthy volunteers (n = 56). Psychological evaluation included a set of questionnaires: the Beck Depression Inventory II, the World Health Organization shortened version of the WHOQOL-100 quality of life questionnaire, the Acceptance of Illness Scale and the Beliefs about Pain Control Questionnaire. Results showed that the control group participants obtained significantly better results than both groups of CM-I patients in terms of all indicators of QoL, symptoms of depression, acceptance of illness, pain level (average and present) and perceived influence of doctors regarding coping with pain. Patients with CM-I (operated and non-operated) obtained similar results in most of the questionnaires and the QoL indices correlated significantly with the majority of the analyzed variables. Moreover, CM-I patients with higher depression scores described their pain as more severe and had a stronger belief that pain levels were not influenced by them but only by doctors, or that it could be controlled randomly; they were also less willing to accept their illness. CM-I symptoms affect the mood and QoL of patients. Psychological and psychiatric care should be the golden standard in managing this clinical group.

Role of multimodal advanced biomarkers as potential predictors of cognitive and psychiatric aspects of Parkinson's disease

BackgroundThe value of biomarker research in Parkinson's disease (PD) exists in the early detection and accurate diagnosis of non-motor neuropsychiatric symptoms with implications for future treatment strategies. The aim of the this work was to assess and predict risk for possible cognitive, psychiatric abnormalities in patients with early stage idiopathic PD using a combination of advanced diagnostic biomarkers for early recognition and intervention.MethodsThis cross-sectional case–control study was conducted on 58 eligible idiopathic PD-patients, and 45 age/sex-matched healthy controls. All participants were subjected to neuro-psychiatric-, radiological-, audiological-, and laboratory-evaluations. Cognitive assessment was performed using Montreal Cognitive Assessment, Mattis Dementia, and Parkinson’s Disease-Cognitive scales. Depression was evaluated by Hamilton Depression and Beck Depression Inventory-II rating scales. Radiologically, volumetric-MRI, diffusion tensor imaging (DTI), and susceptibility weighted imaging were done. Audiologically, P300 and cortical auditory evoked potentials were elicited. Laboratory investigations included 24 h-urinary 5-HIAA and serum levels of IL6, BDNF, 5-HT, and aberrant cimiRNA 132-3p expression profile.ResultsNeuropsychological scales revealed mild depression and mild cognitive impairment, with significant differences in PD group. Volumetric-MRI highlighted that PD-patients had a significant bilateral decrease in the mean cortical thickness and thickness/volume of many brain areas. DTI showed a reduction in fractional isotropy and a significant bilateral increase in mean diffusivity through many areas in PD-patients. Patients also had either absent or diminished amplitude of P300,P1, diminished amplitude of N1,P2,N2 and delayed latency of all previous waves. There was a significant reduction of 24 h-urinary 5-HIAA and serum BDNF, with significant elevation of serum IL6, as well as non-significant reduction of serum 5-HT and microRNA-132-3p(2-ΔCt) in PD-patients.ConclusionsEarly stage PD-patients had subtle cognitive impairment and depression as detected by psychometric scales and correlated significantly with the various biomarkers, including advanced neuro-imaging, evoked potential studies, and laboratory markers. The key message of this work include evaluating the high prevalence of cognitive and psychiatric impairment in early idiopathic PD has encouraged research and workup for precision medicine. Proper integration of advanced multimodal biomarkers in this study has led to predict the risk of early mild cognitive and psychiaric affection. This will optimize the health strategies for early proper management to improve quality of life.

Psychiatric aspects of ophthalmic disorders: A narrative review

Ophthalmic disorders have psychiatric aspects associated with them at various levels. Psychological factors have a well-documented role in the causation, aggravation, and maintenance of various ophthalmic conditions, including glaucoma, central serous retinopathy, dry eye disease, and retinitis pigmentosa. Many ophthalmic conditions, including blindness, have psychological manifestations as well, which need to be addressed, in addition to the ophthalmic pathology. There is also significant overlap in the treatment of the two disciplines in many ways. For instance, many ophthalmic drugs have psychiatric side effects. Even ophthalmological surgeries have psychiatric aspects associated with them, which primarily include black patch psychosis and anxiety in the operation theater. This review will be useful for psychiatrists and ophthalmologists, for their clinical practice and research. Future research should focus on this interface to give it its well-deserved attention.

Palliative Measurement of Anxiety in Young Women With Gynecologic Malignancy: A Review of Three Instruments

Palliative care involvement is common among patients with gynecologic cancers related to delayed diagnosis and symptom burden. Physical symptoms such as pain, nausea, and weakness can be managed with analgesics, antiemetics, nutrition, and physical therapy. Psychiatric side effects like anxiety disorders, however, are harder to capture. Associations among palliative care, anxiety assessment, and intervention in this population are not well studied. This could be related to lack of psychiatric-specific education in medical, nursing, and continuing palliative education programs. Palliative guidelines suggest systematically addressing psychiatric aspects of care in each patient encounter. Prior to intervention, providers must first properly assess anxiety. In this paper, development and validity of three instruments designed to measure clinical anxiety will be reviewed, including National Comprehensive Cancer Network Distress Thermometer, State-Trait Anxiety Inventory Form Y1, and Beck Anxiety Inventory. Conclusions will be drawn regarding reliability and validity of each tool, and recommendations will be made based on respective psychometric properties.

Dissociative identity disorder as interdisciplinary problem. Part I - psychiatric and psychological aspects.

Dissociative identity disorder (DID) belongs to the complicated issues of psychiatry and psychology areas. The specificity of the disorder and its clinical picture imply numerous difficulties in the diagnosis and treatment process. The diagnosis of DID can also have significant legal consequences, especially in the context of criminal liability or the general ability to be a witness. Thus, DID is an interdisciplinary problem. In practice, DID is rarely diagnosed, although it is estimated that it occurs in about 1% of the general population. In many cases, the period from the first contact with the healthcare system to a correct diagnosis exceeds several years (on average, 6.7 to 8 years). The average misdiagnosis rate is 2.8 per patient. The lack of a quick and proper diagnosis makes it impossible to undertake adequate treatment, which extends the entire therapeutic process, affects its effectiveness and significantly increases costs. There is no doubt that in educating psychiatrists and clinical psychologists, greater emphasis should be placed on correctly detecting dissociative symptoms and the use of adequate diagnostic tools. The aim of this article is to present and identify the main problems that DID implies in the diagnostic and therapeutic (psychological and psychiatric) areas. The article discusses the existing diagnostic tools, the issues of comorbidity and the causes of incorrect diagnoses. The issues of false-positive diagnoses and difficulties in differentiating patients with DID from simulators were also discussed. The primary mistakes made during the therapy, such as the strategy of minimization or the actions leading to multiple therapist disorder, were analyzed. Legal aspects will be presented in a separate article.

Psychological, psychiatric and neurological aspects of COVID-19

To analyze neurological, psychological and psychiatric aspects of COVID-19, as well as to study the current state of the problem. The study included 103 patients with COVID-19. The main research method was clinical/psychopathological. To study the impact of activities related to the care of patients with COVID-19 in a hospital setting, the medical and psychological state of 197 hospital workers involved in the treatment of patients with COVID-19 was assessed. The level of anxiety distress was assessed with the Psychological Stress Scale (PSM-25), distress indicators corresponded to values of more than 100 points. The severity of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale (HADS). When considering psychopathological disorders in the context of COVID-19, it is necessary to distinguish between two main groups of disorders: mental disorders during the pandemic, and mental disorders directly caused by the causative agent SARS-CoV-2. The analysis of psychological and psychiatric aspects in various periods of the initial stage of COVID-19 showed that each of them was characterized by specific features depending on the nature of the influence of different pathogenic factors. In the structure of nosogenic mental disorders in patients with COVID-19 (103 patients), the following clinical forms were identified: acute reaction to stress (9.7%), anxiety-phobic disorders (41.7%), depressive symptoms (28.1%), hyponosognosic nosogenic reactions (20.5%). At the same time, the majority of the patients had manifestations of somatogenic asthenia (93.2%). A comparative analysis of neurological and psychological/psychiatric aspects of COVID-19 showed that the main mechanisms of the impact of highly contagious coronaviruses, including the SARS-CoV-2, on the central nervous system are: cerebral thrombosis and cerebral thromboembolism, damage to the neurovascular unit, neurodegeneration, including that induced by cytokines, and immune-mediated demyelinating nerve damage. Neurological and psychological/psychiatric aspects of COVID-19 should be taken into account both at the stage of disease treatment and in the post-infection period due to the pronounced neurotropism of SARS-CoV-2 and its effect on the neurovascular unit. Along with helping patients, an important aspect is the preservation of the mental health of medical personnel working in hospitals for infectious diseases, due to special working conditions and a high level of professional stress.

Psychiatric and psychologic aspects of chronic skin diseases.

Chronic skin diseases can substantially affect a patient's physical, psychologic, and social well-being. Physicians may play a critical role in identifying and managing the psychologic sequelae of the most common chronic skin conditions. Acne, atopic dermatitis, psoriasis, vitiligo, alopecia areata, and hidradenitis suppurativa are chronic dermatologic diseases that put patients at high risk for symptoms of depression, anxiety, and decreased quality of life. Both general and disease-specific scales exist to assess the quality of life in patients with chronic skin disease, the most common being the Dermatology Life Quality Index. The general management approach to the patient with chronic skin disease should incorporate acknowledgment and validation of the patient's struggles; patient education on the potential effect of disease and prognosis; medical management of the dermatologic lesions; coaching on stress management; and psychotherapy. Psychotherapies include talk therapy (eg, cognitive behavioral therapy), arousal-reducing therapies (eg, meditation, relaxation), and behavioral therapies (eg, habit reversal therapy). Improved understanding, identification, and management of the psychiatric and psychologic aspects of the most common chronic skin conditions by dermatologists and other health care providers may positively affect patient outcomes.

Dermatitis Artefacta.

Dermatitis artefacta (factitious skin disorder) is a rare psychocutaneous disorder that poses a complex clinical challenge to clinicians. The hallmarks of diagnosis include self-inflicted lesions in accessible areas of the face and extremities that do not correlate with organic disease patterns. Importantly, patients are unable to take ownership of the cutaneous signs. It is essential to acknowledge and focus on the psychological disorders and life stressors that have predisposed the condition rather than the mechanism of self-injury. The best outcomes are achieved via a holistic approach in the setting of a multidisciplinary psychocutaneous team addressing cutaneous, psychiatric, and psychological aspects of the condition simultaneously. A non-confrontational approach to patient care builds rapport and trust, facilitating sustained engagement with treatment. Emphasis on patient education, reassurance with ongoing support, and judgment-free consultations are key. Enhancing patient and clinician education is essential in raising awareness of this condition to promote appropriate and timely referral to the psychocutaneous multidisciplinary team.