Psychiatric Center Research Articles

Trajectory of the body mass index of children and adolescents attending a reference mental health center.

The primary objective was to describe the standardized body mass index (z-BMI) trajectory of children and adolescents admitted to a psychiatric reference center in Mexico City according to their diagnosis and medication use. The secondary objective was to compare z-BMI between antipsychotic users and non-users. This is a retrospective cohort study. The psychiatric diagnosis, prescribed medications, serial heights, and weights were collected from the medical records. The median baseline z-BMI of the 129 analyzed cases was 0.88 (interquartile range [IQR]: 0-1.92), and the prevalence of excessive weight (obesity or overweight) was 46.8 %. At the end of follow-up (median 50.3weeks), the median change in z-BMI was-0.09 (IQR:-0.68 to 0.42). New long-term users of antipsychotics (n=29) had an increase in their z-BMI, in contrast to never-users (median difference 0.73, p=0.01) and to previous users (median difference 0.92, p=0.047). The 59 subjects with excessive weight at admission had a median z-BMI change of-0.39 (IQR:-0.81 to-0.04). Among patients with excessive weight and depression, there was a greater decrease in z-BMI in sertraline users (n=13) compared with fluoxetine users (n=15) (median-0.65 vs. 0.21, p<0.001). New long-term users of antipsychotics showed a significant increase in their z-BMI. Patients with depressive disorders and obesity on sertraline therapy tended to show a decrease in their z-BMI.

Relationship between changing cognitive domains and atypical antipsychotic treatment in bipolar disorders: a three-year observational study in a psychiatric rehabilitation center during COVID-19 pandemic

IntroductionBipolar Disorders have been consistently associated with cognitive dysfunction across a broad range of cognitive domains (patients, who usually took psychiatric drugs, sometimes presented changes of cognitive disorders). Many studies have focused on improving the illness severity of patients with MDD or BD by combining mood-stabilizing drugs with atypical antipsychotics (AA). However, the results are contradictory and have not confirmed the certain superiority of AA to other therapeutic strategies. Among these, the cognitive remedy has demonstrated important effectiveness on cognitive variations in this group of patients.ObjectivesIn our study, we tried to evaluate some changes in cognitive function in patients with BD treated with antipsychotics related to critical problems with typical cognitive tests.MethodsIn our observational study, we recruited forty-three inpatients (20 females, 23 males) affected by Bipolar Disorder (DSM-5 criteria; particularly 78.5% affected by BD-I), in a psychiatric rehabilitation center. All patients were included in the ordinary rehabilitation treatment. All patients were treated with mood stabilizers (lithium n. 14; valproate n. 29), and at least one AA. The AAs have been the following: quetiapine, aripiprazole, and olanzapine (authorized in Italy)(Table 1). The observation period lasted three years, during three significant waves of the COVID-19 pandemic.All patients at baseline (T0) (March-April 2020), T1 (Maj-June 2021), T2 (April-Maj 2022), and T3 (April – June 2023) were administered the following rating scales: BPRS, YMRS, GAF, and HAM-DThe data were statistically analyzed with the EZAnalyze 3.0 software for the Excel platform.ResultsIn Table 2 and Graphic the results obtained with the rating scales and statistical analysis are shown. In BRPS the data shows a statistically significant reduction in the total score in all periods analyzed. Similar results were found in the GAF and YRMS scales. However, with the HAM-D Scale, there was evidence of an increase in T2, although the differences were not statistically demonstrated. The differences in mean scores are more evident for quetiapine and olanzapine.Image:Image 2:Image 3:ConclusionsOur observational study showed that the atypical antipsychotics used in our work allowed a significant improvement of the symptoms in BD. However, the pandemic waves have no correlation with the treatment performed. New studies are necessary to highlight the relationship of the pharmacological treatment of BD with the progress of the COVID-19 pandemic.Disclosure of InterestNone Declared

Who benefits from multifamily psychoeducation groups ? Descriptive anaysis of participants

IntroductionGuidelines for relapse prevention in schizophrenia recommend psychoeducation for patients and caregivers (Bighelli I, Leucht S et al. Lancet Psychiatry 2021). Considering that, in 2021, we implemented in our Psychiatric community center a multifamily therapy (MFT). The program is based on systemic approach and psychoeducation, focusing on schizophrenia.ObjectivesDescribe participants of MFT groups focusing on schizophrenia.* Patients’ characteristics : age, gender, duration of psychiatric follow-up, history of hospitalization* Caregivers’ characterics: status, age.MethodsWe carried out a descriptive study of the different profile of MFT groups participants in our community center from 2021 to today.ResultsSince 2021, 4 MFT groups took place including 50 participants: 18 patients suffering from schizophrenia and 32 relatives.Image 1 illustrates the different participants of each group.Each group was different. Some patients came with both their parents, even if divorced, some came only with their mother. Some came with a sibling. Nevertheless, the numbers of fathers and siblings did not always allow us to work in sub-groups.Considering patients: 18 patients benefited from our program. 8 female and 10 male patients (55.6%) were admitted and distributed in each group as described in image 2. The mean age of patients was 31.9 years old [20.1 – 57.5]. Each group was made up of patients with psychiatric follow-up ranging from 1 year to more than 20 years, and having experienced between 1 to more than 5 psychiatric hospitalizations. It appears that Group 4 was noticeably younger than the other groups with a mean age of 22.4 years old [20.4 – 26.7] and a shorter history in psychiatry with less hospitalisations (image 3).Considering relatives: 15 mothers, 9 fathers, 5 siblings, 1 spouse, 1 aunt and 1 uncle benefited from psychoeducation to caregivers. The relatives were from 47 to 81 years old for the parents, and from 17 to 50,7 for the siblings. Unlike parents, siblings generally attended a limited number of sessions.Image:Image 2:Image 3:ConclusionsThis descriptive study reflects the work carried out with 18 patients and their relatives in an MFT group providing psychoeducation to patients suffering from schizophrenia and their caregivers. 50 persons benefited from psychoeducation in 2 years. We learned from these results to improve the constitution of our groups and the benefits of our psychoeducation program. We were careful to include families with siblings as we know they are affected by the mental illness in the family and are often left aside of all care/support proposals. We questioned ourselves on the advantages of homogeneous or heterogeneous groups, considering age, history of follow up. How could it impact affiliation to the group or differentiation movements ? How useful or harmful it is for sharing experiences between the families. A proper study would be necessary to answer these questions.Disclosure of InterestNone Declared

An integrative, systemic day-clinic approach for the treatment of psychiatric disorders in young adults: a detailed study of two cases

IntroductionMore than 75% of the psychiatric disorders arise before the age of 30. Adolescence and young adulthood pose numerous developmental challenges like identity development, educational and occupational concerns, gaining autonomy and boundary-setting skills. The adolescent crises, which can involve a broad spectrum of psychiatric symptoms, demands a multidisciplinary approach to diagnosis and treatment.ObjectivesOur goal is to present a best practice example of an interdisciplinary day clinic through two case presentations, aiming improving innovative strategies for assessment/treatment of psychiatric disorders in young adulthood.MethodsVia two comprehensive case presentations, we will introduce a psychotherapeutic day-clinic concept from a psychiatric training hospital in Germany.ResultsThe day clinic’s interdisciplinary team uses therapeutic approaches like dynamic, cognitive-behavioral, and systemic therapy to understand young adults beyond just their symptoms. Milieu-therapeutic methods, family constellations, socio-therapeutic approaches and non-verbal therapies are incorporated into our concept. Case 1: A 20-year-old male patient, previously diagnosed with schizophrenia, was referred due to symptoms of living in an unreal world with perceived magical abilities and family conflicts. In the evaluation the features of high-functioning autism spectrum disorder (ASD) were more prominent than the psychotic symptoms. Developmental history and diagnostic tools yielded the diagnosis of ASD. Magical abilities in an unreal world appears to align more closely with repetitive/restrictive patterns of behavior, hereby we excluded in the follow-up the diagnosis of schizophrenia. Psychoeducation, social-skills-training and family interventions helped him to comprehend his strengths and discover a clearer direction in his life.Case 2: Another 20-year-old male patient was referred with depressive symptoms, a sense of emptiness and self-mutilation. Following routine evaluation, we employed systemic methods (genogram constellations) to gain deeper insight into the patient’s psychopathology. His mother’s migration history from Thailand, coupled with unfulfilled aspirations, echoed in his recurring thought: “Where are my roots?” During follow-up, we recognized his passive stance toward therapeutic change, addressed through a systemic intervention known as ‘taking the side of non-change.’ This shifted his position from resistance to openness. Non-verbal approaches, family interventions, and corrective in-vivo experiences significantly contributed to his stabilization.ConclusionsSpecialized psychiatric centers tailored to the unique needs of young adults play a critical role in evaluating, diagnosing, and treating psychiatric crises during this developmental stage. Achieving this requires the implementation of interdisciplinary holistic therapeutic approaches.Disclosure of InterestNone Declared

AN EXPLORATORY STUDY OF STRESS, ANXIETY AND DEPRESSION AMONG 10TH AND 12TH GRADE STUDENTS OF NCT OF DELHI IN REFERENCE TO THEIR ACADEMIC ANXIETY

The current study was planned as an Exploratory Study of Stress, Anxiety and Depression in grade 10 and Grade 12 Students in reference to school anxiety. The purpose of the study is to interview high school and upper secondary students who dealing with a broad range of stress factors associated with school requirements. Past research indicates that school-related stress can decrease the school performance level, reduce motivation and increase the risk of abandonment. Mental health issues are playing a vital role in the school/college student’s life. School pressure and typical stressors at the beginning and end of college can precipitate the First onset of mental health and substance abuse issues or worsening of symptoms. Long-term impacts, which include a reduction in the likelihood of lasting jobs, Governments are worth billions of rupees every year. As a result, expertise in family dynamics, developmental psychopathology, special college issues and care systems is essential for conducting clinical treatment with college students. This narrative report presents the up-to-date recent research on the impact of education-related stress, including a discussion about the impact on students’ Ability to learn and succeed at school, mental health problems such as depression and anxiety, sleep disturbances and addictions. Method: For that purpose, the current study, a total sample of 100 school students, out of which 47 were 10th grade Students and 53 were 12th grade students. The individuals selected from this sample were 15 and 20 years of age. This study sample was chosen from among Grade 10 and 12 students (Govt. Boys &amp; Girls Sr. Sec School) Delhi. The students here refer to the students, especially the 10 and 12 year students of the Delhi government School. To measure the Stress, Anxiety and Depression among 10th and 12th Grade Students, Stress, Anxiety and Depression Scale (ADSS -BSPSA) by Pallavi Bhatnagar et. al. was used. To measure the Academic Anxiety these students, Academic Anxiety Scale (AAS) by A.K. Sen &amp; A. Sen Gupta was used by the 10th And 12th Grade Students. Results: This study points to a high prevalence of symptoms of Academic Anxiety among male students (49.42%) and female students (56.04%). The results of the study also show that the incidence of stress, anxiety, and depression were 37.7%, 31.15%, and 33.13%, respectively. Academic Anxiety was much higher amongst females, then that stress, anxiety, and depression were significantly higher among 12th Grade students. This study found that male and female students were found to be different from stress. Finding: We have seen that male students are very stressed compared to girls. In Anxiety 10th Grade Boys Students high Anxiety than 10th Grade Girls Students. At a glance Depression of Grade 10th Boys Students score higher than Grade 10th Girls Students, Grade 12th Girls Students shows higher score than Grade 12th Boys Students. Given the importance of a high incidence of stress, anxiety and depression among these students. There is a need to detect symptoms of stress, anxiety and depression in the school students &amp; follow through with a further recommendation to get the proper diagnosis and treatment in specialized psychiatric centers. Do not interfere with the learning/development process by doing. Moreover, other studies are recommended to remove the factors behind these mental disorders in relation to their school-related anxiety.

A STUDY OF MENTAL HEALTH DISORDER IN REFERENCE TO VOCATIONAL INTEREST AT THE SECONDARY LEVEL STUDENT OF GOVERNMENT SCHOOLS OF DELHI

This present study was planned a study of Mental Health Disorder in reference to Vocational Interest at the Secondary Level Student of Government Schools of Delhi.Mental health issues are playing a vital role in the school student’s life. School pressure and typical stressors at the beginning and end of college can precipitate the First onset of mental health and substance abuse issues or worsening of symptoms. In many cases, The nature of the pathology has been chronic because low demand for treatment and and lack of adherence to treatment. Awareness programs and strategies must be used to ensure the maintenance of treatment. Because many traditional students remain dependent on their families during college, parental participation in treatment is important. Lastly, in view of How the school calendar can affect continuity of care, clinicians should Make sure students at the college receive treatment all year long and Coordination with other clinicians/psychologist who are able to participate in student care. As a result, expertise in family dynamics, developmental psychopathology, special college issues and care systems is essential for conducting clinical treatment with college students. Method: A descriptive research methodology was used to perform this research work. All upper secondary students were registered for the study. In this study, researchers randomly selected 257 students (138 boys and 119 girls) from schools of Government of Delhi. The sample consisted of students in the upper secondary and upper secondary classes in different schools and colleges. Three psychological tests were used for this research. (1).“Academic/school Anxiety Scale for Children (AAFC-GS) – prepared by A.K. Singh and A. Sengupta. (2). “Academic Achievement Test for Children,” one criterion was developed and standardized by researchers on all Class VIII topics. The test was administered to the sample group by the researchers to collect results. (3).“The Strong Interest Inventory”- It has helped educational institutions and businesses develop the best and brightest and guided thousands of people—From high school and university students to mid-career workers seeking meaningful and rewarding careers. Results: This study points to a high prevalence of symptoms of Academic Anxiety among male students (49.42%) and female students (56.04%). The results of the study also show that the incidence of stress, anxiety, and depression were 37.7%, 31.15%, and 33.13%, respectively. Academic Anxiety was much higher amongst females, then that stress, anxiety, and depression were significantly higher among senior secondary students. This study found that male and female students were found to be different from stress. Finding: We found that male students are under a lot of stress compared to girls and are also different bunch of undergraduates A number of important ways, including living on campus and connecting, school responsibilities with academic advisors. We think that mental health expertise who work on campus should improve their education and Knowledge by familiarizing oneself with the topics discussed in this paper. For this reason, Increased levels of stress, anxiety and depression in these students can be observed in society. There is a need to detect levels of stress, anxiety and depression in the school students &amp; follow through with a further recommendation to get the proper diagnosis and treatment in specialized psychiatric centers. Do not interfere with the learning development process by doing. Moreover, other studies are recommended to remove the factors behind these mental disorders in relation to their school-related anxiety. In addition, additional research is recommended “Studies on the mental health disorders treatment and co morbidity, including reflections on students during the high level of stress, anxiety cases”.

Effects of a One-Day Experiential Sheep-Rearing Experience on Motivation, Anxiety, and Frontal Lobe Brain Activity in Patients with Chronic Psychiatric Disorders: A Crossover Pilot Study

The purpose of this study was to investigate the effects of a one-day sheep-rearing experience on motivation and anxiety levels in patients with chronic mental illness. The study assessed changes in oxytocin and cortisol levels and brain activity in the prefrontal cortex, which is known to be associated with emotion and motivation. The study employed a non-randomized controlled trial design, with participants receiving both an intervention day (sheep rearing) and a control day (usual psychiatric day care) in a crossover fashion. Written informed consent was obtained from all participants. The intervention day consisted of hands-on sheep rearing activities, while the control day consisted of general activities available at the psychiatric day care center. Results showed that the sheep-raising experience had an equal effect on motivation and increased mean oxytocin levels. In addition, significantly more activity was observed in the dorsolateral prefrontal cortex (DLPFC) region of the brain compared to typical psychiatric daycare activities (p &lt; 0.032, p &lt; 0.043). Participants tended to have increased oxytocin levels after sheep rearing, and the activation of the DLPFC has not previously been observed in animal intervention studies. These are new findings in psychiatric occupational therapy that may have effects on social cognition and interpersonal relationships in patients with chronic mental illness.

Somatische pathologie bij ‘high security’-geïnterneerden

Somatic pathology in high security internees Psychiatric problems of forensic patients have already been identified in Flanders (Belgium), but no research has been done on the occurrence of somatic comorbidity. In order to improve somatic care, the authors aim to map the prevalence and nature of somatic diagnoses and the causes of death. Through a retrospective study, the medical records of all patients admitted and discharged in a high security forensic psychiatric center were analyzed. All somatic diseases were coded dichotomously. In order to obtain the most complete picture possible, various sources of information (file information, measured parameters, laboratory results) were used. The nature of the deaths (natural, unnatural, suicide) and the causes of natural deaths were examined. More than 2/3 of the deaths were caused by suicides. The 3 most prevalent somatic conditions were obesity (38.9%), hypertension (34.4%) and the metabolic syndrome (33.7%). The current study further indicates that certain data were missing in the files, such as registrations of blood pressure measurements, weight and waist circumferences. Therefore, some problems may have remained underdiagnosed and undertreated. As a consequence, there is room for improvement in the detection and monitoring of somatic diseases. This first study demonstrates an important somatic comorbidity in forensic patients with high security needs and may contribute to a better understanding and treatment of physical problems. This aspect of the holistic treatment of forensic-psychiatric patients has been recognized insufficiently, despite its great importance.

A comparative study of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in bipolar mania and schizophrenia

Objectives The role of immunological disturbance in bipolar disorder (BD) and schizophrenia has been highlighted by some studies. There are few studies available that compared the inflammatory markers between schizophrenia and BD, but only one study demonstrated the difference in terms of neutrophil/lymphocyte ratio (NLR) and Platelet/lymphocyte ratio (PLR) between them. So this study was conducted to compare the NLR and PLR values among schizophrenia, bipolar mania, and healthy controls in order to find out a potential biomarker for these disorders. Material and Methods Eighty consecutive patients suffering from bipolar mania, 80 suffering from schizophrenia, and 80 healthy controls were recruited in the psychiatric center situated at a tertiary care hospital. Blood samples of all groups were transferred to the laboratory for complete blood count analysis. Thereafter, all the groups were compared by applying proper statistics. Results Significant higher level of neutrophil count and NLR value was seen in both bipolar mania and schizophrenia groups compared to healthy controls. There was no difference observed between schizophrenia and the bipolar mania group regarding NLR, PLR, neutrophils, lymphocytes, and platelets values. Conclusion NLR has appeared as a potential marker in our study, and it reflects a state of low-grade inflammation in both schizophrenia and bipolar mania. BD and schizophrenia have been considered as part of one continuum, which is also supported by the findings of our study. These markers can help in the prognosis and treatment of at least a subsection of patients and also are inexpensive and easy to assess.

Auricular Acupressure Improve Constipation of Patients With Schizophrenia: A Pilot Randomized Controlled Study.

Background. Constipation is a common distressing problem in patients with schizophrenia that can cause complications and impair quality of life. Objective. The objective of this study was to investigate the efficacy of applying auricular acupressure (AA) treatment in improving constipation in patients with schizophrenia. Methods. A crossover randomized controlled trial design was performed from April 2022 to December 2023 at four psychiatric rehabilitation care centers. A total of 23 patients with schizophrenia received an AA intervention or usual care according to the designated treatment sequences. Measurements comprised subjective assessment of constipation by the Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire, an objective assessment of the stool pattern rated by a Bristol stool form scale, and heart rate variability. A generalized estimating equation model was used for data analyses. Results. After completing an 8-week AA intervention stimulating the Shenmen, San Jiao, Large intestine and Rectum, the AA group exhibited lower scores in the PAC-SYM total score (difference = -12.66, ,0.001), and the subscales: abdominal (difference = -3.36, p < .001), rectal (difference = -3.51, p < .001), and stool (difference = -5.79, p < .001), compared to those receiving usual care. The cases of constipation indicated by type 1 and type 2 of the BSF scale significantly decreased after the 8-week AA intervention. Moreover, the AA group displayed more parasympathetic dominance compared to the usual care group, with a low frequency to high frequency ratio of -1.15. Conclusion. AA is an effective non-pharmacological method for improving subjective constipation symptoms and objective stool pattern in patients with schizophrenia.

Empathic Lighting Design for Healthcare Environments

Light has the powerful capacity to generate a certain quality and atmosphere within a room. However, lighting design specification is often only characterized via quantitative metrics. In healthcare institutions, such as care homes, hospitals and rehabilitation centres, the use of lighting design may support a positive atmosphere, and potentially also support the health and wellbeing of patients. When people are hospitalised, they are in a difficult and often stressful situation, in which they meet nurses, physicians and relatives within new, unfamiliar surroundings. These situations call for supportive architectural spaces with atmospheres that help people relax and feel safe. Nevertheless, these spaces often lack a lighting design that supports this intent. The objective of this study is to implement two different lighting scenarios and investigate how they affect patients in a psychiatric affective healthcare unit at Copenhagen Psychiatric Centre. Two different lighting scenarios were implemented and tested in a SW-facing group therapy room, during one winter period (November 2022–March 2023). In all, the study included 12 patients. Through questionnaires, the patients were asked how they perceived the luminous environments of two lighting scenarios, one in the existing healthcare lighting vs. a new lighting setup. The patients indicated their preferences and how the lighting design affected and supported heir therapeutic session. The two lighting scenarios are: a) Four high-positioned LED-luminaires (H=2,65 m) in the ceiling; and b) Two low-positioned LED-luminaires suspended above the meeting table (H=1,50 m). The results of the survey showed that patients overall preferred the low-positioned, non-uniform lighting, which scored a total of 60 points in the semantic analysis, compared to 35 points for the high-positioned, uniform lighting. In addition, from a sustainability viewpoint, energy consumption for the low-positioned lighting scenario was only 21 W, compared to 140 W for the high-positioned lighting scenario, providing an 85% reduction in total energy consumption.

Patients with first-episode psychosis in northern Taiwan: neurocognitive performance and niacin response profile in comparison with schizophrenia patients of different familial loadings and relationship with clinical features

BackgroundExamining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features.MethodsPatients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale. Quantitative measurements included the Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), niacin response abnormality (NRA), and minor physical anomalies and craniofacial features (MPAs). To evaluate the relative performance of the quantitative measures in our FEP patients, four external comparison groups from previous studies were used, including three independent healthy controls for the CPT, WCST, and NRA, respectively, and one group of treatment-resistant schizophrenia patients for the MPAs. Additionally, patients from simplex families and patients from multiplex families were used to assess the magnitude of FEP patients’ impairment on the CPT, WCST, and NRA.ResultsAmong the 80 patients with FEP recruited in this study (58% female, mean age = 25.6 years, mean duration of untreated psychosis = 132 days), the clinical severity was mild to moderate (mean PANSS score = 67.3; mean PSP score = 61.8). Patients exhibited both neurocognitive and niacin response impairments (mean Z-scores: −1.24 for NRA, − 1.06 for undegraded d', − 0.70 for degraded d', − 0.32 for categories achieved, and 0.44 for perseverative errors) but did not show MPAs indicative of treatment resistance. Among these quantitative measures, three of the four neurocognitive indices were correlated with the baseline clinical features, whereas NRA did not show such correlation.ConclusionsThis FEP study of Taiwanese patients revealed the presence of neurocognitive performance and niacin response and their different relationships with clinical features, rendering this sample useful for future follow-up and incorporation of multiomics investigation.

Characteristics and correlates of seclusion and mechanical restraint measures in a Parisian psychiatric hospital group.

Seclusion or restraint (S/R) are last-resort measures used in psychiatry to ensure the safety of the patient and the staff. However, they have harmful physical and psychological effects on patients, and efforts to limit their use are needed. We describe the characteristics and correlates of S/R events in four Parisian psychiatric centers. Within a 3-month period, November 5, 2018 to February 3, 2019, we recorded data for patients experiencing an S/R measure as well as characteristics of the measures. We studied the mean duration of a S/R event, the time between hospital admission and the occurrence of the event, as well as correlates of these durations. We also examined factors associated with use of a restraint versus a seclusion measure. For the 233 patients included, we recorded 217 seclusion measures and 64 mechanical restraints. Seclusion measures mostly occurred after the patient's transfer from the emergency department. The duration of a seclusion measure was about 10 days. Patients considered resistant to psychotropic treatments more frequently had a longer seclusion duration than others. The mean duration of a mechanical restraint measure was 4 days. Male sex and younger age were associated with experiencing mechanical restraint. S/R measures mostly occur among patients perceived as resistant to psychotropic drugs who are arriving from the emergency department. Developing specific emergency department protocols might be useful in limiting the use of coercive measures.

Uniqueness of auditory hallucinations in patients with schizophrenia and depressive disorder

ABSTRACT Background: While over three-quarters of those suffering from schizophrenia and schizophrenia-like illnesses experience auditory hallucinations, 6% of individuals with depressive disorder report the same. Differentiating between auditory hallucinations in these two illnesses is important both diagnostically and prognostically. Aim: To compare the characteristics of auditory hallucinations in patients with schizophrenia and depressive disorder. Materials and Methods: For both schizophrenia and depressive disorder, 110 patients were selected from inpatients of a tertiary care psychiatric center by purposive sampling. They were assessed with a specially designed proforma containing sociodemographic information, information about clinical features, and characteristics of the Auditory Hallucination Scale. Results: Schizophrenia and depressive disorder patients were matched on age, education, occupation, and socioeconomic status. The patients with schizophrenia rated significantly higher on frequency, clarity, tone, intensity, distractibility, self-control, and distress dimensions of auditory hallucinations as compared to patients with depressive disorder. Conclusion: The characteristics of auditory hallucinations in schizophrenia differ significantly than those in depressive disorder, which bears significant transdiagnostic importance. Clinical evaluation of these differentiating characteristics of auditory hallucinations may aid in diagnostic workup in patients.

Integrating Multifaceted Strategies to Prevent Patient Falls: Insights and Implementations at Taoyuan Psychiatric Center.

Integrating Multifaceted Strategies to Prevent Patient Falls: Insights and Implementations at Taoyuan Psychiatric Center.

Coping Strategies Among Family Caregivers of Patients with Chronic Mental Disorders: A Cross-Sectional Study

Background: It is widely acknowledged that family caregivers of patients with chronic mental disorders face numerous challenges that can jeopardize their mental well-being. Therefore, the adoption of effective coping strategies can equip them to navigate the difficult and stressful situations encountered in their daily lives. Objectives: The primary objective of this study was to assess the coping strategies employed by family caregivers of patients with chronic mental disorders who were receiving care at psychiatric centers in Isfahan, Iran. Methods: This descriptive-analytical study involved 188 family caregivers of individuals with mental disorders selected through convenience sampling. Data were collected using a demographic characteristics form and the Endler and Parker Coping Inventory for Stressful Situations – Short Form (CISS-SF). The relationship between demographic variables and coping strategy scores was analyzed using independent t-tests, one-way analysis of variance (ANOVA), and Pearson and Spearman correlation tests in SPSS v. 20. Results: The results revealed that 55.1% of family caregivers utilized emotion-oriented coping strategies, 30.3% employed problem-solving coping strategies, and 14.6% adopted avoidance coping strategies. Furthermore, there was no significant relationship between the types of coping strategies and any of the demographic variables (P &gt; 0.05). Conclusions: Given the findings of this study, which suggest that family caregivers tend to use ineffective coping strategies, it is imperative to implement preventive and psychological interventions aimed at enhancing the utilization of problem-oriented coping strategies within this group.

Augmenting predictive models in forensic psychiatry with Cultural Consensus Theory

Abstract Forensic psychiatric hospitals regularly monitor the mental health and forensic risk factors of their patients. As part of this monitoring, staff score patients on various items. Common practice is to aggregate these scores across staff members. However, this is suboptimal because it assumes that assessors are interchangeable and that patients are independent. An improvement over averaging scores is the use of Cultural Consensus Theory (CCT), which imposes a hierarchical model across patients, staff members, and items. While accounting for differences between patients and staff members, CCT estimates a ‘true’ score for each patient on each item based on the consensus among staff members. Here, we apply a CCT model to data from a Dutch maximum-security forensic psychiatric centre and use the inferences to predict violent behaviour in patients. The CCT model outpredicts several alternatives, such as random forest and boosted regression trees, albeit by a small margin. We discuss practical limitations and directions for how future monitoring of patients could be adapted to maximize the added value of a CCT-based approach.

Decrease in alcohol use disorder hospitalizations in Brazil: what does it mean?

To analyze the trend of hospitalizations for alcohol use disorder (AUD) in Brazil, by region, and establish its relationship with mental health care facilities. Data were collected through the Brazilian Unified Health System's (SIH/SUS) Hospital Information System (Sistema de Informação Hospitalar) and the National Register of Health Establishments of Brazil (Cadastro Nacional de Estabelecimentos de Saúde [CNES]). We used linear regression models to estimate the effect of SUS psychiatric beds and Center for Psychosocial Care (Centro de Atenção Psicossocial [CAPS]) numbers on AUD hospitalizations. From 2015 to 2020, 298,735 hospitalizations for AUD were recorded. Most of the patients admitted for AUD were male (88.8%). Individuals aged 60 years and older accounted for 11.7% of our cohort. The highest concentration of hospitalizations occurred in the South region (40.1%). The rate of hospitalizations per hospital bed remained relatively constant. The number of CAPS has a negative effect on SUS psychiatric beds in Brazil (average effect -22.31 [95% confidence interval {95%CI} -26.92, -17.70]). Psychiatric beds have a positive effect on AUD hospitalizations in the country (average effect 1.82 [95%CI 0.91, 2.74]). Prioritization guidelines for other forms of care are associated with a decrease in hospitalizations for AUD, so we highlight the importance of adequate training of health care professionals for proper referral of these patients to hospital admission when necessary.

Effectiveness of Recovery-Oriented Cognitive Therapy on Depression Symptoms and Interpersonal Relationships in Patients with Schizophrenia

Background and Objective: The aim of this study was to examine the effectiveness of recovery-oriented cognitive therapy on depression symptoms and interpersonal relationships in patients with schizophrenia. Methods and Materials: The research method was quasi-experimental with a pre-test, post-test, and follow-up design with a control group. The statistical population of the present study included all schizophrenic patients admitted to psychiatric residential centers in Tehran in 2023. The sample size consisted of 30 individuals (15 in the experimental group and 15 in the control group) selected by convenience sampling and assigned to two groups. For the experimental group, recovery-oriented cognitive therapy was administered, while the control group remained on the waiting list. Research instruments included the Beck Depression Inventory (Beck, 1987) and the Interpersonal Skills Questionnaire (Manjamizadeh, 2012). Findings: The results showed that recovery-oriented cognitive therapy had a significant impact on depression symptoms and interpersonal relationships in the post-test and follow-up phases. Conclusion: The findings of this study provide useful information regarding recovery-oriented cognitive therapy, and psychologists and psychiatrists can use this intervention to improve depression symptoms and interpersonal relationships in patients with schizophrenia.

Awareness and utilization of complimentary and alternative medicine (CAM) therapies in managing mentally ill patients at Dorayi psychiatric rehabilitation center, Kano, Nigeria

Awareness and utilization of complimentary and alternative medicine (CAM) therapies in managing mentally ill patients at Dorayi psychiatric rehabilitation center, Kano, Nigeria