Psychiatric Perspective Research Articles

An Examination of CACREP Curriculum Standards From a Psychiatric Rehabilitation Recovery Model Perspective

PurposeThis article compares disability-related social justice, inclusion, and psychiatric rehabilitation recovery model principles with the Council for Accreditation of Counseling and Related Educational Programs (CACREP, 2016) counseling curriculum standards in order to clearly articulate areas in the current standards that need revisions.MethodWe conducted a structured analysis of the CACREP curriculum standards in light of the Psychiatric Rehabilitation Association's 12 principles and values.ResultsSections of the CACREP curriculum standards are very beneficial for RC education, such as the additional emphasis on Diagnostic and Statistical Manual 5 (DSM-5) diagnoses, human development theories, crisis intervention, trauma-informed strategies, and the use of evidence-based counseling practices. Standards emphasizing the importance of client autonomy and respect, quality of life, community inclusion, advocacy, access, and evidence-based recovery model approaches need to be strengthened. The term “disability” does not currently appear in the eight core curriculum standards.ConclusionsThe authors offer specific course materials and activities that rehabilitation counselor (RC) educators can begin to incorporate into the design of their curriculum in order to better infuse ethical, social justice, disability inclusion, and recovery model principles into required coursework. Recommendations for changes to the CACREP curriculum standards are discussed.

Beyond antidepressant effects of deep brain stimulation – A systematic qualitative approach

BackgroundIn the field of psychiatric disorders Deep brain stimulation (DBS) is an experimental treatment method for which not all causes and (long-term) effects have yet been clarified. Especially in this experimental stage any kind of information is necessary for an efficient use of this treatment method. MethodHere, an interdisciplinary research approach was used to uncover blind spots of one's own research perspective. To this end, a psychological and psychiatric perspective was expanded including a sociological research approach. Within this sociological qualitative perspective, 524 pages of research material were generated, consisting of observation protocols and sketches as well as qualitative interviews with patients (N = 17) and the research team (N = 7). The data collection and field phase started in 03/2014 and ended in 07/2016, within FORESEE I and FORESEE II study (ClinicalTrials.gov Identifier: NCT01095263; NCT01778790). ResultsTwo central concerns of the patients became visible: On the one hand, the striving for normality with the focus on the stimulation settings. On the other hand, the desire for self-regulation by means of technology in the event of a deterioration in mood. In addition, almost all patients report that they do not feel the technique and do not feel externally determined by the technique. ConclusionRegarding the focus of the current ethical-philosophical debate about potential external control and external determination by technology, this aspect was no issue for the patients interviewed. Accordingly, we propose to use this as an important source for add-on in future studies.

Perceiving those who are gone: Cultural research on post-bereavement perception or hallucination of the deceased.

Experiencing the continued presence of the deceased is common among the bereaved, whether as a sensory perception or as a felt presence. This phenomenon has been researched from psychological and psychiatric perspectives during the last five decades. Such experiences have been also documented in the ethnographic literature but, despite the extensive cross-cultural research in the area, anthropological data has generally not been considered in the psychological literature about this phenomenon. This paper provides an overview aimed at bridging these two areas of knowledge, and approaches the post-bereavement perception or hallucination of the deceased in cultural context. Ongoing debates are addressed from the vantage point of ethnographic and clinical case study research focusing on the cultural repertoires (in constant flux as cultures change) from which these experiences are labelled as desirable and normal, on the one hand, or as dangerous and pathological, on the other.

Oral dysesthesia with a psychiatric perspective

Oral dysesthesia defines unusual sensation like inexplicable tingling sensation that could not be explained by organic causes, foreign body feeling, taste changes, oral burn, and pain in the oral area. Burning mouth syndrome, atypic odontalgia, persistent idiopathic facial pain are considered a variant of oral dysesthesia and they are characterized by pain in the orofacial area and abnormal sensation. Many of the oral dysesthesia and variants are idiopathic and the underlying pathogenesis is not yet clear. It has been shown that it can coexist with many psychiatric diseases, especially somatoform disorder. Despite the frequency of psychiatric comorbidity, patients with oral dysesthesia apply to non-psychiatric branches, especially dental clinics, and possible psychiatric diagnoses may be skipped. This can cause symptoms to become chronic. In this regard, patients with oral dysesthesia and their complaints also need to be handled psychiatricly.

Disorders due to substance use or addictive behaviours in the ICD-11

Disorders due to substance use or addictive behaviours in the ICD-11 Abstract. This paper concerns the revised classification of Substance-Related and Addictive Disorders in the 11th edition of the International Classification of Diseases (ICD-11) of the World Health Organization. The revision of the ICD serves to reflect changes in the understanding and diagnosis of addictive disorders and the need to improve clinical applicability. Regarding substance-related and non-substance-related addictive disorders, considerable innovations were introduced compared to the previous version. Major innovations include an expanded range of substance classes, significant adjustments (i. e., simplifications) in the conceptual and diagnostic guidelines of substance-related disorders, particularly "substance dependence", the introduction of the category of "addictive behaviour," and, associated with this, the assignment of "gambling disorder" to the addictive disorders, and the inclusion of the new (screen-related) "gaming disorder." In addition, for the first time the ICD catalogue includes an expansion of diagnostic options for early, preclinical phenotypes of addiction disorders ("Episodic Harmful Use"). This article summarizes the changes in the field of addiction disorders and discusses them from a child and adolescent psychiatric perspective.

Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates.

BackgroundPatients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses.MethodsWe used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained.ResultsThere were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes ‘excessive.’ The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features.ConclusionsThe concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.

THE RELATIONSHIP BETWEEN PERSONALITY DISORDERS AND DOMESTIC VIOLENCE IN FORENSIC CONTEXT

Aim, methods and outcomes. In this research, the mediators of domestic violence were approached from psychological, psychiatric, and forensic theoretical-experimental paradigm perspective, but also by studying working hypotheses issue regarding correlations between mediators (personality disorders) and participants’ behavioral output from experimental perspective. The research included 3 samples: 2 control samples and one experimental sample. These are part of the Institute of Forensic Medicine of Cluj-Napoca database. The gross results of examined patients revealed psychiatric morbidity and co-morbidity, personality disorders and psychiatric disorders absence at the time of forensic psychiatric examination. Results. The following statistical data were obtained from a total of N120 respondents: significant results were obtained (GVD, GDD and GM) F = 25,465, Sig. 0,000 in multiple comparisons using the ANOVA method on independent samples; significant results were obtained for mixed analysis of variance ANOVA two-way on GVD and GM groups F 25,465, Sig. 0.000; and good results weren’t obtained for GVD and GDD groups F 0.453, Sig. 0.503; whereas no significant results were obtained for the Test of Homogeneity of Variances Levene Statistic 0.295 and Sig. 0,589; and significant scores of KMO 0.477 and Sig. 0.000 were obtrained to the statistical method KMO and Bartlett’s Test regarding the eligibility of study participants. Clinical implications and Conclusion. Our research confirms the transdiagnostic approaches from literature perspective about the eight variables of criminal risk regarding domestic violence: history of deviant behavior, antisocial personality pattern, psychopathological cognitive schemas, parental antisocial model, education/ work, leisure / recreation, substances abuse. The correlation/ mediator of domestic violence is the morbidity/ co-morbidity of personality disorders. Our proposal is developing new assessment tools and testing mental and personality disorders in order to be used effectively within the forensic psychiatric committees.

The COVID-19 pandemic from an acute psychiatric perspective: a London psychiatric intensive care unit experience.

The COVID-19 pandemic has put the UK's National Health Service under extreme pressure, and acute psychiatric services have had to rapidly adapt to a new way of working. This editorial describes the experience of a London psychiatric intensive care unit (PICU) where all nine in-patients ultimately tested COVID-19 positive.

MP59: Exploring adverse events in boarded psychiatric patients in Calgary zone adult emergency departments

Introduction: Adult Emergency Departments (EDs) in Calgary are facing a crisis of boarded patients admitted to psychiatric in-patient units. In psychiatric emergency care, “boarding” describes the holding of patients in the ED after the decision to admit has been made by a staff psychiatrist and a bed request has been submitted. Literature review suggests psychiatric patients face exorbitantly higher boarding times than any other service in the hospital however little is published on the nature of these adverse events. Examples of adverse patient events from a psychiatric perspective could include: the need to initiate mechanical and/or chemical restraints after admission and while still in the ED, attempts to self-harm, and verbal and physical assault on ED staff. Methods: This study quantifies the incidence of adverse events experienced by psychiatric patients while boarded in the ED. It uses a retrospective chart review of all adult psychiatric patients, age 18 - 55yo, who presented to one of four adult EDs and who were admitted to a psychiatric in-patient unit in the Calgary Zone between January 1, 2019 and May 15, 2019. A randomly generated convenience sample identified 200 patients, 50 from each site, for in-depth review. Results: During the study time period, 1862 adult patients were admitted from emergency departments to the psychiatry service across all four sites. Of the 200 charts reviewed, patients ranged in age from 26-41 (average 34). 52.5% were male with the majority being admitted to a non-high observation bed. The average boarding time was 23.5 hours with an average total ED length of stay of 31 hours for all comers. Those who experienced an adverse event while boarded in the ED experienced a significantly prolonged average boarding time (35 hours) compared to those who did not experience an adverse event (6.5 hours) (p = 0.005). Significant adverse events were associated with the specific hospital site and the type of admission bed needed (high observation versus normal versus short stay) (p < 0.05). Conclusion: Psychiatric patients boarded in Calgary EDs experience a number of significant adverse events. The importance of understanding the reality of the conditions that psychiatric ED patients face while waiting for in-patient placement cannot be overstated. This study is important to emergency medicine as it will allow for deeper understanding of the patient experience while in the ED and identifies areas that may require further advocacy amongst ED staff and our psychiatry colleagues.

What's Important: A Call for a Preoperative Psychiatric Risk-Assessment Metric for Orthopaedic Surgery.

What's Important: A Call for a Preoperative Psychiatric Risk-Assessment Metric for Orthopaedic Surgery.

How does ayahuasca work from a psychiatric perspective? Pros and cons of the entheogenic therapy.

Ayahuasca is a hallucinogenic plant preparation, traditionally consumed in sacred ceremonies by indigenous North-Westerner Amazonian countries like Colombia, Peru, Brazil, and Ecuador. It is fundamental to carefully balance benefits/risks related to the ayahuasca intake, both during ceremonies and experimental settings. The aim is at evaluating and comparing the potential therapeutic benefits versus health risks related to ayahuasca intake (both acutely and chronically), focusing on its application in psychedelic psychiatry. A comprehensive mini overview focusing on psychiatric outcomes following ayahuasca intake both in healthy volunteers and in clinical samples. Preclinical, observational, and experimental studies in healthy volunteers as well as in clinical samples suggest that ayahuasca may be beneficial as an antidepressant, emotional regulator, anxiolytic, and antiaddictive drug, by exerting fast-acting and enduring clinical effects. Ayahuasca appears to be safe and well tolerated, nausea and emesis being the most reported and transient side effects. Some findings suggest not to use ayahuasca in bipolar or psychotic patients because of an increased risk of manic switch and/or psychotic onset. Further research should be carried out in randomized, double-blind, placebo-controlled trials, by implementing neuroimaging studies, in order to better evaluate therapeutic potential of ayahuasca in mental disorders.

Increasing the Clinical Psychiatric Knowledge Base About Pathogenic Copy Number Variation.

Specific copy number variants (CNVs) have been robustly associated with intellectual disability, autism, and schizophrenia. Most of the literature focus has been on documenting the existence of these phenomena. There are few data to guide therapeutic choices for these “orphan” diseases. We call for systematic and longitudinal case reports which, if carefully conducted, may provide crucial initial knowledge to guide therapeutics. We provide a step-by-step overview, a tailored set of consensus criteria for high-quality case reports, and a specific set of learning resources.

The assessment of self-esteem: a psychiatric perspective.

The assessment of self-esteem: a psychiatric perspective.

COVID-19, Social Distancing: Mental Health Implications for Children, Adolescents, and Families – Pediatric and Psychiatric Perspectives

COVID-19 is creating a mental health crisis among children and youth around the globe. At the time of this writing, more than 1.5 billion, i.e., 91% of the world's students are out of school. The pandemic is raising fears, and causing clinginess, distraction, irritability, anxiety, depression, lethargy, impaired social interaction, and reduced appetite. Adolescents are at higher risk for depression, anxiety, distress, low self-esteem, substance use disorder, and suicide. Mental health consequences of the pandemic can be categorized as adjustment disorders, reactions to social isolation, reactions to family and family events, violence against women and children, and intensification of preexisting mental health conditions. Major challenges are being experienced by those struggling with attention-deficit hyperactivity disorder, autistic spectrum disorders, medical complications, posttraumatic stress disorder, and other conditions. After a short description of each category, we provide case examples, which, though fictitious, bear sufficient resemblance to real-life situations encountered in our daily practice to serve as useful vignettes. The mental health community, social psychiatrists and pediatricians, and other health-care providers should take an active role to address these serious issues.

Fibromyalgia from the Psychiatric Perspective

Fibromyalgia from the Psychiatric Perspective

Work and childrearing in eating disorders : a psychiatric perspective

Work and childrearing in eating disorders : a psychiatric perspective

Management of Rehabilitation needs of "Unknown" Traumatic Brain Injury Survivors: A Medical and Psychiatric Social Work Perspective.

Traumatic brain injuries [TBI] caused by road traffic accidents [RTA] are a serious health problem for people of all countries across the globe. RTA will be a leading cause of mortality, morbidity, disabilities and creating many rehabilitation needs. Hence, this, article highlights the clinical concerns, burden, challenges, role of medical and psychiatric social worker, rehabilitation strategies and practical guidelines needed for successful rehabilitation of the unknown and abandoned TBI survivors.

A Forensic Psychiatric Perspective on the Draft Mental Health Act of Turkey in Light of Similar Laws and Practice in a Foreign Jurisdiction

Designated Acts for issues related to mental health are in force in many countries throughout the world. A mental health act is also expected to be approved in Turkey soon. Under the leadership of the Psychiatric Association of Turkey, non-governmental organizations operating in the field of mental health has contributed to the emergence of a comprehensive draft. The current draft, after extensive discussion and reiterations for almost a decade, was brought to a state close to its final form and accepted as a draft bill, ready to be legislated in the Turkish Grand National Assembly. This review will discuss the potential impact of the law in matters involving Forensic Psychiatry, and present our recommendations. Current draft, which has not yet been finalized, was compared to similar statutes in Massachusetts, USA, and potential benefits and pitfalls were discussed in light of experience with these laws in this jurisdiction. The draft introduces several new concepts and practices which have never existed in Turkey before. It also attempts to organize some of the existing de facto clinical practices in a uniform manner. As a whole, it appears to be in compliance with human rights and related international treaties. However, it is likely that some of the sections might have compliance issues in daily practice. In this review, we aimed to draw attention to a number of issues, based on our experience in Massachusetts, USA, where similar laws have been in force for a very long time. Rather than literally comparing the statutes in both jurisdictions, we attempted to emphasize positive aspects as well as likely problems that we might encounter should Turkish draft be legislated in the present form.

Psychiatry and Fitness to Fly After Germanwings.

In March 2015, a co-pilot flying Germanwings Flight 9525 deliberately pointed his airplane into a descent, killing himself, five other crew members, and 144 passengers. Subsequent investigation and review teams examined the incident and considered potential lessons to maximize air safety. In this article, aviation industry clinical leaders, including the U.S. Federal Air Surgeon and Chief Psychiatrist from the Federal Aviation Administration (FAA), along with a professional pilot and collaborating forensic psychiatrists, discuss suicide-by-plane, evolving themes related to public safety responsibilities for psychiatrists treating pilots, and forensic trends in pilot evaluation for medical certification from an aerospace psychiatric perspective. We explore how psychiatric aspects of pilot fitness and aviation safety are examined across perspectives, including unsafe acts, preconditions, organizational factors, and unsafe supervision. We explore practices for civilian pilots and offer information related to military pilot fitness. Lessons from Germanwings are presented, as is the need for increased support for pilots who might be concerned about revealing mental health challenges for fear of loss of medical certification and pilot employment. The Air Line Pilots Association Pilot Assistance Network is highlighted as one example of pilots supporting pilots to increase airway safety.

PEMULIHAN TERPIDANA PENGGUNA NARKOBA DI PUSAT YAYASAN REHABILITASI NARKOBA AR-RAHMAN PALEMBANG

Drug abuse problems have broad and complex dimensions, both from the medical, psychiatric, mental health and psychosocial perspectives. The use of drugs can damage the order of family life, the environment of the community and the school environment, even directly or indirectly a threat to the sustainability of development and the future of the nation and the State. The results in this study are in rehabilitating the Ar-Rahman foundation using emphasis on four main aspects, namely the recovery of physical, mental, spiritual and emotional. The recovery program for 6 months, in the reception of residents or addicts, does not limit the related services such as the BNN, but the family and the community play an important role, the majority of residents at the ArRahman foundation enter with coercion from their parents or family and. From the results of research conducted related to social rehabilitation of drug abuse carried out by the ArRahman Drug Rehabilitation Foundation, it has helped in returning or repairing addicts from drug dependence so that they can re-function as social beings. This is in accordance with the objectives of Islamic law or MaqashidShari'ah to maintain reason. Therefore rehabilitation can be done.