Psychiatry Clinic Research Articles

Investigation of Nurse's Knowledge and Practices to Assess the Metabolic Syndrome Risks of Patients Treated in Psychiatry Clinics

Investigation of Nurse's Knowledge and Practices to Assess the Metabolic Syndrome Risks of Patients Treated in Psychiatry Clinics

Sociodemographic and Clinical Characteristics of Delinquent Children and Factors Associated with Recidivism

Introduction: Many studies have shown that the prevalence and rate of delinquency in adolescents tends to increase during adolescence and decreases rapidly from the 20s to the early 30s. Juvenile delinquency is considered as a serious social problem because it is often occurs at a young age, is repeated and is often committed as a group. In this study, we aimed to investigate the demographic and clinical characteristics of children between the ages of 12 and 18 who engage in delinquent behavior and the factors that contribute to recidivism. Methods: Children between the ages of 12 and 18 who were referred by the judicial authorities for alleged crimes were included in the study. The files of the children were reviewed retrospectively. Age, gender, psychiatric diagnoses, types of crimes, intelligence levels, family history of crime, number of crimes were evaluated and the factors associated with recidivism behaviors were investigated. Results: A total of 91 children referred by the judicial authorities to the outpatient clinic for child and adolescent psychiatry were included in the study. The average age of the children at the time of the offense was 14.10±1.25 years and 87 (95.6%) were boys and 4 (4.4%) were girls. At least one active psychopathology was found in 38 (41.8%) of the cases. The most frequent psychiatric disorders among the psychopathologies during the study were attention deficit hyperactivity disorder in 19 (50.0%) children and conduct disorder in 17 (44.7%) children. The presence of a family criminal history (p=0.024), school attendance (p

Reconfiguration of Structural and Functional Connectivity Coupling in Patient Subgroups With Adolescent Depression

Adolescent major depressive disorder (MDD) is associated with serious adverse implications for brain development and higher rates of self-injury and suicide, raising concerns about its neurobiological mechanisms in clinical neuroscience. However, most previous studies regarding the brain alterations in adolescent MDD focused on single-modal images or analyzed images of different modalities separately, ignoring the potential role of aberrant interactions between brain structure and function in the psychopathology. To examine alterations of structural and functional connectivity (SC-FC) coupling in adolescent MDD by integrating both diffusion magnetic resonance imaging (MRI) and resting-state functional MRI data. This cross-sectional study recruited participants aged 10 to 18 years from January 2, 2020, to December 28, 2021. Patients with first-episode MDD were recruited from the outpatient psychiatry clinics at The First Affiliated Hospital of Chongqing Medical University. Healthy controls were recruited by local media advertisement from the general population in Chongqing, China. The sample was divided into 5 subgroup pairs according to different environmental stressors and clinical characteristics. Data were analyzed from January 10, 2022, to February 20, 2023. The SC-FC coupling was calculated for each brain region of each participant using whole-brain SC and FC. Primary analyses included the group differences in SC-FC coupling and clinical symptom associations between SC-FC coupling and participants with adolescent MDD and healthy controls. Secondary analyses included differences among 5 types of MDD subgroups: with or without suicide attempt, with or without nonsuicidal self-injury behavior, with or without major life events, with or without childhood trauma, and with or without school bullying. Final analyses examined SC-FC coupling of 168 participants with adolescent MDD (mean [mean absolute deviation (MAD)] age, 16.0 [1.7] years; 124 females [73.8%]) and 101 healthy controls (mean [MAD] age, 15.1 [2.4] years; 61 females [60.4%]). Adolescent MDD showed increased SC-FC coupling in the visual network, default mode network, and insula (Cohen d ranged from 0.365 to 0.581; false discovery rate [FDR]-corrected P < .05). Some subgroup-specific alterations were identified via subgroup analyses, particularly involving parahippocampal coupling decrease in participants with suicide attempt (partial η2 = 0.069; 90% CI, 0.025-0.121; FDR-corrected P = .007) and frontal-limbic coupling increase in participants with major life events (partial η2 ranged from 0.046 to 0.068; FDR-corrected P < .05). Results of this cross-sectional study suggest increased SC-FC coupling in adolescent MDD, especially involving hub regions of the default mode network, visual network, and insula. The findings enrich knowledge of the aberrant brain SC-FC coupling in the psychopathology of adolescent MDD, underscoring the vulnerability of frontal-limbic SC-FC coupling to external stressors and the parahippocampal coupling in shaping future-minded behavior.

The symptoms and management of children with attention-deficit/hyperactivity disorder during COVID-19 pandemic at the child and adolescent psychiatry clinic, King Chulalongkorn Memorial Hospital

The symptoms and management of children with attention-deficit/hyperactivity disorder during COVID-19 pandemic at the child and adolescent psychiatry clinic, King Chulalongkorn Memorial Hospital

Development and Evaluation of a Training Program for Mental Health Clinicians in Evidence-Based Eating Disorders Treatment

ABSTRACT Mental health clinicians working in outpatient clinics frequently receive little to no training in the treatment of pediatric eating disorders. This dearth of training has led to insufficient access to care for these critically ill patients in their communities. The goal of this study was to describe the development and evaluation of a novel training program for mental health clinicians. Five clinicians working in an outpatient psychiatry clinic within an academic medical center were enrolled in a six-month training program. Their comfort/competence in the delivery of eating disorder treatment and overall knowledge around diagnosis and treatment of eating disorders was evaluated at baseline, one month, and six months. Clinicians reported their comfort in making the diagnosis of an eating disorder went from low or very low pre-training to moderate or high at six months. Further, they rated their comfort with providing the necessary treatment for patients with eating disorders as low or very low pre-training compared to moderate or high at six months. These clinicians were able to regularly incorporate eating disorder patients on their caseloads, thus increasing access to care in the clinic. Future training would benefit from more experiential learning and ongoing institutional support to prevent drift from evidence-based treatments for mental health clinicians working with eating disorder patients.

Our Newspaper as Care: Narrative Approaches in Fanon's Psychiatry Clinic.

This paper argues that the newspaper Notre Journal enshrined the importance of narrative in the revolutionary psychiatry of its founder and editor, Frantz Fanon. Anchoring my analysis in the interdisciplinarity of the medical humanities, I demonstrate how care at Hôpital Blida-Joinville in colonial Algeria was mediated by the written word. I examine Fanon's physician writing and editorial texts detailing the use of narrative approaches in the clinic. As an object of care, Notre Journal's promotion of psychic healing, social actions, and engaged professional practice shaped the interactions and experiences of patients and staff. Printed and distributed to the wider institution, the newspaper created community-during an oppressive French Occupation and at the outset of the War of Independence-in addition to nurturing creativity, curiosity, solidarity, and accountability. Still, Fanon would come to recognize the limits of narrative methods amidst cultural oral traditions, illiteracy, and divergent attitudes about narrating the self.

From genes to drugs: CYP2C19 and pharmacogenetics in clinical practice.

The CYP2C19 gene is frequently included in different pharmacogenomic panels tested in clinical practice, due to its involvement in the metabolism of a myriad of frequently prescribed medications. Accordingly, CYP2C19 genotyping can promote precise therapeutic decisions and avoid the occurrence of significant drug-drug-gene interactions in the clinical setting. A comprehensive examination of the role of the CYP2C19 gene in real-world medical settings is presented in this review. This review summarizes the most recent information on how genetic variants in CYP2C19 affect drug metabolism and therapeutic outcomes. It goes into the wide range of CYP2C19 phenotypes, with different degrees of metabolizing activity, and their implications for customized medication response through a review of the literature. The review also analyzes the clinical significance of CYP2C19 in several medical specialties, including cardiology, psychiatry, and gastro-enterology clinics, and illuminates how it affects pharmacological efficacy, safety, and adverse effects. Finally, CYP2C19-supported clinical decision-making is outlined, highlighting the possibility of improving therapeutic outcomes and achieving more affordable treatment options, a step towards optimizing healthcare provision through precision medicine.

Potential role of the lncRNA "HOTAIR"/miRNA "206"/BDNF network in the alteration in expression of synaptic plasticity gene arc and BDNF level in sera of patients with heroin use disorder through the PI3K/AKT/mTOR pathway compared to the controls

IntroductionHeroin use disorder (HUD) is a seriously increasing health issue, accounting for most deaths among drug abusers. Studying non-coding ribonucleic acid gene expression among drug abusers is a promising approach, as it may be used in diagnosis and therapeutics.Participants and methodsA total of 49 male heroin-dependent patients and 49 male control participants were recruited from Kasr Al Ainy Psychiatry and Addiction outpatient clinics, Faculty of Medicine, Cairo University. Sera were gathered. qRT-PCR was utilized for the detection of gene expression of non-coding RNAs such as "HOX transcript antisense RNA" (HOTAIR), micro-RNA (miRNA-206), phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT), mechanistic target of rapamycin (mTOR), and Activity Regulated Cytoskeleton Associated Protein (Arc). Sera Brain-Derived Neurotrophic Factor (BDNF) levels were assessed using ELISA. Using a western blot made it possible to determine the protein expression of PI3K, AKT, and mTOR.ResultsThe study demonstrated that gene expressions of HOTAIR, AKT, PI3K, and Arc were considerably lowered between cases and controls, while gene expressions of miR-206 and mTOR1 were significantly raised. PI3K and AKT protein expressions were downregulated, while mTOR expressions were upregulated. BDNF levels were significantly decreased in some cases.ConclusionThe results of this study suggest that decreased HOTAIR in HUD relieves miR-206 inhibition, which thus increases and affects downstream PI3K/AKT/mTOR, ARC, and BDNF expression. This may be shared in addictive and relapsing behaviors.Graphical

Prevalence of Enuresis in Children, Adolescents, and Young Adults Diagnosed With Attention Deficit Hyperactivity Disorder.

Background Enuresis, or bedwetting, is a common condition affecting millions of children worldwide. This can be a source of distress for both children and their families. Children, adolescents, and young adults with attention deficit hyperactivity disorder (ADHD) are at risk of developing enuresis. They have difficulties with executive functioning, including impulse control and emotional regulation. These difficulties may contribute to the development of enuresis, as individuals may struggle to recognize the urge to use the bathroom or have difficulty controlling their bladder during sleep. Objective To assess the prevalence of enuresis in children, adolescents, and young adults with ADHD and determine whether the presence of other behavioral disorders such anxiety, depression, learning disabilities, and autism comorbid with ADHDis a risk factor for developing enuresis. Method A case-control studyincluded 213 children, adolescents, and young adults aged seven to 23 years, with 139 males and 74 females. A total of 161 participantswere diagnosed with ADHD. Data collection consisted of a semi-structured interview conducted with each participant or theirparents in person during their visit to Developmental Pediatric Clinics and Psychiatry Clinics. The questions were designed to collect data on the participant's ADHD diagnosis, enuresis history, other behavioral disorders, such as anxiety, depression, and learning difficulties, and any relevant medical or developmental history. The interview lasted approximately 30 minutes. Results Children, adolescents, and young adults with ADHD had a significantly higher prevalence of enuresis than the control group (13.6% vs. 0.9%, p = 0.01). Other behavioral disorders comorbid with ADHD did not pose a statistically significant risk for the development of enuresis (p = 0.36). Conclusions This study supports that children, adolescents, and young adults diagnosed with ADHD are more likely to have enuresis than those without ADHD. This finding is consistent with previous research and emphasizes the importance of a thorough evaluation and comprehensive treatment plan for individuals with ADHD.

Impact of Pharmacogenomics on Pediatric Psychotropic Medication Prescribing in an Ambulatory Care Setting.

Objective: Evidence for pharmacogenomic (PGx) guided treatment in child and adolescent psychiatry is growing. This study evaluated the impact of PGx testing on psychotropic medication prescribing in an ambulatory child and adolescent psychiatry and a developmental pediatrics clinic. Methods: This was a single-center, retrospective, descriptive analysis of patients who underwent PGx testing between January 2015 and October 2022 at a child and adolescent psychiatry clinic or developmental pediatrics clinic. The primary outcome was the proportion of patients with at least one psychotropic medication modification made 6-month posttesting that could be attributed to CYP2C19, CYP2D6, HLA-B*15:02, or HLA-A*31:01. Secondary outcomes included reason for testing, types of therapeutic modifications made, and whether the therapeutic modifications concorded with PGx guidelines. Results: A total of 193 patients were analyzed. The average age was 10 ± 4 years old, 60% were male, 78% were Caucasian. Sixty-eight percent had a primary diagnosis of a neurodevelopmental disorder, namely autism spectrum disorder (51%), and attention-deficit/hyperactivity disorder (14%). The reasons for PGx testing included medication inefficacy (34%), medication intolerance (20%), and family request (19%). At the time of PGx testing, 37% of patients were taking ≥1 psychotropic medication with PGx annotation. Overall, 35 PGx-related therapeutic modifications were made in 32 (17%) patients. These included continuing current PGx medication (6.2%) and starting PGx medication (5.2%). These modifications mainly involved antidepressants. Out of these 35 PGx-related therapeutic modifications, 94% were concordant with PGx guidelines. Among 29 patients who were prescribed at least one CYP2D6 inhibitor, 25 (86%) underwent CYP2D6 phenoconversion. Conclusions: It is critical to apply pediatric age-specific considerations when utilizing PGx testing in child and adolescent psychiatry. PGx testing stewardship could provide a framework to guide the clinical utility of PGx in a pediatric population with mental health conditions, including neurodevelopmental disorders.

Evaluation of patients under the age of 18 who applied to an adult psychiatric policy clinic

Aims: The aim of this study is to evaluate the sociodemographic data and diagnoses of patients under the age of 18 who applied to an adult psychiatry clinic . Methods: 311 applicants under the age of 18 who applied to the adult psychiatry outpatient clinic of our hospital between January 2020 and December 2022 were included in the study. has been included . Sociodemographic data and diseases were evaluated retrospectively. Results: Of the 309 applicants in total, 194 ( 62.8 % ) were girls and 115 (37.2%) were boys. Considering the ages, 12.3 % of the applications were 15 years old and under, and 86.7% were over 15 years old. The psychiatric diagnosis rate was 84.5 % when both genders were evaluated . This rate was 86.5 % for girls and 82.6% for boys. Looking at the most common diagnoses in total; Diagnosis of anxiety disorders (21.7%), depressive disorder (21.7%), and activity and attention disorders (15.2%) were in the top 3 ranks . Conclusion: This study is important as it is the first study on adolescent patients admitted to an adult psychiatric service in our city. It is thought that these findings may guide interventions in the field of child and adolescent psychiatry.

Abstract C001: A pilot study of palliadelic treatment with psilocybin to reduce psychological distress and improve quality of life in patients with advanced pancreatic adenocarcinoma

Abstract Background: Psychological distress is a common reaction to a cancer diagnosis and its treatment. Distress impacts quality of life, adherence to treatment, decision making and survival. Patients with pancreatic adenocarcinoma (PDAC) experience exceptionally high rates of psychological distress, most commonly depression, anxiety and suicidality. Psilocybin, a serotonergic psychedelic which is the active component in “magic mushrooms,” is a promising treatment for several mental health disorders. Prior studies in patients with cancer have combined a single dose of psilocybin with preparation and integration counseling and have shown significant, rapid and sustained improvement in depression, anxiety and quality of life. These studies have primarily been conducted in psychiatry or neuroscience clinics in heterogenous groups of patients, many of whom had completed cancer treatment. This study will evaluate the feasibility and safety of psilocybin-assisted therapy delivered in the outpatient palliative care clinic in patients with advanced PDAC who are receiving chemotherapy. Methods: This is a single center, open label pilot study of a psilocybin-assisted therapy integrated with palliative care in patients with advanced PDAC. The primary endpoints are the feasibility and safety of this strategy when integrated into routine palliative care. Secondary endpoints include short term changes in depression, anxiety and demoralization and changes in neuronal activity by functional MRI (fMRI). After 2-4 outpatient preparation sessions with a palliative medicine physician (PMP), the subject will take psilocybin (25mg capsule) at an individual session supported by a PMP and a trained mental health professional. Up to 3 integration sessions with a PMP will follow. Patient-reported measures of psychological distress and quality of life will be assessed at baseline, after the psilocybin dose and periodically during follow-up. Neuronal changes will be measured using fMRI before and after the psilocybin dose. Eligible patients are adults (ECOG 0-3) with advanced PDAC with adequate organ function. Patients with psychiatric conditions which preclude safe cessation of psychotropic drugs or requires hospitalization, a personal or family history of schizophrenia, psychotic disorder or bipolar disorder, who have a high risk of suicide or have serious or uncontrolled hypertension or cardiovascular disease are ineligible. Given the exploratory nature of the study, a formal statistical assessment of the sample size was not conducted. Twelve evaluable subjects will provide sufficient power to detect large effect sizes (Cohen’s d1.0) in the secondary endpoints. Wilcoxon signed rank test will determine the reduction in distress scores before and after the psilocybin session. Enrollment began in June 2023; two subjects have enrolled. The study is funded by the Jim Young Pancreatic Cancer Research Memorial Fund. Psilocybin is provided by Usona. ClinicalTrials.gov Identifier: NCT05220046 Citation Format: Kelsey A. Klute, Lou Lukas, Soonjo Hwang, Yeongjin Gwon, Mridula Krishnan, Jean Grem, Sunil Hingorani, Jody Koenig Kellas. A pilot study of palliadelic treatment with psilocybin to reduce psychological distress and improve quality of life in patients with advanced pancreatic adenocarcinoma [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr C001.

Challenges Faced by University of Limpopo Learner Nurses during Psychiatry Clinical Exposure: A Qualitative Study.

Clinical exposure of learner nurses to psychiatric hospitals is a requirement by the South African Nursing Council. Clinical experience helps learner nurses build cognitive and affective skills, cultural acculturation, and professional identity. The clinical placement also aids nursing learner nurses in making decisions regarding future career paths. The goal of psychiatric nursing practice is to enhance mental and physical health and improve the patient's quality of life and rehabilitation. A qualitative research approach was followed, and a descriptive, explorative, and contextual design was used in this study to explore the challenges faced by University of Limpopo learner nurses during psychiatry clinical exposure. The population included learner nurses from level two to level four who registered for psychiatric nursing science practice. Convenience sampling was adopted. Semi-structured interviews were used to collect data, and the data were analyzed using the Tesch open coding method. Measures to ensure trustworthiness were adhered to, and ethical considerations were observed. The findings of this study indicated that learner nurses go through challenges and discomfort in the form of mental health care users, clinical environment matters, and the attitude of clinical staff in the hospital. Proper preparation of the learner nurses and clinical areas can assist in reducing the challenges that learner nurses go through.

Early Maladaptive Schemas and Their Associations with Perceived Parental Bonding among Adolescents Entering Specialized Health Care

Early maladaptive schemas (EMSs) have scarcely been studied in adolescents. The present study investigates EMSs in two clinical samples of 12–22-year-olds recruited from patients entering a specialized adolescent psychiatry clinic [n = 190] or a pediatric clinic [n = 119] in Finland. The endorsement of EMSs was compared between these samples, and the association of EMSs with perceived parental bonding was assessed. EMSs were assessed with the Young Schema Questionnaire-Short Form 2-Extended and particularly affectionless control parenting style with the Parental Bonding Instrument. The main analyses were conducted using general linear modeling. Significant differences existed between the two samples, with most EMSs and EMS domains being stronger in the adolescent psychiatry sample. The Disconnection and Rejection domain was associated with maternal affectionless control in the adolescent psychiatry sample and paternal affectionless control in the pediatric sample. The results provide novel findings of EMSs in adolescents and their links to parenting.

Investigating the Effectiveness of an Intervention Protocol Based on Grounded Theory on the Quality of Life and Worry of Patients with Irritable Bowel Syndrome

The present study aimed to investigate the effectiveness of an intervention protocol based on grounded theory on the quality of life and worry of patients with irritable bowel syndrome (IBS). The research method of the present study was mixed-methods, implemented in an exploratory design with a two-phase sequential strategy. The qualitative part of the research, considering its grounded theory basis, was phenomenological based on the Strauss and Corbin (1997) theory. The quantitative part employed a quasi-experimental method with a pretest-posttest control group design and a 2-month follow-up phase. The qualitative study population included books, articles, and theses in the field of IBS patients, and IBS patients visiting the Rāh-e Ehyā Psychiatry Clinic, Shahid Tajrish Hospital, and Behboud Gastroenterology Clinic in Tehran during the fall and winter of 2022. The quantitative study population consisted of all IBS patients visiting the Rāh-e Ehyā Psychiatry Clinic, Shahid Tajrish Hospital, and Behboud Gastroenterology Clinic in Tehran during the fall and winter of 2022. In the quantitative part, 28 IBS patients meeting the inclusion criteria were randomly assigned to either the control or experimental groups. Worry was measured using the Penn State Worry Scale. After eight intervention sessions, the research data were analyzed using repeated measures ANOVA and SPSS software, with a significance level of 0.05. The interaction effect of group×time for the components of physical health (η² = 0.157, P = 0.017, F = 4.85), psychological health (η² = 0.302, P = 0.001, F = 11.27), social health (η² = 0.234, P = 0.001, F = 7.96), and total quality of life score (η² = 0.362, P = 0.001, F = 14.72) was significant. Additionally, the effect of the independent variable on worry (η² = 0.352, P = 0.001, F = 14.15) was significant. The results indicated that the intervention protocol designed based on grounded theory is effective in improving the quality of life and reducing worry in patients with irritable bowel syndrome.

Assessing service usage and protective factors in a pediatric psychiatry clinic during the COVID-19 pandemic.

Youth with developmental and pre-existing mental health conditions have been particularly vulnerable to declines in psychological functioning during the COVID-19 pandemic. This study aimed to first, analyze service usage within an outpatient child and adolescent psychiatry clinic in the months preceding and during the COVID-19 pandemic, and second, to examine associations with potential protective factors against mental health concerns in a treatment-engaged sample. Service usage was examined using clinic billing data, and reports on protective factors were gathered via parent survey of 81 children ages 6-17 years who received mental health treatment in an outpatient psychiatry clinic during the pandemic. Protective factors were assessed at the individual, family, and community levels, and included children's use of coping strategies, parental resilience, and parents' perceived social supports. Study outcomes, including mental health concerns, mental health emergencies, pandemic-related distress, and social impact of the pandemic, were analyzed via Pearson correlations and simultaneous multiple linear regressions. Findings suggest increased service usage and child coping, parental resilience, and social connectedness as factors associated with fewer mental health concerns in youth with psychiatric concerns during the pandemic. This study lends support for expanding psychiatric services with continued use of telemedicine platforms. Further, findings suggest a mental health benefit to optimizing individual, parental, and community-based resources to enhance children's psychological functioning, particularly for youth with pre-existing mental health conditions.

Retrospective analysis of lithium treatment: examination of blood levels.

Lithium is a key medication for treating various neuropsychiatric disorders, with a narrow therapeutic index and significant drug interactions. Monitoring lithium blood levels is crucial. This study aims to investigate the relationship between lithium blood levels and demographic characteristics such as age and gender, as well as possible drug interactions, in patients with a history of lithium use who applied to various services and outpatient clinics. The files of 438 patients who were admitted to various services and outpatient clinics of Kırklareli Training and Research Hospital between January 1 and December 31, 2023, were retrospectively reviewed. Patients' blood lithium levels, gender, age, service/outpatient clinic they admitted to, other medications used, urea, creatinine, and eGFR values were recorded. When the demographic characteristics of 438 patients were examined, 62% were female (270), 38% were male (168), and the average age was 46.3 ± 14.8 years, showing a normal distribution. It was found that 192 patients (71 males, 121 females) had therapeutic lithium blood levels, while 244 patients (97 males, 147 females) had levels below 0.6 mmol/L. Two female patients had blood levels above the therapeutic range (1.23 and 1.43 mmol/L). Among the clinics and services, the four most frequented were the psychiatry clinic (314 patients), internal medicine clinic (36 patients), emergency service (27 patients), and medical oncology clinic (17 patients). Of the 314 patients admitted to the psychiatry clinic, 168 had therapeutic drug levels; only 7 of the 36 admitted to internal medicine had therapeutic levels; 12 of the 27 patients in the emergency service had therapeutic levels; and all 17 patients in medical oncology had levels below therapeutic limits. The data emphasize the importance of regular blood level monitoring to ensure lithium treatment's efficacy and patient safety. It is noteworthy that most patients in the psychiatry clinic had therapeutic drug levels, while those in other clinics had lower levels. In conclusion, this study highlights the importance of regular blood level monitoring to ensure the efficacy and safety of lithium treatment.

Patient Satisfaction with the Quality of Healthcare Services at Selected Major Outpatient Clinics at Sultan Ahmad Shah Medical Centre Kuantan Pahang

INTRODUCTION: Patient satisfaction is a key factor in determining any gaps or inadequacies in the healthcare provider's services. This study aimed to measure the level of patient satisfaction and its associated factors towards the healthcare service of outpatient clinics in Sultan Ahmad Shah Medical Centre (SASMEC), IIUM, Kuantan, Pahang. MATERIALS AND METHODS: A total of 1050 patients were recruited from internal medicine, paediatrics, surgery, obstetrics and gynaecology, orthopaedics, and psychiatry clinics between February 2021 and February 2022. A questionnaire was administered which consists of two parts: one that covers patients’ sociodemographic data and the other that assesses the patients’ level of satisfaction with the healthcare services using the Malay-validated Short-Form Patient Satisfaction Questionnaire (PSQ-18). RESULTS: The mean overall satisfaction level was 3.94 ± 0.46, with the highest mean scores in the interpersonal manners (4.2 ± 0.64) and communications (4.26 ± 0.56) domains. From the multivariate analysis, it was found that those patients in the lower income group (B40) were more satisfied with the quality of the healthcare services (B=0.172, 95% CI=0.08, 0.263) compared to the middle-income group. Being a student (B=- 0.202, 95% CI=- 0.296, -0.108) and having a follow-up treatment visit (B=-0.082, 95% CI=-0.156, -0.008), were significantly associated with lower satisfaction levels as compared to their counterparts. CONCLUSION: Overall, patients who attended SASMEC were satisfied with the service provided. Continuous service improvement aimed at patients’ household income, occupation and purpose of visit may help SASMEC enhance its service in the future

The Effectiveness of Schema Therapy on Impulsivity, Sexual Variety Seeking, and Anxiety in Borderline Patients

Objective: Borderline Personality Disorder (BPD) is a complex disorder associated with significant prevalence, mortality, and public health costs. This study aimed to determine the effectiveness of schema therapy on impulsivity, sexual variety seeking, and anxiety in borderline patients. Methods and Materials: This study was a clinical trial with pre-test, post-test, and follow-up along with a control group, conducted in a semi-experimental research design. The statistical population consisted of individuals with BPD who visited psychology and psychiatry clinics in Sari from April to June 2022 (N=172). The sample was selected using the convenience sampling method and included two groups of 10 participants each (experimental and control). The data collection tools were the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (First, Spitzer, Gibbon, &amp; Williams, 1997), Beck Anxiety Inventory (Beck &amp; Steer, 1990), Barratt Impulsiveness Scale (Fossati et al., 2002), and Sexual Variety Seeking Questionnaire (Aref-Nazari et al., 2011). Data were analyzed using repeated measures ANOVA with SPSS.22 software. Findings: The results indicated that schema therapy was effective in reducing impulsive behaviors (F=66.00, P&lt;0.001), sexual variety seeking (F=29.82, P&lt;0.001), and anxiety (F=3.00, P&lt;0.001) in borderline patients. Conclusion: It can be concluded that schema therapy is effective in reducing impulsivity, sexual variety seeking, and anxiety in borderline patients, and can be utilized to mitigate the psychological problems in these patients.

Comparison of Behavioral Systems and Thought Control in Individuals with Obsessive-Compulsive Disorder, Major Depression, Panic Disorder, and Healthy Individuals

Objective: The purpose of this study was to compare behavioral systems and thought control among individuals with obsessive-compulsive disorder, major depression, panic disorder, and healthy individuals. Methods and Materials: The method of the current research was applied in terms of purpose and descriptive-post-event in terms of implementation. The study population included all individuals attending neurology and psychiatry clinics in Qom during 2021-2022. In this study, a total of 200 individuals were selected as the sample (individuals with obsessive-compulsive disorder: 50, individuals with major depression: 50, individuals with panic disorder: 50, and healthy individuals: 50) using a non-random and convenient sampling method. The research tools included the Carver and White (1994) Behavioral Systems Questionnaires and the Wells and Davies (1994) Thought Control Questionnaire. The research data were analyzed using the SPSS-24 statistical software, through descriptive and inferential statistics, specifically the multivariate analysis of variance. Findings: The results of the analysis indicated that behavioral systems and thought control vary among individuals with obsessive-compulsive disorder, major depression, panic disorder, and healthy individuals. Conclusion: Therefore, in the current study, thought control varies among individuals with obsessive-compulsive disorder, major depression, panic disorder, and healthy individuals.