Range Of Psychiatric Illnesses Research Articles

Challenges for setting up psychiatric services in a trauma centre in India.

Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients.

An Iterative and Collaborative End-to-End Methodology Applied to Digital Mental Health.

Artificial intelligence (AI) algorithms together with advances in data storage have recently made it possible to better characterize, predict, prevent, and treat a range of psychiatric illnesses. Amid the rapidly growing number of biological devices and the exponential accumulation of data in the mental health sector, the upcoming years are facing a need to homogenize research and development processes in academia as well as in the private sector and to centralize data into federalizing platforms. This has become even more important in light of the current global pandemic. Here, we propose an end-to-end methodology that optimizes and homogenizes digital research processes. Each step of the process is elaborated from project conception to knowledge extraction, with a focus on data analysis. The methodology is based on iterative processes, thus allowing an adaptation to the rate at which digital technologies evolve. The methodology also advocates for interdisciplinary (from mathematics to psychology) and intersectoral (from academia to the industry) collaborations to merge the gap between fundamental and applied research. We also pinpoint the ethical challenges and technical and human biases (from data recorded to the end user) associated with digital mental health. In conclusion, our work provides guidelines for upcoming digital mental health studies, which will accompany the translation of fundamental mental health research to digital technologies.

Complexities and conundrums in mental health

Delegates at the 16th Latest Advances in Psychiatry Symposium held in London in March 2017, were treated to a cornucopia of data and insights from the latest research into a range of psychiatric illnesses. Psychiatry is fully intent on proving its worth with brain imaging, genetics, and many other sophisticated clinical research techniques being used to demonstrate its interventions have value. Steve Titmarsh sat back and took it all in and here reports on some of what intrigued him most.

Long-term inyectable antipsychotics in adolescents. A case report

IntroductionActually psychiatrists around the world are treating children and adolescents (despite limited medical indications in this age group) with atypical antipsychotics at increasing rates for a range of psychiatric illnesses (schizophrenia, bipolar disorder, behavioral changes…). Over the last few years, a number of new long-term injectable treatments (ILD) have emerged, the advantages of which are found in adult (adherence, functionality, consistent blood level without daily peaks…) but we do not have enough data in minors.ObjectivesDiscuss utility of ILD in adolescents.MethodsWe expose a case report about a 17-year-old man, when he was a child he was diagnosed with attention deficit disorder and autism spectrum disorder and also he had a story of disrupted behavioural and aggressively. After been hospitalized in our hospital we remake his clinic history and he was diagnosed with schizophrenia. Before the injectable treatment (ABILIFY MAINTENA®) this patient tried various treatments (mood stabilizers, antidepressants…) and many hospitalizations.ResultsAfter the ILD, our patient has good functionality, he is now living with his parents and studying in the high school. He has not needed another hospitalization after the last one.ConclusionsThe ILD in adolescents must be a therapeutic option in mental disease, in this group is very difficult the complementation of the treatment, it's frequent the comorbid use of substances, this population are not used to take medications… so every treatment that facility this kind of problems must be a perfect weapon to improve their mental health and to prevent relapse and hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A systematic review of the effects of neuromodulation on eating behaviour: implications for brain directed treatments in eating disorders

Eating disorders (ED) are chronic, deadly illnesses and especially for adults with anorexia nervosa, existing treatments have limited proven efficacy. Growing knowledge about the neural underpinnings to ED provides an avenue for more targeted, brain directed interventions. Brain stimulation techniques, such as Transcranial Magnetic Stimulation (TMS), transcranial Direct Current Stimulation (tDCS), Vagus Nerve Stimulation (VNS) and Deep Brain Stimulation (DBS) have the ability to directly alter neural activity within the brain. Such methods are being used extensively within both research and clinical settings to treat movement disorders such as Parkinson's and a range of psychiatric illnesses including depression. Findings within such disorders, relevant animal models and more recent research within ED populations have led to a strong rationale for the use of brain stimulation in ED. This paper systematically reviews this literature, identifying deficits in the current knowledge in an attempt to help guide future research and clinical practice within the imminent field of brain directed interventions for ED. This abstract was presented in the Understanding and Treating Eating Pathology stream of the 2013 ANZAED Conference.

Economic probes of mental function and the extraction of computational phenotypes

Economic games are now routinely used to characterize human cognition across multiple dimensions. These games allow for effective computational modeling of mental function because they typically come equipped with notions of optimal play, which provide quantitatively prescribed target functions that can be tracked throughout an experiment. The combination of these games, computational models, and neuroimaging tools open up the possibility for new ways to characterize normal cognition and associated brain function. We propose that these tools may also be used to characterize mental dysfunction, such as that found in a range of psychiatric illnesses. We describe early efforts using a multi-round trust game to probe brain responses associated with healthy social exchange and review how this game has provided a novel and useful characterization of autism spectrum disorder. Lastly, we use the multi-round trust game as an example to discuss how these kinds of games could produce novel bases for representing healthy behavior and brain function and thus provide objectively identifiable subtypes within a broad spectrum of mental function.

Molecular Genetics of the Psychosis Phenotype

Relative to recent successes in elucidating the genetic mechanisms associated with complex diseases, including macular degeneration, diabetes mellitus, type 2, heart disease, and cancer, molecular genetic approaches to psychiatric illness have met with more limited success. While factors such as small allelic effects, allelic heterogeneity, and variation in population substructure have received considerable attention in attempt to explain the paucity of significant results in psychiatric genetics, significantly less focus has been directed toward phenotypic factors. Data derived from molecular genetic studies of the psychosis phenotype in patients with a range of psychiatric illnesses are reviewed. Available data suggest that genes do not respect the boundaries of the current diagnostic system but may confer risk for symptom-based phenotypic variation that traverses those boundaries. Molecular genetic studies offer convincing evidence for a relation between genetic variation and symptom-based phenotypic variation within psychiatric illness. These data may provide novel insights into the pathophysiology of schizophrenia and other related disorders. The exploration of relations between genetic variation and symptom variation that traverses traditional diagnostic boundaries may ultimately lead to more refined classification systems that more closely reflect the genetic etiology of psychiatric illness.

Molecular Genetics of the Psychosis Phenotype

Objective: Relative to recent successes in elucidating the genetic mechanisms associated with complex diseases, including macular degeneration, diabetes mellitus, type 2, heart disease, and cancer, molecular genetic approaches to psychiatric illness have met with more limited success. While factors such as small allelic effects, allelic heterogeneity, and variation in population substructure have received considerable attention in attempt to explain the paucity of significant results in psychiatric genetics, significantly less focus has been directed toward phenotypic factors. Method: Data derived from molecular genetic studies of the psychosis phenotype in patients with a range of psychiatric illnesses are reviewed. Results: Available data suggest that genes do not respect the boundaries of the current diagnostic system but may confer risk for symptom-based phenotypic variation that traverses those boundaries. Conclusions: Molecular genetic studies offer convincing evidence for a relation between genetic variation and symptom-based phenotypic variation within psychiatric illness. These data may provide novel insights into the pathophysiology of schizophrenia and other related disorders. The exploration of relations between genetic variation and symptom variation that traverses traditional diagnostic boundaries may ultimately lead to more refined classification systems that more closely reflect the genetic etiology of psychiatric illness.

Can employment positively affect the recovery of people with psychiatric disabilities?

This study explored the relationship between employment and recovery in individuals with psychiatric disabilities and proposed that participants who were employed would have higher levels of recovery than participants who were not employed. Data were analysed from a pre-existing data-set produced in a large scale NHMRC project conducted as part of the Australian Integrated Mental Health Initiative (AIMhi), High Support Stream. Participants were 344 people with a range of psychiatric illnesses who received support from 11 public sector and non-government mental health organizations in Queensland and New South Wales, Australia. Scores on the Recovery Assessment Scale (RAS) were compared between those participants who were engaged in paid employment and those who were not. The results revealed that there was no difference in total recovery scores between those who worked and those who did not work. This finding indicated that higher recovery scores were not associated with participants who were employed. Also contrary to expectations, the results showed that workers scored lower than non-workers on the RAS factor described as "reliance on others" and there was a trend towards significance in the same direction on the factor "willingness to ask for help." Further research needs to be conducted to determine if the differences between workers and non-workers on the above factors represent a personal variable such as independence or self-determination that is associated with individuals with psychiatric disabilities that are engaged in employment. Rehabilitation interventions aimed at increasing levels of employment in people with psychiatric disabilities could improve recovery and employment outcomes through focusing on these personal variables.

Jury Still Out on Supplement's Role in Reducing Suicide Risk

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessJury Still Out on Supplement's Role in Reducing Suicide RiskJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:16 Mar 2007https://doi.org/10.1176/pn.42.6.0016aThe omega-3 fatty acids—which show promise against a range of psychiatric illnesses and can be obtained by eating fish or taking supplements—can reduce symptoms in suicidal persons.So suggest two studies in the February British Journal of Psychiatry. Both studies were headed by psychiatrist Malcolm Garland, M.D., who was affiliated with Beaumont Hospital in Dublin, Ireland, when the studies were conducted. He is now on staff of St. Ita's Hospital in Dublin. First Garland and colleagues launched a study to learn whether suicidality is associated with low levels of the omega-3 fatty acids in the body. The subjects were 80 patients at a university teaching hospital, half of whom were suicidal and who had been brought to the hospital's emergency room. The other half were nonsuicidal patients in the hospital's medical day ward who matched the subjects on age, gender, and amount of fish eaten weekly.The researchers took blood samples from both groups and then compared the levels of omega-3 fatty acids in the blood of the suicidal group with those in the control group, taking possibly confounding factors such as social class, exercise, smoking, or alcohol intake, into consideration. They found that the levels were significantly lower in the suicidal group.They also assessed both groups for depression and impulsivity. Not surprisingly, the suicidal group scored higher on both depression and impulsivity than the control group did, since depression and impulsivity are risk factors for suicide. The researchers then looked to see whether there was any relationship between subjects' depression and impulsivity scores and the level of omega-3 fatty acids in their blood. There was, they found. Low omega-3 fatty acid levels were significantly and inversely related to high depression and impulsivity scores.So it looked as if persons with a paucity of omega-3 fatty acids in their bodies might be more vulnerable to suicide than persons with higher levels of the acids and that the mediating factors might be depression and impulsivity.The researchers then decided to investigate whether giving omega-3 fatty acid supplements to suicidal individuals keeps them from engaging in self-harm.Forty-nine individuals who had tried repeatedly to kill themselves were randomized to receive either omega-3 fatty acid supplements or a placebo for 12 weeks in addition to standard psychiatric care. Subjects were tested both at the start of the study and 12 weeks later in six psychological domains—depression, suicidal ideation, daily stress perception, impulsivity, aggression, and hostility. Changes in scores over the 12-week period were calculated for each subject, and score changes the supplement group experienced were compared with changes registered by the control group.By the end of the 12-week period, the group receiving the supplement had significantly less depression, suicidal ideation, and daily stress perception than the control group did—especially less depression. Moreover, the gap between the supplement group's depression scores and the control group's depression scores widened even more toward the end of the study, suggesting that the supplement group might have experienced an even more dramatic drop in depression if it had received supplements for a longer period.The supplement group's final scores for impulsivity, aggression, and hostility did not differ, however, from those of the control group, and seven individuals in the supplement group attempted to harm themselves, just as seven in the control group did.Thus, the true value of omega-3 supplementation as a suicide-prevention tool can be determined only by a large-scale, multicenter, long-term investigation, Garland and his team concluded.The studies were partially funded by the Institute of Psychiatry at the University of Illinois at Chicago. The remaining costs were paid by the researchers.An abstract of “Lipids and Essential Fatty Acids in Patients Presenting With Self-Harm” is posted at<http://bjp.rcpsych.org/cgi/content/abstract/190/2/112>. An abstract of “Omega-3 Fatty Acid Supplementation in Patients With Recurrent Self-Harm” is posted at<http://bjp.rcpsych.org/cgi/content/abstract/190/2/118>.▪ ISSUES NewArchived

Cultures as a Causative of Mental Disorder

A review of previous papers makes it evident that mental disorder is considered to be the product of multiple factors. The present paper is in harmony with this orientation, and its title, which was assigned to us, should not be interpreted as implying ideas of mono-causal relationship. The discussion of our topic will be necessarily limited and selective, since talking about culture in its global sense touches on virtually all aspects of human behavior. Some areas such as family relationships and social change have been discussed earlier. Others such as cultural history and philosophy are too vast to be treated adequately in one chapter. We shall attempt, therefore, to present some points from salient literature, and to give impressions derived from several years of research dealing with socio-cultural factors and mental disorder.

Comparison of CATEGO-Derived ICD–8 and DSM–III Classifications using the Composite International Diagnostic Interview in Severely Ill Subjects

Two classifications, DSM-III and CATEGO4-derived ICD-8, included in the CIDI, are compared in 63 in-patients and out-patients with a broad range of psychiatric illness. Agreement for main diagnosis between these classifications was statistically significant for two time frames, the present state and lifetime. However, while diagnostic assignment by CATEGO4 remained fairly constant between time frames, there was a marked shift in DSM-III-assigned diagnosis, with cases changing from anxiety state diagnosis (present state) to affective disorder (lifetime). Thirty-nine subjects were assigned a DSM-III diagnosis of affective disorder for lifetime illness compared with 21 assigned to this diagnostic group by CATEGO4.