Objectives:In 2019,the Insititue for Health Metrics and Evaluation reported that 16%of life lost were attributed to mental health.As a result,global shortage of psychiatrists is a pressing issue due to the increasing ...Objectives:In 2019,the Insititue for Health Metrics and Evaluation reported that 16%of life lost were attributed to mental health.As a result,global shortage of psychiatrists is a pressing issue due to the increasing burden of mental illness.In 2016,a mere 5%of US medical students chose psychiatry as a career,a trend mirrored in Germany and Italy.As the medical students of 2016 have graduated or transitioned into residency in 2023,their attitudes towards psychiatry could have contributed to today’s shortage of psychiatrists.The global mental health burden has only been exacerbated by the COVID-19 pandemic.This study explores the attitudes of German and Italian medical students towards psychiatry,their career aspirations,and the influence of factors such as personal experience and education on their interest in the field.Methods:A cross-sectional survey was conducted among 799 medical students in two European countries in 2016.Participants answered questions about their attitudes towards psychiatry,their psychiatric education,and personal experiences.Inferential analyses were performed using chi-square tests and a significance level of 0.05.Results:The number of years in medical school,personal experiences,and perceived quality of education significantly affected specialty choice and ranking of psychiatry compared to other specialties.Internships,psychiatric placements,and views on psychiatric instructors also played a significant role in choosing psychiatry as a career.Conclusions:Assessing medical students’attitudes towards psychiatry and the factors that influence their career choices,such as psychiatric education and personal experiences,can inform changes to attract students to the field.Addressing the worldwide shortage of psychiatrists is crucial to reduce the burden of mental health and substance use disorders.展开更多
Computational psychiatry is an emerging field that not only explores the biological basis of mental illness but also considers the diagnoses and identifies the underlying mechanisms.One of the key strengths of computa...Computational psychiatry is an emerging field that not only explores the biological basis of mental illness but also considers the diagnoses and identifies the underlying mechanisms.One of the key strengths of computational psychiatry is that it may identify patterns in large datasets that are not easily identifiable.This may help researchers develop more effective treatments and interventions for mental health problems.This paper is a narrative review that reviews the literature and produces an artificial intelligence ecosystem for computational psychiatry.The artificial intelligence ecosystem for computational psychiatry includes data acquisition,preparation,modeling,application,and evaluation.This approach allows researchers to integrate data from a variety of sources,such as brain imaging,genetics,and behavioral experiments,to obtain a more complete understanding of mental health conditions.Through the process of data preprocessing,training,and testing,the data that are required for model building can be prepared.By using machine learning,neural networks,artificial intelligence,and other methods,researchers have been able to develop diagnostic tools that can accurately identify mental health conditions based on a patient’s symptoms and other factors.Despite the continuous development and breakthrough of computational psychiatry,it has not yet influenced routine clinical practice and still faces many challenges,such as data availability and quality,biological risks,equity,and data protection.As we move progress in this field,it is vital to ensure that computational psychiatry remains accessible and inclusive so that all researchers may contribute to this significant and exciting field.展开更多
Objectives: At the beginning of 2012, northern Mali was occupied by several jihadist movements with the aim of creating a Khalifa that required the intervention of a UN peacekeeping mission after a war that slowed dow...Objectives: At the beginning of 2012, northern Mali was occupied by several jihadist movements with the aim of creating a Khalifa that required the intervention of a UN peacekeeping mission after a war that slowed down their development. This mission is the deadliest in a complex attack and UN attack. This experience feedback in an international context of the resurgence of asymmetrical wars makes it possible to share in order to better anticipate and improve strategic approaches to assessments and therapeutic techniques. Description: After the presentation of the context with these particularities and the various adaptations, we made formulations of the missions such as lived and the details on the medico-psychological techniques used. The place of the brief physical examination should not be overlooked. The debriefings, even if they have proven themselves in the evaluation and prevention of psychotraumatic pathologies, must be adapted on a case-by-case basis in a certain programmed improvisation. Maintaining the site of the attack survivors without real military activities by reinforcing them with a new functional team was a decisive element in the mourning process according to their own statement. Conclusion: Forward psychiatry is a necessity in asymmetric warfare to maintain the operationality of the troops.展开更多
Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality worldwide.Disorder variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developi...Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality worldwide.Disorder variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developing countries,as well as infectious causes,like Tuberculosis(TB)in developing countries,contribute to significant disease burden.The literature points towards the coexistence of psychiatric disorders with respiratory disorders responsible for poorer outcomes.Despite the extensive burden of respiratory disorders and the presence of concurrent psychiatric disorders,studies focusing on their prevalence are limited in India.Methods:A cross-sectional psychiatric screening was carried out on sequential patients attending the tertiary respiratory unit over eight months.Those screened positive were interviewed in detail for psychiatric diagnosis and challenges in the management were discussed.Psychiatric diagnosis,pulmonary TB and medical comorbidity were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20.Results:Psychiatric morbidity was present in 100 out of 350 patients(28.57%).Tuberculosis was the most common diagnosis(46%)in subjects attending the respiratory clinic services while common mental disorders like depression,anxiety,and insomnia were the most common psychiatric concern(88%)in this study.Conclusion:Psychiatric disorders and medical morbidities are common in patients with respiratory disorders.Multiple factors determine the treatment adherence in both respiratory and psychiatric disorders.Screening for psychiatric disorders with the help of a consultation-liaison psychiatrist in respiratory units is recommended.Future studies should focus on developing dedicated psychiatry services to enhance overall outcomes in patients with respiratory disorders.展开更多
Psychiatry remains in a permanent state of crisis,which fragmented psychiatry from the field of medicine.The crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness includin...Psychiatry remains in a permanent state of crisis,which fragmented psychiatry from the field of medicine.The crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness including psychodynamic,biological,molecular,pan-omics,precision,cognitive and phenomenological psychiatry,folk psychology,mind-brain dualism,descriptive psychopathology,and postpsychiatry.The current“gold standard”Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases taxonomies of mood disorders and schizophrenia are unreliable and preclude to employ a deductive reasoning approach.Therefore,it is not surprising that mood disorders and schizophrenia research was unable to revise the conventional classifications and did not provide more adequate therapeutic approaches.The aim of this paper is to explain the new nomothetic network psychiatry(NNP)approach,which uses machine learning methods to build data-driven causal models of mental illness by assembling risk-resilience,adverse outcome pathways(AOP),cognitome,brainome,staging,symptomatome,and phenomenome latent scores in a causal model.The latter may be trained,tested and validated with Partial Least Squares analysis.This approach not only allows to compute pathway-phenotypes or biosignatures,but also to construct reliable and replicable nomothetic networks,which are,therefore,generalizable as disease models.After integrating the validated feature vectors into a well-fitting nomothetic network,clustering analysis may be applied on the latent variable scores of the R/R,AOP,cognitome,brainome,and phenome latent vectors.This pattern recognition method may expose new(transdiagnostic)classes of patients which if cross-validated in independent samples may constitute new(transdiagnostic)nosological categories.展开更多
The essence of my talk is to identify the changes in psychiatric clinical services over this designated time and illustrate my personal conjecture on what the field of psychiatiy will be like in 10 years' time. To...The essence of my talk is to identify the changes in psychiatric clinical services over this designated time and illustrate my personal conjecture on what the field of psychiatiy will be like in 10 years' time. To put it simply, that is to tell the difference between visiting a psychiatrist today and visiting one 10 years from now.展开更多
The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issue...The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issued for outpatients was carried out at the Psychiatric Hospital, the only facility that provides psychiatric services for both inpatients and outpatients in the Kingdom of Bahrain. Antipsychotic monotherapy was prescribed for 89.2% patients, whereas polytherapy with two- and three-drugs in 10.4 and 0.4%, respectively. Atypical antipsychotics were prescribed more often (67.7%) than typical antipsychotics. Risperidone and haloperidol were the most frequently prescribed antipsychotics. Long-acting risperidone injection was the only depot preparation prescribed. The mean antipsychotic dose expressed as chlorpromazine equivalent (CPZeq;mg/day) was 242 (220 for monotherapy and 414 for polytherapy). The prevalence of high dose antipsychotic (mean CPZeq > 1000 mg/day) was 1.8%, prescribed at a mean CPZeq dose of 1531 (1925 for monotherapy and 1137 for polytherapy), mainly attributed to haloperidol. Anticholinergics were co-prescribed for almost two third of patients receiving antipsychotics, particularly for those on polytherapy (monotherapy 57.3%;poly-therapy 87.5%). Antipsychotic polytherapy, high dose and co-prescription of an oral with a depot antipsychotic preparation were strongly associated with concurrent prescription of anticholinergics. Procyclidine and orphenadrine were the most often prescribed anticholinergics. In Bahrain, antipsychotic monotherapy is a common practice for outpatients with psychotic disorders. Some of the antipsychotic polytherapies, dosage strategies, and high prevalence of anticholinergic use are therapeutic issues that need to be addressed to foster evidence-based prescribing practice.展开更多
Introduction: For patients, GPs are the most accessible medical resource in the community and are the gatekeepers to other community resources including psychiatrists. Qualifying as a psychiatrist in Australia involve...Introduction: For patients, GPs are the most accessible medical resource in the community and are the gatekeepers to other community resources including psychiatrists. Qualifying as a psychiatrist in Australia involves completing a five-year training program that includes rotations in hospitals and community settings. The aims of this research were to 1) explore psychiatry registrars’ perceptions of difficult-to-treat-depression (DTTD) and 2) what they thought about the GPs’ role in this regard. Methods: A semi-structured interview schedule comprising six questions was used;10 psychiatry registrars (6 females, 4 males) participated in a one-and-half-hour focus group. All were in their final year of training and undertaking a training post in a public hospital in Melbourne, Australia. Data were analysed using the Framework Method. Findings: Similar to GPs and GP trainees, psychiatry registrars’ perceptions and understanding of DTTD varied. While acknowledging limited experience in diagnosis and management, issues important to them included the utility of labels such as DTTD;patients distressed because of another diagnosis, substance abuse and/or life problems, the importance of accurate histories and notes, cost and limited availability of services particularly in the private sector, prescribing regimens, referring to allied health professionals, and suggesting/prescribing non pharmacological and/or complementary treatment. Also what was of concern was communication, both between health professionals and between health professionals and patients. Consensus was that treating depression in general practice is one of the hardest things for GPs to manage but there was value in using mental health plans. Discussion and Conclusion: While this cohort was small in number with limited experience, this study is the first to contribute to the literature that provides some insight into psychiatry registrars’ experiences and perceptions of DTTD. Outcomes may have implications for thepsychiatry training program and GPs who diagnose and manage patients with mental health problems.展开更多
"The 16^th Chinese Society of Neuroscience & Psychiatry (CSNP)National Academic Conference", sponsored by Chinese Society of Neuroscience & Psychiatry, co-sp on sored by Shanghai Mentai Health Center..."The 16^th Chinese Society of Neuroscience & Psychiatry (CSNP)National Academic Conference", sponsored by Chinese Society of Neuroscience & Psychiatry, co-sp on sored by Shanghai Mentai Health Center Affiliated to Shanghai Jiao Tong Un iversity School of Medicine,Harbin First Specialized Hospital, will be held on June 27-29, 2019 at Rong Chuang Wanda Vista Hotel, Harbin. The conference will bring communication of the latest advances of mental disorders through keynote talks, forums, symposiums, oral reports, and poster presentations.展开更多
In issues 2 and 3, some interesting and popular topics are presented and they may inspire new ideas in psychiatric research. A systematic review conducted by Dr Chen and her colleagues has drawn much attention to the ...In issues 2 and 3, some interesting and popular topics are presented and they may inspire new ideas in psychiatric research. A systematic review conducted by Dr Chen and her colleagues has drawn much attention to the worldwide media, that it was positive to treat anxiety symptoms by regulating intestinal flora (RIF).展开更多
The first issue of World Journal of Psychiatry(WJP),whose preparatory work was initiated on May 18,2011,will be published on December 31,2011.The WJP Editorial Board has now been established and consists of 103 distin...The first issue of World Journal of Psychiatry(WJP),whose preparatory work was initiated on May 18,2011,will be published on December 31,2011.The WJP Editorial Board has now been established and consists of 103 distinguished experts from 32 countries.Our purpose of launching WJP is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.展开更多
Time:December 7-10,2017Venue:San Diego,California,USA Website:www.aaap.org/annual-meeting The Annual Meeting of American Academy of Addiction Psychiatry 2017 will be held on December 7-10,2017 in San Diego,California,...Time:December 7-10,2017Venue:San Diego,California,USA Website:www.aaap.org/annual-meeting The Annual Meeting of American Academy of Addiction Psychiatry 2017 will be held on December 7-10,2017 in San Diego,California,USA.The Annual Meeting and Scientific Symposium provide the latest scientific developments in addiction展开更多
Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementati...Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementation of bariatric procedures has progres-sively revealed critical issues that were not evident when the number of obese patients treated with surgery was relatively small.One critical issue is the importance of mental health assessment and care of bariatric patients.The aim of this review is to provide readers with an up-to-date summary of the goals,methods,and clinical strategies of bariatric psychiatry.The aims can be grouped into three distinct categories.First,to ascertain that there are no psychiatric contraindications to safe bariatric surgery.Second,to diagnose and treat pre-surgery mental conditions that could predict poor weight loss.Third,to diagnose and treat post-surgery mental conditions associated with poor quality of life.Although bariatric psychiatry has gained the status of a new subspecialty within the field of mental health and psychopathology,many clinical questions remain unsolved.We need more long-term data on outcome measures such as quality of life,adherence to behavioral guidelines,risk of suicide,and postsurgery prevalence of psychological disturbances and mental disorders.展开更多
Consultation-liaison psychiatry remains the guardian of holistic approach to the patient and consultation services in general hospital could therefore be referred to as“filters”for mental health care,in particular f...Consultation-liaison psychiatry remains the guardian of holistic approach to the patient and consultation services in general hospital could therefore be referred to as“filters”for mental health care,in particular for patients with minor depressive or anxiety disorders.It is worth noting that psychiatric disorders,even when sub-clinical,worsen outcome whereas their early detection and treatment reduce health care costs significantly.The present study was transversal,exploratory,and descriptive in order to investigate the sample of outpatients referred from general practitioners(GP)to service of consultation-liaison psychiatry of the ASST Great Metropolitan Hospital Niguarda of Milan over a 7-months period.Data from all psychiatric consultations for outpatients were collected by a structured clinical report including socio-demographic features,features of referrals,and features of back-referrals.Five hundred and eleven consultations were performed.Participants were mainly female(58.7%)with an average age between 45 and 55 years(27.6%);31.1%of these patients was at the first contact with a mental health specialist.The diagnoses formulated were distributed as follows:The most common diagnoses were affective disorders(44.6%),followed by neurotic disorders(34.1%),personality disorders(6.8%),and finally,psychosis(6.2%).The study showed an example of a consultation-liaison service situated in a Great Metropolitan Hospital offering to GP the opportunity of a diagnostic assessment and shared management of minor psychiatric disorders.This approach could lead to several vantages,such as the management in a non-psychiatric setting of patients with reduction of stigma and reduced costs for specific psychiatric services where are referred more severe patients.展开更多
Objective: The forensic mental health system in Japan changed dramatically with the enforcement of the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity”...Objective: The forensic mental health system in Japan changed dramatically with the enforcement of the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity” or MTS Act, in 2005. The aim of this study is to evaluate the changes in attitude and behavior of general psychiatrists, towards forensic psychiatry. Methods: We conducted a questionnaire survey in 2010 on forensic psychiatry for Japanese psychiatrists, mirroring a previous study from 2007. Results: Comparing the results from both questionnaires, it is not evident that awareness of forensic mental health has improved among psychiatrists in the intervening three years. Conclusion: Further education about forensic mental health needs to be considered inJapan.展开更多
Traditional therapeutic methods in psychiatry,such as psychopharmacology and psychotherapy help many people suffering from mental disorders,but in the long-term prove to be effective in a relatively small proportion o...Traditional therapeutic methods in psychiatry,such as psychopharmacology and psychotherapy help many people suffering from mental disorders,but in the long-term prove to be effective in a relatively small proportion of those affected.Therapeutically,resistant forms of mental disorders such as schizophrenia,major depressive disorder,and bipolar disorder lead to persistent distress and dysfunction in personal,social,and professional aspects.In an effort to address these problems,the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising results.For instance,neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity,integration,and segregation of neural networks,focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy(ECT),transcranial magnetic stimulation(TMS),transcranial direct current stimulation(tDCS)and deep brain stimulation(DBS).These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective disorders.The current review is focused on the translational approach in the management of schizophrenia and mood disorders,as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT,TMS,tDCS and DBS.展开更多
Uniforms represent more than just a body cover. There could be symbols of status, power, authority, values, beliefs, identity, wealth representation, self-protection, health and safety, suppression of individuality an...Uniforms represent more than just a body cover. There could be symbols of status, power, authority, values, beliefs, identity, wealth representation, self-protection, health and safety, suppression of individuality and identification on one hand by the wearer. The observers may perceive uniforms differently based on their experiences, expectations, education, perceptual ability, conformity, status, power, self-confidence, and need for trust and communication without barrier or judgment. Forty five adult mentally ill patients (21 female and 24 male) were administered questionnaires with Linkert Scale regarding how approachable or off-putting they find casual and religious wear in social worker. Significantly more patients preferred casual wear to religious. Chi squared test equals 28.689 with p value of less than 0.0001 for four degrees of freedom.展开更多
Forensic psychiatrists routinely appear in courts for crimes that have been perpetrated by mentally ill patients or when the defendant is suffering from a major psychiatric disorder.However,committing crimes under the...Forensic psychiatrists routinely appear in courts for crimes that have been perpetrated by mentally ill patients or when the defendant is suffering from a major psychiatric disorder.However,committing crimes under the presumed effects of magic and witchcraft is uncommon.A variety of delusional thoughts and personality disorders have been imputed in aggressive behaviour that might culminate in homicide.The patterns of a premeditated homicide,as well as the aberrations of the interpersonal relations,as a rule require long-term and close contact.As such,the family is a setting where such occurrences have been reported.We describe a case of first-degree murder by a woman who killed her mother-in-law after accusing her repeatedly of sorcery and witchcraft.Such complicated cases cannot be resolved without the help of forensic experts,whose role remains multifaceted and of particular importance.展开更多
The coronavirus disease 2019 pandemic has significantly altered many aspects of our professional lives,including how psychiatry as a medical discipline is taught and learnt.Training in psychiatry relies on developing ...The coronavirus disease 2019 pandemic has significantly altered many aspects of our professional lives,including how psychiatry as a medical discipline is taught and learnt.Training in psychiatry relies on developing competencies through observing and interacting with patients,developing empathic consultation skills and seeking feedback from colleagues derived from cognitive and constructivist theories of learning,in a time-bound manner.The pandemic has drawn attention to the dual role of psychiatry residents as both trainees and physicians,with a pressing identity crisis at an inopportune time.This paper aims to illustrate some of the emerging themes in psychiatry training during the pandemic and some solutions for the same.展开更多
<strong>Background and Objectives:</strong> Neuroleptics have revolutionized pharmacological management in psychiatry. The advent of atypical neuroleptics constitutes a major turning point in this therapeu...<strong>Background and Objectives:</strong> Neuroleptics have revolutionized pharmacological management in psychiatry. The advent of atypical neuroleptics constitutes a major turning point in this therapeutic challenge. The objective of our study was to determine the prescription of these atypical neuroleptics in Fann’s psychiatry department. <strong>Methodology:</strong> It was a descriptive retrospective cross-sectional study that involved 223 patients hospitalized in the psychiatry department of Fann Hospital during the period from January 2015 to December 2017. <strong>Results:</strong> Our study shows a majority prescription of classic neuroleptics in combination Haloperidol-Chlorpromazine 53% and 14% in monotherapy and a prescription of atypical neuroleptics at 4%. They are prescribed in combination with the classics at 4%. <strong>Conclusion:</strong> These results show a still low prescription of atypical neuroleptics which raises questions about the availability and affordability of such drugs, but also about prescription habits in the context of developing country.展开更多
文摘Objectives:In 2019,the Insititue for Health Metrics and Evaluation reported that 16%of life lost were attributed to mental health.As a result,global shortage of psychiatrists is a pressing issue due to the increasing burden of mental illness.In 2016,a mere 5%of US medical students chose psychiatry as a career,a trend mirrored in Germany and Italy.As the medical students of 2016 have graduated or transitioned into residency in 2023,their attitudes towards psychiatry could have contributed to today’s shortage of psychiatrists.The global mental health burden has only been exacerbated by the COVID-19 pandemic.This study explores the attitudes of German and Italian medical students towards psychiatry,their career aspirations,and the influence of factors such as personal experience and education on their interest in the field.Methods:A cross-sectional survey was conducted among 799 medical students in two European countries in 2016.Participants answered questions about their attitudes towards psychiatry,their psychiatric education,and personal experiences.Inferential analyses were performed using chi-square tests and a significance level of 0.05.Results:The number of years in medical school,personal experiences,and perceived quality of education significantly affected specialty choice and ranking of psychiatry compared to other specialties.Internships,psychiatric placements,and views on psychiatric instructors also played a significant role in choosing psychiatry as a career.Conclusions:Assessing medical students’attitudes towards psychiatry and the factors that influence their career choices,such as psychiatric education and personal experiences,can inform changes to attract students to the field.Addressing the worldwide shortage of psychiatrists is crucial to reduce the burden of mental health and substance use disorders.
文摘Computational psychiatry is an emerging field that not only explores the biological basis of mental illness but also considers the diagnoses and identifies the underlying mechanisms.One of the key strengths of computational psychiatry is that it may identify patterns in large datasets that are not easily identifiable.This may help researchers develop more effective treatments and interventions for mental health problems.This paper is a narrative review that reviews the literature and produces an artificial intelligence ecosystem for computational psychiatry.The artificial intelligence ecosystem for computational psychiatry includes data acquisition,preparation,modeling,application,and evaluation.This approach allows researchers to integrate data from a variety of sources,such as brain imaging,genetics,and behavioral experiments,to obtain a more complete understanding of mental health conditions.Through the process of data preprocessing,training,and testing,the data that are required for model building can be prepared.By using machine learning,neural networks,artificial intelligence,and other methods,researchers have been able to develop diagnostic tools that can accurately identify mental health conditions based on a patient’s symptoms and other factors.Despite the continuous development and breakthrough of computational psychiatry,it has not yet influenced routine clinical practice and still faces many challenges,such as data availability and quality,biological risks,equity,and data protection.As we move progress in this field,it is vital to ensure that computational psychiatry remains accessible and inclusive so that all researchers may contribute to this significant and exciting field.
文摘Objectives: At the beginning of 2012, northern Mali was occupied by several jihadist movements with the aim of creating a Khalifa that required the intervention of a UN peacekeeping mission after a war that slowed down their development. This mission is the deadliest in a complex attack and UN attack. This experience feedback in an international context of the resurgence of asymmetrical wars makes it possible to share in order to better anticipate and improve strategic approaches to assessments and therapeutic techniques. Description: After the presentation of the context with these particularities and the various adaptations, we made formulations of the missions such as lived and the details on the medico-psychological techniques used. The place of the brief physical examination should not be overlooked. The debriefings, even if they have proven themselves in the evaluation and prevention of psychotraumatic pathologies, must be adapted on a case-by-case basis in a certain programmed improvisation. Maintaining the site of the attack survivors without real military activities by reinforcing them with a new functional team was a decisive element in the mourning process according to their own statement. Conclusion: Forward psychiatry is a necessity in asymmetric warfare to maintain the operationality of the troops.
文摘Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality worldwide.Disorder variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developing countries,as well as infectious causes,like Tuberculosis(TB)in developing countries,contribute to significant disease burden.The literature points towards the coexistence of psychiatric disorders with respiratory disorders responsible for poorer outcomes.Despite the extensive burden of respiratory disorders and the presence of concurrent psychiatric disorders,studies focusing on their prevalence are limited in India.Methods:A cross-sectional psychiatric screening was carried out on sequential patients attending the tertiary respiratory unit over eight months.Those screened positive were interviewed in detail for psychiatric diagnosis and challenges in the management were discussed.Psychiatric diagnosis,pulmonary TB and medical comorbidity were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20.Results:Psychiatric morbidity was present in 100 out of 350 patients(28.57%).Tuberculosis was the most common diagnosis(46%)in subjects attending the respiratory clinic services while common mental disorders like depression,anxiety,and insomnia were the most common psychiatric concern(88%)in this study.Conclusion:Psychiatric disorders and medical morbidities are common in patients with respiratory disorders.Multiple factors determine the treatment adherence in both respiratory and psychiatric disorders.Screening for psychiatric disorders with the help of a consultation-liaison psychiatrist in respiratory units is recommended.Future studies should focus on developing dedicated psychiatry services to enhance overall outcomes in patients with respiratory disorders.
文摘Psychiatry remains in a permanent state of crisis,which fragmented psychiatry from the field of medicine.The crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness including psychodynamic,biological,molecular,pan-omics,precision,cognitive and phenomenological psychiatry,folk psychology,mind-brain dualism,descriptive psychopathology,and postpsychiatry.The current“gold standard”Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases taxonomies of mood disorders and schizophrenia are unreliable and preclude to employ a deductive reasoning approach.Therefore,it is not surprising that mood disorders and schizophrenia research was unable to revise the conventional classifications and did not provide more adequate therapeutic approaches.The aim of this paper is to explain the new nomothetic network psychiatry(NNP)approach,which uses machine learning methods to build data-driven causal models of mental illness by assembling risk-resilience,adverse outcome pathways(AOP),cognitome,brainome,staging,symptomatome,and phenomenome latent scores in a causal model.The latter may be trained,tested and validated with Partial Least Squares analysis.This approach not only allows to compute pathway-phenotypes or biosignatures,but also to construct reliable and replicable nomothetic networks,which are,therefore,generalizable as disease models.After integrating the validated feature vectors into a well-fitting nomothetic network,clustering analysis may be applied on the latent variable scores of the R/R,AOP,cognitome,brainome,and phenome latent vectors.This pattern recognition method may expose new(transdiagnostic)classes of patients which if cross-validated in independent samples may constitute new(transdiagnostic)nosological categories.
文摘The essence of my talk is to identify the changes in psychiatric clinical services over this designated time and illustrate my personal conjecture on what the field of psychiatiy will be like in 10 years' time. To put it simply, that is to tell the difference between visiting a psychiatrist today and visiting one 10 years from now.
文摘The aim of this study is to determine the antipsychotic prescribing pattern and the prevalence of concurrent anticholinergic prescribing in a psychiatric referral hospital. A retrospective audit of prescriptions issued for outpatients was carried out at the Psychiatric Hospital, the only facility that provides psychiatric services for both inpatients and outpatients in the Kingdom of Bahrain. Antipsychotic monotherapy was prescribed for 89.2% patients, whereas polytherapy with two- and three-drugs in 10.4 and 0.4%, respectively. Atypical antipsychotics were prescribed more often (67.7%) than typical antipsychotics. Risperidone and haloperidol were the most frequently prescribed antipsychotics. Long-acting risperidone injection was the only depot preparation prescribed. The mean antipsychotic dose expressed as chlorpromazine equivalent (CPZeq;mg/day) was 242 (220 for monotherapy and 414 for polytherapy). The prevalence of high dose antipsychotic (mean CPZeq > 1000 mg/day) was 1.8%, prescribed at a mean CPZeq dose of 1531 (1925 for monotherapy and 1137 for polytherapy), mainly attributed to haloperidol. Anticholinergics were co-prescribed for almost two third of patients receiving antipsychotics, particularly for those on polytherapy (monotherapy 57.3%;poly-therapy 87.5%). Antipsychotic polytherapy, high dose and co-prescription of an oral with a depot antipsychotic preparation were strongly associated with concurrent prescription of anticholinergics. Procyclidine and orphenadrine were the most often prescribed anticholinergics. In Bahrain, antipsychotic monotherapy is a common practice for outpatients with psychotic disorders. Some of the antipsychotic polytherapies, dosage strategies, and high prevalence of anticholinergic use are therapeutic issues that need to be addressed to foster evidence-based prescribing practice.
文摘Introduction: For patients, GPs are the most accessible medical resource in the community and are the gatekeepers to other community resources including psychiatrists. Qualifying as a psychiatrist in Australia involves completing a five-year training program that includes rotations in hospitals and community settings. The aims of this research were to 1) explore psychiatry registrars’ perceptions of difficult-to-treat-depression (DTTD) and 2) what they thought about the GPs’ role in this regard. Methods: A semi-structured interview schedule comprising six questions was used;10 psychiatry registrars (6 females, 4 males) participated in a one-and-half-hour focus group. All were in their final year of training and undertaking a training post in a public hospital in Melbourne, Australia. Data were analysed using the Framework Method. Findings: Similar to GPs and GP trainees, psychiatry registrars’ perceptions and understanding of DTTD varied. While acknowledging limited experience in diagnosis and management, issues important to them included the utility of labels such as DTTD;patients distressed because of another diagnosis, substance abuse and/or life problems, the importance of accurate histories and notes, cost and limited availability of services particularly in the private sector, prescribing regimens, referring to allied health professionals, and suggesting/prescribing non pharmacological and/or complementary treatment. Also what was of concern was communication, both between health professionals and between health professionals and patients. Consensus was that treating depression in general practice is one of the hardest things for GPs to manage but there was value in using mental health plans. Discussion and Conclusion: While this cohort was small in number with limited experience, this study is the first to contribute to the literature that provides some insight into psychiatry registrars’ experiences and perceptions of DTTD. Outcomes may have implications for thepsychiatry training program and GPs who diagnose and manage patients with mental health problems.
文摘"The 16^th Chinese Society of Neuroscience & Psychiatry (CSNP)National Academic Conference", sponsored by Chinese Society of Neuroscience & Psychiatry, co-sp on sored by Shanghai Mentai Health Center Affiliated to Shanghai Jiao Tong Un iversity School of Medicine,Harbin First Specialized Hospital, will be held on June 27-29, 2019 at Rong Chuang Wanda Vista Hotel, Harbin. The conference will bring communication of the latest advances of mental disorders through keynote talks, forums, symposiums, oral reports, and poster presentations.
文摘In issues 2 and 3, some interesting and popular topics are presented and they may inspire new ideas in psychiatric research. A systematic review conducted by Dr Chen and her colleagues has drawn much attention to the worldwide media, that it was positive to treat anxiety symptoms by regulating intestinal flora (RIF).
文摘The first issue of World Journal of Psychiatry(WJP),whose preparatory work was initiated on May 18,2011,will be published on December 31,2011.The WJP Editorial Board has now been established and consists of 103 distinguished experts from 32 countries.Our purpose of launching WJP is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.
文摘Time:December 7-10,2017Venue:San Diego,California,USA Website:www.aaap.org/annual-meeting The Annual Meeting of American Academy of Addiction Psychiatry 2017 will be held on December 7-10,2017 in San Diego,California,USA.The Annual Meeting and Scientific Symposium provide the latest scientific developments in addiction
文摘Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementation of bariatric procedures has progres-sively revealed critical issues that were not evident when the number of obese patients treated with surgery was relatively small.One critical issue is the importance of mental health assessment and care of bariatric patients.The aim of this review is to provide readers with an up-to-date summary of the goals,methods,and clinical strategies of bariatric psychiatry.The aims can be grouped into three distinct categories.First,to ascertain that there are no psychiatric contraindications to safe bariatric surgery.Second,to diagnose and treat pre-surgery mental conditions that could predict poor weight loss.Third,to diagnose and treat post-surgery mental conditions associated with poor quality of life.Although bariatric psychiatry has gained the status of a new subspecialty within the field of mental health and psychopathology,many clinical questions remain unsolved.We need more long-term data on outcome measures such as quality of life,adherence to behavioral guidelines,risk of suicide,and postsurgery prevalence of psychological disturbances and mental disorders.
文摘Consultation-liaison psychiatry remains the guardian of holistic approach to the patient and consultation services in general hospital could therefore be referred to as“filters”for mental health care,in particular for patients with minor depressive or anxiety disorders.It is worth noting that psychiatric disorders,even when sub-clinical,worsen outcome whereas their early detection and treatment reduce health care costs significantly.The present study was transversal,exploratory,and descriptive in order to investigate the sample of outpatients referred from general practitioners(GP)to service of consultation-liaison psychiatry of the ASST Great Metropolitan Hospital Niguarda of Milan over a 7-months period.Data from all psychiatric consultations for outpatients were collected by a structured clinical report including socio-demographic features,features of referrals,and features of back-referrals.Five hundred and eleven consultations were performed.Participants were mainly female(58.7%)with an average age between 45 and 55 years(27.6%);31.1%of these patients was at the first contact with a mental health specialist.The diagnoses formulated were distributed as follows:The most common diagnoses were affective disorders(44.6%),followed by neurotic disorders(34.1%),personality disorders(6.8%),and finally,psychosis(6.2%).The study showed an example of a consultation-liaison service situated in a Great Metropolitan Hospital offering to GP the opportunity of a diagnostic assessment and shared management of minor psychiatric disorders.This approach could lead to several vantages,such as the management in a non-psychiatric setting of patients with reduction of stigma and reduced costs for specific psychiatric services where are referred more severe patients.
文摘Objective: The forensic mental health system in Japan changed dramatically with the enforcement of the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity” or MTS Act, in 2005. The aim of this study is to evaluate the changes in attitude and behavior of general psychiatrists, towards forensic psychiatry. Methods: We conducted a questionnaire survey in 2010 on forensic psychiatry for Japanese psychiatrists, mirroring a previous study from 2007. Results: Comparing the results from both questionnaires, it is not evident that awareness of forensic mental health has improved among psychiatrists in the intervening three years. Conclusion: Further education about forensic mental health needs to be considered inJapan.
文摘Traditional therapeutic methods in psychiatry,such as psychopharmacology and psychotherapy help many people suffering from mental disorders,but in the long-term prove to be effective in a relatively small proportion of those affected.Therapeutically,resistant forms of mental disorders such as schizophrenia,major depressive disorder,and bipolar disorder lead to persistent distress and dysfunction in personal,social,and professional aspects.In an effort to address these problems,the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising results.For instance,neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity,integration,and segregation of neural networks,focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy(ECT),transcranial magnetic stimulation(TMS),transcranial direct current stimulation(tDCS)and deep brain stimulation(DBS).These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective disorders.The current review is focused on the translational approach in the management of schizophrenia and mood disorders,as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT,TMS,tDCS and DBS.
文摘Uniforms represent more than just a body cover. There could be symbols of status, power, authority, values, beliefs, identity, wealth representation, self-protection, health and safety, suppression of individuality and identification on one hand by the wearer. The observers may perceive uniforms differently based on their experiences, expectations, education, perceptual ability, conformity, status, power, self-confidence, and need for trust and communication without barrier or judgment. Forty five adult mentally ill patients (21 female and 24 male) were administered questionnaires with Linkert Scale regarding how approachable or off-putting they find casual and religious wear in social worker. Significantly more patients preferred casual wear to religious. Chi squared test equals 28.689 with p value of less than 0.0001 for four degrees of freedom.
文摘Forensic psychiatrists routinely appear in courts for crimes that have been perpetrated by mentally ill patients or when the defendant is suffering from a major psychiatric disorder.However,committing crimes under the presumed effects of magic and witchcraft is uncommon.A variety of delusional thoughts and personality disorders have been imputed in aggressive behaviour that might culminate in homicide.The patterns of a premeditated homicide,as well as the aberrations of the interpersonal relations,as a rule require long-term and close contact.As such,the family is a setting where such occurrences have been reported.We describe a case of first-degree murder by a woman who killed her mother-in-law after accusing her repeatedly of sorcery and witchcraft.Such complicated cases cannot be resolved without the help of forensic experts,whose role remains multifaceted and of particular importance.
文摘The coronavirus disease 2019 pandemic has significantly altered many aspects of our professional lives,including how psychiatry as a medical discipline is taught and learnt.Training in psychiatry relies on developing competencies through observing and interacting with patients,developing empathic consultation skills and seeking feedback from colleagues derived from cognitive and constructivist theories of learning,in a time-bound manner.The pandemic has drawn attention to the dual role of psychiatry residents as both trainees and physicians,with a pressing identity crisis at an inopportune time.This paper aims to illustrate some of the emerging themes in psychiatry training during the pandemic and some solutions for the same.
文摘<strong>Background and Objectives:</strong> Neuroleptics have revolutionized pharmacological management in psychiatry. The advent of atypical neuroleptics constitutes a major turning point in this therapeutic challenge. The objective of our study was to determine the prescription of these atypical neuroleptics in Fann’s psychiatry department. <strong>Methodology:</strong> It was a descriptive retrospective cross-sectional study that involved 223 patients hospitalized in the psychiatry department of Fann Hospital during the period from January 2015 to December 2017. <strong>Results:</strong> Our study shows a majority prescription of classic neuroleptics in combination Haloperidol-Chlorpromazine 53% and 14% in monotherapy and a prescription of atypical neuroleptics at 4%. They are prescribed in combination with the classics at 4%. <strong>Conclusion:</strong> These results show a still low prescription of atypical neuroleptics which raises questions about the availability and affordability of such drugs, but also about prescription habits in the context of developing country.
