Who are the Europeans admitted to psychiatric hospital in Tunisia?

2017 ◽  
Vol 41 (S1) ◽  
pp. S698-S698
Author(s):  
U. Ouali ◽  
K. Ben Neticha ◽  
R. Jomli ◽  
A. Ouertani ◽  
F. Nacef
Keyword(s):  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Insurance Coverage ◽  
University Hospital ◽  
Public Authorities ◽  
Early Action ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Competing Interest ◽  
Almost All

IntroductionA large number of foreign travellers and expatriates visits or lives in Tunisia.ObjectivesTo explore socio-demographic, clinical and therapeutic characteristics of European patients admitted to psychiatric care in Tunisia.MethodsThis is a retrospective, descriptive study on all European patients admitted to Razi psychiatric university hospital, which is situated at the outskirts of the capital Tunis, between 2000 and 2015.ResultsA total of 44 Europeans was admitted. Most frequent nationalities were: French and Germans (19 and 16 patients). The stay in Tunisia was mainly due to pathologic travel (17 subjects) and tourism (13 subjects). In total, 25 patients travelled without being accompanied. Average age was 51.3 years with extremes from 16 to 78 years. A history of psychiatric disorder was found in 15 patients, of whom almost all had stopped treatment. A majority (19 patients) was diagnosed with bipolar I disorder, and 8 patients suffered from schizophrenia. Average duration of hospitalization was 19 days. A total of, 22 patients were repatriated for medical reasons. Major difficulties during hospitalization were the language barrier, difficulties to contact family members or former treating psychiatrists for further information on the patient and his medical history, and the lack of insurance covering repatriation for medical reasons.ConclusionPsycho-education and early action on the precipitating factors could help to prevent psychiatric illness or relapse in these patients. Furthermore, attention of public authorities should be drawn to incomplete insurance coverage in many psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Moral Treatment: Philippe Pinel

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Mrs. Sushma. C ◽  
Dr. Meghamala. S. Tavaragi
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Social Stress ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Demonic Possession ◽  
Moral Treatment ◽  
Modern Psychiatry ◽  
History Of ◽  
First Time

Philippe Pinel a pioneer, a french psychiatrist, a physician, known as father of modern psychiatry, revolutions psychiatric care of patients with mental illness by introducing concept of moral treatment. Pinel rejected the then prevailing popular notion that mental illness was caused by demonic possession and stated that mental disorders could be caused by a variety of factors including psychological or social stress, congenital conditions, or physiological injury, psychological damage, or heredity. Philippe Pinel for the first time in history of psychiatric patients treated them humanly by unchaining patients known as madmen. This historic event was done for first time in Bicêtre Hospital in 1798 a Parisian insane asylum. In this article a brief history of life and work of pioneer Philippe Pinel is mentioned.

International research on social withdrawal

2016 ◽  
Vol 33 (S1) ◽  
pp. S23-S23
Author(s):  
A.R. Teo
Keyword(s):  
Personality Disorder ◽  
Assessment Tool ◽  
Social Withdrawal ◽  
Psychosocial Impairment ◽  
Loneliness Scale ◽  
History Of ◽  
Axis I ◽  
Competing Interest ◽  
Almost All ◽  
Depressive Personality

IntroductionSince the 1990s the term “Hikikomori” has emerged as a way to describe a modern form of severe social withdrawal first described in Japan. Recently, there have been increasing reports of Hikikomori around the globe.ObjectivesTo describe operationalized research criteria for Hikikomori, as well as epidemiologic, diagnostic, and psychosocial features of the Hikikomori in international settings.MethodsParticipants were recruited from sites in India, Japan, Korea, and the US. Hikikomori was defined as a six-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Lifetime history of psychiatric diagnosis was determined by the Structured Clinical Interview for the DSM-IV Axis-I and Axis-II Disorders. Additional measures included the Internet Addiction Test, UCLA Loneliness Scale, Lubben Social Network Scale (LSNS-6), and Sheehan Disability Scale (SDS).ResultsThirty-six participants meeting diagnostic criteria for Hikikomori were identified, with cases detected in all four countries. Avoidant personality disorder (41%), major depressive disorder (32%), paranoid personality disorder (32%), social anxiety disorder (27%), posttraumatic stress disorder (27%), and depressive personality disorder (27%) were the most common diagnoses. Sixty-eight percent had at least two psychiatric diagnoses. Individuals with Hikikomori had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5), and moderate functional impairment (SDS M = 16.5, SD = 7.9).ConclusionsHikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with Hikikomori have substantial psychosocial impairment and disability, and a history of multiple psychiatric disorders is common.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Letter from America: how will health reform affect psychiatric care?

2010 ◽  
Vol 16 (6) ◽  
pp. 398-401
Author(s):  
Steven S. Sharfstein
Keyword(s):  
Health Reform ◽  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Cost Of Care ◽  
Public And Private ◽  
The Usa ◽  
The Cost ◽  
Major Emphasis

SummaryHealth reform in America will lead to major changes in medical care in the USA, with opportunities for improved access to care, especially for psychiatric patients. Combined with recently enacted ‘parity’ legislation, health reform will expand public and private insurance coverage to an additional 33 million Americans, leading to increased pressure on the psychiatrists who are willing to practise with the insured population and on opportunities for subspecialisation within the field. Some essential non-medical tasks will not be funded by insurance, and these must be given due consideration. A major emphasis of health reform is to integrate general health and mental health services. The reform will have an impact on the use of the hospital and emergency room as well. A major concern is the cost of care and how it will be controlled.

Nootropics: Emergents drugs associated with new clinical challenges

2017 ◽  
Vol 41 (S1) ◽  
pp. s877-s878 ◽  
Author(s):  
H. Saiz Garcia ◽  
L. Montes Reula ◽  
A. Portilla Fernandez ◽  
V. Pereira Sanchez ◽  
N. Olmo Lopez ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Psychiatric Patients ◽  
Mental Performance ◽  
Neuroprotective Effects ◽  
Beneficial Effects ◽  
Secondary Messenger ◽  
Common Term ◽  
History Of ◽  
Competing Interest ◽  
Smart Drug

IntroductionThe “nootropic” or simplified as a “smart drug”, is a common term that will tag along with the compound responsible for the enhancement of mental performance. Certain individuals with a history of mental or substance use disorders might be particularly vulnerable to its adverse effects.MethodologyA review was conducted aiming to clarify the mechanisms associated of how these drugs increase mental functions including memory, motivation, concentration, and attention; and which kind of individuals are at risk of developing adverse effects when taking these drugs. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016.Results– Glutaminergic Signalling, Cholinergic System, Amyloid Precursor Protein and Secondary Messenger may be related to the cognitive enhancement achieved by Nootropics. Others, like insulin and angiotensin receptor may involved too.– Some of them, like Ginkgo biloba, seem to have neuroprotective effects observed in human and animal models, acting as antioxidant and antiapoptotic, also inducing inhibition effects against caspase-3 activation and amyloid-aggregation toward Alzheimer's disease.– Synthetic nootropics, a lab created compound such as piracetam, especially in people with history of drug abuse, may be associated with psychiatric exacerbations of some patients.ConclusionsYoung adults all over Europe, especially university students, are starting to use nootropic drugs to improve their academic results. Some of them seem to have beneficial effects over mental health but others are sometimes related with sudden and unexplained exacerbations in stable psychiatric patients. It is important to early identify symptoms and to treat them properly.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Forensic psychiatric expertise of patients with anti-social personality

2017 ◽  
Vol 41 (S1) ◽  
pp. S592-S592
Author(s):  
M. Turki ◽  
N. Charfi ◽  
M. Maalej Bouali ◽  
J. Ben Thabet ◽  
N. Zouari ◽  
...  
Keyword(s):  
Violent Behavior ◽  
Epidemiological Studies ◽  
University Hospital ◽  
School Level ◽  
Addictive Behaviors ◽  
Psychiatric Expertise ◽  
History Of ◽  
Forensic Psychiatric ◽  
Competing Interest ◽  
High Crime

IntroductionEpidemiological studies in the general population confirm the indisputable link between criminological dangerousness and mental disorders especially anti-social personality, which increase clearly the prevalence of violent behavior.AimTo dress socio-demographic, clinical and medico-legal profile of offenders, with anti-social personality, in forensic psychiatric examination.MethodsIt was a retrospective study of a series of 195 patients with antisocial personality (DSM-IV). They were examined, during the period, from 2009 to 2013, on the occasion of a penal expertise in the department of psychiatry C in the Hedi Chaker university hospital, Sfax, Tunisia.ResultsThe mean age of patients at the offense moment, was 29.58 years, with a sex ratio of 26.85. Among them, 66.2% were single, 49.2% had a primary school level and 41% had no profession. Between the patients, 58.5% lived in urban area and 38.5% in a high crime area. Addictive behaviors were reported in 80% of cases. Self-injury behaviors were noted in 33.8% of offenders. Psychiatric histories were reported in 66.2%, and 25.6% of patients have been already hospitalized in psychiatry department. 64.1% had already committed forensic acts, and 36% had been imprisoned at least once. The current offense was: homicide 16.9%; sexual offense 9.2%; violence 18.5%; theft 30.2%. The offense was related to impulsivity (40%) or utilitarian purpose (39%).ConclusionA young single man with no profession, a limited educational attainment and a history of impulsive behaviors, such is the profile most frequently encountered among offenders with anti-social personality. Interventions for reducing forensic behavior should focus on those social and clinical characteristics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Room for hope: How to deal with growing racism and discrimination?

2016 ◽  
Vol 33 (S1) ◽  
pp. S43-S43
Author(s):  
L. Küey
Keyword(s):  
The Other ◽  
Group Differences ◽  
Psychosocial Characteristics ◽  
Group Identities ◽  
History Of ◽  
The Subject ◽  
Competing Interest ◽  
Almost All ◽  
And Behavior ◽  
Attitudes And Behavior

Discrimination could be defined as the attitudes and behavior based on the group differences. Any group acknowledged and proclaimed as ‘the other’ by prevailing zeitgeist and dominant social powers, and further dehumanized may become the subject of discrimination. Moreover, internalized discrimination perpetuates this process. In a spectrum from dislike and micro-aggression to overt violence towards ‘the other’, it exists almost in all societies in varying degrees and forms; all forms involving some practices of exclusion and rejection. Hence, almost all the same human physical and psychosocial characteristics that constitute the bases for in-group identities and reference systems could also become the foundations of discrimination towards the humans identified as out-groups. Added to this, othering, arising from imagined and generalized differences and used to distinguish groups of people as separate from the norm reinforces and maintains discrimination.Accordingly, discrimination built on race, color, sex, gender, gender identity, nationality and ethnicity, religious beliefs, age, physical and mental disabilities, employment, caste and language have been the focus of a vast variety of anti-discriminatory and inclusive efforts. National acts and international legislative measures and conventions, political and public movements and campaigns, human rights movements, education programs, NGO activities are some examples of such anti-discriminatory and inclusive efforts. All these efforts have significant economic, political and psychosocial components.Albeit the widespread exercise of discrimination, peoples of the world also have a long history of searching, aiming and practicing more inclusive ways of solving conflicts of interests between in-groups and out-groups. This presentation will mainly focus on the psychosocial aspects of the anti-discriminative efforts and search a room for hope and its realistic bases for a more non-violent, egalitarian and peaceful human existence.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals The history of organization of care for psychiatric patients in Kazan and in Kazan province from the establishment and to the end of the XIX century

2012 ◽  
Vol 93 (1) ◽  
pp. 146-152
Author(s):  
D M Mendelevich ◽  
A S Sozinov ◽  
E V Morozova
Keyword(s):  
Psychiatric Care ◽  
Historical Data ◽  
Psychiatric Patients ◽  
Organization Of Care ◽  
History Of ◽  
Xix Century

Present was the historical data, dedicated to the establishment of psychiatric care in Kazan province.

In-Patient and Post-Discharge Suicides in Tyrol 2004–2011

2017 ◽  
Vol 41 (S1) ◽  
pp. S292-S292
Author(s):  
E.A. Deisenhammer ◽  
E.M. Behrndt ◽  
G. Kemmler ◽  
C. Haring ◽  
C. Miller
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
High Risk Population ◽  
Post Discharge ◽  
Patient Status ◽  
History Of ◽  
Competing Interest ◽  
Commit Suicide

IntroductionPsychiatric patients constitute a high-risk population for suicide. In-patient status and the period after discharge are of particular interest concerning risk assessment.ObjectiveTo assess risk factors for in-patient and post-discharge suicides.MethodsThe Tyrol suicide register was linked with the registers of three psychiatric departments/hospitals of the region. Suicides were categorized according to whether the suicide was committed during a hospital stay or within 12 weeks after discharge or whether the suicide subject had not recently been hospitalized. Groups were compared with regard to demographic and clinical variables. Further, case-control comparisons were performed for the in-patient and post-discharge groups.ResultsDuring the study period (2004–2011) 30 in-patients, 89 post-discharge and 592 not recently hospitalized suicides were identified. Groups differed in terms of gender distribution, history of suicide attempts, warning signals and suicide methods. Compared with controls matched for a number of variables, in-patient suicides were significantly more suicidal and depressed at admission, reported more often a recent life event and showed less often aggressive behavior and plans for the future. Post-discharge suicides had more often a history of attempted suicide, depressive and thought disorder symptomatology, a ward change and an unplanned discharge and less often a scheduled appointment with a non-psychiatric physician.ConclusionsSuicide victims differ with regard to whether they die during, shortly after or not associated with a hospitalization. Compared to controls there are specific risk factors for those who commit suicide during a hospital stay and within 12 weeks after discharge.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Hospitalization Durations and Remission Rates of Patients in a Psychiatry Clinic

2016 ◽  
Vol 33 (S1) ◽  
pp. S522-S523
Author(s):  
R. Tutuncu ◽  
H. Kullakçı ◽  
B. Hakan ◽  
A. Algul ◽  
A. Ates ◽  
...  
Keyword(s):  
Service Delivery ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Contributing Factors ◽  
Psychiatry Clinic ◽  
Hospitalization Period ◽  
Remission Rates ◽  
Duration Of Hospitalization ◽  
Competing Interest

ObjectiveThe duration of hospitalization is related to many well-documented factors in literature. However, little is known about psychiatric patients and psychiatric service delivery in non-Western developing countries. It is supposed that major contributing factors in discharge are remission rates and functional levels. Therefore, this naturalistic preliminary study aimed at analyzing and describing the hospitalization duration and remission rates of a psychiatric population treated in the mental health inpatient facility.MethodsA total of 88 male patients, who were hospitalized in a psychiatry clinic were included in the study. They were evaluated at admission and before discharge using the Brief Psychiatric Rating Scale (BPRS) and the Clinic Global Impression Scale (CGI). Other variables, including length of stay, number of previous admissions, demographic characteristics, and diagnosis were also assessed.ResultsMean of the total scores on BPRS were declined from 24.95 to 13, and the mean CGI scores were declined from 3.85 to 2.04 during hospitalization period. Mean length of hospitalization was 7.91 days.ConclusionOur study shows that patients are discharged from the hospital with approximately 50% decrease in symptom severity. Such research can contribute to understand better, the needs of psychiatric patients, and help to develop continuously improved service delivery and optimize therapeutic options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Risk Factors for Acquisition of Multidrug-Resistant Pseudomonas aeruginosa Producing SPM Metallo-β-Lactamase

2005 ◽  
Vol 49 (9) ◽  
pp. 3663-3667 ◽  
Author(s):  
Simone Aranha Nouér ◽  
Marcio Nucci ◽  
Márcia P. de-Oliveira ◽  
Flávia Lúcia Piffano Costa Pellegrino ◽  
Beatriz Meurer Moreira
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Case Patient ◽  
Case Definitions ◽  
Duration Of Hospitalization ◽  
History Of

ABSTRACT To evaluate risk factors for colonization or infection due to multidrug-resistant Pseudomonas aeruginosa (MDRPa) carrying the bla SPM gene (SPM-MRDPa) among hospitalized patients, we undertook a case control study at a 480-bed, tertiary-care university hospital. Two different case definitions were used. In the first definition, a case patient (SPM case patient) was defined as a patient who had at least one isolate of SPM-MDRPa (14 patients). In the second, a case patient (non-SPM case patient) was defined as a patient who had at least one isolate of non-SPM-MDRPa (18 patients). For each case patient, we selected two controls, defined as a patient colonized and/or infected by a non-MDRPa isolate during the same study period and with the closest duration of hospitalization until the isolation of P. aeruginosa as cases. The use of quinolones was the single independent predictor of colonization and/or infection by bla SPM MDRPa (odds ratrio [OR] = 14.70, 95% confidence interval [95% CI] = 1.70 to 127.34, P = 0.01), whereas the use of cefepime was the single predictor of colonization and/or infection by non-bla SPM MDRPa (OR = 8.50, 95% CI = 1.51 to 47.96, P = 0.01). The main risk factor for MDRPa was a history of antibiotics usage. Stratification of risk factor analysis by a precise mechanism of resistance led us to identify a specific antibiotic, a quinolone, as a predictor for SPM-MDRPa.

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