Multidisciplinary approach about contraception in a day hospital of mental health

2017 ◽  
Vol 41 (S1) ◽  
pp. s848-s848
Author(s):  
C.M. Calahorro ◽  
M. Guerrero Jiménez ◽  
B.M. Girela Serrano
Keyword(s):  
Mental Illness ◽  
Reproductive Health ◽  
Mental Illnesses ◽  
Healthy Population ◽  
Day Hospital ◽  
Attitudes And Practices ◽  
Hospital Patients ◽  
Unwanted Pregnancies ◽  
Competing Interest ◽  
Healthy Sexuality

BackgroundWomen with mental illness are a disadvantaged group both in terms of their gender and because of their mental disorders, and they experience serious problems related to reproductive health.The high rates of unplanned and unwanted pregnancies among women with schizophrenia underscore the importance of understanding their attitudes and practices related to family planning. Different studies reveal that even though many sexually active women with serious mental illnesses do not want to become pregnant, they do not use birth control.ObjectivesRelease last data about contraception methods among patients with severe mental illness after doing a bibliographical review. Also reflect present setup in Motril day hospital women patients and their relationship with sexuality and contraception. At the same time we intend to clarify and unify the proceedings on ethical problems respecting subject's autonomy, beneficence, qualification and minors’ protection.MethodsData were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing.ResultsIt was found that female patients with psychiatric disorders had more negative attributes with regard to contraception approach and sexuality compared with a corresponding healthy population.ConclusionsWe reached an agreement about future contraception approaches in Motril day hospital users as part of the global treatment offered in our section.MotrilHospital gynaecology service has facilitated the proceedings for contraceptive subcutaneous implants insertion in those indicated women.Day hospital patients were instructed individually and through group work about healthy sexuality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

On Becoming Ill: An Exploration of the Concept of “Transition” to a Mental Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S509-S510
Author(s):  
B. Moura
Keyword(s):  
Mental Illness ◽  
Clinical Practice ◽  
Mental Disorder ◽  
Systems Approach ◽  
Mental Illnesses ◽  
Clinical Population ◽  
Longitudinal Models ◽  
Cross Sectional ◽  
Competing Interest ◽  
Models Of Disease

IntroductionAs a general problem in nosology, the moment when one becomes ill may be hard to define. In Psychiatry, the boundaries of disease may be more difficult to establish. In the last decade, we’ve been observing a growing interest in early diagnosis in this field, and the concept of “transition” to a mental illness became an important topic of discussion with implications in clinical practice.ObjectiveTo review different author's models of evolution of symptoms and transition to mental illness and discuss their advantages and limitations in the actual context of Psychiatry research and clinical practice.AimTo increase understanding on the different paradigms of becoming ill and their relevance to present and future psychiatric practice.MethodsNon-systematic review of literature devoted to the creation of models that describe the establishment of a mental disorder.ResultsOne of the first accounts of becoming mentally ill was developed by K. Jaspers within a phenomenological life-history analysis. Nonetheless, a cross-sectional approach to diagnosis has dominated Psychiatry for most of the time. With the advent of early intervention studies, longitudinal models of disease have been emphasized. The concept of a transition to disease was then operationalized but also highly criticized. Recently, McGorry proposed a staging model for psychiatric disorders in continuum with the non-clinical population. Finally, a dynamic systems approach to diagnosis in Psychiatry will be discussed.ConclusionDriven by research in early phases of mental illnesses, current models of disease propose a longitudinal approach that emphasizes the complex and non-linear course of symptom clusters.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prejudice towards people with mental illness

2017 ◽  
Vol 41 (S1) ◽  
pp. S740-S740
Author(s):  
J. Radović ◽  
I. Roncevic-Grzeta ◽  
J. Rebic
Keyword(s):  
Mental Illness ◽  
Medical Students ◽  
General Population ◽  
Medical Research ◽  
Mentally Ill ◽  
Online Survey ◽  
Psychology Students ◽  
Mental Illnesses ◽  
People With Mental Illness ◽  
Competing Interest

This paper reports the results of a medical research that measured prejudice and attitudes towards mentally ill people and towards the mental illness. Three groups of respondents were studied: medical students, psychology students and the general population. Medical students and psychology students represented a population that is educated in regards to mental illness, and the general population was not trained so much about mental illness. The hypothesis was that the respondents who have been working with mentally ill people and had lots of knowledge about mental illnesses were the persons with less prejudice towards people with mental illness. The main objective of research was to examine the differences in prejudice and attitudes between respondents who had experience and knowledge related to mental illness and people with mental illness compared to those without such knowledge and experience. Testing was conducted using an anonymous online survey consisting of thirteen questions. The research confirmed the hypothesis and it could be an incentive for education aimed at specific groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Identifying and Managing Mental Health Needs of Homeless Individuals

2017 ◽  
Vol 41 (S1) ◽  
pp. S7-S7
Author(s):  
D. Bhugra
Keyword(s):  
Mental Illness ◽  
Mental Illnesses ◽  
Policy Support ◽  
Economic Downturn ◽  
Care Needs ◽  
Co Morbidity ◽  
Circular Argument ◽  
Downward Spiral ◽  
Competing Interest ◽  
The Uk

The economic downturn worldwide since 2008 has raised many issues, including an increase in homelessness. Individuals who are homeless are visible across the globe. Definitions of homelessness also vary. Living on the streets in all kinds of inclement weather, brings a different set of issues and problems including physical and mental illnesses. Here homelessness is defined as a lack of customary regular access to a conventional dwelling unit. It has been shown in several studies that nearly half were either depressed or had substance use disorders and half had traumatic brain injury. Homelessness is a social issue and the role of the psychiatrist in reaching these vulnerable individuals is a matter of critical importance. In the UK health services are geographically delineated making it more difficult for ‘out of area’ individuals to get help. The responsibility for looking after people who are homeless, have mental illness or physical co-morbidity, lies with policymakers as well. As clinicians we must advocate for vulnerable patients and psychiatry care needs to be in a joined-up manner. Early interventions and home treatments where and if available are suitable and can be effective but are often linked with secure addresses. Policies must take into account huge variations across cultures and societies and the contributions that unemployment and poverty can play in increasing homelessness. Whether psychiatric disorders lead to homelessness and whether homelessness leads to mental illness is a circular argument and this vicious downward spiral needs to be broken by adequate care and policy support.Disclosure of interestThe author has not supplied his declaration of competing interest.

Which Type Of Management Is Most Suited For Patients With A Diagnosis Of False Self Personality (FSP) Within A Psychodynamically-Oriented Institutional Day Hospital? A Study

2016 ◽  
Vol 33 (S1) ◽  
pp. S530-S530
Author(s):  
G. Giorgio ◽  
F. Marmo
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Hospital Admissions ◽  
Small Sample ◽  
Good Effect ◽  
Data Sets ◽  
Day Hospital ◽  
Psychodynamically Oriented ◽  
Competing Interest ◽  
Different Response

IntroductionOur work team have already found that our Institutional Psychiatric Open Light Treatment (IPOLT) model allows the patient affected by severe mental illness (SMI) to more easily express her/his personal coping skills rather than behaving passively thanks to the “real free spaces” separating a structured intervention from another. Our work consisted in evaluating how patients with FSP respond to IPOLT.ObjectivesThis paper describes observations of psychotic patients operating from the position of FSP in order to evaluate how they respond to IPOLT compared with other patients according to three standards (day hospital attendance, psychotic episodes and hospital admissions).AimsIdentify the core factors for management of patients with FSP in the context of IPOLT.MethodsWe isolated a sample including patients affected by severe mental illness (SMI); within this sample, we selected a small group of patients with FSP. During the last three years, we have been evaluating patients with FSP in terms of day hospital attendance, number of psychotic episodes and number of hospital admissions compared with data obtained from other patients with SMI without diagnosis of FSP.ResultsThe two data sets revealed no statistically significant differences in terms of the three standards.ConclusionsOur preliminary study showed a good effect for IPOLT treatment on patients with SMI. We expected that patients affected by SMI with FSP would have a different response to IPOLT, but it was not. We do not know whether such results depend on a too small sample of patients or inappropriate descriptors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Promotion mental health: Healthy habits program in patients with severe mental illness in the north Almeria mental health unit (Activarte)

2017 ◽  
Vol 41 (S1) ◽  
pp. S737-S738
Author(s):  
M. Marin Olalla ◽  
A. Vidal Lopez ◽  
B. Perez Ramirez ◽  
R. Maldonado Lozano ◽  
A.L. loret Lopez
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Social Inclusion ◽  
Participation Rate ◽  
Recovery Process ◽  
The North ◽  
Competing Interest ◽  
Healthy Sexuality ◽  
Initial Target

IntroductionPromoting healthy lifestyles in patients with severe mental illness (balance diet, physical activity, smoking withdraw, adequate oral hygiene, optimal self-esteem and healthy sexuality) help patients to rely on their recovery.Aims– avoid social isolation and stigma.– encourage the recovery process, considering as well as the manage of symptoms together the functioning and quality of life of the patients.– improve the progress and illness prognosis.Methods– The program is introduced in the North Health Area of Almeria (Hospital Huercal–Overa) and FAISEM–Andalusia foundation to the social inclusion of mental illness patients;– patients included in the program has been previously assess and informed-therapeutical contract;– the program started in January 2013, with 10 sessions in the community, and groups sessions.Results– fifty patients included between a total of 300–initial target 16%;– the initial target considered was at least 60–75% of participation rate—being the result of 80–95%;– physical assessment detected 10% of metabolic syndrome being the patients referred to primary medical care to the adequate management.Program:– twenty group sessions scheduled being performed 19: 95%;– ten active sessions in community scheduled being performed 9: 90%–one sessions (beach trip) was cancelled due to budget problem;– patients level of satisfaction: under assessment;– broadcasting: 2 press articles, scientific communications, and shared the experience through FAISEM to all the Andalusia Areas.– research: expecting spreading the experience and improve the results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prescriptive Power: Biologism, Biopsychiatry and Drug-centred Psychopharmacology

Somatechnics ◽  
2019 ◽  
Vol 9 (2-3) ◽  
pp. 291-309
Author(s):  
Francis Russell
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Justice ◽  
Cultural Theory ◽  
Human Experience ◽  
Mental Illnesses ◽  
False Consciousness ◽  
The Subject ◽  
Biological Ontology ◽  
Health Discourse

This paper looks to make a contribution to the critical project of psychiatrist Joanna Moncrieff, by elucidating her account of ‘drug-centred’ psychiatry, and its relation to critical and cultural theory. Moncrieff's ‘drug-centred’ approach to psychiatry challenges the dominant view of mental illness, and psychopharmacology, as necessitating a strictly biological ontology. Against the mainstream view that mental illnesses have biological causes, and that medications like ‘anti-depressants’ target specific biological abnormalities, Moncrieff looks to connect pharmacotherapy for mental illness to human experience, and to issues of social justice and emancipation. However, Moncrieff's project is complicated by her framing of psychopharmacological politics in classical Marxist notions of ideology and false consciousness. Accordingly, she articulates a political project that would open up psychiatry to the subjugated knowledge of mental health sufferers, whilst also characterising those sufferers as beholden to ideology, and as being effectively without knowledge. Accordingly, in order to contribute to Moncrieff's project, and to help introduce her work to a broader humanities readership, this paper elucidates her account of ‘drug-centred psychiatry’, whilst also connecting her critique of biopsychiatry to notions of biologism, biopolitics, and bio-citizenship. This is done in order to re-describe the subject of mental health discourse, so as to better reveal their capacities and agency. As a result, this paper contends that, once reframed, Moncrieff's work helps us to see value in attending to human experience when considering pharmacotherapy for mental illness.

Effective e-health design for those with, and without, mental health disorders: shallow navigation, concentrated contents, modest number of links, one screen area for links. (Preprint)

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Success Rate ◽  
Fractional Factorial ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Design Elements ◽  
Website Usability ◽  
Schizophrenia Spectrum ◽  
Health Applications

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.

scholarly journals Use of a Consultation Service Following Pharmacogenomic Testing in Psychiatry

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 179-180
Author(s):  
Daniel Dowd ◽  
David S. Krause
Keyword(s):  
Mental Illness ◽  
Drug Interactions ◽  
Metabolic Pathways ◽  
Patient Characteristics ◽  
Healthcare Resource Utilization ◽  
Machine Learning Algorithms ◽  
Mental Illnesses ◽  
Variable Response ◽  
Drug Induced ◽  
Commercial Laboratory

AbstractBackgroundThere is a plethora of drugs available to psychiatrists for treatment of mental illness, which can vary in efficacy, tolerability, metabolic pathways and drug-drug interactions. Psychotropics are the second most commonly listed therapeutic class mentioned in the FDA’s Table of Pharmacogenomic Biomarkers in Drug Labeling. Pharmacogenomic (PGx) assays are increasingly used in psychiatry to help select safe and appropriate medication for a variety of mental illnesses. Our commercial laboratory offers PGx expert consultations by PharmDs and PhDs to clinician-users. Our database contains valuable information regarding the treatment of a diverse and challenging population.MethodsGenomind offers a PGx assay currently measuring variants of 24 genes relevant for selection of drugs with a mental illness indication. Since 2012 we have analyzed > 250,000 DNA samples. Between 10/18 - 8/20 6,401 reports received a consult. The data contained herein are derived from those consults. Consultants record information on prior meds, reason for failure or intolerability, potential risk-associated or useful drugs based on the genetic variants. Consultants only recommend specific drugs and doses consistent with a published PGx guideline.ResultsThe 5 most commonly discussed genes were SLC6A4, MTHFR, CACNA1C, COMT and BDNF. The 3 most commonly discussed drugs were fluoxetine, lithium and duloxetine. The most common reasons for drug failure were inefficacy and drug induced “agitation, irritability and/or anxiety”. SSRIs were the most common class of discontinued drug; sertraline, escitalopram and fluoxetine were the three most commonly reported discontinuations and were also the 3 most likely to be associated with “no improvement”. Aripiprazole was the most commonly reported discontinued atypical antipsychotic. The providers rated 94% of consultations as extremely or very helpful at the time of consult. An independent validation survey of 128 providers confirmed these ratings, with 96% reporting a rating of “very helpful” or “extremely helpful”. In addition, 94% reported that these consults were superior to PGx consults provided through other laboratories. Patient characteristics captured during consults via a Clinical Global Impressions-Severity (CGI-S) scale revealed that the majority of patients were moderately (54%) or markedly ill (23%). The most frequent symptoms reported were depression, anxiety, insomnia and inattentiveness.DiscussionThe large variety of psychotropic drugs available to providers, and their highly variable response rates, tolerability, capacity for drug-drug interactions and metabolic pathways present a challenge for even expert psychopharmacologists. Consultation with experts in PGx provides additional useful information that may improve outcomes and decrease healthcare resource utilization. This database may provide future opportunities for machine learning algorithms to further inform implications of included gene variants.FundingGenomind, Inc.

scholarly journals Priority vaccination for mental illness, developmental or intellectual disability

2021 ◽  
pp. medethics-2021-107247
Author(s):  
Nina Shevzov-Zebrun ◽  
Arthur L Caplan
Keyword(s):  
Mental Illness ◽  
Living Arrangement ◽  
State Level ◽  
Elevated Risk ◽  
Mental Illnesses ◽  
Healthcare Personnel ◽  
Diverse Populations ◽  
Federal Level ◽  
Control And Prevention ◽  
Prevention Guidelines

Coronavirus vaccines have made their debut. Now, allocation practices have stepped into the spotlight. Following Centers for Disease Control and Prevention guidelines, states and healthcare institutions initially prioritised healthcare personnel and elderly residents of congregant facilities; other groups at elevated risk for severe complications are now becoming eligible through locally administered programmes. The question remains, however: who else should be prioritised for immunisation? Here, we call attention to individuals institutionalised with severe mental illnesses and/or developmental or intellectual disabilities—a group highly susceptible to the damages of COVID-19, recent research shows, and critical to consider for priority vaccination. The language describing both federal-level and state-level intentions for this population remains largely vague, despite the population’s diversity across age, diagnosis, functional status and living arrangement. Such absence of specificity, in turn, leaves room for confusion and even neglect of various subgroups. We review data stressing this group’s vulnerability, as well as select state plans for priority vaccination, highlighting the importance of clarity when describing intentions to vaccinate, or even generally care for, diverse populations composed of distinct subgroups in need.

scholarly journals The effect of nutrition and reproductive health education of pregnant women in Indonesia using quasi experimental study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tria Astika Endah Permatasari ◽  
Fauza Rizqiya ◽  
Walliyana Kusumaningati ◽  
Inne Indraaryani Suryaalamsah ◽  
Zahrofa Hermiwahyoeni
Keyword(s):  
Health Education ◽  
Reproductive Health ◽  
Pregnant Women ◽  
Intervention Group ◽  
Control Group ◽  
Attitudes And Practices ◽  
Significant Difference ◽  
Reproductive Health Education ◽  
Post Test ◽  
Knowledge Attitudes And Practices

Abstract Background Almost one-third of children under 5 years old in Indonesia suffer from stunting. Stunting can be prevented optimally during pregnancy as the initial phase of the first 1000 days of life. This study aims to determine the effect of nutrition and reproductive health education of pregnant women in Bogor Regency, Indonesia. Methods A quasi-experimental study was conducted among 194 pregnant women from August to November 2019. The pregnant women were randomly selected from four different villages in Bogor Regency. The intervention group (n = 97) received 2 h of nutrition and reproductive health education in small groups (four or five mothers per group) every 2 weeks for 3 consecutive months. This interactive education was given by facilitators using techniques such as lectures, role-playing, simulation, and games. The control group (n = 97) received regular health care services. A structured questionnaire was applied to collect data consisting of maternal characteristics, nutritional and reproductive health knowledge, attitudes, and practices in the intervention and control groups. Data were analysed using t-test and chi-square analysis. Results Pregnant women in the intervention group indicated a significant increase in knowledge, attitudes, and practices regarding nutrition and reproductive health after receiving education. The pre-test and post-test mean scores in the intervention group were 55.1 and 83.1 for overall knowledge, 40.2 and 49.0 for attitudes, and 36.2 and 40.2 for practices, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for these three variables. There was a significant difference (P < 0.001) in the post-test mean between the intervention group and the control group, but the difference was not significant (P > 0.05) in the pre-test. Conclusion Providing nutrition and reproductive health education through small groups with interactive methods improves the knowledge, attitudes, and practices of pregnant women. This intervention has the potential to be replicated and developed for large-scale implementation by optimising collaboration between government, non-governmental organizations, and maternal and child health service providers.

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