scholarly journals Dual Diagnosis and Treatment: The Experience of a Multiprofessional Team in Mental Health

2017 ◽  
Vol 41 (S1) ◽  
pp. S309-S310
Author(s):  
J. Jaber ◽  
J. Verissimo ◽  
J. Mendonça ◽  
M. Schwartz ◽  
S. Leite ◽  
...  
Keyword(s):  
Dual Diagnosis ◽  
Positive Impact ◽  
Treatment Plan ◽  
Family Therapist ◽  
Individual Treatment ◽  
Psychiatric Clinic ◽  
Moderate Physical Activity ◽  
Psychoactive Substances ◽  
Multiprofessional Team ◽  
General Practicioner

IntroductionThe work was developed with the people hospitalized in the period of 1 year in a psychiatric clinic in Rio de Janeiro city, Brazil. 175 patients who presented dual diagnosis were evaluated.ObjectivesThe research aims to know the distribution of the most frequent psychiatric diagnosis associated with the disorders for the use of psychoactive substances. The work also has as objective to assess the treatment of patients carrying these disorders so that there is a better efficiency of the individual treatment plan.MethodsThe work consisted of the evaluation of all patients who were admitted to the clinic in the period of 1 year, using the ICD-10 for the diagnosis of dual pathologies. All the patients were assessed by the multiprofessional team, composed by general practicioner, psychiatrist, psychologist, pharmaceutic, therapist in chemical dependence, family therapist and physiotherapist. The patients were treated with the use of psychopharms, cognitive behavioral psychotherapy, 12-step program, art therapy and moderate physical activity. Family members of all patients were also interviewed.ResultsIn the evaluation conducted by the team, it was found the following distribution of the most frequent diagnosis associated to disorder for the use of psychoactive substances: depression (26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-schizophrenic psychosis (12.6%), schizophrenia (9.1%), and other diagnosis (6.8%).ConclusionsThe formulation of the dual diagnosis provided a better approach of the patients on the part of the team, promoting the strengthening of the therapeutic bond and causing positive impact on the evolution of these disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The dual-diagnosis concept used by Swedish social workers: limited validity upon examination using a structured diagnostic approach

2002 ◽  
Vol 17 (6) ◽  
pp. 363-365 ◽  
Author(s):  
Markus Heilig ◽  
Kaj Forslund ◽  
Marie Åsberg ◽  
Ulf Rydberg
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Psychiatric Symptoms ◽  
Treatment Plan ◽  
Population Sample ◽  
Diagnostic Procedures ◽  
Individual Treatment ◽  
Self Medication ◽  
Axis I

SummaryA co-existence of chemical dependence and other psychiatric syndromes is commonly referred to as “dual-diagnosis.” This categorization is commonly made by social workers in several European countries assigned the primary responsibility for the care of drug and alcohol dependence. Here, we examined the validity of this categorization through systematic, structured patient evaluation following a minimum of 3 weeks of abstinence from drugs and alcohol. Less than one-third of patients originally labelled as suffering from “dual-diagnosis” by the social services did in fact obtain any Axis I DSM IIIR diagnosis, and less than half of the patients had any psychiatric diagnosis other than dependence. Syndromes commonly discussed in the context of self-medication, i.e., unipolar depression and anxiety syndromes, were not over-represented compared to a population sample, while chronic psychoses and bipolar syndromes were highly significantly more common. We conclude that the dual-diagnosis concept, unless substantiated through stringent diagnostic procedures by psychiatrically trained personnel, may be of questionable utility in caring for patients presenting with psychiatric symptoms and substance dependence. A systematic individual evaluation in an alcohol- and drug-free state of sufficient duration is necessary to obtain a basis for an adequate individual treatment plan.

The Relationship of Metabolic and Endocrine Parameters with Associated Diseases in Diabetes Mellitus

2018 ◽  
Vol 69 (5) ◽  
pp. 1288-1291 ◽  
Author(s):  
Mariana Cornelia Tilinca ◽  
Sandor Pal ◽  
Zoltan Preg ◽  
Eniko Barabas Hajdu ◽  
Raluca Tilinca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Scoring System ◽  
Laboratory Tests ◽  
Treatment Plan ◽  
Individual Treatment ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Associated Diseases ◽  
Investigation Methods ◽  
Predictive Role

The most common comorbidities in patients with diabetes mellitus are cardiovascular diseases, obesity, dyslipidemia, thyroid disorders but other associated diseases may frequently occur. Laboratory tests are useful investigation methods that may reveal the subclinical manifestations of the disease but they are also essential for patient monitoring. The aim of the study was to assess laboratory parameters and associated diseases in diabetic subjects and to implement a scoring system with a predictive role in the evolution of the cases. Material and methods: The study group consisted of 195 subjects with documented type 1 or type 2 diabetes. About half of the cases were collected from the Procardia outpatient unit, and the rest were patients admitted to the Diabetology Clinic in T�rgu Mure�. The study was performed between January - June 2017. The results of the laboratory tests, as well as the information regarding comorbidities and treatment, was collected and patients� body mass index was calculated. Based on the clinical data, a scoring system, called Diabetes Complication Severity Index (DCSI) with a predictive role, was implemented. The diabetic outpatients presented significantly better carbohydrate metabolic balance compared to the hospitalized subjects. No significant differences could be observed regarding kidney function, hepatic status and lipid profile of the two subgroups of diabetic subjects. The most important comorbidity observed in both patient groups was arterial hypertension. The hospitalized diabetic subjects had significantly higher incidence of ischemic heart disease and significantly lower incidence of thyroid disorders compared to the outpatients. The DCSI scoring system revealed that comorbidities are more frequently present in the hospitalized patients compared to the ambulant diabetic subjects. Evaluation of clinical status and laboratory results in diabetic patients followed by implementation of a scoring system based on the data obtained regarding comorbidities could help clinicians to set up an individual treatment plan for these patients, focusing on preventing other complications.

scholarly journals Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

2021 ◽  
Author(s):  
Sonja Rahim-Wöstefeld ◽  
Dorothea Kronsteiner ◽  
Shirin ElSayed ◽  
Nihad ElSayed ◽  
Peter Eickholz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Tooth Loss ◽  
Treatment Plan ◽  
Periodontal Therapy ◽  
Outcome Variable ◽  
Individual Treatment ◽  
Risk Indicator ◽  
Related Factors ◽  
Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 3 (3) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

Onco-specific sleep disorders and fatigue: tactics of psychological test and cognitive behavioral therapy

2021 ◽  
Vol LIII (3) ◽  
pp. 51-63
Author(s):  
Aleksey I. Melehin
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Sleep Disorders ◽  
Cancer Patients ◽  
Behavioral Therapy ◽  
Treatment Plan ◽  
Cognitive Behavioral ◽  
Individual Treatment ◽  
Team Approach ◽  
Oncological Patient ◽  
Psychological Assistance

Introduction. Sleep disorders are widespread throughout the entire period of treatment of an oncological patient from the moment of diagnosis, and in many patients persist after completion of treatment. The nature of cancer and its treatment expose patients to many potential provoking and/or supportive factors that are atypical for the general population. In addition, sleep disturbance rarely manifests as a separate symptom, but more often occurs together with such symptoms as fatigue, pain, depression and/or cognitive impairment. This complicates the assessment and often requires an individual treatment plan with a team approach. AIM. of the work is to acquaint mental health specialists, oncologists, chemotherapists with the specifics of the examination of cancer-specific insomnia and fatigue, the construction of team treatment tactics, the organization of psychotherapeutic care for cancer patients. Results. The article describes for the first time the specifics of onco-specific insomnia and fatigue. The general predisposing and supporting factors of insomnia characteristic of cancer patients are systematized. The relationship between onco-specific fatigue and sleep disorders is shown. The role of pro-inflammatory cytokines as a common neuroendocrine-immune mechanism underlying the behavioral symptoms of sleep disorders, fatigue, depression and cognitive dysfunction in people with cancer is noted. Due to the limitations of the pharmacological approach, the purpose, forms, modes and approaches of using cognitive behavioral therapy protocols to minimize insomnia and fatigue are described. Based on the data of our foreign colleagues, we have proposed an algorithm for assessing sleep disorders in a patient with an oncological profile. The effectiveness of the standard protocol of cognitive behavioral psychotherapy of insomnia (SCBT-I) in a patient of the oncological profile Lavini Fiorentino is described in detail and shown; as well as the short protocol of CBT of cancer-specific insomnia by Eric Zo et al.; remote protocol of mindfulness enhancement therapy to minimize onco-specific fatigue Z.by Fieke et al. Conclusions. CBT in the framework of complex treatment has a positive effect on the immune system, reducing inflammation mediated through the hypothalamic-pituitary-adrenal axis. Despite the accumulation of evidence confirming the effectiveness of this form of psychological assistance, its availability in Russia remains extremely limited and not fully appreciated.

Differences in clinical and needs assessment between inmates with high versus low risk of suicide

2011 ◽  
Vol 26 (S2) ◽  
pp. 769-769
Author(s):  
A.M. Cardoso ◽  
M. Talina ◽  
F. Fortes ◽  
T. Leal ◽  
J.M. Caldas de Almeida ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Suicide Risk ◽  
Unmet Needs ◽  
Positive Impact ◽  
Care Delivery ◽  
Low Risk ◽  
Psychiatric Clinic ◽  
User File ◽  
Forensic Psychiatric ◽  
Male Inmates

IntroductionDrugs addiction, suicide and mental health disorders are the major problems of inmates health. In Portugal the suicide is the second cause of death and is increasing in a panorama of general decreased mortality in prisons.ObjectivesTo characterize and compare the inmate population with high versus low risk of suicidality, according several variables including the needs for care.MethodsA descriptive study of a non-probabilistic sample constituted by all male inmates referenced to a forensic psychiatric clinic in Lisbon region, during a year (April 2009–2010), was performed. The data was collect from user and professional interviews and user file. The instruments, besides a specific questionnaire, includes MINI; BPRS and the Camberwell Assessment of Need, Forensic Version (CANFOR). The suicide risk was defined by C section from MINI and defined as a dichotomic variable: null/low or moderate/high suicide risk.ResultsThe sample was composed of seventy nine inmates (median age 36). Major depression was the only diagnostic significantly associated with suicide risk. There was a significant association between moderate/high risk of suicide and the unmet needs rated by users in psychological distress, safety to self, drugs and company domains and unmet needs rated by staff in daytime activities, psychological distress, safety to self and drugs domains.ConclusionThe suicide prevention is a crucial issue in prisons. The assessment of suicide risk, psychiatric care and care delivery in unmet needs domains may have a positive impact in self harm and suicide incidence.

scholarly journals Life-quality of orthognathic surgery patients: The search for an integral diagnosis

2014 ◽  
Vol 19 (1) ◽  
pp. 123-137 ◽  
Author(s):  
José Augusto Mendes Miguel ◽  
Nathália Barbosa Palomares ◽  
Daniela Feu
Keyword(s):  
Quality Of Life ◽  
Orthognathic Surgery ◽  
Social Impact ◽  
Treatment Plan ◽  
Life Quality ◽  
Individual Treatment ◽  
Great Satisfaction ◽  
Dentofacial Deformities ◽  
Functional Components

The decision on whether starting an orthosurgical treatment depends on the negative esthetic, functional and social impact the dentofacial deformity has on the quality of life of each patient. The objective of this article is to demonstrate the importance of assessing the quality of life of these individuals by means of applying specific questionnaires before treatment onset in order to increase the success rate of orthosurgical treatment. These questionnaires assess not only the esthetic factor, but also the functional conditions that may be affected as well as the psychological issues related to self-esteem and sociability, all of which must be assessed in order to enable the development of an individual treatment plan that meets patient's expectations. Thus, a more predictable level of satisfaction can be achieved at treatment completion, not only from a normative standpoint stated by professionals, but also from a subjective standpoint stated by patients. Although not enough comparable data is available in the literature for us to assess the extent of improvements produced by orthosurgical treatment, a few recent reports conducted by different universities around the world reveal a good response from the majority of patients after surgery, demonstrating great satisfaction with regard to esthetic, functional and psychosocial factors. Therefore, it is reasonable to conclude that the current objective of orthodontic treatment associated with orthognathic surgery consists not only in treating the esthetic functional components of dentofacial deformities, but also in considering patients' psychological factor.

scholarly journals Mobile Health Intervention for Outpatient Treatment of Tuberculosis and HIV Infection

2020 ◽  
Vol 5 (3) ◽  
pp. 46-53
Author(s):  
S. N. Zhdanova ◽  
O. B. Ogarkov ◽  
S. K. Heysell
Keyword(s):  
Mobile Health ◽  
Positive Impact ◽  
Health Intervention ◽  
Control Group ◽  
Longitudinal Impact ◽  
Psychoactive Substances ◽  
Cd4 Counts ◽  
Viral Loads ◽  
Tb Treatment ◽  
History Of

Aim of the study. To describe the results of using mobile health intervention for improving the compliance of patients with tuberculosis and HIV (TB/HIV). Materials and methods. Piloted clinic-affiliated mobile intervention was carried out in 54 patients with TB/HIV and with a history of psychoactive substances abuse in Irkutsk Regional Clinical Tuberculosis Hospital. The mobile intervention included a smartphone application that connected the participants to the staff of Irkutsk Regional TB Hospital and provided daily queries on stress, mood and medication adherence; appointment reminders; virtual support group and consultation resources; weekly quizzes. We assessed longitudinal impact on retention in medical care, visit constancy, viral loads and CD4 counts, TB outcomes. Results. In 6 months, we registered the increase (in comparison with baseline) in mean CD4 counts (F = 6.61; р = 0.04) and in the number of cases of suppressed viral loads – from 20.5 % (9/44) to 55.3 % (21/38) (p < 0.01) in TB/HIV users of e-health app. We found a lower level of TB treatment interruption in patients who used the application in comparison with the patients who refused to use it (4/44 vs 5/10; χ2 = 7.09; р = 0.008). App users completed the course of TB treatment in 63.6 % of cases (28/44), and 61.4 % of patients (27/44) were cured which was higher than the level in the control group (20 % (2/10)) (χ2 = 7.54; p = 0.03). Conclusion. This study has demonstrated that a mobile health intervention can have a positive impact on improving the medical and social care and clinical outcomes for TB/HIV patients with history of psychoactive substances abuse.

scholarly journals Dental extraction in patients with HIV/AIDS: report of two cases

RSBO ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 51-06
Author(s):  
Mariane Cristina Sloniak ◽  
Sara Regina Barancelli Todero ◽  
Luciana Aparecida Lyra ◽  
Elenara Beatriz Fontana ◽  
Paulo Sérgio Batista ◽  
...  
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Hiv Infection ◽  
Dental Treatment ◽  
Treatment Plan ◽  
Healing Process ◽  
Special Treatment ◽  
Individual Treatment ◽  
Dental Surgery ◽  
First Case

The oral health of patients with HIV infection is often compromised by caries and periodontal disease. Thus, many patients need to undergo oral surgical procedures. Case report: This article describes two cases of patients with HIV infection who had undergone exodontia due to prosthetic indications. Both patients had been hospitalized for treatment of respiratory complications from HIV infection and were referred for dental treatment. In the first case, the adult patient had generally good oral health. However, the treatment plan for the installation of a removable prosthesis required the removal of tooth 38 since it was fairly inclined to the mesial. The second patient had poor oral conditions due to advanced periodontal disease. Thus, all upper arch teeth were removed in a single session followed by the installation of an immediate total prosthesis. No postoperative complications were recorded and the healing process occurred without incident for both patients. Dental treatment of patients with asymptomatic HIV infection does not differ from that performed for any other patient in practice. Nevertheless, patients in advanced stages of disease may require special treatment and an individual treatment plan must be developed for even routine procedures. Conclusion: The dental care of these individuals often requires more rigorous clinical follow-up for maintaining oral health. The performance of dental surgery in patients with HIV infection does not require technical modifications, but does require a complete anamnesis.

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