Expressed emotion and perceived family interaction in the key relatives of elderly patients with dementia

SynopsisFour groups of families were investigated using an interview designed to assess expressed emotion (EE) in relatives of psychiatric patients and a family interaction questionnaire (FIQ) based upon the Leary and Benjamin schemes for coding interpersonal behaviour. The families included 25 containing a psychiatric patient aged between 18 and 46, and three groups of 12 families each, all containing a patient over 60 (patients with dementia, a functional psychiatric disorder, or a chronic physical disorder respectively). In all cases data were obtained from key relatives.The FIQ clearly separated out the group of dementia relatives who reported the most dominant and protective behaviours and the highest levels of hostile-dominance and the lowest levels of affection. EE was not found to be so sensitive to interactions occurring in families with a member with dementia, and the possible reasons for this are discussed.

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Shame and Expressed Emotion: A Case Study

Sociological Perspectives ◽

10.2307/1389428 ◽

1993 ◽

Vol 36 (2) ◽

pp. 167-183 ◽

Cited By ~ 6

Author(s):

Michael Timothy Ryan

Keyword(s):

Expressed Emotion ◽

Psychiatric Patients ◽

Family Members ◽

Family Interaction ◽

The Relationship

This article interprets excerpts from a dialogue between an ex-patient and his wife to develop a theory of “expressed emotion” (EE). EE has been shown to be predictive of relapse among schizophrenic and depressed psychiatric patients. I propose a model of emotions occurring both within and between family members to explain the relationship between EE and rate of relapse. EE is hypothesized to correspond with the shame/anger dynamics of a patient's family interaction. Microlevel analysis of a tape-recorded conversation between a patient and spouse rated for EE is used to identify cues for emotion in the couple's interaction. My analysis suggests that high ratings of EE correspond to high levels of unacknowledged shame and anger in patients' families. When shame is evoked and not acknowledged or dispelled, affectional bonds are threatened and symptoms are likely to recur.

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Stress-Indicative Patterns of Non-Verbal Behaviour Their Role in Family Interaction

The British Journal of Psychiatry ◽

10.1192/s0007125000297122 ◽

1992 ◽

Vol 161 (S18) ◽

pp. 103-113 ◽

Cited By ~ 6

Author(s):

Andreas Altorfer ◽

Michael J. Goldstein ◽

David J. Miklowitz ◽

Keith H. Nuechterlein

Keyword(s):

Mental Illness ◽

Social Interaction ◽

Hospital Admission ◽

Expressed Emotion ◽

Family Interaction ◽

Short Term ◽

Interpersonal Behaviour ◽

Affective Attitudes ◽

Verbal Behaviour ◽

Schizophrenic Patients

Research in the field of interpersonal behaviour is widely recognised as an important key to understanding the nature of mental illness. In schizophrenic patients especially, deviant social interaction has been proved to be associated with pathological behaviour (see Bellack et al, 1989). Numerous studies have revealed that affective attitudes expressed towards the patient by a relative during hospital admission for an episode of schizophrenia (high expressed emotion (EE)) are predictive of the short-term course of the disorder (Leff & Vaughn, 1985; Jenkins et al, 1986; Nuechterlein et al, 1986; Mintz et al, 1987).

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The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia

Reviews on Recent Clinical Trials ◽

10.2174/1574887112666170522142315 ◽

2017 ◽

Vol 12 (3) ◽

pp. 182-186 ◽

Cited By ~ 1

Author(s):

Fatemeh Mohammadi ◽

Yadollah Abolfathi Momtaz ◽

Seyedeh Ameneh Motalebi ◽

Shahnaz Boosepasi

Keyword(s):

Social Skills ◽

Elderly Patients ◽

Behavioral Problems ◽

Psychiatric Patients ◽

Intervention Group ◽

Cognitive Remediation ◽

Control Group ◽

Cognitive Remediation Therapy ◽

Chi Square ◽

Institutionalized Elderly

Background: There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. Methods: The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. Results: The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. Conclusion: The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.

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Recommendation of Repeated Ammonia Tests for Intrahepatic Portal-Systemic Shunt Without Cirrhosis in Elderly Patients With Psychiatric Symptoms

Japanese Clinical Medicine ◽

10.1177/1179066017693597 ◽

2017 ◽

Vol 8 ◽

pp. 117906601769359

Author(s):

Michiaki Abe ◽

Temma Soga ◽

Nobuya Obana ◽

Kazumasa Seiji ◽

Masao Tabata ◽

...

Keyword(s):

Computed Tomography ◽

Elderly Patients ◽

Psychiatric Disorder ◽

Male Patient ◽

Psychiatric Symptoms ◽

Blood Ammonia ◽

Elderly Male ◽

Blood Tests ◽

Portal Systemic Shunt

We report an elderly male patient with hyperammonemia induced by intrahepatic portal-systemic shunt without cirrhosis (IPSSwoC). The occasional emergence of his erratic behaviors was misdiagnosed as a psychiatric disorder. Regardless of his uneven symptoms, IPSSwoC was suspected due to his hyperammonemia. The contrast computed tomography of the abdomen revealed a congenital type of IPSSwoC. As blood ammonia levels are inconstant, repeated blood tests are recommended when this disease is suspected in elderly patients with psychiatric symptoms.

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Plastic Surgery: Review on Screening of Psychiatric Disorder

Open Access Indonesian Journal of Medical Reviews ◽

10.37275/oaijmr.v1i5.567 ◽

2021 ◽

Vol 1 (5) ◽

pp. 91-94

Author(s):

Angeline Fenisenda

Keyword(s):

Psychiatric Disorder ◽

Plastic Surgery ◽

Cosmetic Surgery ◽

Psychiatric Patients ◽

Emotional Adjustment ◽

Aesthetic Surgery ◽

Well Being ◽

Pilot Studies ◽

Cosmetic Procedure ◽

Poor Outcomes

Recently the popularity of plastic surgical procedure has been increased. Many people surgically alter their physical appearance with the intent of boosting their social and psychological well-being; however, the long-term effectiveness of aesthetic surgery on improving well-being is unconfirmed. To have successful cosmetic plastic surgery result, it is imperative to assess candidates for predictors of poor outcomes. These include the following factor : psychiatric disorder, demographic factors (male and younger age), relationship issues, unrealistic expectations, previous dissatisfied surgery, and minimal deformity. For psychiatric patients, despite having technically satisfactory cosmetic surgery, poor emotional adjustment and social functioning were seen post procedure. Proper screening and evaluation of these patients could save money and resources. In this brief review we discuss about psychiatric disorder screen on plastic surgery to prevent unwanted outcome. A literature review was conducted in the electronic database PubMed using keyword “Psychiatric Disorder”, “Plastic surgery”, “Prevention” and “Screening”. All type of studies were included for this study, such as controlled trials, systematic reviews, literature reviews, and pilot studies published between 2011 and 2021. Articles which not written in English were excluded from the study. This search resulted in 18 papers. Some patient who undergo cosmetic surgery suffer from underdiagnosed or untreated psychiatric disorder. To avoid unnecessary expense and resource it is advisable that all patient who seek cosmetic procedure undergo psychiatric screen such as PHQ-9, GAD-7, BDDQ and other test to avoid un-necessary expense and resource.

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Machine learning for psychiatric patient triaging: an investigation of cascading classifiers

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocy109 ◽

2018 ◽

Vol 25 (11) ◽

pp. 1481-1487 ◽

Cited By ~ 1

Author(s):

Vivek Kumar Singh ◽

Utkarsh Shrivastava ◽

Lina Bouayad ◽

Balaji Padmanabhan ◽

Anna Ialynytchev ◽

...

Keyword(s):

Machine Learning ◽

Psychiatric Patient ◽

Classification Accuracy ◽

Psychiatric Patients ◽

Patient Records ◽

Classification Technique ◽

Machine Learning Approach ◽

The One ◽

Unique Dataset

Abstract Objective Develop an approach, One-class-at-a-time, for triaging psychiatric patients using machine learning on textual patient records. Our approach aims to automate the triaging process and reduce expert effort while providing high classification reliability. Materials and Methods The One-class-at-a-time approach is a multistage cascading classification technique that achieves higher triage classification accuracy compared to traditional multiclass classifiers through 1) classifying one class at a time (or stage), and 2) identification and application of the highest accuracy classifier at each stage. The approach was evaluated using a unique dataset of 433 psychiatric patient records with a triage class label provided by “I2B2 challenge,” a recent competition in the medical informatics community. Results The One-class-at-a-time cascading classifier outperformed state-of-the-art classification techniques with overall classification accuracy of 77% among 4 classes, exceeding accuracies of existing multiclass classifiers. The approach also enabled highly accurate classification of individual classes—the severe and mild with 85% accuracy, moderate with 64% accuracy, and absent with 60% accuracy. Discussion The triaging of psychiatric cases is a challenging problem due to the lack of clear guidelines and protocols. Our work presents a machine learning approach using psychiatric records for triaging patients based on their severity condition. Conclusion The One-class-at-a-time cascading classifier can be used as a decision aid to reduce triaging effort of physicians and nurses, while providing a unique opportunity to involve experts at each stage to reduce false positive and further improve the system’s accuracy.

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Intestinal Obstruction following Ingestion of Metallic Instruments in a Psychiatric Patient

Case Reports in Surgery ◽

10.1155/2018/2469462 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Oscar Kivike ◽

Israel Soko ◽

David Mgaya ◽

Frank Sandi

Keyword(s):

Physical Examination ◽

Intestinal Obstruction ◽

Female Patient ◽

Psychiatric Patient ◽

Psychiatric Patients ◽

Abdominal Distension ◽

History Taking ◽

Proximal Intestine ◽

Psychotic Features

Pica among psychiatric patients has been well documented. We report a 25-year-old female patient who presented with abdominal distension for one week. She is a known psychiatric patient for 5 years. Through history taking, physical examination, and investigations, the patient was found to have psychotic features and features of intestinal obstruction. Surgery was done by opening the abdomen and then the stomach. The stomach, together with the proximal intestine, was found to be filled with metallic instruments weighing 780 mg. The diagnosis of a metalophagia type of pica was reached. All instruments were removed and the patient did well postoperatively.

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Standardization and Validation of the Personality Disorder Inventory PSGP-IPDI

Shanlax International Journal of Arts, Science and Humanities ◽

10.34293/sijash.v7i1.484 ◽

2019 ◽

Vol 7 (1) ◽

pp. 112-122

Author(s):

K Abilash ◽

P Sindhuja Manisha Kamini ◽

T Jothimani

Keyword(s):

Personality Disorder ◽

Psychiatric Disorder ◽

Internal Consistency ◽

Psychiatric Patients ◽

Personality Inventory ◽

Clinical Population ◽

Positive Correlation ◽

Characteristic Behavior ◽

The Individual ◽

The Relationship

Background: Personality is the dynamic organization within the individual of those psychophysical systems that determine characteristic behavior and thought. Aim: To standardize and validate personality disorder inventory in clinical population. Methods and Samples: 100 Psychiatric patients were taken as a sample as a clinical population in various hospital Coimbatore age ranged 28 – 58. PSGP- IPDI- Indian Personality Disorder Inventory assessed for 100 psychiatric disorder individuals. Results: The relationship among the disorders of the personality inventory shows both positive and negative correlations among the dimensions most of the dimensions exhibited positive correlation. The internal consistency of the inventory is reliable.Conclusion: The personality disorder inventory is reliable and significant and this tool can be administered on the clinical population.

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How nurses' attire affects elderly psychiatric patients' ability to recognise them

Psychiatric Bulletin ◽

10.1192/pb.22.4.236 ◽

1998 ◽

Vol 22 (4) ◽

pp. 236-238

Author(s):

Hugh Joseph McCreedy ◽

Peter William Bentham

Keyword(s):

Elderly Patients ◽

Test Score ◽

Psychiatric Patients ◽

Mental Test ◽

Mental Test Score ◽

Abbreviated Mental Test

The ability of elderly patients to identify a nurse wearing a uniform as opposed to mufti was investigated together with the effect of administrator attire on the Abbreviated Mental Test score (AMT). Thirty-six out of 71 patients identified a nurse wearing mufti increasing to 59/71 when wearing uniform (P < 0.005). Patients rated by a uniformed nurse had significantly higher mean AMT scores (6.1) than when rated by a nurse in mufti (5.6) (P < 0.01), and this also had a significant effect on the sensitivity in predicting an organic diagnosis.

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