Implications for psychiatry and psychological medicine

2017 ◽  
pp. 251-278
Author(s):  
Thomas Fuchs
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Interpersonal Relationships ◽  
Somatic Therapy ◽  
Psychological Medicine ◽  
Embodied Subjectivity

‘Implications for psychiatry and psychological medicine’ examines the ecological conception with regard to its consequences for mental disorders and their treatment. After an introduction on current neuroreductionist trends in psychiatry, the chapter develops a concept of mental illness as a fundamentally circular process with a pivotal impact on a person’s self-experience and interpersonal relationships. This dimension is traced as far as aetiology. Psychotherapy and somatic therapy and are then contrasted from the standpoint of dual aspectivity. In summary, an orientation towards embodied subjectivity is shown to be indispensable for psychopathology and psychological medicine.

scholarly journals Nutritional psychiatry: the present state of the evidence

2017 ◽  
Vol 76 (4) ◽  
pp. 427-436 ◽  
Author(s):  
Wolfgang Marx ◽  
Genevieve Moseley ◽  
Michael Berk ◽  
Felice Jacka
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Diet Quality ◽  
Age Groups ◽  
Significant Proportion ◽  
Behavioural Therapy ◽  
Future Research ◽  
Reverse Causality ◽  
Dietary Interventions ◽  
Cognitive Behavioural

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and heath burden. Treatment is presently dominated by pharmacotherapy, such as antidepressants, and psychotherapy, such as cognitive behavioural therapy; however, such treatments avert less than half of the disease burden, suggesting that additional strategies are needed to prevent and treat mental disorders. There are now consistent mechanistic, observational and interventional data to suggest diet quality may be a modifiable risk factor for mental illness. This review provides an overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research. Potential biological pathways related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Consistent epidemiological evidence, particularly for depression, suggests an association between measures of diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by other demographic, lifestyle factors or reverse causality. Our recently published intervention trial provides preliminary clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Furthermore, nutraceuticals including n-3 fatty acids, folate, S-adenosylmethionine, N-acetyl cysteine and probiotics, among others, are promising avenues for future research. Continued research is now required to investigate the efficacy of intervention studies in large cohorts and within clinically relevant populations, particularly in patients with schizophrenia, bipolar and anxiety disorders.

scholarly journals Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years

2017 ◽  
Vol 52 (6) ◽  
pp. 530-541 ◽  
Author(s):  
Melissa J Green ◽  
Stacy Tzoumakis ◽  
Kristin R Laurens ◽  
Kimberlie Dean ◽  
Maina Kariuki ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Early Development ◽  
Latent Class ◽  
New South ◽  
Criminal Offending ◽  
Parental History ◽  
South Wales ◽  
History Of

Objective: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. Methods: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census–defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. Results: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ ( N = 4368; 6.5%); (2) ‘pervasive risk’ ( N = 2668; 4.0%); (3) ‘mild generalised risk’ ( N = 7822; 11.6%); and (4) ‘no risk’ ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. Conclusion: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

Stigma and its impact on help-seeking for mental disorders: what do we know?

2008 ◽  
Vol 17 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Georg Schomerus ◽  
Matthias C. Angermeyer
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Public Attitudes ◽  
Population Based ◽  
Professional Help ◽  
Promising Target ◽  
Individual Discrimination ◽  
Stigma Of Mental Illness ◽  
Seeking Help

SummaryAims – Many people suffering from serious mental illness do not seek appropriate medical help. The stigma of mental illness has often been considered a potential cause for reluctance in seeking help. We review recent evidence on this topic. Methods – Narrative review of the recent literature on stigma and helpseeking for psychiatric disorders. Results – There is proof of a particular stigma attached to seeking help for a mental problem. Anticipated individual discrimination and discrimination qua self-stigmatisation are associated with a reduced readiness to seek professional help for mental disorders. Intervention studies show that destigmatisation may lead to increased readiness to seek professional help, but other aspects like knowledge about mental diseases seem to be at least as important. The belief that seeking help for a mental health problem is actually helpful has been shown to be at the core of help-seeking intentions and thus offers a promising target for information programmes. Population based time-trend studies show that public attitudes towards help-seeking have improved over the last decade. Discussion – The relationship between help-seeking intentions and actual help-seeking needs further exploration. While many studies have been able to relate attitudes to intentions, predicting actual help-seeking has proved more difficult.Declaration of Interest: None.

scholarly journals Associations between common mental disorders and the Mental Illness Needs Index in community settings

2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Small Area ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Service Planning ◽  
Individual Risk ◽  
Community Settings

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.

scholarly journals Impact of mental illness on in-patient hospital costs for somatic disorders and associated factors

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Michel ◽  
A J Hammami ◽  
K Chevreul
Keyword(s):  
Primary Care ◽  
Health Promotion ◽  
Mental Illness ◽  
Mental Disorders ◽  
Economic Burden ◽  
Mentally Ill ◽  
Hospital Costs ◽  
Healthcare Systems ◽  
Interaction Terms

Abstract Background People suffering from mental disorders are in poorer somatic health that the general population. This is due in part to poor quality of care in primary care settings, which can in turn have a major impact on hospitals and healthcare systems, in particular in terms of costs. Our objective was to assess the economic burden of acute care admissions for somatic diseases in patients with a mental illness compared to other patients and analyse the factors associated with it. Methods An exhaustive study using French hospital discharge databases was carried out between 2009 and 2013. Total acute hospital costs were calculated from the all payer perspective (statutory health insurance, private health insurances and patient out-of pocket payments). A multivariate regression modelled the association between mental illness and hospital costs while adjusting for other explanatory variables, with and without interaction terms. Results 37,458,810 admissions were included in the analysis. 1,163,972 patients (6.54%) were identified as being mentally ill. Mean total hospital costs at five years per patient were €8,114. Costs per mentally ill patient were on average 34% higher than for a non-mentally patient (€10,637 vs. €7,949). A longitudinal analysis of costs showed a widening of the gap between the two groups as time went by, from 1.60% in 2009 to 10.51% in 2013. In the multivariate model, mental disorders were significantly associated with increased costs, and interaction terms found an increased impact of mental illness on costs in deprived patients. Conclusions Improving quality of primary care and health promotion in people with a mental illness both for their own sake and to decrease the economic burden on the healthcare system, is of vital importance. Key messages There is a significant increase in hospital costs for somatic care in patients with a mental illness compared to other patients, in particular in patients who are also deprived. It is necessary to improve primary care and health promotion in mentally ill patients, for their sake and for the sake of healthcare systems.

scholarly journals Empathy, Burnout, and Attitudes towards Mental Illness among Spanish Mental Health Nurses

2022 ◽  
Vol 19 (2) ◽  
pp. 692
Author(s):  
Daniel Román-Sánchez ◽  
Juan Carlos Paramio-Cuevas ◽  
Olga Paloma-Castro ◽  
José Luis Palazón-Fernández ◽  
Isabel Lepiani-Díaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Protective Factor ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Snowball Sampling ◽  
Cross Sectional ◽  
Mental Health Nurses ◽  
Positive Attitudes

Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.

scholarly journals Challange and Fighting Social Stigma in Patient With Schizophrenia in Indonesia.

2018 ◽  
Vol 2 (01) ◽  
pp. 76-77
Author(s):  
Amar Akbar ◽  
Imam Zainuri ◽  
Lilik Ma'rifatul Azizah ◽  
Kyle Dornhofer
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Design Methodology ◽  
Antipsychotic Drugs ◽  
Social Stigma ◽  
Physical Restraint ◽  
Social Intervention ◽  
Literature Study ◽  
Government Program ◽  
People With Mental Illness

Purpose - This article aims to give an opinion on the cause of still the case of pasung in Indonesia, physical restraint and reduction in people with mental illness (called pasung in indonesia), still found in indonesia, government program ” indonesia free of pasung” still can not erase indonesia from pasung. Design/methodology/approach -The approach to literature study causes the escape especially social stigma that occurs to make the case of the pipe still continues to exist Findings -The findings of many literature studies suggest that social stigma is a cause of social restraint in patients with severe psychiatric disorders Originality/value -The value of this study envolve Empowering people with mental disorders through social intervention can reduce the side effects of antipsychotic drugs and simultaneously help self-stigma in people with mental disorders

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.

scholarly journals Lunacy, insanity, and the purpose of psychiatry

1990 ◽  
Vol 14 (11) ◽  
pp. 663-665
Author(s):  
Bruce G. Charlton
Keyword(s):  
Mental Illness ◽  
Interpersonal Relations ◽  
Mental Disease ◽  
Human Behaviour ◽  
Universal Theory ◽  
Psychological Medicine ◽  
Normal Human ◽  
The Subject ◽  
The One

Within psychiatry there are two distinct tendencies. On the one hand there is the tendency for the subject to expand beyond its concern with psychological medicine and encroach upon diverse aspects of society. “The psychiatrist who believes that the phenomena of mental illness can be explained on the basis of a universal theory … finds little difficulty in inflating his theory to explain not only mental disease but also normal human behaviour, interpersonal relations, and ultimately human affairs” (Miller, 1970)

scholarly journals Pre-Existing Mental Disorder, Clinical Profile, Inpatient Services, And Costs in People Hospitalised Following Traumatic Spinal Injury: A Population Record-Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Lisa Nicole Sharwood ◽  
Taneal Wiseman ◽  
Emma Tseris ◽  
Kate Curtis ◽  
Bharat Vaikuntam ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Dual Diagnosis ◽  
Record Linkage ◽  
Injury Severity ◽  
Spinal Injury ◽  
Linkage Study ◽  
Icd 10

IntroductionRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management, and cost of this often complex comorbid health profile is not sufficiently understood. Objectives and ApproachIn a whole-population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders, and compare differences in injury epidemiology, costs and inpatient allied health service access. Record-linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific ICD-10-AM codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. Results13,489 individuals sustained acute TSI during this study. 13.11%, 6.06%, and 1.82% had pre-existing mental illness, substance use disorder, and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared to individuals without mental disorder (p<0.001). Conclusion / ImplicationsIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared to individuals without mental disorder. Care pathway optimisation including prevention of hospital acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

Sign in / Sign up

Export Citation Format

Share Document