A longitudinal analysis of a work inclusion model for psychiatric patients in the Mental Health Departments of the city of Milan

Background: Work functioning impairment is a key diagnostic and transnosographic criterion for psychiatric disorders in both DSM-5 and ICD-11. Occupational inclusion is a fundamental aspect of the care path for patients attending the territorial services provided by the Italian Mental Health and Addiction Departments (DSMDs). Since 2009, the Regional Innovative Programme (PIR) TR106, promoted by the Fatebenefratelli-Sacco hospital of Milan, Italy, in collaboration with six other metropolitan DSMDs, was created to promote integration for people suffering from mental health problems in the city of Milan. Method: Here we present the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients, conducted between 2012 and 2019. Results: Most of the interventions were conducted with people with psychotic disorders (39%), followed by personality disorders (25.2%) and affective disorders (22.2%). The age range of 25 to 54 years represented 91.5% of the whole sample, mainly in the 35 to 44 years range (36.4%). Significant age group-related changes in interventions were observed in the observation period, with a reduction in the interventions provided to subjects of the 35 to 44 age group, and an increase in the 25 to 34 age group. Conclusions: PIR TR106 provided the most accurate assessment and data collection so far for the city of Milan. Our data characterised psychiatric groups in order to develop specific treatment plans and work inclusion interventions.

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Using Perceptual Control Theory and the Method of Levels to work with people who experience psychosis

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x09990134 ◽

2009 ◽

Vol 2 (3) ◽

pp. 227-242 ◽

Cited By ~ 13

Author(s):

Sara J. Tai

Keyword(s):

Mental Health ◽

Control Theory ◽

Psychotic Disorders ◽

Mental Health Problems ◽

Specific Treatment ◽

Health Problems ◽

Therapeutic Application ◽

Perceptual Control Theory ◽

Perceptual Control ◽

Potential Benefits

AbstractThis paper provides an overview of perceptual control theory (PCT) in relation to understanding severe and enduring mental health problems. The core principles of control and conflict are reviewed in relation to understanding the experiences associated with psychotic disorders. The therapeutic application of PCT known as the Method of Levels (MOL) is described and an overview of how this might be a useful approach to use with people experiencing psychosis is provided. The benefits and difficulties of using MOL to work with people experiencing psychosis are described including case illustrations of preliminary work based on the application of MOL in clinical practice. It is concluded that PCT is a useful framework for understanding severe and enduring mental health problems and there are potential benefits in using MOL as a therapeutic intervention. Further research examining the effectiveness and feasibility of MOL as a specific treatment for psychosis is recommended.

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Psychological/psychiatric impact of the novel coronavirus outbreak: lessons learnt from China and call for timely crisis interventions in Italy

10.31234/osf.io/z26yk ◽

2020 ◽

Cited By ~ 2

Author(s):

Patrizia Zeppegno ◽

Carla Gramaglia ◽

Chiara Guerriero ◽

Fabio Madeddu ◽

Raffaella Calati

Keyword(s):

Mental Health ◽

Migrant Workers ◽

Mental Health Problems ◽

Virus Disease ◽

Selection Process ◽

Psychiatric Patients ◽

Homeless People ◽

World Health ◽

Rapid Review ◽

Post Traumatic Stress

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.

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Impact of ethnicity, unemployment and economy on mental disorders : A study from Western Nepal

Nepal Journal of Epidemiology ◽

10.3126/nje.v4i1.10132 ◽

2014 ◽

Vol 4 (1) ◽

pp. 306-315

Author(s):

Indrajit Banerjee ◽

Indraneel Banerjee ◽

Bedanta Roy ◽

Brijesh Sathian ◽

Shovit Kadkha ◽

...

Keyword(s):

Mental Health ◽

Psychiatric Illness ◽

Family Income ◽

Mental Health Problems ◽

Psychiatric Patients ◽

Population Based ◽

Ethnic Variation ◽

Cross Sectional ◽

Economic Class ◽

Specific Objective

Background: The causes of mental health problems and ethnic variation are poorlyunderstood. The main objective of the study was to find out about psychiatricdiseases which frequently occur in Western Nepal for which hospitalization isrequired. The specific objective was to research about theeconomic condition ofthe psychiatric patients and the prevalence of common psychiatric disorderwitnessed among hospitalized patients who belong to diverse ethnic and culturalgroups in Western Nepal. Materials and Methods: It was a cross sectional studywhich was conducted in between 1st October 2009 and 31th March 2010 between at Manipalteaching hospital, Pokhara, Nepal. Odds ratios and adjusted odds ratio andtheir 95% confidence intervals (95% CI) were calculated. p < 0.05 wasconsidered as statistically significant. Results: Out of 240 cases the commonestcases of psychiatric disorders include Schizophrenia, Schizotypal and DelusionDisorders 36.3%, Mood Disorders 27.9%, Neurotic, stress-related and somatoformdisorders 15.8%. Study based on ethnicity revealed that the majority ofpatients were Dalit [n= 72] followed by Brahmin [n = 66], Chettri [n = 46],Newar [n = 19], Gurung [n = 17], others [n = 13] and Magar and Pun [n = 7].Most of the patients were <40yrs [n=191] unemployed [n=199], monthly familyincome <10000 NPR/month [n= 187], students [n = 102] housewives [n = 74,], job holders [n= 17]. Study showed that Mental and Behavioural disorder due toPsychoactive Substance abuse, Schizophrenia, Schizotypal and Delusion DisordersMood (Affective) Disorders, Neurotic, stress-related and somatoform disorderswere prevalent among unemployed patients [OR 8.170(CI 1.062, 62.853)], [OR3.033(CI 1.334, 6.897)], [OR 0.413(CI 0.199, 0.856)[OR 0.228(CI 0.089,0.583)]as compared to employed patients(p=0.001). Conclusion: Schizophrenia was the commonestpsychiatric disorder among the low socio-economic class of like Dalits. The study showed that culture based differences concerning mental health is furthermediated by poverty, unemployment and dearth of family income which leads tohigh prevalence of psychiatric illness among Nepalese population. Based on thefinding of the study, interventions should target these factors to minimise theload of various psychiatric illness among poor Dalit Nepalese population.DOI: http://dx.doi.org/10.3126/nje.v4i1.10132Nepal Journal of Epidemiology 2014;4 (1): 306-315Keywords:Culture, Ethnicity,Nepal, Psychiatry

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Admission experiences of psychiatric patients in tertiary care: An implication toward Mental Health Care Bill, 2013

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.193527 ◽

2017 ◽

Vol 08 (01) ◽

pp. 089-095 ◽

Cited By ~ 2

Author(s):

Vijayalakshmi Poreddi ◽

Rajalakshmi Ramu ◽

Sugavana Selvi ◽

Sailaxmi Gandhi ◽

Lalitha Krishnasamy ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Psychiatric Hospital ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Care Center ◽

Tertiary Care ◽

Perceived Coercion ◽

Negative Pressures

ABSTRACT Background: Coercion is not uncommon phenomenon among mental health service users during their admission into psychiatric hospital. Research on perceived coercion of psychiatric patients is limited from India. Aim: To investigate perceived coercion of psychiatric patients during admission into a tertiary care psychiatric hospital. Materials and Methods: This was a cross-sectional descriptive survey carried out among randomly selected psychiatric patients (n = 205) at a tertiary care center. Data were collected through face-to-face interviews using structured questionnaire. Results: Our findings revealed that participants experienced low levels of coercion during their admission process. However, a majority of the participants were threatened with commitment (71.7%) as well as they were sad (67.8%), unpleased (69.7%), confused (73.2%), and frightened (71.2%) with regard to hospitalization into a psychiatric hospital. In addition, the participants expressed higher levels of negative pressures (mean ± standard deviation, 3.76 ± 2.12). Participants those were admitted involuntarily (P > 0.001), diagnosed to be having psychotic disorders (P > 0.003), and unmarried (P > 0.04) perceived higher levels of coercion. Conclusion: The present study showed that more formal coercion was experienced by the patients those got admitted involuntarily. On the contrary, participants with voluntary admission encountered informal coercion (negative pressures). There is an urgent need to modify the Mental Health Care (MHC) Bill so that treatment of persons with mental illness is facilitated. Family member plays an important role in providing MHC; hence, they need to be empowered.

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Physical Activity at 11 Years of Age and Incidence of Mental Health Problems in Adolescence: Prospective Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2013-0029 ◽

2015 ◽

Vol 12 (4) ◽

pp. 535-539 ◽

Cited By ~ 6

Author(s):

Pedro C. Hallal ◽

Jeovany Martínez-Mesa ◽

Carolina V.N. Coll ◽

Grégore I. Mielke ◽

Márcio A. Mendes ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Mental Health Problems ◽

Physical Activity Behavior ◽

Health Problems ◽

Outcome Variable ◽

Validated Questionnaire ◽

Longitudinal Association ◽

Activity Behavior ◽

The City

Aim:To evaluate the longitudinal association between physical activity behavior at 11 years of age and the incidence of mental health problems from 11 to 15 years of age.Methods:Individuals born in the city of Pelotas, Brazil, in 1993 have been followed up since birth. At 11 and 15 years of age, mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ). At 11 years of age, physical activity was assessed through a validated questionnaire. The continuous SDQ score at 15 years was used as the outcome variable. The main exposure was physical activity behavior at 11 years of age divided into 3 categories (0, 1−299, >300 min/wk).Results:The incidence of mental health problems from 11 to 15 years was 13.6% (95% CI, 12.4−14.9). At 11 years, 35.2% of the adolescents achieved 300 min/wk of physical activity. In the unadjusted analysis, physical activity was inversely related to mental health problems (P = .04). After adjustment for confounders, the association was no longer significant in the whole sample but was still significant among boys.Conclusion:Physical activity appears to be inversely related to mental health problems in adolescence, but the magnitude of the association is weak to moderate.

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Bridging the service divide

Advances in Psychiatric Treatment ◽

10.1192/apt.10.4.257 ◽

2004 ◽

Vol 10 (4) ◽

pp. 257-259 ◽

Cited By ~ 9

Author(s):

Philip P. Asherson

Keyword(s):

Mental Health ◽

Adult Adhd ◽

Mental Health Problems ◽

Stimulant Medication ◽

Adult Life ◽

Specific Treatment ◽

Good Deal ◽

Clinical Activity ◽

Need For Treatment ◽

Adult Psychiatry

Most child and adolescent mental health services recognise the existence of, and need for treatment in, attention-deficit hyperactivity disorder (ADHD). Many specialist multidisciplinary ADHD clinics have been developed in recent years, and many paediatricians have included the treatment of ADHD as an important part of their clinical activity. A good deal of the justification for this increase in therapeutic activity has been the demonstration that ADHD is indeed a predictor of adult mental health problems. General adult psychiatry, however, has not followed suit in identifying and treating substantial numbers of affected people. It is likely none the less that an increasing load in adult psychiatry will develop. A rising number of young people will enter adult life still receiving stimulant medication or other treatment for ADHD, and adult psychiatrists are likely to be consulted. Furthermore, an increasing number of adults are likely to recognise themselves as having been disabled by ADHD and therefore to seek assistance. In many cases, individuals with adult ADHD who require specific treatment for the condition will have been treated unsuccessfully for disorders with overlapping symptom profiles such as anxiety, depression, bipolar disorder and antisocial personality disorder.

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Hard routes of mental health in Portugal: what can we offer to an adolescent with serious mental illness and multiple social risk factors?

BMJ Case Reports ◽

10.1136/bcr-2018-229120 ◽

2020 ◽

Vol 13 (4) ◽

pp. e229120

Author(s):

Rita Goncalves ◽

Mafalda Marques ◽

Teresa Cartaxo ◽

Vera Santos

Keyword(s):

Mental Health ◽

Risk Factors ◽

Best Practice ◽

Mental Health Problems ◽

Psychiatric Patients ◽

Mental Healthcare ◽

Developed Countries ◽

First Episode ◽

Social Risk ◽

Social Risk Factors

Worldwide, millions of children and adolescents are suffering due to a lack of efficient mental healthcare. Although some progress has been made to address the mental health problems in this age group, currently, even developed countries fail in providing psychiatric patients with the best practice care. We present a case of a Portuguese adolescent with a first episode of psychosis in whom multiple social and environmental risk factors were identified as triggers to his clinical presentation, as well as fundamental determinants of prognosis in the short and long term. In this case, we demonstrate how social determinants, including poverty, family dysfunction and difficulties in accessing appropriate mental healthcare, strongly influence the development, maintenance and prognosis in early psychosis during adolescence. Furthermore, we consider the implications of an absence of community-based mental healthcare and rehabilitation services and reasons for why this may complicate the management and limit opportunities to this patient population.

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Differences between specialist community adolescent mental health teams and generic child and adolescent mental health services: training issues for specialist registrars

Psychiatric Bulletin ◽

10.1192/pb.30.6.232 ◽

2006 ◽

Vol 30 (6) ◽

pp. 232-233 ◽

Cited By ~ 1

Author(s):

Carmen Pinto

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Mental Health Problems ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Department Of Health ◽

National Service Framework ◽

First Onset ◽

Age Range

Following the National Service Framework (Department of Health, 2004) recommendation of extending the age range of child and adolescent mental health services to 18 years there is an increasing expectation that these generic services will provide the comprehensive care for severe mental health problems in areas where specialist teams do not exist. Services have responded to this with a variety of teams from generic adolescent teams to smaller first-onset psychosis or assertive outreach teams.

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Mobile Mental Health Apps in China: Systematic App Store Search (Preprint)

10.2196/preprints.14915 ◽

2019 ◽

Author(s):

Huifang Yin ◽

Klaas J Wardenaar ◽

Yuhao Wang ◽

Nan Wang ◽

Wenjin Chen ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Problems ◽

Mobile Apps ◽

Psychiatric Patients ◽

Evidence Based ◽

Health Apps ◽

Main Technique ◽

Stress Relieving ◽

Mobile Mental Health

BACKGROUND Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. OBJECTIVE The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. METHODS A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. RESULTS Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. CONCLUSIONS Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

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