Does Being Unusual and Dangerous Mean You are Mad?

1997 ◽  
Vol 37 (1) ◽  
pp. 32-34
Author(s):  
Michael Browning
Keyword(s):  
Mental Illness ◽  
Medical Profession ◽  
The State ◽  
Rational Approach ◽  
Modern Psychiatry ◽  
Icd 10 ◽  
Dsm Iv

This article is, essentially, an examination of what the medical profession and society generally mean by the term ‘mad’, and what relevance ‘madness’ has to modern psychiatry. It suggests that ‘madness’ differs from ‘mental illness’ and that psychiatry only deals with the latter. It concludes that for any rigorous, rational approach to psychiatry to be attempted an accepted framework of what constitutes mental illness must be used. This is the important role of ICD 10 and DSM IV which help to ensure that psychiatrists do not act as ‘moral gaolers of the state’.

Struggle and Revolt in the Spanish Health Policy Process: The Changing Role of the Medical Profession

1992 ◽  
Vol 22 (1) ◽  
pp. 19-44
Author(s):  
Josep A. Rodríguez
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Medical Profession ◽  
The State ◽  
Political Organization ◽  
Political Activity ◽  
Professional Status ◽  
Political Role ◽  
Care System

Many changes have taken place in the professional status and political role of the Spanish medical profession during the process of construction of the health care system (1940–1990). There is a strong correlation between the different characteristics of the several phases of construction of the national health care system and some of the changes in the status, organization, and political activity of the medical profession. The democratic transition coincided with changes in the orientation of the system brought about by financial imperatives, which forced readjustments in the survival and political projects of the profession. The creation of a democratic regime has allowed the medical profession to create its own independent mechanisms of interest representation and has given rise to a process of negotiation of the new political relations (and their mechanisms) between the State and the profession. The last 15 years have witnessed important transformations in some parameters of the profession, in its political organization, its political role, and its relation with the State.

scholarly journals En innføring i depresjonsvurdering med PHQ-9

2020 ◽  
Author(s):  
Tomas Formo Langkaas ◽  
Even Rognan ◽  
Sverre Urnes Johnson
Keyword(s):  
Clinical Practice ◽  
Diagnostic Algorithm ◽  
Test Results ◽  
Measurement Instruments ◽  
National Guidelines ◽  
General Introduction ◽  
Icd 10 ◽  
Dsm Iv ◽  
Cutoff Scores

Assessment of depression is a routine task in clinical practice in Norway. National guidelines (Helsedirektoratet, 2009) recommend the use of measurement instruments in assessment of depression. PHQ-9 is widely used in research and practice. The official PHQ-9 manual provides practical guidance on interpreting test results with the use of clinical cutoff scores and a diagnostic algorithm for DSM-IV. With background from clinical practice and research, we summarize and provide guidance on the practical use of PHQ-9 beyond what the official PHQ-9 manual offers, applied to a Norwegian context. We provide a general introduction to diagnostic assessment of depression and the limited role of measurement instruments in such assessments. We describe how the original diagnostic algorithm can be adapted to ICD-10 criteria, we describe how to apply clinical significance to use PHQ-9 as a feedback instrument to monitor treatment progress, and we describe how to interpret results with missing answers. Finally, we discuss the shortcomings of relying on measurement instruments in assessment of depression and conclude that PHQ-9 is better suited in ordinary practice than other instruments recommended in the national guidelines.

Intercapitalist Maneuvers and the ICD-10 Transition: The Instrumental Role of the State in the Corporate Governance of U.S. Health Care

2019 ◽  
Vol 49 (3) ◽  
pp. 457-475 ◽  
Author(s):  
Mary Bugbee
Keyword(s):  
Health Care ◽  
Corporate Governance ◽  
Financial Burden ◽  
Health Sector ◽  
The United States ◽  
The State ◽  
Coding System ◽  
Role Of The State ◽  
Icd 10

In 2015, the United States transitioned to the ICD-10-CM/PCS, a comprehensive updated coding system for medical reimbursement. This transition was part of a larger move toward value-based reimbursement in U.S. health care and required nearly 2 decades of planning. As an unfunded mandate from Congress, it created a substantial financial burden for many groups within the health sector. This article traces the ICD-10 transition using the concept of the corporate governance of health care, attending to the role the state plays in mediating intercapitalist maneuvers. The ICD-10 was not a simple top-down declaration originating in a neutral state. Rather, it was produced and modified through lobbying efforts on the part of various stakeholders who, along with their competitors, would be affected by the transition in differential ways. The health information technology industry, in particular, stood to gain the most from this transition, at the expense of other capitalist players. An examination of the intercapitalist maneuevers behind the ICD-10 transition demonstrates that even when corporate powers govern U.S. health care, the role of the state should not be written off as inconsequential but rather interrogated and analyzed in relation to the corporate interests with which it is entangled.

Relapsing versus non relapsing course of schizophrenia: a cohort study in a community based mental health service

2007 ◽  
Vol 16 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Vittorio Di Michele ◽  
Francesca Bolino ◽  
Monica Mazza ◽  
Rita Roncone ◽  
Massimo Casacchia
Keyword(s):  
Predictive Power ◽  
Cox Regression ◽  
Community Based ◽  
Course Of Illness ◽  
Clinical Phase ◽  
Syndrome Scale ◽  
Icd 10 ◽  
Dsm Iv ◽  
Negative Syndrome

SUMMARYAim - We examined the effect of several clinical variables on the tendency to relapse and to require hospitalization in a cohort of patients, living in the community and followed up naturalistically for seven years. Method - Forty-six patients affected by schizophrenia and schizoaffective disorder, according to both DSM-IV and ICD-10 criteria, were assessed by Positive and Negative Syndrome Scale and Life Skills Profile (LSP). All patients consecutively enrolled, were assessed in a stable clinical phase of illness and treated as usual by their reference psychiatrist. Social and clinical outcome was assessed yearly for seven years after the study entry and analyzed with survival analysis. Results - Patients who did not relapse, were characterized by higher functioning, lower positive symptoms, higher ability in self-care and non-turbulence and higher IQ at their baseline clinical evaluation. These variables were entered in a Cox regression model to corroborate the predictive power on the relapsing course of illness. Only IQ and non-turbulence scores of LSP were entered in the equation (Wald method: p=0.007 and p=0.002 respectively). Conclusions - Several factors interact with the course of illness and influence the tendency to require hospitalization. In the present study we report that non-turbulence is a significant predictor of a non-relapsing course of illness. Further studies are needed to clarify the role of other mediating variables.Declaration of Interest: none.

scholarly journals Delirium: the role of psychiatry

2001 ◽  
Vol 7 (6) ◽  
pp. 433-442 ◽  
Author(s):  
David Meagher
Keyword(s):  
Medical Literature ◽  
Classification Systems ◽  
World Health ◽  
Clinical Settings ◽  
Mental Disturbance ◽  
Psychotropic Agents ◽  
Icd 10 ◽  
Dsm Iv ◽  
Health Organization

Acute mental disturbance associated with physical illness is well described in early medical literature, but it was not until 1 AD that Celsus coined the term ‘delirium’ (Lindesay, 1999). Although delirium has many synonyms that are applied in particular clinical settings (Box 1), all acute disturbances of global cognitive functioning are now recognised as ‘delirium’, a consensus supported by both ICD–10 (World Health Organization, 1992) and DSM–IV (American Psychiatric Association, 1994) classification systems. Delirium is a complex neuropsychiatric syndrome that typically involves a plethora of cognitive and non-cognitive symptoms, resulting in a broad differential diagnosis dominated by mental disorders. Psychiatrists' skills in assessing cognitive function and psychopathology, coupled with their knowledge of psychotropic agents, make them well suited to improving detection, coordinating management and facilitating research into this understudied disorder.

scholarly journals Sexual dysfunction: classification and assessment

2013 ◽  
Vol 19 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Dinesh Bhugra ◽  
Gabriele Colombini
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Dysfunctions ◽  
Success Rates ◽  
Medical Interventions ◽  
Assessment And Treatment ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Dsm Iv

SummarySexual dysfunction is one of the most common psychiatric disorders, but it is often ignored in assessment. It can be primary or secondary (a result of psychiatric disorder or medication). Success rates in managing sexual dysfunction are relatively high, with good response to psychological and medical interventions. In ICD-10 and DSM-IV-TR, sexual dysfunctions are broadly classified on the basis of the stages of sexual activity, from arousal to orgasm. There are major similarities between ICD and DSM in diagnosis and classification of sexual dysfunction, but both systems raise challenges. These include definitions of what is ‘normal’ and how abnormality is defined. In this article, we describe the role of the two systems and possible amendments that might help researchers and clinicians. We also present key principles for the assessment and treatment of people who experience sexual dysfunction. We consider problems that need to be managed in engaging and in the therapeutic alliance.

Família de baixa renda que convive com uma pessoa com transtorno mental: uma revisão bibliográfica

2008 ◽  
Vol 2 (4) ◽  
pp. 417 ◽  
Author(s):  
Iracema Silva Frazão ◽  
Maria Eduarda Batista de Lima
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
The State ◽  
Care Needs ◽  
The Family ◽  
Salud Mental ◽  
Review Systematic ◽  
Role Of Nursing

ABSTRACTObjective: to describe the relation between income and mental health as well as the process of dehospitalization and the family responsibility when taking care of a person with mental disorder and the difficulties through this process and the importance of the State in the promotion of a family’s financial and psychic support and to the role of nursing dealing with family and patients with mental illness. Methodology: literature review systematic study using the followings describers: health mental; family; poverty; nursing, as axles of the following contents: family, financial conditions and mental health; poor families coping with mental disorders; the family burden; the importance of the State in the promotion of a family’s financial and psychic support and to the role of nursing dealing with family and patients with mental illness. Results: it’s consent the idea that the State should be the responsible for the guarantee of the social rights of all the citizens; all of the health’s professionals should support the familiars who live with a person with mental disorder teaching them how give the care and giving orientations about the social’s benefices. Conclusion: the humanist action of the nursing and of the others mental heath’s professional is so much important to the family who cooping with mental disorder, because who gives the care needs receive the same care too. Descriptors: health mental; family; poverty; nursing. RESUMOObjetivo: abordar a relação entre renda e saúde mental, bem como o processo de deshospitalização e responsabilização da família no cuidado à pessoa com transtorno mental e suas dificuldades, destacando-se o papel do Estado na promoção de um maior suporte financeiro e psicológico a essas famílias e também a importância da Enfermagem na atuação junto à família e ao portador desses transtornos. Metodologia: estudo de revisão de literatura sistemática no qual foi levantada a produção científica na área de saúde mental preferencialmente dos últimos cinco anos, partindo dos descritores: saúde mental; família; pobreza; enfermagem, como eixos norteadores para o encadeamento dos seguintes conteúdos: família, condições de renda e saúde mental; a família de baixa renda convivendo com a pessoa em sofrimento mental; as sobrecargas vivenciadas pelas famílias cuidadoras; o acolhimento da família que acolhe; o papel da enfermagem no cuidado às famílias. Resultados: é consensual a idéia de que o Estado deve ser responsável pela garantia dos direitos sociais de todos os cidadãos, assim como os profissionais de saúde que compõem a rede de serviços devem apoiar os familiares das pessoas em sofrimento mental, tanto na capacitação para o cuidado, como na orientação para adquirir benefícios sociais e previdenciários àqueles que necessitem. Conclusão: o olhar humanizado não só da equipe de Enfermagem, mas de todos os profissionais envolvidos na saúde mental dos familiares cuidadores, é de extrema necessidade, já que quem cuida também precisa de cuidados. Descritores: saúde mental; família; pobreza; enfermagem.RESUMENObjetivo: describir la relación entre la renta y la salud mental así como el proceso del dehospitalizacion y la responsabilidad de la familia al cuidar de una persona con desorden mental y las dificultades con este proceso, destacando la prominencia al papel delo Estado en la promoción de un mayor suporte financiero e psicológico a estas familias e también del oficio de enfermera que trata de la familia y de los pacientes con enfermedad mental. Metodología: Es un estudio de revisión de literatura sistemática con los descriptores: salud mental; familia; pobreza; enfermería, como ejes para la articulación de los siguientes contenidos: familia, condiciones de renta e salud mental; familia de ingressos bajos que cohabita con enfermos mentales; la sobrecargas vividas por la familia que cuida; el acolhimiento de la familia que acolhe; el oficio de enfermera que trata de la familia de los pacientes con enfermedad mental. Resultados: es un consenso que lo Estado es el responsabile per la garantía de los derechos sociales de todo ciudadano; los professionales de la salud debem apoyar los familiares de las personas con sufrimiento mental, tanto con la capacitación del cuidado y también con la orientación de los derechos sociales que necessitam. Conclusión: la acción humanizada del grupo de Enfermeria y también de todos los professionales de la salud mental es muy importante para la familia cuidadora, porque quién cuida también necessita de los mismos cuidados. Descriptores: salud mental; familia; pobreza; enfermería.  

scholarly journals Psychiatry in the Nazi Era

2005 ◽  
Vol 50 (4) ◽  
pp. 218-225 ◽  
Author(s):  
Mary V Seeman
Keyword(s):  
Mental Illness ◽  
World War Ii ◽  
National Socialism ◽  
Medical Profession ◽  
Review Of The Literature ◽  
World War ◽  
Recent Information ◽  
Nazi Era ◽  
Knowledge Demands

Objectives: To update Canadian psychiatrists on recent information from newly discovered Berlin archives about the actions of physicians, especially psychiatrists, during the era of National Socialism in Germany and to encourage introspection about the role of the medical profession, its relationship with government, and its vulnerability to manipulation by ideology and economic pressures. Method: This is a selective review of the literature on the collaboration of physicians, especially psychiatrists, in the sterilization, experimentation, and annihilation of patients with mental illness before and during World War II. Results: Directed to value the health of the nation over the care of individual patients and convinced that a hierarchy of worth distinguished one person from another, German psychiatrists were enlisted to commit atrocities during the Nazi period. Conclusions: The values of care and compassion can be eroded; this knowledge demands constant vigilance.

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