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2021 ◽  
Vol XII (2) ◽  
pp. 272-276
Author(s):  
V. N. Obraztsov

Senior physician of the Odessa psychiatric hospital, doctor of medicine B.I. Vorotynskiy was elected as a medical faculty in Odessa as a privat-docent in the department of nervous and mental illnesses.

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 137-145
Author(s):  
Petronela Nechita ◽  
◽  
Liliana Luca ◽  
Alina-Ioana Voinea ◽  
Codrina Moraru ◽  
...  

The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict. The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance. Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036). Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.


2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Ankit Patel

Carl Gustav Jung (1875-1961) had a significant contribution to the psychoanalytical movement and is generally considered as the prototype of the dissident through the impact of his scission and the amplification of the movement he created in his turn (analytical psychology). Jung was the son of a Swiss reverend. He completed his medical studies, specialized in psychiatry and joined the staff of Burgholzli, the renowned psychiatric hospital in Zurich, run at that time by the famous Dr. Eugen Bleuler. In 1902-1903 he attended a traineeship in Paris with Pierre Janet, and then returned to Zurich and he was called senior physician at Burgholzli. It was in this context that Jung was introduced to Freud in 1907. Freud would be seduced by the prestige and personality of Jung and would soon see in him the spiritual son that could ensure the survival of psychoanalysis, so much so as Jung was not Jewish. Intense, professional and friendship bonds form between the two, with an ambivalence dominated by the inclination of Jung to underestimate himself in comparison with Freud, the fervor of his devotion to the “father” of psychoanalysis and oneiric hostility (emphasized by Freud in the common interpretation of dreams).


2020 ◽  
Vol 10 (5) ◽  
pp. 275-281
Author(s):  
Nina Vadiei ◽  
Jonathan Chien ◽  
Jude Enwereji ◽  
Britt Myslinski ◽  
Alexander Guzman

Abstract Introduction Antipsychotics are commonly used to treat psychotic symptoms and severe mental illnesses. Treatment guidelines recommend antipsychotics be titrated quickly to therapeutic effect in the acute setting but acknowledge that determining the optimal dose is complicated by a delay between treatment initiation and therapeutic response. The purpose of this study was to evaluate antipsychotic titration patterns in an inpatient psychiatric hospital. Methods This study is a retrospective chart review of adult patients admitted to a teaching hospital and initiated on an antipsychotic for treatment of psychosis between January and December 2018. Patients were excluded if they had substance-induced psychosis, delirium, were prescribed >1 antipsychotic, or had no antipsychotic dose changes. The primary outcome was the average titration rate of the newly initiated antipsychotic. Secondary outcomes included differences in titration rate between involuntary and voluntary admissions and other antipsychotic characteristics. Results Of 149 patients included, the majority had a primary diagnosis of schizophrenia. Antipsychotics were titrated on average every 2 days regardless of admission type. Eighteen percent of patients were titrated to guideline-recommended maximum doses, and it took, on average, 3 days for patients to reach their final dose during hospitalization. Average length of stay was 9 days, and 43.6% of patients were readmitted within 1 year. Discussion Antipsychotics are titrated rapidly in the inpatient setting despite a lack of evidence regarding the impact of titration rate on clinical outcomes. Further studies comparing slow versus rapid titration strategies are needed to elucidate the impact of this on patient outcomes.


1998 ◽  
Vol 22 (3) ◽  
pp. 150-152 ◽  
Author(s):  
P. Y. Elwood ◽  
P. De Silva

Records were obtained of all suicide and open verdicts in York (n=127) between 1990–1994 inclusive. Those with no past or current contact with psychiatric services were identified (n=67). The extent and nature of this group's general (i.e. non-psychiatric) hospital contact in the months prior to death was established. Thirteen per cent (9/67) of these received general hospital input in the month before death with eight out of the nine aged over 65. Five of the 67 suicides showed evidence of depression. General hospital practitioners are in a position to make a small but important contribution in reducing the suicide rate.


2017 ◽  
Vol 127 (3) ◽  
pp. 140-142
Author(s):  
Błażej Kmieciak

Abstract A psychiatric hospital is a special place. People undergoing treatment are in a unique situation. Mental illness remains a mystery for scientists because we do not know what factors influence its appearance. There were also no drugs that would completely cure the patient, as you never know whether the medicine will affect a particular person. Mental illnesses evoke anxiety and fear of the community. Some patients take disturbing or dangerous actions. Their behaviors are referred to as specific and different ones. A similar situation is caused by the appearance of psychotic symptoms. One should pay attention to delusions and hallucinations here. These symptoms cause the patient’s situation to deteriorate. Ultimately, they can cause dangerous behavior. It happens that a relative of a patient, who is in such condition, must take action without his/her consent. A similar issue has been analyzed in Poland for almost thirty years. Individual regulations, in exceptional cases, allow for undertaking coercive actions: treating the patient without consent, applying direct coercion. These interventions are controlled. Polish psychiatric legislation is constantly changing (new control institutions are introduced, the role of the family court is increased). This article presents the latest amendments. They are based on the principle of respect for human rights and freedoms.


1905 ◽  
Vol XIII (1) ◽  
pp. 137-141
Author(s):  
B. Obraztsov

The report of the Odessa City Hospital, compiled according to the program of the previous report, consists of several chapters (medical part, internal life of the hospital, economic part, administrative part) and an appendix containing articles and notes of hospital doctors, the department of literary works of the mentally ill.


2020 ◽  
Author(s):  
Yarong Ma ◽  
Robert Rosenheck ◽  
Hongbo He

Abstract Background: Involuntary hospitalization (IH) is a controversial issue in psychiatry as it risks violation of the human right to autonomy. This study aimed to examine the rates and correlates of IH in a large psychiatric hospital from 2014-2017 after China’s Mental Health Law (MHL) was implemented in 2013 specifying criteria for IH and a structured assessment was required for IH.Methods: Unduplicated electronic medical records concerning all inpatients admitted to the Guangzhou Psychiatric Hospital with primary psychiatric diagnoses were examined and trends in annual IH rates were examined. We extracted medical, sociodemographic and socioeconomic data from these records to identify correlates of IH using bivariate chi square tests followed by logistic regression analysis. Results: Of 11,086 hospitalized patients, there was a significant but small increase from 71.6% to 74.9% in rates of IH in the years after the structured assessment was implemented. Logistic regression analysis showed IH was positively associated with being younger, having a local residence, and a diagnosis of bipolar disorder, schizophrenia spectrum disorders or a substance abuse disorder as compared to those diagnosed with major depressive disorder.Conclusions: Adjusting for these factors those with IH had a longer length of stays. Under China’s Mental Health Law in 2013, and a locally implemented checklist, the adjusted risk of IH increased significantly, but by only 3.3% from 2014 to 2017. IH was greatest younger patients with severe mental illnesses, and those with local access to psychiatric hospital services.


2017 ◽  
Vol 41 (S1) ◽  
pp. S517-S517
Author(s):  
B. Ory ◽  
S. Benmansour ◽  
B. Pachoud

IntroductionThe accompagnant model was set up at the Fann psychiatric hospital in Dakar in 1971 by prof. H. Collomb. It requires the patient to be hospitalized with a non-patient to accompany him/her at all time during the hospitalization. This model compensates for economic and human deficiencies, and also presents itself as a therapeutic tool in the treatment of mental illnesses.ObjectivesThe contemporary use of the accompagnant model will be presented and its advantages and disadvantages assessed.AimsWe investigate how the accompagnant model may have a role in the therapeutic process, and to what extent this model (or part of it) could be exported.MethodsA qualitative study of the practice at Fann Psychiatric Hospital has been carried out, based on interviews with patients, professionals and accompanying persons.ResultsThere is a striking consensus between patients, professionals and the accompanying persons about the advantages of this practice. It facilitates the encounter between professionals and patients, and reduces the risk of living hospitalization as a traumatic experience. The accompanying persons contribute to warrant the respect of human dignity, and to maintain a therapeutic dynamic through their participation in the development of a caring environment and their expectation of a recovery process. They help ensure continuity of care and medication after the hospital stay.ConclusionThe accompagnant model emphasizes the role relatives may play during and after the hospitalization, in ways that could be compared with what is currently expected from family therapeutic education.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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