scholarly journals Clinical and demographic profile of catatonic patients who received electroconvulsive therapy in a South African setting

Author(s):  
Kavendren Odayar ◽  
Ingrid Eloff ◽  
Willem Esterhuysen

Background: Catatonia is a psychomotor dysregulation syndrome seen in several illnesses. Uncertainties exist regarding its prevalence and causes. While some research shows a strong association with mood disorders, other data show catatonia to be strongly associated with schizophrenia. Data from low- and middle-income countries are required.Aim: To determine the clinical and demographic profile of patients with catatonia that received electroconvulsive therapy (ECT) between 01 January 2012 and 31 December 2014.Setting: The study was conducted at Elizabeth Donkin Psychiatric Hospital in Port Elizabeth, Eastern Cape. The hospital has mostly patients admitted under the Mental Health Care Act 17 of 2002 as Involuntary Mental Health Care Users.Method: A retrospective chart review was conducted. Using the hospital ECT database, all files of patients who received ECT for catatonia were identified. Demographics, psychiatric and medical diagnoses, signs of catatonia and other data were abstracted from these files.Results: Forty-two patients received ECT for catatonia, of whom 34 (80.95%) were diagnosed with a psychotic illness. Schizophrenia was the most common diagnosis (n = 19; 45.24%), followed by psychotic disorder owing to a general medical condition (n = 8; 19.05). Human immunodeficiency deficiency virus was the cause in 75.00% of the patients whose medical conditions caused catatonia. Seven (16.67%) patients had mood disorders, with bipolar I disorder accounting for 6 (14.29%) of these.Conclusion: Psychotic disorders were more frequent than mood disorders in the sample. Schizophrenia was the most common diagnosis, followed by psychotic disorder owing to a general medical condition.

2018 ◽  
Vol 3 (4) ◽  

In mental health care, the body takes an undeserved, modest place. It is precisely the body that you can use you to test the beliefs of patients on functionality. Dysfunctional beliefs lead to dysfunctional emotions and corresponding response representations in the body. This is entirely in line with the therapeutic elaboration of Lang’s emotion theory. That is, linking existing stimulus representations to incompatible response and meaning representations. This practical paper introduces readers to body-oriented counter conditioning techniques and how to apply the principles of counter conditioning in various anxiety and mood disorders. A report is done from a short mindfulness group training for cardiology patients with anxiety and mood complaints.


2020 ◽  
pp. 39-62
Author(s):  
Elizabeth M. Scott ◽  
Joanne S. Carpenter ◽  
Frank Iorfino ◽  
Shane P.M. Cross ◽  
Daniel F. Hermens ◽  
...  

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 175-175
Author(s):  
Lisa M Lines ◽  
Daniel H Barch ◽  
Diana Zabala ◽  
Michael T. Halpern ◽  
Paul Jacobsen ◽  
...  

175 Background: Older adults with cancer and worse self-rated mental health report worse care experiences. We hypothesized that, controlling for health and demographic characteristics, older adults with cancer who received care for anxiety or mood disorders would report better care experiences. Methods: We used SEER-CAHPS data to identify Medicare beneficiaries, aged 66 and over, diagnosed from August 2006 through December 2013 with one of the 10 most prevalent solid tumor malignancies. To identify utilization for anxiety or mood disorders (screening, diagnosis, or treatment), we analyzed inpatient, outpatient, home health, physician, and prescription drug claims from 12 months before through up to 5 years after cancer diagnosis. Outcomes of interest were global care experience ratings (Overall Care, Personal Doctor, and Specialist; rated on a 0-10 scale) and composite measures (Getting Needed Care, Getting Care Quickly, and Doctor Communication; scored from 0-100). We estimated linear regression models and also used a Bayesian Model Averaging approach, adjusting for standard case-mix adjustors (including sociodemographics and self-reported general health and mental health status [MHS]) and other characteristics, including cancer site and stage at diagnosis. We also included interaction terms between mental health care utilization and MHS. Results: Approximately 22% of the overall sample (n = 4,998) had both cancer and a claim for an anxiety or mood disorder, and of those individuals, 18% reported fair/poor MHS. Only 7% of those in the cancer-only cohort reported fair/poor MHS. Before adjusting for mental health utilization, worse MHS was significantly associated with worse experience of care. After accounting for anxiety/mood disorder-related utilization, linear regression models showed no significant associations between fair/poor MHS and worse care experiences, while Bayesian models found that reliable associations remained between worse MHS and lower global ratings of Overall Care and Specialist. Conclusions: Utilization for anxiety/mood disorders mediates the association between fair/poor MHS and worse care experiences. Although MHS is a case-mix adjustor for CAHPS public reporting, it is important to recognize that care for anxiety or mood disorders may improve care experiences among seniors with cancer.


2018 ◽  
Vol 5 (1) ◽  
pp. e20 ◽  
Author(s):  
Christiaan Vis ◽  
Mayke Mol ◽  
Annet Kleiboer ◽  
Leah Bührmann ◽  
Tracy Finch ◽  
...  

Background Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. Objective This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. Methods A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. Results A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. Conclusions Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients’ mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.


Author(s):  
Gali Katznelson ◽  
Jacek Orzylowski

A 2017 survey of 529 psychiatrists in Canada found that while 72% of psychiatrists supported medical assistance in dying (MAID) in some cases, only 29.4% supported MAID solely on the basis of mental disorders.  Understanding and addressing the concerns of mental health professionals will be crucial in deciding whether and how to expand MAID solely for a mental disorder in Canada. The report, “The State of Knowledge on Medical Assistance in Dying Where a Mental Disorder Is the Sole Underlying Medical Condition,” authored by The Council of Canadian Academies, highlights some concerns that mental health professionals might harbour. These include potentially feeling that there is a conflict between providing MAID and their duties as mental health care workers, the subjectivity of the current law, and Canada’s inequitable mental health care system.


2016 ◽  
Vol 16 (1) ◽  
pp. 75-88
Author(s):  
S. Thothela ◽  
A.E. Van der Wath ◽  
E.S. Janse van Rensburg

This study explored the factors contributing to relapse of mental health care users (MHCUs) treated for substance-induced psychotic disorder in a public psychiatric hospital in Gauteng, South Africa. A qualitative, explorative, descriptive and contextual research design was followed. The study was conducted at the outpatient department of the hospital. Participants were selected purposefully from MHCUs visiting the outpatient department for follow-up. Ten semistructured interviews were used to collect data until data saturation occurred. The transcribed interviews and field notes were analysed using Tesch’s method of qualitative data analysis. The researcher and an independent coder reached consensus on the categories, sub-categories and themes. Trustworthiness was ensured through application of the strategies of dependability, transferability, conformability, credibility and authenticity. The findings explicated the factors contributing to relapse of MHCUs treated for substanceinduced psychotic disorder in a psychiatric hospital. These factors included psychological, physical and social factors. Recommendations were provided for psychiatric nurses in terms of therapeutic programme planning and involvement of the community and family in the management of MHCUs treated for substance-induced psychotic disorder. 


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