scholarly journals Prevalence of Cannabis Residues in Psychiatric Patients: A Case Study of Two Mental Health Referral Hospitals in Uganda

2014 ◽  
Vol 8 ◽  
pp. SART.S13254 ◽  
Author(s):  
Epaenetus A. Awuzu ◽  
Emmanuel Kaye ◽  
Patrick Vudriko
Keyword(s):  
Mental Health ◽  
Medical Records ◽  
Psychiatric Patients ◽  
Strong Association ◽  
Diagnostic Kits ◽  
Referral Hospitals ◽  
Other Substances ◽  
History Of ◽  
Diagnostic Capacity

Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea). Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05) between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

Anxiety disorders and substance abuse

2016 ◽  
Vol 33 (S1) ◽  
pp. S384-S384
Author(s):  
I. Prieto Sánchez ◽  
M.D.L.C. Ramírez Domínguez ◽  
S. Fernández León ◽  
M. Reina Domínguez ◽  
N. Garrido Torres ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Dual Diagnosis ◽  
Behavioral Problems ◽  
Strong Association ◽  
Epidemiological Studies ◽  
Distinctive Features ◽  
Other Substances ◽  
History Of ◽  
Competing Interest ◽  
Substance Disorder

IntroductionPatients with anxiety disorders are more vulnerable to develop other comorbid conditions. In particular, large epidemiological studies show a strong association between different anxiety disorders and substance use disorders.ObjectivesTo show the prevalence of major anxiety disorders and the consumption of different substances. As well as the particular characteristics of this dual diagnosis and treatments that have proven more effective.MethodsExhaustive review of all the material published on this topic in the recent years.ConclusionsNearly 24% of patients with anxiety disorder suffer from a comorbid substance disorder use in their lifetime (17.9% diagnosis of alcohol abuse or dependence diagnosis and 11.9% of abuse or dependence on other drugs). Dual patients show a number of distinctive features, such as more frequency in males, family history of alcohol or other substances abuse and behavioral problems, early parental loss among others.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Del hospital de pobres a la cultura hospitalo-céntrica. Economía política y cambio cultural en el sistema hospitalario catalán / From the poor hospital to the hospital-centric culture. Political economy and cultural change in the Catalan hospital system

2017 ◽  
pp. 57
Author(s):  
Josep Maria Comelles Esteban ◽  
Elisa Alegre Agís ◽  
Josep Barceló Prats
Keyword(s):  
Mental Health ◽  
Health System ◽  
Cultural Change ◽  
Hospital System ◽  
Palabras Clave ◽  
El Sistema ◽  
Salud Mental ◽  
History Of ◽  
Hospital Institution

Resumen: En el presente artículo se describe la evolución del sistema sanitario catalán utilizando, para ello, el desarrollo de un concepto cultural –el hospitalo-centrismo– clave para entender la hegemonía de la institución hospitalaria en los dispositivos de salud actuales. A tales efectos y utilizando dos perspectivas complementarias como son la historia antropológica y la antropología médica, el artículo analiza un case study a partir de tres ejemplos: la demanda de urgencias hospitalarias asociadas a una concepción cultural de lo que es “grave” y al embodiment de su eficacia por los ciudadanos; la necesidad del rol de asilo en las enfermedades crónicas o terminales; y la conversión del cuidado doméstico como “hospitalización doméstica” en el caso de la salud mental. Palabras clave: hospital-centrismo, sistema sanitario, historia de hospitales, urgencias, cuidados crónicos, salud mental. Abstract: This article describes the evolution of the Catalan Health System, using the development of a key cultural concept –hospital-centrism– to understand the hegemony of the hospital institution in the current health devices. To this purpose, and using two complementary perspectives such as anthropological history and medical anthropology, the article analyzes a case study from three examples: the demand for hospital emergencies related with a cultural conception of what is “severe”, and with its effectiveness embodied by the citizens; the need of the asylum role in chronic or terminal diseases; and the transformation of domestic care to “domestic hospitalization” in mental health cases. Keywords: hospital-centrism, health system, history of hospitals, emergencies, chronic care, mental health.

Per una storia dell'affidamento dei malati psichiatrici alle famiglie: Towards a history of the family care of psychiatric patients

2009 ◽  
Vol 18 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Patrizia Guarnieri
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Family Care ◽  
Special Role ◽  
The Past ◽  
The Family ◽  
History Of ◽  
Psychiatric Staff

SummaryInserting adults with psychic problems into families has recently been practiced in various European countries and also in Italy, where some mental health departments support such families. Beyond the well known story of Gheel, the etero and omofamily care of psychiatric patients has a forgotten history. Methods – On the basis of unexplored and exceptionally rich sources from the archives of the asylums in Florence, as well as of the Province di Florence, which funded assistance to the mentally ill – this research focuses on the subsidized “domestic custody” of hundreds of psychiatric patients, who had already been institutionalized. Beginning in 1866, outboarding was supported by the provincial administration in Florence with the collaboration of the asylum medical direction. Results – In the late 19th C. and in the early 20th C. prestigious psychiatrists sought alternatives to the institutionalisation. These alternatives involved varied participants in a community (the patients and their families, the administrators and the medical specialists, the neighborhood and the police). The families played a special role that historians of the psychiatry exclusively dedicated to the insane asylums have not really seen. Conclusions – The role of the families in the interaction with the psychiatric staff is not, even on a historiographical level, simply an additional and marginal chapter of the practices and of the culture of the mental health. These archival evidence contradicts some common places on the past of the Italian psychiatry before 1978, and provokes new reflections of possible relevance to the present.

scholarly journals History of psychosurgery at Sainte-Anne Hospital, Paris, France, through translational interactions between psychiatrists and neurosurgeons

2017 ◽  
Vol 43 (3) ◽  
pp. E9 ◽  
Author(s):  
Marc Zanello ◽  
Johan Pallud ◽  
Nicolas Baup ◽  
Sophie Peeters ◽  
Baris Turak ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Hospital ◽  
18Th Century ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Public Institution ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of

Sainte-Anne Hospital is the largest psychiatric hospital in Paris. Its long and fascinating history began in the 18th century. In 1952, it was at Sainte-Anne Hospital that Jean Delay and Pierre Deniker used the first neuroleptic, chlorpromazine, to cure psychiatric patients, putting an end to the expansion of psychosurgery. The Department of Neuro-psychosurgery was created in 1941. The works of successive heads of the Neurosurgery Department at Sainte-Anne Hospital summarized the history of psychosurgery in France.Pierre Puech defined psychosurgery as the necessary cooperation between neurosurgeons and psychiatrists to treat the conditions causing psychiatric symptoms, from brain tumors to mental health disorders. He reported the results of his series of 369 cases and underlined the necessity for proper follow-up and postoperative re-education, illustrating the relative caution of French neurosurgeons concerning psychosurgery.Marcel David and his assistants tried to follow their patients closely postoperatively; this resulted in numerous publications with significant follow-up and conclusions. As early as 1955, David reported intellectual degradation 2 years after prefrontal leucotomies.Jean Talairach, a psychiatrist who eventually trained as a neurosurgeon, was the first to describe anterior capsulotomy in 1949. He operated in several hospitals outside of Paris, including the Sarthe Psychiatric Hospital and the Public Institution of Mental Health in the Lille region. He developed stereotactic surgery, notably stereo-electroencephalography, for epilepsy surgery but also to treat psychiatric patients using stereotactic lesioning with radiofrequency ablation or radioactive seeds of yttrium-90.The evolution of functional neurosurgery has been marked by the development of deep brain stimulation, in particular for obsessive-compulsive disorder, replacing the former lesional stereotactic procedures.The history of Sainte-Anne Hospital’s Neurosurgery Department sheds light on the initiation—yet fast reconsideration—of psychosurgery in France. This relatively more prudent attitude toward the practice of psychosurgery compared with other countries was probably due to the historically strong collaboration between psychiatrists and neurosurgeons in France.

scholarly journals Psychiatry, the law and death on the roads

2004 ◽  
Vol 10 (6) ◽  
pp. 439-445 ◽  
Author(s):  
Harvey Gordon
Keyword(s):  
Mental Health ◽  
Public Transport ◽  
Mental Health Problems ◽  
Motor Vehicle ◽  
Psychiatric Patients ◽  
Motor Vehicles ◽  
Factors Associated ◽  
The Road ◽  
History Of ◽  
On The Road

The motor vehicle on the road has a history of only just over 100 years. It is a major form of personal and public transport, but is also associated with hazards and risks. Many more people are killed on the roads each year in Britain than are the victims of homicide. General and forensic pyschiatric evaluation of offenders charged with or convicted of motoring offences is, however, infrequent, despite the presence of mental health problems in some of them. I describe psychiatric, criminological and legal factors associated with driving of motor vehicles, as many psychiatric patients have driving licences and have access to a vehicle or, indeed, may decide to drive unlicensed.

Coercion in psychiatry: is it right to involuntarily treat inpatients with capacity?

2019 ◽  
Vol 45 (11) ◽  
pp. 742-745 ◽  
Author(s):  
Harry Hudson
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Involuntary Treatment ◽  
The Public ◽  
Mental Health Act ◽  
The Impact ◽  
Fusion Approach

Psychiatric inpatients with capacity may be treated paternalistically under the Mental Health Act 1983. This violates bodily autonomy and causes potentially significant harm to health and moral status, both of which may be long-lasting. I suggest that such harms may extend to killing moral persons through the impact of psychotropic drugs on psychological connectedness. Unsurprisingly, existing legislation is overwhelmingly disliked by psychiatric inpatients, the majority of whom have capacity. I present four arguments for involuntary treatment: individual safety, public safety, authentic wishes and protection of autonomy. I explore these through a case study: a patient with schizophrenia admitted to a psychiatric hospital under the Mental Health Act 1983 after an episode of self-poisoning. Through its discussion of preventative detention, the public safety argument articulates the (un)ethical underpinnings of the current position in English law. Ultimately, none of the four arguments are cogent—all fail to justify the current legal discrimination faced by psychiatric inpatients. I conclude against any use of involuntary treatment in psychiatric inpatients with capacity, endorsing the fusion approach where only psychiatric patients lacking capacity may be treated involuntarily.

Substance-Use Disorders in DSM-III-R

1987 ◽  
Vol 151 (6) ◽  
pp. 834-843 ◽  
Author(s):  
Thomas R. Kosten ◽  
Bruce J. Rounsaville ◽  
Thomas F. Babor ◽  
Robert L. Spitzer ◽  
Janet B. W. Williams
Keyword(s):  
Substance Abuse ◽  
Drugs Of Abuse ◽  
Psychiatric Patients ◽  
Empirical Support ◽  
The Other ◽  
Single Factor ◽  
Psychosocial Consequences ◽  
Excellent Internal Consistency ◽  
Other Substances ◽  
History Of

Using the newly revised DSM-III-R criteria for substance-abuse diagnoses, we examined dependence syndrome elements among 83 psychiatric patients. The sample included 14 with no history of substance abuse. The remainder abused alcohol (52), sedatives (31), hallucinogens (12), stimulants (33), cannabis (44), cocaine (52), or opiates (47). Many patients (52) had abused more than one type of drug. Ten items assessing the proposed dependence symptoms for each type of drug were factor-analysed. The dependence syndrome items formed a single factor for opiates, cocaine, and alcohol, but not for other drugs. When the items were combined into cumulative scales, they had excellent internal consistency. Furthermore, they formed good approximations of unidimensional Guttman scales on which higher scores indicated greater syndrome severity. The items associated with higher scores differed across drugs, with opiates having the most striking differences from the other substances. Medical-psychosocial consequences were relatively independent of the dependence syndrome, although alcohol and cocaine dependence had some association with other problem areas. These findings support the utility of a common dependence syndrome concept for drugs of abuse as well as alcohol, and provide empirical support for the current revision of the DSM-III diagnostic criteria.

scholarly journals Realigning Expectations With Reality: A Case Study on Maternal Mental Health During a Difficult Breastfeeding Journey

2021 ◽  
pp. 089033442110311
Author(s):  
Mason Elder ◽  
Lorann Murphy ◽  
Stacy Notestine ◽  
Ashley Weber
Keyword(s):  
Mental Health ◽  
Support Groups ◽  
Maternal Mental Health ◽  
Bottle Feeding ◽  
Perineal Pain ◽  
Physical Trauma ◽  
Difficult Decision ◽  
History Of ◽  
Nutritional Benefits

Introduction: Many mothers have the goal to breastfeed. However, more than 50% will have breastfeeding difficulty by the 3rd day of life. Mothers who are unable to meet their breastfeeding goals are at higher risk for anxiety, depression, embarrassment, and guilt. Those who stop breastfeeding need support and help resolving these feelings. This case study aims to describe one woman’s difficulty with mental health surrounding breastfeeding, her decision to bottle feed, and her successful transition back to direct breastfeeding. Main Issue: Barriers to the participant’s success with breastfeeding were pre-existing history of depression/anxiety, forceps delivery, uncontrolled perineal pain, infant physical trauma, and nipple/flow confusion. The decision to discontinue direct breastfeeding and start bottle feeding came after 2 months of anxiety, frustration, and persistence. Management: The participant followed her healthcare team’s recommendations of triple feeding, lactation support groups, pediatric chiropractic adjustments, and prescribed galactagogues. After 2 months of exhaustion and deliberation, she made the difficult decision to stop breastfeeding for nutritional benefits and switched to breastfeeding only for her infant’s pleasure and comfort. Lowered expectations allowed the dyad to heal and her son to transition to nearly exclusive breastfeeding at 4 months of life. Conclusion: Clinicians must be aware of the delicate balance between promoting breastfeeding for its nutritional value and health benefits and supporting a struggling mother with mental health needs.

scholarly journals Rules, indications and documentation for applying physical coercion by emergency medical services

2015 ◽  
Vol 125 (2) ◽  
pp. 83-86
Author(s):  
Tomasz Kucmin ◽  
Adriana Kucmin ◽  
Małgorzata Płowaś-Goral ◽  
Adam Nogalski
Keyword(s):  
Mental Health ◽  
Medical Records ◽  
Emergency Services ◽  
Psychiatric Patients ◽  
Medical Emergency ◽  
Mental Health Act ◽  
Legal Foundations ◽  
Apply Physical ◽  
The Right ◽  
Medical Emergency Services

Abstract Helping people with mental disorders poses a challenge to the members of medical emergency services (EMS). Psychiatric patients are often unpredictable and applying physical coercion is necessary in some cases. The aim of this paper was to present and comment on legal foundations of application of different forms of physical coercion by EMS members and describe how to fill out medical records required every time physical coercion was used. According to the amendments of Polish Mental Health Act made in 2010, the EMS members were granted the right to apply physical coercion. Further amendments to the Mental Health Act and the introduction of appropriate Ministry of Health decree define forms of physical coercion, indications to apply physical coercion and include a sample of proper medical records which are required in all cases of application of physical coercion. Application of physical coercion should always be treated as last-line treatment option while helping patients suffering from mental disturbances. Obeying the law every time a decision regarding physical coercion is made protects patients’ right to receive dignified care and treatment as well as the rights of medical professionals

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