scholarly journals Psychiatric Services and Teaching during the Covid-19 Pandemic in Romania

2021 ◽  
Author(s):  
Ioana Valentina Micluţia

The Covid-19 pandemic has been declared in Romania on the 16th March 2020.The medical system reacted promptly: chronic patients had to be discharged within 48 h and further scheduled admittances were postponed, adequate epidemiological measures and circuits were organized. Anxiety, insomnia, frustration, binge eating, domestic violence were reported. The majority respected the general advises but soon, persons selected their information sources rather from social media, being victims of the infodemia and peculiar conspirationist theories. A new disorder has been described: coronaphobia. The psychiatric hospitals and outpatient settings had to reduce or innactivate their activity, switch as much as possible to TelePsychiatry. Psychiatry admittances were: onsets of psychosis, relapses of schizophrenia and alcohol, other psychoactive substances abuses, intoxications, and withdrawal states. Later, there were depressions, bipolar disorders, suicide attempts, self-harm in borderline disorder, dementia and delirium. Due to the closure of outpatient units for several months, patients visited the Emergency rooms. Personnel experienced burnout and new psychiatric pathology developed in the aftermath of Covid-19 infection. A big relief occurred with the initial vaccination of the medical staff and seniors, chronically ill persons, psychiatric patients being again left behind. Medical teaching shifted entirely to online and in 2021 the hybrid teaching system has been employed.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Petra Schmid ◽  
Agata Czekaj ◽  
Jürgen Frick ◽  
Tilman Steinert ◽  
Scot E. Purdon ◽  
...  

Abstract Background Cognitive dysfunction has been reported in acute psychiatric patients for a long time. The detection of cognitive deficits is crucial both for clinical treatment and for predicting the psychosocial functional level in the further course of the disease. The SCIP is a well-evaluated screening instrument for the examination of cognitive performance in psychiatric patients. We recently integrated the SCIP into our routine admission and discharge assessments on two inpatient wards, and we examined the cognitive profiles of patients with psychotic and affective disorders over the course of their admission. Methods Shortly after admission, and prior to discharge, patients were routinely referred for examination with the SCIP. A total of 529 assessments were completed on admission, and 227 returned for SCIP at the time of discharge. After standardization of the test results against a normative sample, we examined the normalized test values in terms of percentages of pathological cognitive performance based on the total SCIP score, and each of the SCIP subscale scores. We conducted cluster analysis to identify cognitive subgroups within the clinical sample. Results More than 70% of the SCIP results on admission were pathological. At discharge, improvements were observed, especially on tests with attention and speed components. Cluster analysis identified two groups. The cluster with chronic patients showed poorer results at admission, but greater improvement and reached the level of the others at discharge. Conclusions The SCIP appears to have value in routine diagnostic assessments, and in the quantification of improvements in cognitive performance during an inpatient stay. The greatest benefit was observed in chronically ill patients with many previous stays. Trial registration DRKS00019825 (retrospectively registered on 03.12.2019).


Psihiatru ro ◽  
2019 ◽  
Vol 58 (3) (1) ◽  
pp. 46-50
Author(s):  
Romulus-Dan Nicoară

Suicide is a global health problem, causing almost a million of deaths worldwide. Suicide tendencies can be controlled, and suicide risk can be treated. Cognitive behavior therapy (CBT) and dialectic behavior therapy (DBT) are the most frequent and effective psychotherapies. Cognitive behavior approach consists in two models of intervention in case of suicide risk: cognitive behavior psychotherapy for prevention, and mindfulness (contemplative meditation). Dialectic behavior therapy is used to treat people with multiple suicide attempts and self-harm tendencies. Lately, the method has become the standard for the treatment of people suffering from borderline disorder. Inter-personal therapy (IPT) is a short type of psychotherapy, well structured and documented, used to treat people suffering from acute major depression, but the method has been used lately to prevent new episodes of depression by solving interpersonal problems.


1967 ◽  
Vol 113 (502) ◽  
pp. 941-949 ◽  
Author(s):  
A. D. Harris ◽  
F. J. J. Letemendia ◽  
P. J. A. Willems

The assessment of change in psychiatric patients is never easy. The problem is accentuated in the chronic inhabitants of psychiatric hospitals, since the period of treatment and observation may have to be prolonged, and the changes found may be small and gradual. A rating scale can be of value, in recording findings in a uniform manner and in preserving the observations from selective amnesia, so making comparison possible over a long period. In the present communication we report a scale devised by two of us (F.J.J.L. and A.D.H.) for use with chronic patients. This scale summarizes the relevant parts of the examination of mental state found in standard text books of psychiatry, and we have tried to avoid presuppositions about the meaning or distribution of symptoms.


2021 ◽  
Vol 12 ◽  
Author(s):  
Natalie Laporte ◽  
Andrejs Ozolins ◽  
Sofie Westling ◽  
Åsa Westrin ◽  
Märta Wallinius

Self-harm, comprising non-suicidal self-injury, and suicide attempts, is a serious and potentially life-threatening behavior that has been associated with poor life quality and an increased risk of suicide. In forensic populations, increased rates of self-harm have been reported, and suicide is one of the leading causes of death. Aside from associations between self-harm and mental disorders, knowledge on self-harm in forensic psychiatric populations is limited. The purpose of this study was to characterize the clinical needs of a cohort of forensic psychiatric patients, including self-harm and possible risk factors thereof. Participants (N = 98) were consecutively recruited from a cohort of forensic psychiatric patients in Sweden from 2016 to 2020. Data were collected through file information, self-reports, and complemented with semi-structured interviews. Results showed that self-harm was common among the participants, more than half (68.4%) of whom had at some point engaged in self-harm. The most common methods of non-suicidal self-injury were banging one's head or fist against a wall or other solid surface and cutting, and the most common method of suicide attempt was hanging. The most prominent functions of non-suicidal self-injury among the participants were intrapersonal functions such as affect regulation, self-punishment, and marking distress. Self-harm in general was associated to neurodevelopmental disorders (p = 0.014, CI = 1.23–8.02, OR = 3.14) and disruptive impulse-control and conduct disorders (p = 0.012, CI = 1.19–74.6, OR = 9.41), with reservation to very wide confidence intervals. Conclusions drawn from this study are that self-harm was highly prevalent in this sample and seems to have similar function in this group of individuals as in other studied clinical and non-clinical groups.


2003 ◽  
Vol 62 (4) ◽  
pp. 241-249 ◽  
Author(s):  
M. Bolognini ◽  
B. Plancherel ◽  
J. Laget ◽  
P. Stéphan ◽  
O. Halfon

The aim of this study, which was carried out in the French-speacking part of Switzerland, was to examine the relationship between suicide attempts and self-mutilation by adolescents and young adults. The population, aged 14-25 years (N = 308), included a clinical sample of dependent subjects (drug abuse and eating disorders) compared to a control sample. On the basis of the Mini Neuropsychiatric Interview ( Sheehan et al., 1998 ), DSM-IV criteria were used for the inclusion of the clinical population. The results concerning the occurrence of suicide attempts as well as on self-mutilation confirm most of the hypotheses postulated: suicidal attempts and self-mutilation were more common in the clinical group compared to the control group, and there was a correlation between suicide attempts and self-mutilation. However, there was only a partial overlap, attesting that suicide and self-harm might correspond to two different types of behaviour.


Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.


Crisis ◽  
2020 ◽  
Vol 41 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Nadia Bounoua ◽  
Jasmeet P. Hayes ◽  
Naomi Sadeh

Abstract. Background: Suicide among veterans has increased in recent years, making the identification of those at greatest risk for self-injurious behavior a high research priority. Aims: We investigated whether affective impulsivity and risky behaviors distinguished typologies of self-injurious thoughts and behaviors in a sample of trauma-exposed veterans. Method: A total of 95 trauma-exposed veterans (ages 21–55; 87% men) completed self-report measures of self-injurious thoughts and behaviors, impulsivity, and clinical symptoms. Results: A latent profile analysis produced three classes that differed in suicidal ideation, suicide attempts and nonsuicidal self-injury (NSSI): A low class that reported little to no self-injurious thoughts or behaviors; a self-injurious thoughts (ST) class that endorsed high levels of ideation but no self-harm behaviors; and a self-injurious thoughts and behaviors (STaB) class that reported ideation, suicide attempts and NSSI. Membership in the STaB class was associated with greater affective impulsivity, disinhibition, and distress/arousal than the other two classes. Limitations: Limitations include an overrepresentation of males in our sample, the cross-sectional nature of the data, and reliance on self-report measures. Conclusion: Findings point to affective impulsivity and risky behaviors as important characteristics of veterans who engage in self-injurious behaviors.


2013 ◽  
Author(s):  
Ashley Pritchard ◽  
Adam Joseph Evans Blanchard ◽  
Diane S. Strub ◽  
Kevin Douglas ◽  
Tonia Nicholls

2019 ◽  
Vol 18 (3) ◽  
pp. 256-259
Author(s):  
Hou Y.C. ◽  
Hsieh Y.L. ◽  
Tzeng I.S. ◽  
Kuo C.Y.

Malnutrition is an important issue in hospitalized patients. Poor nutrition may lead to increased risk of morbidity and death, impaired mental and physical conditions, apathy, depression, self-neglect, increased risk of medical complications, increased risk of pressure ulcers, reduced immune response, delayed wound healing, longer hospital stays, and reduced quality of life. However, few studies have investigated malnutrition in psychiatric patients. Psychiatric patients are known to have an increased risk of malnutrition, but psychiatric hospitals rarely conduct physical examinations and nutritional assessments. In this preliminary study, patients from a psychiatric ward of the Taipei Tzu Chi Hospital were chosen using the Malnutrition Universal Screening Tool. We used the before-and-after analysis to test the effect of a nutrition intervention on the selected parameters. We found that patients who had an impaired nutritional status showed significant increases in body weight (mean: 43.6 ± 7.5 vs. 46.5 ± 8.2 kg; P < 0.001), BMI (mean: 16.8 ± 2.0 vs. 17.9 ± 2.1 kg/m2; P < 0.001), and total calorie intake (mean: 1128 ± 230 vs. 1378 ± 320 Kcal; P < 0.001). Nutritional intervention significantly improved body weight, BMI, and total calorie intake. Nutritional intervention may help prevent malnutrition and improve the management of psychiatric patients.


2015 ◽  
Vol 66 (1) ◽  
pp. 43-52
Author(s):  
Katalin Nagyváradi ◽  
Zsuzsa Mátrai

AbstractSeveral research works in the related international literature on sociology and health sciences deal with the state of health in one selected population. In these studies, the chosen sample is often connected with special jobs, especially with healthcare professionals and their working conditions. These studies predominantly examine the self-rated subjective health status using questionnaires. There are others that assess the state of health based not only on self-rated subjective indicators, but also using objective data gained by measuring. Considering the international experiences, we chose a special population in our research – healthcare professionals working in an institute for chronically ill psychiatric patients. Our choice was influenced by the fact that we wanted to include their unique working conditions when exploring and assessing their health status. Moreover, our approach was to assess the objective state of health alongside the subjective factors, as our hypothesis was that the majority of the indicators presumably coincided. The data were collected with the help of three questionnaires and some indicators of the objective health statuses were measured. The findings were processed using the SPSS 17.0 mathematical-statistical software package. Following the descriptive statistics, we applied hierarchic cluster-analysis based on results of the WHOQOLD-BREF26 life-quality questionnaire, the WHO WBI-5 Well Being Index, and on the body composition analysis. The results show the objective and subjective health status of population and the factors that influenced it; the working conditions and the interpersonal contacts in the workplace. The conclusion was that in the examined population the subjective and objective health status doesn’t coincide.


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