Virtual Reality and Forensic Mental Health

This chapter provides an overview of virtual reality (VR) treatment and rehabilitation for mentally ill patients who have committed a crime or are at risk of relapse. The authors focus on the forensic mental health field since this area relates to any individual dealing with a psychiatric condition that is in trouble with the law, whether they be inpatient offenders, outpatient offenders, or inmates at a regular prison. Virtual reality (VR) and its current uses, as well as its benefits and barriers, are presented as a successful and individualized eHealth treatment. In addition, some examples of VR studies that were recently done with these individuals will be presented to show the results of their current approaches, demonstrate their limitations, and figure out possible ways of improvement.

Tobacco/Nicotine Use Among Individuals Using Cannabis for Therapeutic Purposes

OBJECTIVE: While the relationship between recreational cannabis and nicotine use is well established, little is known about nicotine use among users of cannabis for therapeutic purposes (CTP). METHOD: Patients attending a medical marijuana dispensary (N = 697; 75.3% White; 60.0% male) completed a survey examining nicotine use, routes of administration of nicotine and cannabis, and CTP qualifying conditions. RESULTS: More than one-third (39.3%) of participants reported current nicotine use. Compared to exclusive cigarette smokers, non-users of nicotine, and e-cigarette users were approximately four times more likely to vape, rather than to smoke, cannabis. Almost a third of those reporting e-cigarette use (30.6%) and more than half (56.7%) of those reporting smoking cigarettes reported stopping for one day or longer in the past year because they were trying to quit. Furthermore, 46.8% of cigarette smokers reported plans to quit smoking in the next six months (but not in the next month) and an additional 31.6% planned to quit in the next month. Having a psychiatric condition was associated with nicotine use and higher motivation to quit smoking. CONCLUSIONS: Users of CTP are more likely to use nicotine products than the general population. Importantly, the route of administration of nicotine products is related to the route of administration of CTP. If aerosolized (vaped) CTP is a less harmful route of administration than smoked CTP, dispensary staff should be aware of this relationship and take this into account when recommending a non-combustible route.

Psychological Stress Due to Covid-19 on Pregnant Women in Post Partal Period

There is no indication that covid-19 has a long-term effect on pregnancy, the mother's psychiatric condition, or the infant's developmental delay. Between May 1st and July 31st 2020, 72 pregnant patients with covid-19 took part in a study that took place in different locations. Since giving birth these woman patients engaged in three-month follow-up surveys. The data was collected from Covid-19 medical history, maternal reports, quarantine questionnaires, mother-baby feeding separation, and assessing the mothers psychiatric illnesses. While there is no conclusive evidence of vertical transmission of SARS-COV-2, in order to reduce the risk of infection, healthcare professionals and researchers must focus more on the mental health of pregnant women, infant feeding, and closeness to the parents. This will aid in the early development of the new born, reducing stress on the mother.

When Cotard's syndrome fits the sociocultural context: The singular case of Per “Dead” Ohlin and the Norwegian black metal music scene

The sociocultural context of psychiatric patients shapes symptoms experience and expression, as well as how patients deal with a disorder and how society appraises its symptoms. Specifically, the context may influence the social appraisal of a behavior as normal or pathological. Therefore, markedly pathological symptoms may not be accordingly recognized by peers when they are in consonance with the sociocultural context. Per “Dead” Ohlin was a Swedish musician who was a member of the Norwegian black metal band Mayhem from 1988 until his suicide in 1991, at age 22. Black metal is a musical movement characterized by death worshiping and anti-Christianism, and is also associated with church arsons and murders during the 1990s. Even among peculiar personalities such as black metal musicians, Ohlin was considered the personification of the movement ideals due to his eccentric and unparalleled beliefs and behaviors, claiming, for instance, that he was already dead. In this article, we propose that Ohlin's eccentric beliefs and behaviors were symptoms of an unrecognized psychiatric condition, Cotard's syndrome, and discuss the diagnostic dilemma presented by Ohlin's artistic persona and singular context. The compatibility between his symptoms and the sociocultural context of black metal may have obscured his mental disorder. If so, Ohlin's unique case may shed light upon one of the effects of context in a psychopathological process: concealing a psychiatric disorder and reinforcing symptoms that fit a particular environment.

ART THERAPY GROUP AS EFFORTS OF PSYCHIATRIC EMERGENCY PREVENTION

World Health Organization (WHO) works hard for facing this covid-19 pandemic. The whole world applied WHO suggestions in public health actions, such as social distancing to reduce the spread of COVID-19. However, these protocols lead societies to feel isolated and lonely that increase stress and anxiety. Community service activities are one of the efforts that can be taken to empower family members to carry out simple therapy in reducing anxiety. This community service will focus on the mother who has a big influence on managing the family. This community service aimed to educate the mother’s group to help their family in improving knowledge and skill of emergency psychiatric prevention. This activity was divided into two main parts, a seminar about health education about Psychiatric Emergency and ran a workshop in the art therapy group. These community service results showed that health education can improve knowledge related to emergency psychiatric, and mothers could implement art drawing therapy as an effort of psychiatric emergency prevention. In conclusion, Art group therapy is recommended for the mother and her family to prevent the emergency psychiatric condition.

Burnout and Sense of Coherence in Dentistry Students of Karachi

OBJECTIVE: This study aimed to assess burnout and sense of coherence levels in dentistry students of Karachi. METHODOLOGY: A cross-sectional study involving 361 students from four renowned dental colleges in Karachi was carried out. The students were distributed a questionnaire derived from the Mayo Clinic Well-being Index (WBI) and a modified 13-item Antonovsky's Sense of Coherence Scale (SOC scale). They were stratified on the basis of gender, age, professional year, institution, relationship status, history of chronic medical condition and history of chronic psychiatric condition. Scores for the WBI and SOC scale were calculated. For the WBI, a score of >4 was a sign that an individual was at risk of developing burnout or other severe outcomes. A high or low total score on the SOC scale demonstrated whether the individual was able to cope with his environment or not. MS Excel and SPSS version 23 were used for data compilation and statistical analysis. Descriptive statistics were calculated. Chi-square test of independence was applied to gauge any association between the strata and outcome variables. After determination of statistical difference, Mann Whitney-U Test and Kruskal Wallis Test were applied to compare the means where a significant association was found. A p-value of 0.05 or less was considered significant. RESULTS: The mean WBI score was found to be 4.07. Around 64% respondents were at-risk of burnout (score > 4). A greater percentage of females was at risk (66%) as compared to males (50%). Third professional students were found to be the most affected (77% with WBI score > 4 and 9% in the low coherence category). The mean SOC score was found to be 36.39 (moderate levels of coherence). Overall, around 4-9% of each professional year students exhibited a low sense of coherence. Age, relationship status, institution and a history of chronic medical and/or psychiatric condition were not found to have a significant association with the outcome variables (p>0.05). CONCLUSION: A significant number of dentistry students are at risk of burn-out and suffer from a low sense of coherence. The risk factors need to be evaluated and solutions need to be found to create a healthy and conducive environment for the growth and learning of the students. More research needs to be focused on gathering data related to the well-being of dentistry students. KEYWORDS: Burnout, sense of coherence, well-being index, dentistry.

Same Gender Erotomania: When the Psychiatrist Became the Delusional Theme—A Case Report and Literature Review

Erotomania is a rare subtype of delusional disorder, whereby the affected person believes that another individual, usually someone with higher socio-economic status, is in love with them despite having little or no contact. To the best of our knowledge, this is the first published case of same gender erotomania, involving a 28-year-old single lady and a 42-year-old divorcee towards a female psychiatrist. We aimed to share the challenges experienced by the managing psychiatrist as she inopportunely became the theme of her patients’ delusion. We also reviewed and discussed recent literature on erotomania to create awareness among psychiatrists towards this rare psychiatric condition.

Between Punishment and Care: Autonomous Offenders Who Commit Crimes Under the Influence of Mental Disorder

The aim of this paper is to present a solution to a problem that arises from the fact that people who commit crimes under the influence of serious mental disorders may still have a capacity to refuse treatment. Several ethicists have argued that the present legislation concerning involuntary treatment of people with mental disorder is discriminatory and should change to the effect that psychiatric patients can refuse care on the same grounds as patients in somatic care. However, people with mental disorders who have committed crimes and been exempted from criminal responsibility would then fall outside the scope of criminal justice as well as that of the psychiatric institutions if they were to refuse care. In this paper, I present and develop a solution to how society should deal with this group of people, called Advance criminal responsibility. The basic idea being that if a person with a potentially responsibility exempting psychiatric condition refuses care, that person is responsible for any future criminal acts which are due to the mental disorder.