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Casopis Lekaru Ceskych 2023In medicine, there are two main methods of improving the healthcare provided: perfecting (optimizing) the existing ones and seeking new treatment procedures. Despite of...
In medicine, there are two main methods of improving the healthcare provided: perfecting (optimizing) the existing ones and seeking new treatment procedures. Despite of tremendous development in the central nervous system research, current treatment of severe mental illnesses, such as schizophrenia and depressive disorder, is suboptimal. Nowadays, optimization of treatment in psychiatry includes therapeutic drug monitoring (TDM) and pharmacogenomic testing, which examines genetic variation involved in medication metabolism and drug action. The TDM enables to determine drug concentrations in blood and adjust the dose accordingly if clinical effects correlate better with drug blood levels than drug doses. The first international guidelines for TDM in neuropsychopharmacology were published in 2004 and regularly updated. The recent update provides therapeutic reference ranges for a majority of commonly prescribed psychiatric medications and gives example of patients regularly treated in clinical practice profiting from TDM (using antipsychotics and changing their smoking habits). TDM in psychiatry is an underused tool, given its ability to optimize treatment, as well as to improve treatment effectiveness.
Topics: Humans; Drug Monitoring; Psychiatry; Antipsychotic Agents; Mental Disorders
PubMed: 37734940
DOI: No ID Found -
The American Journal of Psychiatry Jun 2024
Topics: Humans; Psychiatry; COVID-19; Mental Disorders
PubMed: 38822587
DOI: 10.1176/appi.ajp.20240255 -
Asian Journal of Psychiatry Aug 2023
Topics: Asia; Culture; Philosophy; Psychiatry
PubMed: 37480817
DOI: 10.1016/j.ajp.2023.103700 -
Fortschritte Der Neurologie-Psychiatrie Jun 2024
Topics: Psychiatry; Neurology; Humans; Mental Disorders; Nervous System Diseases
PubMed: 38876142
DOI: 10.1055/a-2289-3195 -
Der Nervenarzt Jul 2023Due to the demographic development, the number of dementia patients in Germany is continuously increasing. The complex care situation of those affected calls for... (Review)
Review
Due to the demographic development, the number of dementia patients in Germany is continuously increasing. The complex care situation of those affected calls for meaningful guidelines. In 2008, the first S3 guideline on dementia was published, coordinated by the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and the German Association for Neurology (DGN) and accompanied by the Association of the Scientific Medical Societies in Germany (AWMF). An update was published in 2016. In recent years, the diagnostic possibilities for Alzheimer's disease, in particular, have greatly developed and a new disease concept has emerged that includes mild cognitive impairment (MCI) as part of the clinical manifestation of the disease and also enables the diagnosis of Alzheimer's disease in this phase. In the area of treatment, the first causal disease-modifying therapies will likely soon be available. Furthermore, epidemiological studies have also shown that up to 40% of the risks for dementia are dependent on modifiable risk factors, making prevention increasingly more important. In order to do justice to these developments a completely updated S3 guideline on dementia is currently being developed, which will be available digitally for the first time in the form of an app and which, in the sense of living guidelines, will enable rapid adjustments to progress in the future.
Topics: Humans; Alzheimer Disease; Psychotherapy; Psychiatry; Germany; Neurology
PubMed: 37233772
DOI: 10.1007/s00115-023-01492-6 -
European Psychiatry : the Journal of... Apr 2024
Topics: Humans; Psychiatry; Europe; Benchmarking; Specialty Boards
PubMed: 38654499
DOI: 10.1192/j.eurpsy.2024.1746 -
Psychiatry Research Jan 2024A number of congenital and inherited diseases present with both ocular and psychiatric features. The genetic inheritance and phenotypic variants play a key role in... (Review)
Review
A number of congenital and inherited diseases present with both ocular and psychiatric features. The genetic inheritance and phenotypic variants play a key role in disease severity. Early recognition of the signs and symptoms of those disorders is critical to earlier intervention and improved prognosis. Typically, the associations between these two medical subspecialties of ophthalmology and psychiatry are poorly understood by most practitioners so we hope to provide a narrative review to improve the identification and management of these disorders. We conducted a comprehensive review of the literature detailing the diseases with ophthalmic and psychiatric overlap that were more widely represented in the literature. Herein, we describe the clinical features, pathophysiology, molecular biology, diagnostic tests, and the most recent approaches for the treatment of these diseases. Recent studies have combined technologies for ocular and brain imaging such as optical coherence tomography (OCT) and functional imaging with genetic testing to identify the genetic basis for eye-brain connections. Additional work is needed to further explore these potential biomarkers. Overall, accurate, efficient, widely distributed and non-invasive tests that can help with early recognition of these diseases will improve the management of these patients using a multidisciplinary approach.
Topics: Humans; Ophthalmology; Genetic Testing; Psychiatry
PubMed: 38029629
DOI: 10.1016/j.psychres.2023.115629 -
Annals of Clinical Psychiatry :... Nov 2023
Topics: Humans; Obesity; Bariatrics; Psychiatry
PubMed: 37850993
DOI: 10.12788/acp.0122 -
Soins. Psychiatrie 2023When we talk about the clinic of delusional symptoms, we are first and foremost affirming that delusions exist. Professionals working in psychiatry know that delusions...
When we talk about the clinic of delusional symptoms, we are first and foremost affirming that delusions exist. Professionals working in psychiatry know that delusions can be listened to, that they give meaning to suffering and are part of the history of the subject. Taking the time to reflect on this type of symptom allows us to invest in the clinical field specific to psychiatry, and only makes sense if the clinical approach is based on work referring to the patient's individual history. Maintaining and developing these attitudes to care is essential to the survival of psychiatry as a discipline. Focusing on the clinic of delusion is neither a luxury nor a waste of time.
Topics: Humans; Delusions; Psychiatry
PubMed: 37743085
DOI: 10.1016/j.spsy.2023.07.003 -
Missouri Medicine 2023The Department of Psychiatry at Washington University has been innovating psychiatric education during the second millennium at all levels of training - undergraduate...
The Department of Psychiatry at Washington University has been innovating psychiatric education during the second millennium at all levels of training - undergraduate medical, general residency, and child and adolescent psychiatry (CAP) fellowship training. Undergraduate medical education now occurs in three phases. The 18-month pre-clerkship phase is divided into seven multidisciplinary modules that span basic, social, and clinical sciences. Psychiatry is part of the seven-week long Brain and Behavior module. The yearlong second phase includes a six-week traditional psychiatry clerkship-like experience bracketed by an introductory foundational week and a one-week consolidation period. The third phase is 18 months in length and provides in-depth exploration of both clinical and non-clinical areas. The residency training program has enlarged the number of residents undergoing training and simultaneously greatly expanded the clinical exposure to include rotations in eating disorders and perinatal psychiatry. In addition, our residents can choose to enhance their training in either our research or leadership focused options, both of which are also available to trainees in our child and adolescent program. Additionally, our CAP trainees are exposed to several unique areas including eating disorders and substance use disorders. We believe that these innovations across the educational spectrum allow us to prepare our learners for the practice of psychiatry in the 21 century.
Topics: Adolescent; Child; Humans; Washington; Universities; Psychiatry; Internship and Residency; Curriculum
PubMed: 37609462
DOI: No ID Found