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Revista Da Associacao Medica Brasileira... 2024
Topics: Humans; Psychiatry; Medical Oncology; Neoplasms; Mental Disorders
PubMed: 38865548
DOI: 10.1590/1806-9282.2024S129 -
The International Journal of Social... Feb 2024This contribution responds to three articles (we refer to all three as 'editorials') concerning something called 'geopsychiatry'.
BACKGROUND
This contribution responds to three articles (we refer to all three as 'editorials') concerning something called 'geopsychiatry'.
AIMS
To evaluate claims made in these editorials for 'geopsychiatry' as a new field of inquiry at the interface between geography and psychiatry.
METHOD
Close critical reading of two editorials in the - entitled 'Geographical determinants of mental health' and 'Political determinants of mental health' - and one in the - entitled 'What is geopsychiatry?'
RESULTS
While this geopsychiatry initiative is to be applauded, disquiet can be expressed about the almost complete neglect of a pre-existing domain of inquiry - 'mental health geography' or 'the geography of mental health' - that has long been researched by academic geographers and cognate scholars. Key trajectories in this field can be identified and related to the proposed foci for geopsychiatry.
CONCLUSIONS
The hope is voiced that future developments in geopsychiatry will proceed in dialogue with the literature and practitioners of mental health geography.
Topics: Humans; Geography; Mental Health; Psychiatry
PubMed: 37843025
DOI: 10.1177/00207640231195289 -
International Journal of Law and... 2023Circumpolar regions face unique challenges in establishing and maintaining mental health care systems, including forensic psychiatry services. The scarcity of data and...
Circumpolar regions face unique challenges in establishing and maintaining mental health care systems, including forensic psychiatry services. The scarcity of data and lack of evidence concerning the forensic psychiatry patient (FPP) populations of Nunavut and Greenland exacerbates the challenges of informing best practices and healthcare planning. By comparing the prevalence of forensic psychiatry patients, the mental health care services, and the legislation in these two relatively similar but unique regions, insight may be gained that can help inform healthcare planning. This cross-sectional study includes all forensic psychiatry in- and outpatients in one year from Nunavut (2018) and on February 29, 2020, in Greenland. The Greenland sample (n = 93) was nearly four times larger than the Nunavut sample (n = 15) at the population level. Despite considerable differences in forensic legislation and service supply, the forensic psychiatry patients in the two areas share several similarities. A total of 87% (n = 13) in the Nunavut sample were diagnosed with a DSM-5 schizophrenia spectrum disorder or other psychotic disorder. In Greenland, 82% (n = 76) were diagnosed with an ICD-10 F2 diagnosis (schizophrenia, schizotypal and delusional disorders). Approximately 2/3 of the patients in both populations were diagnosed with substance use disorder, and 60% of the Nunavut FPP received long-acting antipsychotic injections versus 62% in Greenland. Nearly half of the FPPs in both populations had never been convicted prior to entering the forensic psychiatry system; Nunavut 45% versus Greenland 47%. A substantial proportion of Greenlandic FPPs were outpatients compared to Nunavut (83% versus 47%). This study is an essential first step toward describing a Model of Care for forensic psychiatry patients in circumpolar regions; furthermore, the clinical similarities between the two populations provide support for future joint Arctic research and the inclusion of artic forensic patients in international studies.
Topics: Humans; Forensic Psychiatry; Nunavut; Greenland; Cross-Sectional Studies; Outpatients
PubMed: 37690360
DOI: 10.1016/j.ijlp.2023.101921 -
Psychiatria Danubina Oct 2023Literature suggests that most people believe in free will and that this belief is associated with more prosocial behavior. However, with the advent of neuroscience, free... (Review)
Review
BACKROUND
Literature suggests that most people believe in free will and that this belief is associated with more prosocial behavior. However, with the advent of neuroscience, free will seems to have been progressively excluded from psychiatry. This paper is a narrative literature review of the ways in which mental health professionals' premises and beliefs in free will influence their clinical practice.
METHODS
The Scopus database was searched for papers concerning free will and psychiatric practice, 24 papers were included. This review looks at explicit links made by authors between free will and clinical practice as well as logical threads linking a premise of free will to clinical implications.
RESULTS
The results suggest that belief in free will leads to trying to strengthen free will in patients. It also appears to be associated with using meaning in psychotherapy, with self-blame in patients, and with ethical questions such as involuntary psychiatric care and assisted suicide requests. Some authors believe the concept of free will should be discarded to make place for concepts such as autonomy, agency, decision-making capacity and self-control.
CONCLUSION
While definitional ambiguity and paucity of data are limiting, the results indicate that mental health professionals' beliefs concerning free will can influence their clinical practice. Concepts such as autonomy and agency can sometimes hide psychiatrists' underlying beliefs. Increasing mental health professionals' awareness of their beliefs could be beneficial for psychiatric care.
Topics: Humans; Personal Autonomy; Psychiatry; Health Personnel; Attitude of Health Personnel
PubMed: 37800235
DOI: No ID Found -
Psychiatria Danubina Oct 2023In the present study, I provide an examination of the neuropsychiatric approach to patients with various types of dementia, including Alzheimer's disease, Parkinson's...
In the present study, I provide an examination of the neuropsychiatric approach to patients with various types of dementia, including Alzheimer's disease, Parkinson's disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia, and more. With a focus on the intersection of psychiatry and neurology, this paper underscores the importance of comprehensive neuropsychiatric evaluation, rigorous diagnosis, and evidence-based management. The paper delineates the neuropsychiatric manifestations specific to each type of dementia and explores both non-pharmacological and pharmacological management strategies, aiming to equip psychiatrists with the latest evidence-based approaches. Case studies are included to demonstrate real-world clinical scenarios and to provide insights into the practical application of the theories discussed. Additionally, this guide addresses current challenges in the neuropsychiatric approach to dementia and highlights potential solutions and future research directions. The primary objective of this guide is to enable psychiatrists to enhance the quality of life for individuals living with dementia by improving understanding, diagnosis, and management of the neuropsychiatric aspects of these conditions.
Topics: Humans; Quality of Life; Neuropsychiatry; Parkinson Disease; Lewy Body Disease; Alzheimer Disease; Frontotemporal Dementia
PubMed: 37800233
DOI: No ID Found -
Harvard Review of PsychiatryThe field of transgender health has grown exponentially since the early 2010s. While this increased visibility has not been without controversy, there is growing... (Review)
Review
The field of transgender health has grown exponentially since the early 2010s. While this increased visibility has not been without controversy, there is growing acknowledgement of the needs of transgender, nonbinary, and gender expansive (TNG) patients and the health disparities they experience compared to the cisgender population. There is also increased interest among clinicians and trainees in providing gender-affirming care in all medical specialties. This is particularly relevant in psychiatry as mental health disparities in TNG patients have been well-documented. TNG patients experience significant minority stress and higher rates of psychiatric illness, self-harm, suicidality, and psychiatric hospitalization compared to their cisgender peers. In this review, we will cover potential interactions and side effects relevant to psychiatric medication management for the three most common medication classes prescribed as part of gender-affirming hormone therapy (GAHT): gonadotropin-releasing hormone receptor agonists, estradiol, and testosterone. Although no studies directly examining the efficacy of psychiatric medications or their interactions with GAHT for TNG patients have been published yet, we have synthesized the existing literature from both cisgender and TNG patients to shed light on health care disparities seen in TNG patients. Since clinicians' lack of comfort and familiarity with gender-affirming care contributes significantly to these disparities, we hope this narrative review will help psychiatric prescribers provide TNG patients with the same quality of care that cisgender patients receive.
Topics: Humans; Transgender Persons; Mental Disorders; Psychiatry; Self-Injurious Behavior; Hormones
PubMed: 37437250
DOI: 10.1097/HRP.0000000000000373 -
Inquiry : a Journal of Medical Care... 2024Telepsychiatry formed part of the Australian mental health response to COVID-19, but relevant reviews pre- and post-pandemic are sparse. This scoping review aimed to map... (Review)
Review
Telepsychiatry formed part of the Australian mental health response to COVID-19, but relevant reviews pre- and post-pandemic are sparse. This scoping review aimed to map the literature on telepsychiatry in Australia and identify key research priorities. We searched databases (Medline, PubMed, PsycINFO, Scopus, Web of Science, EBSCO Psychology & Behavioral Sciences Collection, Proquest databases, and Cochrane Central Register of Controlled Trials) and reference lists from January 1990 to December 2022. Keywords included telepsychiatry, videoconferencing, telephone consultation, psychiatry, mental health, and Australia. Two reviewers independently screened titles, abstracts, and full texts. We identified 96 publications, one-third of which appeared since 2020. Extracted data included article types, service types, usage levels, outcome measures, perceptions, and research gaps. Most publications were quantitative studies (n = 43) and narrative reports of services (n = 17). Seventy-six papers reported mostly publicly established services. Videoconferencing alone was the most common mode of telepsychiatry. There was increased use over time, with the emergence of metropolitan telepsychiatry during the pandemic. Few papers used validated outcome measures (n = 5) or conducted economic evaluations (n = 4). Content analysis of the papers identified perceptions of patient (and caregiver) benefits, clinical care, service sustainability, and technology capability/capacity. Benefits such as convenience and cost-saving, clinical care issues, and implementation challenges were mentioned. Research gaps in patient perspectives, outcomes, clinical practice, health economics, usage patterns, and technological issues were identified. There is consistent interest in, and growth of, telepsychiatry in Australia. The identified perception themes might serve as a framework for future research on user perspectives and service integration. Other research areas include usage trends, outcome measures, and economic evaluation.
Topics: Humans; Psychiatry; Telemedicine; Australia; Referral and Consultation; Telephone
PubMed: 38462906
DOI: 10.1177/00469580241237116 -
Neuroscience and Biobehavioral Reviews Nov 2023A central question in understanding cognition and pathology-related cognitive changes is how we process time. However, time processing difficulties across several... (Review)
Review
A central question in understanding cognition and pathology-related cognitive changes is how we process time. However, time processing difficulties across several neurological and psychiatric conditions remain seldom investigated. The aim of this review is to develop a unifying taxonomy of time processing, and a neuropsychological perspective on temporal difficulties. Four main temporal judgments are discussed: duration processing, simultaneity and synchrony, passage of time, and mental time travel. We present an integrated theoretical framework of timing difficulties across psychiatric and neurological conditions based on selected patient populations. This framework provides new mechanistic insights on both (a) the processes involved in each temporal judgement, and (b) temporal difficulties across pathologies. By identifying underlying transdiagnostic time-processing mechanisms, this framework opens fruitful avenues for future research.
Topics: Humans; Time Perception; Mental Disorders; Cognition; Judgment; Auditory Perception
PubMed: 37871780
DOI: 10.1016/j.neubiorev.2023.105430 -
American Journal of Public Health Mar 2024Antecedents of racist treatments of Black patients by the psychiatric profession in the United States affect the way they view treatment today. Specifically, in this...
Antecedents of racist treatments of Black patients by the psychiatric profession in the United States affect the way they view treatment today. Specifically, in this essay, we explore the enduring consequences of racial science on various treatment practices. We examined a range of primary sources on the history of racial theories about the mind, medical and psychiatric publications, and hospitals. We contextualize this analysis by examining the secondary literature in the history and sociology of psychiatry. Through analyzing racial thinking from the antebellum through the Jim Crow periods, we show how US medicine and psychiatry have roots in antebellum racial science and how carceral logics underpinned the past and present politics of Black mental health. Changing this trajectory requires practitioners to interrogate the historical foundations of racist psychiatric concepts. This essay urges them to reject biological racial realism, which bears reminiscences to 19th-century racial science, and embrace the variable of race as a social construct to study social inequalities in health as a first step toward moving away from the legacies of past injustices in medicine. (. 2024;114(S3):S250-S257. https://doi.org/10.2105/AJPH.2023.307554).
Topics: Humans; Enslavement; Mental Health; Psychiatry; Socioeconomic Factors; United States; Black or African American
PubMed: 38537165
DOI: 10.2105/AJPH.2023.307554 -
AMA Journal of Ethics Sep 2023The nature and scope of palliative psychiatry and associated ethical implications are debated in the literature. This article examines conceptual limitations of extant...
The nature and scope of palliative psychiatry and associated ethical implications are debated in the literature. This article examines conceptual limitations of extant accounts of palliative psychiatry, with a focus on psychopharmacological practice, and suggests that modifiable and unmodifiable psychiatric illnesses exist on a spectrum along which broader or narrower palliative psychiatric care approaches can be outlined. The article also discusses how these approaches intersect with questions about whether and to what extent psychiatric medications have symptom-reducing or disease-modifying effects. The discussion leads to the conclusion that clinicians are ethically obliged to distinguish among and clearly formulate goals of care in a dynamic and ongoing process of shared decision making with patients.
Topics: Humans; Psychopharmacology; Decision Making, Shared; Mental Disorders; Palliative Care; Psychiatry
PubMed: 37695874
DOI: 10.1001/amajethics.2023.710