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Psychodynamic Psychiatry 2020Five months following an earlier report on the initial impact of COVID-19, the same 24 contributing psychodynamic psychiatrists reported on how matters have shifted in... (Review)
Review
Five months following an earlier report on the initial impact of COVID-19, the same 24 contributing psychodynamic psychiatrists reported on how matters have shifted in their experience. Spread of the virus, lockdowns, politicization of all aspects of the pandemic, massive unemployment, and social justice frustrations have characterized the interim. The initial burst of acute uncertainty and worry has shifted into a more adaptive but still destabilizing long-term apprehension: distance treatment and its ramifications have become somewhat normalized, training now incorporates virtual treatment approaches, psychodynamically informed counseling has taken a larger role in the content of care. New theories of clinical practice are emerging that address these changes. As before, contributors' narratives are considered from the perspective of administration and training, structure and content of treatment, and the impact of the pandemic both on patients and psychiatrists.
Topics: COVID-19; Humans; Mental Disorders; Psychotherapy, Psychodynamic; SARS-CoV-2; Telemedicine
PubMed: 33779226
DOI: 10.1521/pdps.2020.48.4.363 -
Der Nervenarzt Feb 2020In 1924 Oswald Bumke was appointed as Emil Kraepelins successor to the Chair of Psychiatry at the University of Munich. After 1933 he was a promoting member of the SS... (Review)
Review
In 1924 Oswald Bumke was appointed as Emil Kraepelins successor to the Chair of Psychiatry at the University of Munich. After 1933 he was a promoting member of the SS and the National Socialist Teachers Federation but he was never a member of the National Socialist German Workers' Party (NSDAP). In 1933 he assumed the presidency of the Society of German Neurologists but only 2 years later he withdrew from the executive board because of scientific and personal differences with Ernst Rüdin, the new "strong man" of the merged Society of German Neurologists and Psychiatrists. After the end of WWII, Bumke affirmed that despite his exposed position as professor of psychiatry during the NS era, he had lacked any influence and that he had sabotaged the "Law for the Prevention of Genetically Diseased Offspring" (GzVeN). He declared that for scientific reasons he had been extremely critical of the GzVeN and even had expressed his views in various publications. Nevertheless, he supported forced sterilization in his treatise "The State and Mental Diseases" published in 1939. His statement that the clinic in Munich had manipulated diagnoses in order to protect patients from eugenic measures and "euthanasia" refers to a potential interference, but as documents are lacking this cannot be substantiated. After 1940 Bumke functioned as a consulting military psychiatrist in expert reports. Political assessments from this period presented him as politically reliable. His biography exemplarily shows that a meticulous juxtaposition of post-war documents with correspondent records stemming from the Nazi period is imperative in order to arrive at a source-critical well-founded and differentiated evaluation.
Topics: Eugenics; Euthanasia; Germany; History, 20th Century; National Socialism; Psychiatry; Sterilization, Involuntary
PubMed: 32067083
DOI: 10.1007/s00115-019-00841-8 -
The Australian and New Zealand Journal... Apr 2023
Topics: Humans; Loneliness; Mental Health; Mental Disorders; Depression; Psychiatry
PubMed: 36949578
DOI: 10.1177/00048674231159622 -
Irish Journal of Psychological Medicine Mar 2024This paper provides a brief overview of the history of occupational therapy in psychiatry in Ireland and explores why the contribution of an early Irish psychiatrist and... (Review)
Review
OBJECTIVES
This paper provides a brief overview of the history of occupational therapy in psychiatry in Ireland and explores why the contribution of an early Irish psychiatrist and proponent of occupational therapy, Dr Eamon O'Sullivan (1897-1966), was not fully recognised in the decades after his retirement in 1962.
METHODS
A review of selected key reports, papers and publications related to the history of occupational therapy was undertaken.
RESULTS
Eamon O'Sullivan was appointed Resident Medical Superintendent at Killarney Mental Hospital Co. Kerry in 1933 and developed an occupational therapy department at the hospital from the 1930s until his retirement in 1962. He wrote one of the first textbooks of occupational therapy published in 1955. His occupational therapy philosophy reflects the early decades after the formalisation of the profession in 1917 when beliefs about the curative properties of occupation flourished and professional education programmes were scarce. By the time O'Sullivan's textbook was published it received a lukewarm reception within occupational therapy as it did not reflect 1950s practice and professional philosophy. The professionalisation of occupational therapy in Ireland in the 1960s was also a factor in the lack of acknowledgement of O'Sullivan's contribution to the profession.
CONCLUSION
Practice and professional philosophy change and the paper concludes by considering O'Sullivan's work in light of contemporary occupational therapy which once again places occupation at its centre and emphasises the importance of balance, health and wellbeing.
Topics: Male; Humans; Psychiatrists; Occupational Therapy; Psychiatry; Hospitals, Psychiatric; Ireland
PubMed: 35831977
DOI: 10.1017/ipm.2022.24 -
Journal of Psychiatric Practice Jan 2023There is a general consensus that the doctor-patient interview should be as productive and efficient as possible. This is becoming increasingly difficult in a health...
There is a general consensus that the doctor-patient interview should be as productive and efficient as possible. This is becoming increasingly difficult in a health care insurance system that demands shorter appointment times. Clinicians must therefore find ways to condense the clinical encounter without sacrificing quality. The purposes of this study were: (1) to facilitate shared decision-making between psychiatrist and patient via pre-visit patient agenda-setting, (2) to evaluate the effectiveness and ease of use of the agenda-setting tool, and (3) to determine patient and clinician satisfaction with the clinical encounter. Patients completed questionnaires to assist in agenda-setting via an electronic tablet while in the waiting area before seeing the psychiatrist. Both patients and psychiatrists then completed post-visit questionnaires to assess their satisfaction with the encounter. We measured patient satisfaction and the extent to which the psychiatrist addressed concerns before and after the visit, as well as ease of use for the patient, psychiatrist satisfaction, and clinical helpfulness to the treating psychiatrist. Additional analyses also indicated that there was a significant increase in patient satisfaction scores, compared with an average of all previous visits, and a significant increase in the number of concerns addressed during the current visit when compared with the average number of previous concerns addressed. Patients reported little difficulty using the tablet. Similarly, psychiatrists reported that the device was helpful in the clinical setting and they expressed high levels of satisfaction with the visit. We hope our work will encourage others to use this agenda-setting tool in their practices to facilitate better patient care.
Topics: Humans; Texas; Physician-Patient Relations; Physicians; Surveys and Questionnaires; Consensus; Patient Satisfaction
PubMed: 36649549
DOI: 10.1097/PRA.0000000000000686 -
Australasian Psychiatry : Bulletin of... Aug 2021In May 2018, a small paperback book was published, which briefly described 10 cases of persons charged with murder whom an Australian psychiatrist had assessed for the...
OBJECTIVE
In May 2018, a small paperback book was published, which briefly described 10 cases of persons charged with murder whom an Australian psychiatrist had assessed for the court. This article considers the ethical issues raised by identifying both the persons charged with murder and their victims in newspaper articles and interviews to promote a book.
CONCLUSIONS
When persons who have committed homicide are named in a 'true crime' book, their recovery trajectory may be prejudiced and the families of their victims may be re-traumatised. Such publications may also contribute to the stigmatisation of persons with mental illness who commit serious offences. Respect for the dignity of the person is fundamental to the ethical practice of forensic report-writing. There can never be any implied agreement or consent that a psychiatrist who writes a report for the court can also use the material in a book written for profit. The Royal Australian and New Zealand College of Psychiatrists includes several principles relevant to psychiatrists who write medico-legal reports. Psychiatrists should carefully consider the ethical issues raised in publishing outside of textbooks and professional journals and engaging with the lay media.
Topics: Australia; Homicide; Humans; New Zealand; Psychiatry
PubMed: 33211550
DOI: 10.1177/1039856220970046 -
European Child & Adolescent Psychiatry Jan 2020The number of children and adolescents with mental disorders in China is increasing year by year, but the child and adolescent psychiatrists (CAPs) remain very scarce....
The number of children and adolescents with mental disorders in China is increasing year by year, but the child and adolescent psychiatrists (CAPs) remain very scarce. So far, there is only a national psychiatrist certification system, and no child and adolescent psychiatrist certification system. Instead, the psychiatrist can receive the post-graduation training certificate or nationally approved Ph.D. and Master's degree training certificate for becoming a CAP. Currently, studies on the training status of CAPs in China are unavailable. This study investigated the current training status of CAPs in China intending to improve the relevant training programs. Self-developed questionnaires were distributed to 28 Executive Committee members of Chinese Society of Child and Adolescent Psychiatry from 32 training hospitals which Nationally approved Ph.D. and Master's degree training base for child and adolescent psychiatry or post-graduation training (Intern and Fellow) base for child and adolescent psychiatry in 14 provinces and municipalities for collecting necessary information of the respondents, and evaluation of current education and training. Using the descriptive analysis for statistical analysis to understand the current training status of child psychiatrists in China. A total of 28 valid questionnaires were returned. The training units were concentrated in large- and medium-sized cities. Moreover, the current medical personnel in China for diagnosing and treatment of children and adolescents with mental disorders was small in number with fixed learning modes. For the training of CAPs, the scientific basis of the training content, as well as the practicality of the training content, and the ability to solve problems, are not sufficient. Furthermore, the effects of current educational training of CAPs regarding teaching and professional, scientific research abilities remained relatively weak. Therefore, it is necessary to focus on training comprehensive qualities and abilities, such as the spirit of dedication. Currently, physicians who have received post-graduate training or Ph.D. and Master's degree training in child and adolescent psychiatry in China are very scarce. Although CAPs have a long history of training, post-graduate, or doctoral master's degree training is mainly a training method. And, the national specialized certification system for CAPs pilot in major cities. The training system of CAPs should be further improved in the future, and the number of CAPs should be increased.
Topics: Adolescent; Adolescent Psychiatry; Child; Child Psychiatry; China; Education, Medical; Female; Humans; Male
PubMed: 31900670
DOI: 10.1007/s00787-019-01453-y -
Australasian Psychiatry : Bulletin of... Jun 2021First, to review the principles and practice of disaster psychiatry, in light of recent global events. Second, to identify opportunities for research. (Review)
Review
OBJECTIVE
First, to review the principles and practice of disaster psychiatry, in light of recent global events. Second, to identify opportunities for research.
METHOD
A literature review of the MEDLINE database, UpToDate and the Cochrane Library was conducted. Reference lists were also reviewed.
RESULTS
Psychiatrists are well-positioned to contribute to positive outcomes at all stages of the disaster response. These contributions derive from their roles as doctors, mental illness specialists and clinical leaders.
CONCLUSION
A novel framework for the psychiatrist's contributions was proposed. Specific knowledge of disaster psychiatry may be worthwhile, and establishment of a public disaster psychiatry centre is reasonable. Research should further examine the role of tele-psychiatry and pursue a best practice for community and front-line employee psychological preparedness.
Topics: COVID-19; Disaster Planning; Disasters; Humans; Physician's Role; Psychiatry
PubMed: 33434047
DOI: 10.1177/1039856220986725 -
Journal of the Academy of... 2023Agitation is a common reason for psychiatric consultation in the general hospital. The consultation-liaison (CL) psychiatrist is often tasked with teaching the medical... (Review)
Review
BACKGROUND
Agitation is a common reason for psychiatric consultation in the general hospital. The consultation-liaison (CL) psychiatrist is often tasked with teaching the medical team how to manage agitation.
OBJECTIVE
The purpose of this scoping review is to explore what resources the CL psychiatrist has for educational tools on teaching about agitation management. Given the frequency with which CL psychiatrists help with on-the-ground management of agitation, we hypothesized that there would be a scarcity of educational resources to teach front-line providers how to manage agitation.
METHODS
Following current Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a scoping review was conducted. The literature search focused on the electronic databases MEDLINE (PubMed), Embase (Embase.com), The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), PsycInfo (EbscoHost), Cumulated Index to Nursing and Allied Health Literature (CINAHL) (EbscoHost), and Web of Science. Using Covidence software, after screening for titles and abstracts, full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, we created a predefined set of criteria according to which each article was analyzed. We then grouped the articles in the full-text review according to which patient population a curriculum was designed for.
RESULTS
The search yielded a total of 3250 articles. After removing duplicates and reviewing procedures, we included 51 articles. Data extraction captured article type and details; educational program information (staff training, web modules, instructor led seminar); learner population; patient population; and setting. The curricula were further divided based on their target patient population, specifically the acute psychiatric patient (n = 10), the general medical patient (n = 9), and the patient with a major neurocognitive disorder such as dementia or traumatic brain injury (n = 32). Learner outcomes included staff comfort, confidence, skills, and knowledge. Patient outcomes included measurements of agitation or violence using validated scales, PRN medication use, and restraint use.
CONCLUSIONS
Despite there being numerous agitation curricula in existence, we found that a large majority of these educational programs were done for patients with major neurocognitive disorders in the long-term care setting. This review highlights the gap in education related to agitation management for both patients and providers in the general medical setting, as less than 20% of total studies are focused on this population. The CL psychiatrist plays a critical role in assisting in agitation management in this setting, which often requires collaboration between technicians, nurses, and nonpsychiatric providers. It calls into question whether the lack of educational programs makes the implementation of management interventions more difficult and less effective, even with the assistance of the CL psychiatrist.
Topics: Humans; Behavior Therapy; Curriculum; Dementia
PubMed: 37211211
DOI: 10.1016/j.jaclp.2023.05.003 -
Dermatology Online Journal Oct 2023Darier disease is an autosomal dominant blistering disorder linked to mutation of the endoplasmic reticulum calcium pump, SERCA2, which compromises keratinocyte adhesion...
Darier disease is an autosomal dominant blistering disorder linked to mutation of the endoplasmic reticulum calcium pump, SERCA2, which compromises keratinocyte adhesion and differentiation. Beyond the typical keratotic and eroded skin lesions, patients with Darier disease often present with psychiatric co-morbidities. Herein, we present a biopsy-confirmed case of Darier disease in a patient with bipolar disorder, whose cutaneous disease dramatically worsened upon initiation of lithium therapy. In consultation with the patient's psychiatrist, lithium was tapered, leading to rapid improvement in her skin. This case highlights the potential for lithium to complicate management of Darier disease and underscores the need for dermatologists to collaborate with psychiatrists to optimize both cutaneous and mental health in patients.
Topics: Humans; Female; Darier Disease; Lithium; Skin; Sarcoplasmic Reticulum Calcium-Transporting ATPases; Keratinocytes; Lithium Compounds
PubMed: 38478641
DOI: 10.5070/D329562405