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Praxis Sep 2022Quality Standards in Old Age Psychiatry Quality standards and regulations are becoming increasingly important and are promoted in the context of the permission to...
Quality Standards in Old Age Psychiatry Quality standards and regulations are becoming increasingly important and are promoted in the context of the permission to treat, to bill and via financial incentives. In this context, the regulatory frameworks focus to varying degrees on structural, process or outcome criteria. On behalf of the Swiss Society for Old Age Psychiatry and Psychotherapy (SGAP), we summarize the quality elements in this document and group the requirements derived from them based on setting (outpatient, intermediate, inpatient) and structural quality criteria (staffing ratio, infrastructure). There is a very extensive requirements matrix, and its implementation requires considerable efforts, not least because of the shortage of specialists and limited financial resources of psychiatric institutions and medical practices. The criteria of the requirements, matrix must be further developed and anchored in a "competence-based training in old age psychiatry".
Topics: Humans; Psychiatry; Psychotherapy; Workforce
PubMed: 36102019
DOI: 10.1024/1661-8157/a003896 -
Australasian Psychiatry : Bulletin of... Aug 2023To expand on psychiatry's duties under the United Nations (UN) Convention Against Torture.
OBJECTIVE
To expand on psychiatry's duties under the United Nations (UN) Convention Against Torture.
CONCLUSIONS
As it is currently practised in Australia, psychiatry is in breach of a number of major international conventions. Full compliance with treaty obligations will entail substantial changes in current practice.
Topics: Humans; Torture; United Nations; International Cooperation; Psychiatry; Australia
PubMed: 36974766
DOI: 10.1177/10398562231166292 -
Journal of Patient Safety Dec 2021The past 20 years have seen the emergence of a national movement to improve hospital-based healthcare safety in the United States. However, much of the foundational work...
OBJECTIVES
The past 20 years have seen the emergence of a national movement to improve hospital-based healthcare safety in the United States. However, much of the foundational work and subsequent research have neglected inpatient psychiatry. The aim of this article was to advance a comprehensive approach for conceptualizing patient safety in inpatient psychiatry as framed by an application of the Institute of Medicine patient safety framework.
METHODS
This article develops a framework for characterizing patient safety in hospital-based mental health care. We discuss some of the conceptual and methodological issues related to defining what constitutes a patient safety event in inpatient psychiatry and then enumerate a comprehensive set of definitions of the types of safety events that occur in this setting.
RESULTS
Patient safety events in inpatient psychiatry are broadly categorized as adverse events and medical errors. Adverse events are composed of adverse drug events and nondrug adverse events, including self-harm or injury to self, assault, sexual contact, patient falls, and other injuries. Medical errors include medication errors and nonmedication errors, such as elopement and contraband. We have developed clear definitions that would be appropriate for use in epidemiological studies of inpatient mental health treatment.
CONCLUSIONS
Psychiatry has not been an integral part of the national safety movement. As a first step toward breaching this chasm, we have considered how psychiatric events fit into the safety framework adopted across much of medicine. Patient safety should become a key part of inpatient psychiatry's mission and pursued rigorously as the subject of research and intervention efforts.
Topics: Drug-Related Side Effects and Adverse Reactions; Humans; Inpatients; Medication Errors; Patient Safety; Psychiatry; United States
PubMed: 30020194
DOI: 10.1097/PTS.0000000000000520 -
Der Nervenarzt Aug 2022
Topics: COVID-19; Humans; Neurology; Psychiatry; Syndrome
PubMed: 35943531
DOI: 10.1007/s00115-022-01320-3 -
Tijdschrift Voor Psychiatrie 2021
Topics: Humans; Psychiatry
PubMed: 33913139
DOI: No ID Found -
Revue Medicale Suisse Sep 2023Insomnia disorder is characterized by disturbed sleep continuity and associated daytime impairment. Insomnia is frequent in patients with psychiatric disorders ; 30-40%...
Insomnia disorder is characterized by disturbed sleep continuity and associated daytime impairment. Insomnia is frequent in patients with psychiatric disorders ; 30-40% fulfill the criteria for insomnia disorder as a comorbidity. According to current guidelines, cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, comprising sleep education, bedtime restriction, relaxation and cognitive restructuring. Despite guideline recommendations, CBT-I is insufficiently implemented, and insomnia is frequently over-treated with hypnotics. 'Become your own SLEEPexpert' is a behavioral treatment program based on CBT-I with the aim of empowering patients to take care of their own sleep health.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Psychotherapy; Psychiatry; Cognitive Behavioral Therapy; Sleep
PubMed: 37728260
DOI: 10.53738/REVMED.2023.19.842.1686 -
International Review of Psychiatry... Mar 2020Education in psychiatry and practice varies hugely across Europe. Historical events and cultural differences, different languages and concepts about mental suffering,... (Review)
Review
Education in psychiatry and practice varies hugely across Europe. Historical events and cultural differences, different languages and concepts about mental suffering, and mental healthcare organization in European countries have all contributed to the actual status. After presenting the legal framework and the role of major stakeholders, this review discusses failing initiatives, possible obstacles, and solutions to come to a more harmonized training. This review then gives an overview of the actual status of psychiatric training before shortly presenting the Task Force on Education in European Psychiatry. Initiatives to train the trainers, the introductions of newer teaching modalities in postgraduate training, and the role of the European Psychiatric Association in continuous medical education precede the conclusion.
Topics: Education, Medical, Graduate; Europe; Humans; Psychiatry
PubMed: 31689126
DOI: 10.1080/09540261.2019.1657810 -
L'Encephale Feb 2023At a time when innovations in psychiatry are booming, particularly in the field of medical devices, we thought it necessary, as members of French Society for Biological...
At a time when innovations in psychiatry are booming, particularly in the field of medical devices, we thought it necessary, as members of French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN), to reconsider one of the oldest medical devices in psychiatry: the ECT apparatus. First, we recall the regulatory aspects of ECT. National guidelines define means of implementation and conditions of administration of ECT. Second, we remind of the indications and levels of evidence of ECT in the main psychiatric disorders, including catatonia. Then, we synthetize the place of ECT alongside other brain stimulation therapies, especially repetitive Trancranial Magnetic Stimulation (rTMS). Furthermore, we explain the general effects of ECT: increased neuronal plasticity and neurogenesis, enhancement of the stress axis, resistance to oxidative stress, improved vascular endothelial function, activation of microglia and astrocytes, decrease in inflammatory events by upregulation of neuroinflammatory cytokines, and production of mitochondrial ATP. These effects appear from the first sessions and continue during the course of ECT treatment, suggesting activation of endogenous neuroprotection. Finally, we remember that most patients perform as well or better on neuropsychological assessments after ECT, relative to pre-ECT results, and this improvement continues over the following months. Memory disorders reported post-ECT are not all attributable to ECT. They may be subjective in nature or linked to residual depressive (and possibly comorbid neurogenerative) symptoms later attributed to ECT, on the basis of preexisting negative representations. We urgently need to reemphasize the crucial role of ECT in psychiatric treatment strategies as well as the need to update ECT recommendations.
Topics: Humans; Electroconvulsive Therapy; Mental Disorders; Transcranial Magnetic Stimulation; Catatonia; Psychiatry
PubMed: 35973849
DOI: 10.1016/j.encep.2022.05.002 -
Biological Psychiatry May 2022
Topics: Biological Psychiatry
PubMed: 35491052
DOI: 10.1016/j.biopsych.2022.02.956 -
Journal of Psychiatric Practice Nov 2019In the Canadian province of Ontario, the Ministry of Health and Long-Term Care is proposing to impose arbitrary limits on access to psychotherapy provided by physicians.... (Review)
Review
In the Canadian province of Ontario, the Ministry of Health and Long-Term Care is proposing to impose arbitrary limits on access to psychotherapy provided by physicians. This column presents and debunks 3 myths associated with this ill-conceived proposal: (1) that long-term psychotherapy costs the health care system too much money, making it necessary for the government to curb this spending; (2) that long-term psychotherapy is a non-evidence-based treatment being needlessly spent on the worried well; and (3) that we need to focus on quick treatments, not long ones.
Topics: Health Care Costs; Humans; Long-Term Care; Mental Disorders; Ontario; Psychiatry; Psychotherapy
PubMed: 31821223
DOI: 10.1097/PRA.0000000000000422