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BJPsych Bulletin Jun 2024was first established as the in 1977. Since then, it has extended its influence within the field, and it is now the go-to journal for practical clinical considerations...
was first established as the in 1977. Since then, it has extended its influence within the field, and it is now the go-to journal for practical clinical considerations in psychiatry, and mental health more widely. It stands together with the wider family of RCPsych journals - , , and - and offers a number of distinct advantages for readers and authors. I commend it to you.
PubMed: 38802108
DOI: 10.1192/bjb.2024.35 -
Frontiers in Psychiatry 2024Epileptologists and psychiatrists have long observed a correlation between epilepsy and personality disorders (PDs) in their clinical practice. We conducted a... (Review)
Review
Epileptologists and psychiatrists have long observed a correlation between epilepsy and personality disorders (PDs) in their clinical practice. We conducted a comprehensive PubMed search looking for evidence on PDs in people with epilepsy (PwE). Out of over 600 results obtained without applying any time restriction, we selected only relevant studies (both analytical and descriptive) limited to English, Italian, French and Spanish languages, with a specific focus on PDs, rather than traits or symptoms, thus narrowing our search down to 23 eligible studies. PDs have been investigated in focal epilepsy (predominantly temporal lobe epilepsy - TLE), juvenile myoclonic epilepsy (JME) and psychogenic non-epileptic seizures (PNES), with heterogeneous methodology. Prevalence rates of PDs in focal epilepsy ranged from 18 to 42% in surgical candidates or post-surgical individuals, with Cluster C personality disorders or related traits and symptoms being most common. In JME, prevalence rates ranged from 8 to 23%, with no strong correlation with any specific PDs subtype. In PNES, prevalence rates ranged from 30 to 60%, with a notable association with Cluster B personality disorders, particularly borderline personality disorder. The presence of a PD in PwE, irrespective of subtype, complicates treatment management. However, substantial gaps of knowledge exist concerning the neurobiological substrate, effects of antiseizure medications and epilepsy surgery on concomitant PDs, all of which are indeed potential paths for future research.
PubMed: 38800062
DOI: 10.3389/fpsyt.2024.1404856 -
Reumatologia 2024Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints, causing inflammation, pain, and potential joint damage. Patients with RA are at high...
INTRODUCTION
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints, causing inflammation, pain, and potential joint damage. Patients with RA are at high risk of developing psychiatric morbidity; it is important to recognize these psychiatric manifestations. The relationship between psychiatric symptoms and RA is complex and can involve various factors, including the impact of chronic pain, inflammation, medications, and the overall burden of managing a chronic illness.Aim of the study was to systematically investigate and analyze the patterns and prevalence of psychiatric morbidity among individuals diagnosed with RA, with the aim of identifying common mental health conditions, understanding the interplay between RA and psychiatric disorders, and providing valuable insights for improved holistic patient care.
MATERIAL AND METHODS
This was a prospective, observational cross-sectional study conducted over a period of three years in patients with RA. Psychiatric morbidity was assessed using International Classification of Diseases-10 criteria and Mini-Plus by dedicated psychiatrists. The diagnosis of RA was confirmed using the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) diagnostic criteria for RA and the disease activity was calculated by Disease Activity Score with 28-joint count (DAS28) using the calculator from the RheumaHelper application. The data were analyzed using SPSS, version 23.0.
RESULTS
A total of 1,000 patients with RA were included in this study. Nearly two-thirds of the patients were female (64.8%). The majority of patients belonged to the age group of 41 to 54 years. Total 47.5% of the patients were unemployed, 27.0% were salaried, 19.0% were businessman, while 6.5% of the patients were students. More than half of the patients (53.2%) had moderate disease activity. Major depressive disorder was the most commonly observed comorbidity (41.0%), followed by somatoform disorder (28.5%), and generalized anxiety disorder was found in 13.5%. No psychiatric manifestations were found in 17% of studied individuals.
CONCLUSIONS
Psychiatric morbidity is associated with RA and there is a need for psychiatric services to be made available to these patients.
PubMed: 38799777
DOI: 10.5114/reum/186975 -
Research Square May 2024Many countries implement a double-shift schooling system, offering morning or afternoon shifts, driven by diverse factors. Young people with ADHD may face educational...
Many countries implement a double-shift schooling system, offering morning or afternoon shifts, driven by diverse factors. Young people with ADHD may face educational problems attending morning shifts compared to afternoon shifts. To investigate this, we used data from a Brazilian school-based cohort (n = 2.240, 6-14 years old, 45.6% female; 50.2% in the morning shift; 11.2% with ADHD). ADHD was determined by child psychiatrists using semi-structured interview. Educational outcomes were measured cross-sectionally and three years later (80% retention) and included reading and writing ability, performance in school subjects, and any negative school events (repetition, suspension, or dropout). Generalized regression models tested the interaction between ADHD and school shift and were adjusted for age, sex, race/ethnicity, intelligence, parental education, socioeconomic status, and site. Attrition was adjusted with inverse probability weights. We used two dimensional measures of attentional problems as sensitivity analysis. ADHD and morning shift were independently associated with lower reading and writing ability and with higher odds for negative school events cross sectionally. ADHD independently predicted lower performance in school subjects and higher negative school events at follow-up. Interaction was found only at the cross-sectional level in a way that those studying in the afternoon present better educational outcomes compared with those studying in the morning only if they have lower ADHD symptom. Thus, ADHD was not associated with poorer educational outcomes among those studying in the morning. However, participants studying in the afternoon with lower levels of attentional problems presented better educational, despite these associations fade away over time.
PubMed: 38798441
DOI: 10.21203/rs.3.rs-4364073/v1 -
International Journal of Environmental... Apr 2024Our consensus statement aims to clarify the use of antidepressants and anxiolytics during breastfeeding amidst clinical uncertainty. Despite recent studies, potential... (Review)
Review
INTRODUCTION
Our consensus statement aims to clarify the use of antidepressants and anxiolytics during breastfeeding amidst clinical uncertainty. Despite recent studies, potential harm to breastfed newborns from these medications remains a concern, leading to abrupt discontinuation of necessary treatments or exclusive formula feeding, depriving newborns of benefits from mother's milk.
METHODS
A panel of 16 experts, representing eight scientific societies with a keen interest in postpartum depression, was convened. Utilizing the Nominal Group Technique and following a comprehensive literature review, a consensus statement on the pharmacological treatment of breastfeeding women with depressive disorders was achieved.
RESULTS
Four key research areas were delineated: (1) The imperative to address depressive and anxiety disorders during lactation, pinpointing the risks linked to untreated maternal depression during this period. (2) The evaluation of the cumulative risk of unfavorable infant outcomes associated with exposure to antidepressants or anxiolytics. (3) The long-term impact on infants' cognitive development or behavior due to exposure to these medications during breastfeeding. (4) The assessment of pharmacological interventions for opioid abuse in lactating women diagnosed with depressive disorders.
CONCLUSIONS
The ensuing recommendations were as follows: Recommendation 1: Depressive and anxiety disorders, as well as their pharmacological treatment, are not contraindications for breastfeeding. Recommendation 2: The Panel advocates for the continuation of medication that has demonstrated efficacy during pregnancy. If initiating an antidepressant during breastfeeding is necessary, drugs with a superior safety profile and substantial epidemiological data, such as SSRIs, should be favored and prescribed at the lowest effective dose. Recommendation 3: For the short-term alleviation of anxiety symptoms and sleep disturbances, the Panel determined that benzodiazepines can be administered during breastfeeding. Recommendation 4: The Panel advises against discontinuing opioid abuse treatment during breastfeeding. Recommendation 5: The Panel endorses collaboration among specialists (e.g., psychiatrists, pediatricians, toxicologists), promoting multidisciplinary care whenever feasible. Coordination with the general practitioner is also recommended.
Topics: Humans; Breast Feeding; Female; Depression, Postpartum; Antidepressive Agents; Anti-Anxiety Agents; Infant, Newborn; Consensus
PubMed: 38791766
DOI: 10.3390/ijerph21050551 -
Archives of Psychiatric Nursing Jun 2024Here we report the reliability and test/re-test validity of a Castillan version of the PCL-5 (PCL5-C) in mental health nurses.
BACKGROUND
Here we report the reliability and test/re-test validity of a Castillan version of the PCL-5 (PCL5-C) in mental health nurses.
METHODS
A sample of 52 consecutive nurses was recruited from two psychiatric hospitals and four psychiatrists units of general hospitals in Madrid, Spain.
RESULTS
We detected high internal consistency for the study questionnaire at the test assessment (n = 52) and at retest 0.929 and 0.935, respectively, by total Cronbach's α. All of the items at test and re-test correlated with the total score.
CONCLUSIONS
Reproducibility analysis showed excellent test/re-test reliability for the total score and each item. Based on our findings, we conclude that the PCL5-C is a valid and reliable questionnaire when applied among Spanish mental health nurses population.
Topics: Humans; Spain; Psychiatric Nursing; Reproducibility of Results; Female; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; Adult; Psychometrics; Checklist; Male; Diagnostic and Statistical Manual of Mental Disorders; Middle Aged
PubMed: 38789224
DOI: 10.1016/j.apnu.2024.02.006 -
Comprehensive Psychiatry Aug 2024To explore the occurrence, demographics, and circumstances of homicides of physicians.
OBJECTIVE
To explore the occurrence, demographics, and circumstances of homicides of physicians.
METHOD
Authors interrogated the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention's surveillance system tracking violent deaths between 2003 and 2018 which integrates data from law enforcement and coroner/medical examiner reports. Authors identified cases of homicide decedents whose profession was physician, surgeon, or psychiatrist. Data collected included decedents' demographics as well as circumstances of death.
RESULTS
Data were provided by 7-41 states as participating states increased over time. Fifty-six homicides were reported, most were male (73.2%) and white (76.8%). Most (67.9%) identified assailants reportedly knew decedents: 23.2% were perpetrated by partners/ex-partners; 10.7% by patients/patients' family members. Deaths were mainly due to gunshot wounds (44.6%), stabbing (16.1%), and blunt force trauma (16.1%). More (58.9%) homicides occurred at victims' homes than work (16.1%).
CONCLUSIONS
Physician homicides are relatively rare and occur at lower rates than in the general population. Physicians were more frequently killed by partners or ex-partners than by patients. Most homicides occurred away from the workplace. Broader efforts are needed to promote interventions throughout America's violent society to reduce domestic/partner violence and gun violence.
Topics: Humans; Homicide; Male; Female; United States; Adult; Physicians; Middle Aged; Aged; Cause of Death; Wounds, Gunshot
PubMed: 38788614
DOI: 10.1016/j.comppsych.2024.152503 -
Healthcare (Basel, Switzerland) May 2024Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to...
BACKGROUND
Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry).
METHOD
The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry.
RESULTS
Statistically significant improvements (all -values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles).
CONCLUSION
According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices.
PubMed: 38786454
DOI: 10.3390/healthcare12101044 -
Healthcare (Basel, Switzerland) May 2024Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress...
Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey ( = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments ( = 273), with relevance drawn to Andersen's Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners' stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.
PubMed: 38786409
DOI: 10.3390/healthcare12100998 -
Healthcare (Basel, Switzerland) May 2024The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting...
The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting trans children and adolescents in their transition processes. To this end, 22 life stories written by parents of trans children and adolescents who had undergone social transition were collected, and a qualitative analysis was carried out using MAXQDA software. For this purpose, three key periods were considered in the stories: before, during and after the transition. Among other aspects, the stories highlight a major lack of understanding on the part of the professionals who should support trans children and adolescents, and their families, in their transition processes. Parents described the attitude of those professionals who actively listened to their children's needs and were cooperative as positive, even if they do not have the necessary training. The need for specific training in diversity is one of the main conclusions of this study.
PubMed: 38786386
DOI: 10.3390/healthcare12100974