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World Journal of Psychiatry May 2024The management of offenders with mental disorders has been a significant concern in forensic psychiatry. In Japan, the introduction of the Medical Treatment and...
BACKGROUND
The management of offenders with mental disorders has been a significant concern in forensic psychiatry. In Japan, the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue. However, numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization (AIH) scheme, which lacks clarity and updated standards.
AIM
To explore current as well as optimized learning strategies for risk assessment in AIH decision making.
METHODS
We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.
RESULTS
The findings of this study's survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.
CONCLUSION
This underscores the pressing need for structured training protocols in AIH consultations. Moreover, feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.
PubMed: 38808086
DOI: 10.5498/wjp.v14.i5.726 -
Frontiers in Psychiatry 2024Online mindfulness-based program (MBP) for parents and families especially in clinical population is limited. Engagement and significant dropout are major issues in MBP...
OBJECTIVES
Online mindfulness-based program (MBP) for parents and families especially in clinical population is limited. Engagement and significant dropout are major issues in MBP implementation. This pilot study examined the effects of an online mindfulness-based program (MBP) on parents of children with Attention Deficit/Hyperactivity Disorder (ADHD).
METHODS
A mixed methods study was applied to evaluate the effects of the MBP. A total of 43 parents were recruited and were randomly assigned into intervention group and waitlist control group. The online MBP lasted for 28 days, including 20 psychoeducation videos, homework audio guidance, and four instructor-led online group meetings. Purposive sampling was used to recruit parents who completed the program to share their experiences and suggestions for improving the program in semi-structured online interviews.
RESULTS
Quantitative data showed that participants from the online MBP reported a medium to large effect on the reduction of child ADHD symptoms. In semi-structured interviews, participants reported positive experiences in their help seeking intention, and personal changes, such as emotion regulation and quality attention to their children. Participants further made suggestions for improvement.
CONCLUSIONS
The effect of online MBP is promising, and the program should be conducted. A large scale randomized controlled trial should be conducted to investigate the effects of MBP in clinical populations.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov NCT05480423.
PubMed: 38807691
DOI: 10.3389/fpsyt.2024.1376867 -
BMC Psychiatry May 2024To examine whether the "Effectiveness of Guideline for Dissemination and Education in psychiatric treatment (EGIUDE)" project affects the rate of prescriptions of...
The effect of education regarding treatment guidelines for schizophrenia and major depressive disorders on psychiatrists' hypnotic medication prescribing behavior: a multicenter study.
BACKGROUND
To examine whether the "Effectiveness of Guideline for Dissemination and Education in psychiatric treatment (EGIUDE)" project affects the rate of prescriptions of hypnotic medication and the type of hypnotic medications prescribed among psychiatrists, for schizophrenia and major depressive disorder in Japan.
METHODS
The EGUIDE project is a nationwide prospective study of evidence-based clinical guidelines for schizophrenia and major depressive disorder in Japan. From 2016 to 2021, clinical and prescribing data from patients discharged from hospitals participating in the EGUIDE project were used to examine hypnotic medication prescriptions The prescribing rate of hypnotics and the prescribing rate of each type of hypnotic (benzodiazepine receptor agonist, nonbenzodiazepine receptor agonist, melatonin receptor agonist, and orexin receptor antagonist) were compared among patients who had been prescribed medication by psychiatrists participating in the EGUIDE project and patients who had been prescribed medication by nonparticipating psychiatrists. Multivariate logistic regression analysis was performed to examine the effect of the EGUIDE project on the prescription of hypnotic medications.
RESULTS
A total of 12,161 patients with schizophrenia and 6,167 patients with major depressive disorder were included. Psychiatrists participating in the EGUIDE project significantly reduced the rate of prescribing hypnotic medication and benzodiazepine receptor agonists for both schizophrenia (P < 0.001) and major depressive disorder (P < 0.001) patients.
CONCLUSION
This is the first study to investigate the educational effects of guidelines for the treatment of psychiatric disorders on psychiatrists in terms of prescribing hypnotic medications to patients. The EGUIDE project may play an important role in reducing hypnotic medication prescription rates, particularly with respect to benzodiazepine receptor agonists. The results suggest that the EGUIDE project may result in improved therapeutic behavior.
Topics: Humans; Depressive Disorder, Major; Schizophrenia; Male; Female; Hypnotics and Sedatives; Middle Aged; Practice Patterns, Physicians'; Japan; Adult; Practice Guidelines as Topic; Psychiatry; Prospective Studies; Drug Prescriptions; Psychiatrists
PubMed: 38807065
DOI: 10.1186/s12888-024-05816-x -
BJPsych Bulletin Jun 2024
PubMed: 38802112
DOI: 10.1192/bjb.2024.29 -
BJPsych Bulletin Jun 2024
PubMed: 38802111
DOI: 10.1192/bjb.2024.27 -
BJPsych Bulletin Jun 2024
PubMed: 38802109
DOI: 10.1192/bjb.2024.28 -
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