-
Diabetology & Metabolic Syndrome Jan 2010Major depression is a disorder that significantly worsens a patient's morbidity and mortality. The association of depression and diabetes is well documented and has...
BACKGROUND
Major depression is a disorder that significantly worsens a patient's morbidity and mortality. The association of depression and diabetes is well documented and has clinical impact in diabetes treatment's outcome. Patients usually aren't evaluated initially by a psychiatrist, so it is important that non-psychiatrists learn to evaluate major depression and its impact.
CONCLUSIONS
Major depression can and should be evaluated on a routine clinical assessment. Depression's impact on the patients' quality of life, productivity and social interactions is well documented. The initial diagnosis of depression should lead to its prompt treatment, and it has to be emphasized that the incorrect treatment can lead to worsening of the condition, relapses, recurrences or even chronification of major depression.
PubMed: 20181035
DOI: 10.1186/1758-5996-2-9 -
Journal of Korean Medical Science May 2015The definition of a "good" psychiatrist has varied over the past decades due to changing roles of psychiatrists. Studies on the qualities of "good" psychiatrists have...
The definition of a "good" psychiatrist has varied over the past decades due to changing roles of psychiatrists. Studies on the qualities of "good" psychiatrists have been completed in many countries. However, no such study has been undertaken in Korea. In Korea, recent growing interest in psychiatry demands the identification of qualities for a good psychiatrist. The purpose of this study was to define the qualities of a good psychiatrist in Korea, subsequently facilitating the improvement of psychiatric training programs. The questionnaire was based on a Singaporean survey with the permission from the original authors. Respondents were divided into patient group and psychiatrist group. The 40-item questionnaire contained items grouped into four themes: Professional, Personal Values, Academic Executive and Relationship. Of the four themes, both patient and psychiatrist groups considered Professional as the most important, whereas Academic Executive as the least important. The mean scores for all items of each theme in the patient group were higher than those in the psychiatrist group, reflecting higher expectations for good psychiatrist in the patient group. Patients emphasized Relationship more than psychiatrists did. It is concluded that a good psychiatrist in Korea can be defined as "a good communicator and listener with a professional manner, who respects confidentiality and has good doctor-patient relationships."
Topics: Adult; Aged; Asian People; Female; Humans; Internship and Residency; Male; Middle Aged; Patients; Physician-Patient Relations; Physicians; Psychiatry; Republic of Korea; Surveys and Questionnaires; Translating
PubMed: 25931796
DOI: 10.3346/jkms.2015.30.5.632 -
BJPsych International May 2021Although training in psychotherapy is an integral part of psychiatry training, standards in psychotherapy training have wide variation across and within countries.... (Review)
Review
Although training in psychotherapy is an integral part of psychiatry training, standards in psychotherapy training have wide variation across and within countries. Post-graduate psychiatry training has been conducted in Nepal for over two decades, but little is known about its psychotherapy training provisions. An online survey was conducted with early career psychiatrists in Nepal. The findings show that the majority recognised psychotherapy training as important and were eager to pursue further training. However, two-thirds had no access to psychotherapy training opportunities. These results highlight the need to improve access to training in different psychotherapy modalities in Nepal.
PubMed: 34287413
DOI: 10.1192/bji.2020.50 -
Frontiers in Psychiatry 2021Physicians, especially psychiatrists, have a high risk of job-related stress, and mental impairment. In our study we examined changes in private and occupational stress...
Physicians, especially psychiatrists, have a high risk of job-related stress, and mental impairment. In our study we examined changes in private and occupational stress factors and mental health within a decade. The legislative reduction of physicians' working hours in Germany during this period made it possible to investigate the impact of working hours in particular. Questionnaires were administered at two psychiatrist meetings (2006 and 2016) about job and family situation, depressiveness, burnout and effort-reward imbalance. A total of = 1,797 datasets were analyzed. Working hours and free weekends were associated with mental health indices. Correlation analyses showed that a reduction in weekly working hours and working days at weekends was related to reduced scores for effort-reward-imbalance, burnout and depression. Our data show changes in workplace stress and mental health in psychiatrists in a decade in which a reduction in working hours has been required by law. These results can provide indications of effective prevention strategies in the professional context of physicians working in psychiatry.
PubMed: 33889101
DOI: 10.3389/fpsyt.2021.641912 -
Turk Psikiyatri Dergisi = Turkish... 2023In this review, we aimed to outline the scientific advances and service capacity in Turkish psychiatry within the century-long history of the Republic. We propose that... (Review)
Review
In this review, we aimed to outline the scientific advances and service capacity in Turkish psychiatry within the century-long history of the Republic. We propose that the history of Turkish Psychiatry also sheds light on the history of our country. We have reviewed significant milestones in Turkish Psychiatry; the establishment of psychiatric hospitals, the development of formal psychiatry training, academic and scientific proceedings and the founding of professional organizations in the Republic era. We aimed to offer insights into the role of psychiatry in the modernization of our country, as well as to establish a foundation for future improvements by evaluating the progress made in the field of mental health services. The story that began with 20 neuropsychiatrists and 300 psychiatric beds in one mental hospital has now reached over 4000 psychiatrists and twenty-thousand psychiatric beds. Psychiatry in Türkiye continues its historical evolution with expansion in size and advancements in quality. Keywords: History of Psychiatry in Türkiye, History of the Republic of Türkiye, History of Medicine.
Topics: Humans; Anniversaries and Special Events; Turkey; Psychiatry; Mental Health Services; Psychiatrists
PubMed: 38173329
DOI: 10.5080/u27437 -
The Psychiatric Quarterly Sep 2021The aim of this study was to explore psychiatrists' experience of vocational rehabilitation for patients with mental illness. The study employed a qualitative design to...
The aim of this study was to explore psychiatrists' experience of vocational rehabilitation for patients with mental illness. The study employed a qualitative design to explore psychiatrists' experience of vocational rehabilitation. Ten psychiatrists, five women and five men, 33-62 years of age (median 40), were interviewed. All of them worked with patients at Sahlgrenska University Hospital. The interviews were analyzed using inductive thematic analysis. All participants considered vocational rehabilitation to be of great importance for patients' well-being and health. The results were characterized by two opposite experiences: frustration and agency, these were the two main themes in the analysis. All narratives embraced both experiences, but some reflected more frustration and others more agency. In order for the psychiatrist to master the assignment, there is a need for further training and supervision. The psychiatrist's role, as well as other professional roles within the team, requires clarification, and the support from rehabilitation coordinators and occupational therapists should be enhanced. There is a need for improved cooperation with external actors.
Topics: Female; Humans; Male; Mental Disorders; Psychiatry; Rehabilitation, Vocational
PubMed: 33665759
DOI: 10.1007/s11126-021-09896-w -
BMC Psychiatry Mar 2022To assess discordance between psychiatrists and their patients with schizophrenia regarding disease management and understand drivers of prescribing long-acting...
BACKGROUND
To assess discordance between psychiatrists and their patients with schizophrenia regarding disease management and understand drivers of prescribing long-acting injectable (LAI) antipsychotics.
METHODS
Data were collected via the Adelphi Schizophrenia Disease Specific Programme™, a point-in-time real-world international survey of psychiatrists and their consulting patients with schizophrenia, conducted in 2019. Psychiatrists completed an attitudinal survey on schizophrenia management and provided patient profiles for their next 10 adult consulting patients. The same patients voluntarily completed patient self-completion forms. Disease severity and improvement were assessed via physician-reported Clinical Global Impression scale; patients' adherence to treatment was rated through a 3-point scale (1=not at all adherent, 3=fully adherent).
RESULTS
Four hundred sixty-six psychiatrists provided data for 4345 patients (1132 receiving a LAI; 3105 on non-LAI treatment; 108 not on treatment). LAIs were more commonly prescribed to patients with severe schizophrenia, with varying reasons for prescribing. Globally, only slight agreement was observed between psychiatrists and patients for Clinical Global Impression severity of illness (κ=0.174) and level of improvement on treatment (κ=0.204). There was moderate agreement regarding level of adherence to treatment (κ=0.524). Reasons for non-adherence did not reach a level of agreement greater than fair.
CONCLUSIONS
Our real-world survey found that LAIs were more often reserved for severe schizophrenia patients and improving adherence was a key driver for prescribing. However, compared with the patients themselves, psychiatrists tended to underestimate patients' disease severity and overestimate their adherence.
Topics: Adult; Antipsychotic Agents; Delayed-Action Preparations; Humans; Psychiatry; Schizophrenia; Surveys and Questionnaires
PubMed: 35300629
DOI: 10.1186/s12888-022-03846-x -
Drug Design, Development and Therapy 2020While the prognosis of patients with schizophrenia has dramatically improved after the advent of chlorpromazine, the antipsychotics currently available are so numerous... (Review)
Review
While the prognosis of patients with schizophrenia has dramatically improved after the advent of chlorpromazine, the antipsychotics currently available are so numerous that it has become a challenge for psychiatrists to choose from among these drugs for each patient presenting for care. In addition, while numerous studies show that an effective antipsychotic should be continued indefinitely to prevent relapses or worsening, many patients appear to have difficulty remaining on any drug thus initiated. Brexpiprazole, a dopamine D receptor partial agonist, appears to provide a unique profile that has much to offer in this light. Specifically, this novel drug is potentially better suited for long-term use, with decreased risk of extrapyramidal side effects, hyperprolactinemia, weight gain, psychosis, insomnia, akathisia, nausea/vomiting or restlessness, thus potentially facilitating patients' reintegration into society. Indeed, brexpiprazole has been shown in randomized, double-blind, placebo-controlled trials to have proven efficacy not only in improving the symptoms of schizophrenia but in preventing relapses. It is also suggested in both short- and long-term studies that brexpiprazole offers a favorable safety and tolerability profile. This review also includes a proposed treatment algorithm incorporating brexpiprazole, based on the clinical trial results available, as well as on the authors' clinical experience, where brexpiprazole may be best used as a drug of first choice for the treatment of schizophrenia. Thus, overall, brexpiprazole appears to play a more significant role in the treatment of schizophrenia than other antipsychotics.
Topics: Adult; Antipsychotic Agents; Dopamine Agonists; Humans; Psychiatry; Quinolones; Receptors, Dopamine D2; Schizophrenia; Thiophenes; Treatment Outcome
PubMed: 33376301
DOI: 10.2147/DDDT.S240859 -
BJPsych International May 2022This article describes the author's discovery of mindfulness and its method and describes the bias against mindfulness even at the beginning of the 21st century. The... (Review)
Review
This article describes the author's discovery of mindfulness and its method and describes the bias against mindfulness even at the beginning of the 21st century. The short essay also throws light on recent developments in mindfulness training and practice in the world and in the state of Kerala in South India.
PubMed: 35532408
DOI: 10.1192/bji.2021.33 -
European Archives of Psychiatry and... Mar 2016Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union...
Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approached from different angles: the cultural differences between countries with regards to how mental health care is considered and founded on, the cultural differences between people throughout Europe in all states. The position of psychotherapy is emphasised. What once was the cornerstone of psychiatry as medical specialty seems to have become a neglected area. Seeing the patient with mental health problems within his cultural context is important, but considering him within his family context. The purpose of any training is enabling the trainee to gain the knowledge and acquire the competencies necessary to become a well-equipped professional is the subject of the last paragraph in which trainees consider their position and early career psychiatrists look back to see whether what they were trained in matches with what they need in the working situation. Common standard for training and certification are a necessity within Europe, for the benefit of the profession of psychiatrist but also for patient safety. UEMS is advised to join forces with the Council of National Psychiatric Associations (NPAs) within the EPA and trainings and early career psychiatrist, to discuss with the users what standards should be implemented in all European countries and how a European board examination could ensure professional quality of psychiatrists throughout the continent.
Topics: Culture; Europe; Humans; Mental Disorders; Psychiatry; Psychotherapy
PubMed: 26880078
DOI: 10.1007/s00406-016-0679-4