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Tijdschrift Voor Psychiatrie 2016
Topics: Female; Humans; Male; Netherlands; Psychiatry; Sex Distribution; Sex Factors
PubMed: 27320506
DOI: No ID Found -
L'Encephale Sep 2018This article analyzes whether psychiatric disorders can be considered different from non-psychiatric disorders on a nosologic or semiologic point of view. The supposed... (Review)
Review
This article analyzes whether psychiatric disorders can be considered different from non-psychiatric disorders on a nosologic or semiologic point of view. The supposed difference between psychiatric and non-psychiatric disorders relates to the fact that the individuation of psychiatric disorders seems more complex than for non-psychiatric disorders. This individuation process can be related to nosologic and semiologic considerations. The first part of the article analyzes whether the ways of constructing classifications of psychiatric disorders are different than for non-psychiatric disorders. The ways of establishing the boundaries between the normal and the pathologic, and of classifying the signs and symptoms in different categories of disorder, are analyzed. Rather than highlighting the specificity of psychiatric disorders, nosologic investigation reveals conceptual notions that apply to the entire field of medicine when we seek to establish the boundaries between the normal and the pathologic and between different disorders. Psychiatry is thus very important in medicine because it exemplifies the inherent problem of the construction of cognitive schemes imposed on clinical and scientific medical information to delineate a classification of disorders and increase its comprehensibility and utility. The second part of this article assesses whether the clinical manifestations of psychiatric disorders (semiology) are specific to the point that they are entities that are different from non-psychiatric disorders. The attribution of clinical manifestations in the different classifications (Research Diagnostic Criteria, Diagnostic Statistic Manual, Research Domain Criteria) is analyzed. Then the two principal models on signs and symptoms, i.e. the latent variable model and the causal network model, are assessed. Unlike nosologic investigation, semiologic analysis is able to reveal specific psychiatric features in a patient. The challenge, therefore, is to better define and classify signs and symptoms in psychiatry based on a dual and mutually interactive biological and psychological perspective, and to incorporate semiologic psychiatry into an integrative, multilevel and multisystem brain and cognitive approach.
Topics: Diagnostic Techniques, Neurological; Diagnostic and Statistical Manual of Mental Disorders; Humans; Mental Disorders; Psychiatry
PubMed: 29885784
DOI: 10.1016/j.encep.2018.01.007 -
La Clinica Terapeutica 2018The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its... (Review)
Review
INTRODUCTION
The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreo- ver, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit".
METHODS
It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regard- ing the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project.
RESULTS
The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not.
CONCLUSIONS
This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relation- ship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregu- lar" in order to discover in it, as far as possible, a rule.
Topics: Humans; Knowledge; Philosophy; Psychiatry; Psychopathology
PubMed: 29938746
DOI: 10.7417/T.2018.2068 -
Dialogues in Clinical Neuroscience Mar 2015This article reviews the role of the French schools in the development of psychiatric nosology. Boissier de Sauvages published the first French treatise on medical... (Review)
Review
This article reviews the role of the French schools in the development of psychiatric nosology. Boissier de Sauvages published the first French treatise on medical nosology in 1763. Until the 1880s, French schools held a pre-eminent position in the development of psychiatric concepts. From the 1880s until World War I, German-speaking schools exerted the most influence, featuring the work of major figures such as Emil Kraepelin and Eugen Bleuler. French schools were probably hampered by excessive administrative and cultural centralization. Between the 1880s and the 1930s, French schools developed diagnostic categories that set them apart from international classifications. The main examples are Bouffée Délirante, and the complex set of chronic delusional psychoses (CDPs), including chronic hallucinatory psychosis. CDPs were distinguished from schizophrenia by the lack of cognitive deterioration during evolution. Modern French psychiatry is now coming into line with international classification, such as DSM-5 and the upcoming ICD-11.
Topics: Diagnostic and Statistical Manual of Mental Disorders; France; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; International Classification of Diseases; Mental Disorders; Psychiatry
PubMed: 25987863
DOI: 10.31887/DCNS.2015.17.1/macrocq -
Tijdschrift Voor Psychiatrie 2016
Topics: Cost-Benefit Analysis; Humans; Psychiatry
PubMed: 27779282
DOI: No ID Found -
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 -
Academic Psychiatry : the Journal of... Apr 2021Medical schools' departments reflect changes in health care and medical school organization. The authors reviewed psychiatry department name categories associated with...
OBJECTIVE
Medical schools' departments reflect changes in health care and medical school organization. The authors reviewed psychiatry department name categories associated with school age, research, and primary care focus.
METHODS
Department names were identified and categorized for US allopathic and osteopathic medical schools. A multinomial regression model analyzed the relationship between department name category and established year, adjusted for school type. Fisher's exact tests analyzed the relationships between name category and research/primary care foci.
RESULTS
Among 147 allopathic schools, 52% had departments with names limited to psychiatry, 42% had names with psychiatry plus other terminology, and 5% had no identified psychiatry department. In 34 osteopathic schools, 12% had psychiatry departments, 12% had departments named psychiatry plus other terminology, and 75% had no identified psychiatry department. Age of school was related to departmental name: for a 1-year increase in the school's established year, the odds of having a department name other than psychiatry were 1.02 times the odds (p < 0.001) of having the name psychiatry. Newer schools were less likely to have departments with "psychiatry" in their name. Associations were found between department name and research and primary care rankings.
CONCLUSIONS
Variability in the names of psychiatry departments in medical schools may suggest changing views within and about academic psychiatry. The limited presence of formal psychiatry departments in newer schools raises questions about psychiatry's impact on educational pathways, the future workforce, and participation in schools' research mission and clinical enterprise.
Topics: Humans; Primary Health Care; Psychiatry; Schools, Medical; Workforce
PubMed: 32638245
DOI: 10.1007/s40596-020-01267-0 -
Tijdschrift Voor Psychiatrie 2021
Topics: Humans; Psychiatry
PubMed: 33913139
DOI: No ID Found -
Tijdschrift Voor Psychiatrie 2021
Topics: Humans; Learning; Policy; Psychiatry
PubMed: 33620719
DOI: No ID Found -
Bundesgesundheitsblatt,... Jul 2023For children and adolescents in need of psychiatric and psychotherapeutic care, outpatient, day patient, and inpatient facilities are provided. A new development is... (Review)
Review
For children and adolescents in need of psychiatric and psychotherapeutic care, outpatient, day patient, and inpatient facilities are provided. A new development is called "inpatient equivalent treatment" that consists of home visits by a multiprofessional team. This paper depicts the landscape of Child and Adolescent Psychiatry (CAP) Services, covering its historical development and the structural, care policy, and financing backgrounds. Until 2014, there was free choice of private practice locations in the outpatient sector, leaving rural areas and marginalized neighborhoods partially undersupplied until today.The number of beds in the hospital sector decreased significantly between 1991 and 2004. It later rose again in favor of improved regional access and smaller units, with an additional 50% of day patient places. Inpatient equivalent treatments are equally effective, but not yet established nationwide; only a few innovative models have been negotiated. Regional networks of all social support systems, aiming for child psychiatric supply networks, are limited due to the pillarization of the social system. In conclusion, an imperative cooperation between all services of the Social Security Code and enabling true cross-sectoral services would benefit CAP patients.
Topics: Adolescent; Humans; Child; Adolescent Psychiatry; Germany; Mental Disorders; Psychiatry; Psychotherapy
PubMed: 37310425
DOI: 10.1007/s00103-023-03724-1