ABSTRACT
The use of psychotropic medications during the perinatal period is often met with fear and discomfort on the part of both clinicians and patients. There is a great deal of misinformation about the risks of medication use during pregnancy and lactation. The risk of untreated or undertreated mental illness during this time is an important consideration when making treatment recommendations. This paper serves as a practical guide for clinicians who may be treating patients with psychotropic medication during the perinatal period. A heuristic tool for making treatment decisions will be introduced, and coverage of specific psychiatric disorders and medication classes will be provided.
Subject(s)
Lactation/drug effects , Mental Disorders/drug therapy , Perinatal Care , Pregnancy Complications/drug therapy , Psychotropic Drugs/adverse effects , Psychotropic Drugs/therapeutic use , Female , Humans , PregnancyABSTRACT
Encopresis is an elimination disorder that involves symptoms of fecal incontinence in children. It affects an estimated 1.5% to 7.5% of children ages 6 to 12 and accounts for approximately 3% to 6% of psychiatric referrals. The etiology of encopresis is thought to be related to physiologic problems such as constipation; however, it is also a psychiatric diagnosis and anecdotally may have some association with psychiatric problems. Publications on this association and publications directed toward psychiatric nurses are limited. Encopresis is typically treated with nutritional and medical management along with behavioral modification. Psychiatric nurses working with patients who have encopresis in inpatient settings will have unique concerns and challenges. This article gives an overview of published literature from the past 10 years on the etiology and treatment of encopresis. Specific suggestions for inpatient psychiatric nurses based on published literature and the author's professional experience are provided.
Subject(s)
Encopresis/nursing , Adolescent , Child , Child, Hospitalized/psychology , Encopresis/etiology , Encopresis/psychology , Encopresis/therapy , Humans , Nurse-Patient Relations , Psychiatric NursingABSTRACT
TOPIC: Attachment theory and reactive attachment disorder (RAD). PURPOSE: To highlight current perspectives on attachment theory, RAD, and treatment implications using a case study of an 8-year-old patient with RAD. SOURCES: Selected multidisciplinary literature related to attachment theory and RAD. CONCLUSIONS: The literature provides a body of work that substantiates the importance of early attachment relationships to human development and highlights gaps in our knowledge related to treatment of children with RAD. The quality of early attachment relationships is correlated with future personality and brain development. Attachment disturbances are associated with psychopathology in childhood and adulthood. Although evidence for the effective treatment of children with attachment disorders is minimal and inconclusive, the two major perspectives, developmental psychology and neuropsychoanalysis, offer guidelines for practice.
