Subject(s)
Domestic Violence/ethnology , Emigrants and Immigrants/statistics & numerical data , Marriage/ethnology , Women's Rights , Asian People/statistics & numerical data , Australia , Domestic Violence/prevention & control , Domestic Violence/statistics & numerical data , Female , Humans , Mandatory Reporting , Marriage/statistics & numerical data , PrevalenceABSTRACT
OBJECTIVE: Domestic family violence (FV) is a serious problem with serious impacts on mental health of victims. One such impact is post-traumatic stress disorder (PTSD), and it can be resistant to treatment (treatment-resistant or TR). This article offers novel treatment. METHODS: Two treatment resistant case studies are described where adjunctive treatment with brexpiprazole was commenced. Possible theoretical considerations are presented to explain improvement. RESULTS: Adjunctive treatment with brexpiprazole was associated with significant improvement in FV subjective and objective measures, with enhanced response to trauma therapy. CONCLUSION: Brexpiprazole improved complex post traumatic stress disorder in FV victims and needs further evaluation.
Subject(s)
Domestic Violence/psychology , Quinolones/therapeutic use , Stress Disorders, Post-Traumatic/drug therapy , Thiophenes/therapeutic use , Adult , Citalopram/therapeutic use , Combined Modality Therapy , Desvenlafaxine Succinate/therapeutic use , Drug Resistance , Drug Therapy, Combination , Female , Humans , Middle Aged , Psychotherapy , Stress Disorders, Post-Traumatic/therapyABSTRACT
OBJECTIVE:: Examine knowledge, opinions and practices of psychiatrists and trainees in responding to domestic violence (DV). METHOD:: Online survey including two sub-scales from PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey): knowledge (10 items) and preparedness (10 items). RESULTS:: Of psychiatrists completing the survey (216), 47% had received less than 2 hours of training in DV. PREMIS findings showed moderate knowledge of, and preparedness to deal with, DV. Participants with more clinical experience had significantly more knowledge and preparedness to deal with DV. CONCLUSIONS:: Findings suggest more training in DV for psychiatrists is needed.
Subject(s)
Attitude of Health Personnel , Domestic Violence , Health Knowledge, Attitudes, Practice , Physicians/statistics & numerical data , Psychiatry/statistics & numerical data , Adult , Australia , Female , Humans , Male , Middle Aged , Psychiatry/education , Surveys and QuestionnairesSubject(s)
Ambulatory Care/statistics & numerical data , Depressive Disorder/ethnology , Domestic Violence/ethnology , Emigrants and Immigrants/statistics & numerical data , Mental Health Services/statistics & numerical data , Outcome Assessment, Health Care , Stress Disorders, Post-Traumatic/ethnology , Suicide/ethnology , Adult , Asia, Western/ethnology , Depressive Disorder/therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Middle East/ethnology , Stress Disorders, Post-Traumatic/therapy , Victoria/ethnology , Suicide PreventionABSTRACT
OVERVIEW: Whilst the majority of evidence supports the adjunctive use of eicosapentaenoic acid (EPA) in improving mood, to date no study exists using low-dose docosahexaenoic acid (DHA) alone as an adjunctive treatment in patients with mild to moderate major depressive disorder (MDD). METHODS: A naturalistic 8-week open-label pilot trial of low-dose DHA, (260â mg or 520â mg/day) in 28 patients with MDD who were non-responsive to medication or psychotherapy, with a Hamilton Depression Rating Scale (HAM-D) score of greater than 17, was conducted. Primary outcomes of depression, clinical severity, and daytime sleepiness were measured. RESULTS: After 8 weeks, 54% of patients had a ≥50% reduction on the HAM-D, and 45% were in remission (HAM-D ≤ 7). The eta-squared statistic (0.59) indicated a large effect size for the reduction of depression (equivalent to Cohen's d of 2.4). However confidence in this effect size is tempered due to the lack of a placebo. The mean score for the Clinical Global Impression Severity Scale was significantly improved by 1.28 points (P < 0.05). Despite a significant reduction in the HAM-D score for middle insomnia (P = 0.02), the reduction in excessive daytime somnolence on the total Epworth Sleepiness Scale (ESS) did not reach significance. No significant adverse reactions to DHA were found. CONCLUSION: Within the major limits of this open-label pilot study, the results suggest that DHA may provide additional adjunctive benefits in patients with mild- to -moderate depression.
Subject(s)
Antidepressive Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Depressive Disorder, Major/diet therapy , Depressive Disorder, Treatment-Resistant/diet therapy , Dietary Supplements , Docosahexaenoic Acids/therapeutic use , Psychotherapy , Adult , Antidepressive Agents/administration & dosage , Antidepressive Agents/adverse effects , Antipsychotic Agents/adverse effects , Combined Modality Therapy/adverse effects , Depression/diet therapy , Depression/drug therapy , Depression/physiopathology , Depression/therapy , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/physiopathology , Depressive Disorder, Major/therapy , Depressive Disorder, Treatment-Resistant/drug therapy , Depressive Disorder, Treatment-Resistant/physiopathology , Depressive Disorder, Treatment-Resistant/therapy , Diagnostic and Statistical Manual of Mental Disorders , Dietary Supplements/adverse effects , Docosahexaenoic Acids/administration & dosage , Docosahexaenoic Acids/adverse effects , Female , Humans , Male , Middle Aged , Mood Disorders/chemically induced , Mood Disorders/etiology , Mood Disorders/prevention & control , Pilot Projects , Psychiatric Status Rating Scales , Severity of Illness Index , Sleep Disorders, Intrinsic/etiology , Sleep Disorders, Intrinsic/prevention & controlABSTRACT
OBJECTIVES: This paper draws attention to the mental health impact of coercive practice of dowry demands, associated with domestic violence (DV) in an immigrant woman. METHODS: This study was based on a case report and selective literature review. RESULTS: This case history illustrates the serious mental health impacts of repeated emotional and physical trauma inflicted by a husband who was dissatisfied with his wife's dowry. Bio-psycho-social / cultural aspects of mental health treatments needed to be augmented with attention to safety, advocacy, and access to support networks. CONCLUSIONS: Cultural factors are important determinants of mental illness. Psychiatrists need to be aware of DV and dowry when treating immigrant women.
Subject(s)
Domestic Violence , Stress Disorders, Post-Traumatic , Adult , Domestic Violence/psychology , Female , Humans , Marriage , Mental Health , Risk FactorsABSTRACT
In many parts of the world, young adult women have higher levels of common mental disorders than men. The exacerbation of domestic violence (DV) by migration is a salient social determinant of poor mental health. Ecological models describe factors contributing to DV as operating at individual, family, cultural, and societal levels. We explored the interplay among these factors in an Indian community living in Melbourne, Australia, in a qualitative participatory action research study using a modified Forum Theater approach. We here present findings on connections between migration, societal factors, and social/family/cultural factors in DV. The study captured the voices of women living in the community as they describe how DV contributes to their emotional difficulties. Improved understanding of the sociocultural dynamics of DV and the associated social distress in this migrant Indian community can be used to guide the development of culturally sensitive prevention and response programs to assist migrant women from the Indian subcontinent who present with psychopathology and suicidal behaviors associated with DV.
Subject(s)
Domestic Violence/psychology , Mental Disorders/ethnology , Mental Health/ethnology , Suicide Prevention , Transients and Migrants/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Australia/ethnology , Cultural Characteristics , Female , Focus Groups , Humans , India , Interviews as Topic , Male , Middle Aged , White People , Young AdultABSTRACT
OBJECTIVE: This article aims to draw psychiatrists' attention to the problem of family violence and offer pragmatic guidance to detect and manage family violence in the psychiatric context. METHODS: Selective narrative review. RESULTS: Family violence involves complex interactions between societal, cultural, family and individual factors. Awareness and understanding of family violence is important for psychiatrists as engagement can result in enhanced opportunities for early intervention and harm reduction. CONCLUSIONS: There are barriers facing psychiatrists regarding successful family violence intervention outcomes. Concerted action is required to improve services and support to victims and perpetrators.
