Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 24
Filter
1.
BMJ Open ; 8(6): e021461, 2018 06 07.
Article in English | MEDLINE | ID: mdl-29880569

ABSTRACT

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries. OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma. DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups. SETTING: The study was conducted across eight sites: (1) University of Southampton, UK; (2) All India Institute of Medical Science, India; (3) Rowan University, USA; (4) Peshawar Medical College, Pakistan; (5) Capital Medical University, China; (6) College of Medicine and Medical sciences, Bahrain; (7) Queens University, Kingston, Canada and (8) University of Cape Town, South Africa. METHOD: This study extended an initial pilot conducted by the Royal College of Psychiatrists on the term schizophrenia and psychosis subgroups to assess whether the subgroup terminology might have an effect on the attitudes of a convenience sample of medical students from eight different countries and potentially play a role in reducing stigmatisation. RESULTS: 1873 medical students completed a questionnaire recording their attitudes to schizophrenia and the psychosis subgroups. A reduction in negative perceptions were found for the psychosis subgroups, especially for the stress sensitivity psychosis and anxiety psychosis subgroups. Negative perceptions were found for drug-related psychosis. Participants who had undergone clinical training had overall positive attitudes. Differences across different countries were found. CONCLUSION: The attitudes towards psychosis subgroups used in this study have shown mixed results and variation across countries. Further research is warranted to investigate acceptability of terminology. Methods of reducing stigma are discussed in line with the findings. ETHICS: The study received ethical approval from ERGO (Ethics and Research Governance Online; ID: 15972) and subsequently from the ethics committee at each site.


Subject(s)
Psychotic Disorders , Schizophrenia , Stereotyping , Students, Medical/psychology , Terminology as Topic , Attitude of Health Personnel , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Internationality , Male , Social Stigma , Surveys and Questionnaires
2.
Health Serv Insights ; 10: 1178632917694350, 2017.
Article in English | MEDLINE | ID: mdl-28469456

ABSTRACT

This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics-how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity.

3.
Clin Neuropharmacol ; 38(5): 183-97, 2015.
Article in English | MEDLINE | ID: mdl-26366970

ABSTRACT

OBJECTIVE: To review the current evidence on the effectiveness of second-generation antipsychotics (SGAs) in the treatment of tardive dystonia (TDt) and give recommendations for treatment. METHODS: Medline/PubMed/Psyclit/Embase database searches were conducted in January 2015, and a manual review of references within the retrieved articles was done. All articles in English and those that had English abstracts and dealt with treatment of TDt were included. RESULTS: Our search and review yielded a total of 88 reports (none of them a controlled trial) involving 145 patients treated with one of the 5 SGAs. Clozapine has the maximum number of published reports (52 reports involving 90 subjects, whereas there were 36 reports involving 55 subjects treated with other SGAs, including olanzapine, risperidone, quetiapine, aripiprazole, and perospirone). CONCLUSIONS: The available evidence points to the effectiveness of clozapine as monotherapy and in combination with clonazepam for the treatment of TDt. When clozapine is not an option, olanzapine and quetiapine are reasonable alternatives. Given the lack of controlled trials, future focus should be on conducting randomized, placebo-controlled, multicenter, collaborative controlled clinical trials of several years' duration.


Subject(s)
Antipsychotic Agents/therapeutic use , Movement Disorders/drug therapy , Antipsychotic Agents/administration & dosage , Clonazepam/administration & dosage , Clonazepam/therapeutic use , Drug Therapy, Combination , GABA Modulators/administration & dosage , GABA Modulators/therapeutic use , Humans
4.
Innov Clin Neurosci ; 12(7-8): 12-9, 2015.
Article in English | MEDLINE | ID: mdl-26351619

ABSTRACT

We reviewed the literature on transcranial magnetic stimulation and its uses and efficacy in schizophrenia. Multiple sources were examined on transcranial magnetic stimulation efficacy in relieving positive and negative symptoms of schizophrenia. Literature review was conducted via Ovid Medline and PubMed databases. We found multiple published studies and metaanalyses that give evidence that repetitive transcranial magnetic stimulation can have benefit in relieving positive and negative symptoms of schizophrenia, particularly auditory hallucinations. These findings should encourage the psychiatric community to expand research into other applications for which transcranial magnetic stimulation may be used to treat patients with psychiatric disability.

5.
Community Ment Health J ; 50(4): 422-6, 2014 May.
Article in English | MEDLINE | ID: mdl-23828035

ABSTRACT

Cognitive behavior therapy (CBT) is an evidence-based intervention for individuals with serious mental illness and potentiates standard medication management. Americans receiving publicly funded treatment for serious mental illnesses have limited access to CBT and hence we need to devise innovative ways of providing access to this important intervention. We present a case of a man who had severe disability, was medication resistant, and diagnosed with Obsessive Compulsive Disorder and Major Depressive Disorder. After being home bound for many years he was provided CBT utilizing his existing case manager as a therapy extender. The specific roles of the primary therapist and case manager as well as the improvement in quality of life of the individual are delineated. This case report opens up the possibility of further studying case managers as therapy extenders for treating serious mental illnesses.


Subject(s)
Case Management , Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/therapy , Obsessive-Compulsive Disorder/therapy , Depressive Disorder, Major/complications , Humans , Male , Middle Aged , Obsessive-Compulsive Disorder/complications , Treatment Outcome
7.
Psychiatr Serv ; 61(9): 940-3, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20810596

ABSTRACT

OBJECTIVE: This study determined whether adding cognitive-behavioral therapy to treatment for outpatients with schizophrenia would be more effective than the use of second-generation antipsychotics alone. Thirty-three patients were randomly assigned to receive either second-generation antipsychotics alone (N=18) or second-generation antipsychotics plus cognitive-behavioral therapy (N=15). METHODS: All patients received pharmacotherapy from a single provider and in a predetermined standard manner. Psychopathology ratings were done at baseline, at the end of treatment (12 weeks) and three months after completion of treatment (24 weeks). RESULTS: Twenty-five (76%) patients completed baseline and 12-week evaluations, and 17 (68%) patients who finished treatment also completed evaluations at 24 weeks. At the end of treatment persons in the second-generation antipsychotics plus cognitive-behavioral therapy group were rated as having less severe delusions than patients in the group receiving second-generation antipsychotics only, and this difference was maintained three months after treatment ended. CONCLUSIONS: Adding cognitive-behavioral therapy may help with reducing the severity of delusions among patients with schizophrenia.


Subject(s)
Antipsychotic Agents/therapeutic use , Cognitive Behavioral Therapy , Schizophrenia/drug therapy , Adult , Combined Modality Therapy , Female , Humans , Male , Mass Screening , Middle Aged , Treatment Outcome
10.
Community Ment Health J ; 46(4): 337-41, 2010 Aug.
Article in English | MEDLINE | ID: mdl-19957105

ABSTRACT

Individuals with Serious mental illness require psychosocial treatments as adjunct to pharmacotherapy to promote recovery. An ACT team was trained in CBT interventions and charts were reviewed to identify sessions where CBT was utilized. Subjects who received at least 3 sessions of CBT went from 10% before training to 44% after training and 54% in the follow up period. All team members including bachelor's level staff provided CBT interventions. Results show that ACT Team members including those at bachelor's level can be trained in CBT and they utilize these interventions after training is completed.


Subject(s)
Alcoholism/rehabilitation , Bipolar Disorder/rehabilitation , Cognitive Behavioral Therapy/methods , Community Mental Health Services/methods , Patient Care Team , Psychotic Disorders/rehabilitation , Schizophrenia/rehabilitation , Adult , Alcoholism/diagnosis , Alcoholism/psychology , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Case Management/statistics & numerical data , Cognitive Behavioral Therapy/statistics & numerical data , Combined Modality Therapy/statistics & numerical data , Community Mental Health Services/statistics & numerical data , Comorbidity , Crisis Intervention/statistics & numerical data , Diagnosis, Dual (Psychiatry) , Evidence-Based Practice , Feasibility Studies , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Male , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Middle Aged , New Jersey , Outcome Assessment, Health Care/statistics & numerical data , Patient Care Team/statistics & numerical data , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Psychotropic Drugs/therapeutic use , Retrospective Studies , Schizophrenia/diagnosis , Utilization Review
11.
Pediatr Neurol ; 39(1): 33-9, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18555170

ABSTRACT

Periodic limb movements of sleep are clinically underdiagnosed in children. Polysomnography is the most accurate diagnostic test. There is a paucity of information regarding polysomnography findings in children. We evaluated the prevalence and correlates of pediatric periodic limb movements detected by polysomnography. Periodic limb movements of sleep were identified in 77 of 982 polysomnograms, with a prevalence of 7.8% and male predominance (47 boys; 30 girls). Mean age was 9.4 +/- 4.2 years (1-19 years) (body mass index, 24.1 +/- 12.3). Mean sleep time was 395.4 +/- 73.4 minutes, of which rapid eye movement sleep constituted 16.6% +/- 6.7%, and slow-wave sleep, 22% +/- 10%. Sleep efficiency was 93.8 +/- 9.83, periodic limb movement index, 9.78 +/-7.9; periodic limb movement arousal, 4.5 +/- 8.4; arousal index, 27.8 +/- 12.4; and peak end-tidal CO(2), 48.9 +/- 10.5 mm Hg. Associated diagnoses included obstructive sleep apnea in 36 (46.8%), attention deficit hyperactivity disorder in 10 (13%), migraine in 7 (9.1%), seizures in 7 (9.1%), autism spectrum disorders in 5 (6.5%), and narcolepsy in 7 (9.1%). Serum ferritin was decreased (mean, 26.1 mug/L) in 29 (96.6%). Prospective studies may clarify the significance of incidental pediatric periodic limb movements in sleep detected on polysomnograms.


Subject(s)
Movement/physiology , Sleep/physiology , Adolescent , Adult , Arousal/physiology , Child , Child, Preschool , Extremities/physiology , Female , Ferritins/blood , Humans , Infant , Male , Mental Disorders/physiopathology , Mental Disorders/psychology , Nervous System Diseases/physiopathology , Nervous System Diseases/psychology , Polysomnography , Retrospective Studies , Sleep Stages/physiology
20.
Int J Psychiatry Med ; 34(3): 259-66, 2004.
Article in English | MEDLINE | ID: mdl-15666960

ABSTRACT

BACKGROUND: As evidence of a biologic determinant of schizophrenia has been elaborated, an interest in the relationship between schizophrenia and autoimmune disorders has become increasingly more developed over the last decade. Pedigree analysis has shown that schizophrenia, like autoimmune disorders, is likely a heritable phenomenon, and a genetic liability in this disorder is hardly disputed. Research has indicated that physiologic connections between IFN-gamma and TNF-alpha are suggestive of a connection between the symptoms associated with schizophrenia and those of hypoglycemic events in IDDM. Autoimmune pathogeneses of schizophrenia have been hypothesized; however, the clinical delineation of a potentially corresponding subset of patients is rarely addressed. CASE REPORT: We treated a 22-year-old white female who carried the concomitant diagnoses of Schizophrenia, IDDM, and Hypothyroidism with quetiapine and risperidone on an acute basis at our inpatient facility, and observed an apparent resolution of her brittle diabetes with the successful treatment of her psychotic disorder. CONCLUSIONS: The well documented link between antipsychotic agents and changes in blood glucose may be of benefit in a subset of patients who suffer from both psychotic and diabetic disorders.


Subject(s)
Antipsychotic Agents/therapeutic use , Diabetes Mellitus, Type 1/complications , Dibenzothiazepines/therapeutic use , Psychotic Disorders/complications , Psychotic Disorders/drug therapy , Adult , Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Female , Humans , Psychotic Disorders/blood , Quetiapine Fumarate , Schizophrenia/blood , Schizophrenia/drug therapy , Schizophrenia/genetics
SELECTION OF CITATIONS
SEARCH DETAIL
...