World addiction medicine reports: formation of the International Society of Addiction Medicine Global Expert Network (ISAM-GEN) and its global surveys.

Addiction medicine is a dynamic field that encompasses clinical practice and research in the context of societal, economic, and cultural factors at the local, national, regional, and global levels. This field has evolved profoundly during the past decades in terms of scopes and activities with the contribution of addiction medicine scientists and professionals globally. The dynamic nature of drug addiction at the global level has resulted in a crucial need for developing an international collaborative network of addiction societies, treatment programs and experts to monitor emerging national, regional, and global concerns. This protocol paper presents methodological details of running longitudinal surveys at national, regional, and global levels through the Global Expert Network of the International Society of Addiction Medicine (ISAM-GEN). The initial formation of the network with a recruitment phase and a round of snowball sampling provided 354 experts from 78 countries across the globe. In addition, 43 national/regional addiction societies/associations are also included in the database. The surveys will be developed by global experts in addiction medicine on treatment services, service coverage, co-occurring disorders, treatment standards and barriers, emerging addictions and/or dynamic changes in treatment needs worldwide. Survey participants in categories of (1) addiction societies/associations, (2) addiction treatment programs, (3) addiction experts/clinicians and (4) related stakeholders will respond to these global longitudinal surveys. The results will be analyzed and cross-examined with available data and peer-reviewed for publication.

The utilization pattern of psychiatric consultation services at the University of the Philippines-Philippine General Hospital (UP-PGH) from 1999-2008

OBJECTIVE: This study describes the utilization pattern of psychiatric consultation services at the UP-PGH from 1999 - 2008 by reviewing the demographic data of patients referred, describing the Axis I (Clinical Disorders and Other Disorders That May Be a Focus of Clinical Attention) and Axis III (General Medical Conditions) diagnoses of referred patients, and by identifying the sources of, and reasons for the different referrals.METHODS: Relevant data from the annual census of the Consultation - Liaison (CL) Psychiatry Section from 1999 - 2008 was reviewed according to age, sex, civil status, reasons for referral, DSM-IV TR Multi-axial diagnoses and sources of referrals.RESULTS: The percentage of referrals to consultation psychiatry has increased from 1.03% in 1999 to 1.77% in 2008. There is equal distribution between males and females. Majority of the consultation referrals were married and belonged to the 21-40 age group. The top five referring services were general medicine, surgery and trauma, obstetrics-gynecology, otorhinolaryngology and orthopaedic departments. The top three reasons for referring patients were mood problems, agitation and restlessness, and suicide attempts/behaviour. Majority of the axis I diagnoses were adjustment disorder, depressive disorders, and psychological reactions to illness. According to Axis III diagnoses, majority of the referrals were associated with poisoning and injury, neoplasms, and endocrine, nutritional, metabolic and immunity disorders.CONCLUSION: The referral rate to the CL-Psychiatry Section at the UP-PGH has increased throughout the period studied. This may be attributed to programs and activities that improve efficiency in the delivery of psychiatric knowledge and skills, and better personnel supervision. The referral rate of 1.03% to 1.82% was consistent with those in other countries.

Developing a trophoblastic disease psychiatric liaison program

Psychiatric Liaison Programs are designed to provide service, training and research technology using the biopsychosocial approach for problems encountered in a general hospital ward or specialty clinic. When psychosocial problems arise in individuals or groups comprehensive liaison programs are designed based on an analysis of needs that consider the psychosocial dynamics of patients, their family, nursing staff, and medical staff of that particular ward or clinic. These programs are created and implemented by a multidisciplinary team of psychiatrists, social worker, nurse, OT/PT, and consultee physician. Liaison Programs have been set up at the Trophoblastic Disease Ward and the Cancer Institute of the Philippine General Hospital. Among the interventions set up are regular group therapy sessions for patients and their relatives, expressive therapy including visual art therapy, and music, relaxation techniques, meditation, and guided imagery activities, and activity therapy. For the nursing and medical staff seminars and workshops were held to aid in the detection and early intervention-of behavioral problems. Group therapy sessions were also done when interpersonal problems and burn-out were detected; Individual psychotherapy was done when the need arose. At the Trophoblastic Disease Ward, the physiological, psychological and social domains of the WHO-DOH Quality of Life questionnaire were administered to in-patient before instituting the Liaison Program, and six months after. A comparison of the pre-test and post-test scores showed a significant improvement in all the domains a p-0.05 level of significance. A Purpose-in-life test was also administered to the bantays of these patients which showed significant improvement in their scores after six months at p-0.05 level of significance. Subjective evaluations done on the ward staff showed an improvement in interpersonal relationships with other staff, patients and their bantays. We endorse Psychiatric Liaison Programs as effective interventions in dealing with the psychosocial problems of cancer patients, their bantays, and the ward staff.