[The influence of maternal choline supplementation on fetal brain development and the risk of psychotic symptoms]. / De invloed van maternale cholinesuppletie op foetale hersenontwikkeling en het risico op psychose.

BACKGROUND: Choline is an essential micronutrient important for fetal brain development. Research suggests that maternal choline supplementation during pregnancy may reduce the risk of developing neuropsychiatric disorders such as psychosis in offspring. AIM: To provide a narrative review of evidence from the literature for the possible prevention of neuropsychiatric problems such as psychosis by maternal choline supplementation. METHOD: A narrative review of the literature obtained after searches in PubMed, Embase and PsycINFO. RESULTS: Nutritional studies indicate that most pregnant women do not receive sufficient dietary choline. This may have adverse effects on fetal brain development. A total of 8 studies were identified; 4 animal and 4 clinical studies. Beneficial effects of maternal choline supplementation were found on fetal brain development, including cognitive and psychosocial functioning of children. No evidence of (serious) side effects was found. Due to the relatively short duration and limited size of the studies, no conclusions could be drawn about the role of maternal choline supplementation in the prevention of neuropsychiatric problems such as psychosis. CONCLUSION: Maternal choline supplementation and/or a choline-rich diet during pregnancy should be further investigated because of evidence of beneficial effects on infant mental functioning, low cost and few side effects. There is no evidence that maternal choline supplementation can prevent psychotic symptoms in offspring.

Maternal choline supplementation during pregnancy to promote mental health in offspring.

AIM: There is increasing interest in the role of choline in brain development, including its possible role in promoting mental health and preventing mental illness. Choline is an essential micronutrient in fetal brain maturation. In more than 90% of pregnant women, choline intake has been found to be lower than the daily-recommended dose. The aim of this article is to review what is known about the effects of maternal choline supplementation on fetal brain development, early child development and mental health. METHODS: A narrative review of the literature. RESULTS: A limited number of studies suggest that maternal choline supplementation during pregnancy may enhance fetal brain development and improve early signs and symptoms that may predispose to mental illness. CONCLUSION: The general low maternal choline intake during pregnancy, expected health benefits and low risks, make a plea for maternal choline supplementation to promote mental health. Choline supplementation may be especially important for pregnant women with a (family) history of severe mental illness and/or alcohol dependence.

[The role of spirituality in psychiatry: important but still unclear]. / De rol van zingeving in de psychiatrie: belangrijk, maar nog onduidelijk.

BACKGROUND: There is an increasing interest in spirituality in relation to psychiatry.
AIM: Exploring the place and meaning of spirituality in mental healthcare.
METHOD: A narrative review of recent developments and results of scientific studies.
RESULTS: Spirituality is related to better (mental) health, wellbeing and longevity, but definitions and conceptualisation are still unclear. Clinical attention is recommended, including awareness of certain risks, but these are not systematically investigated in psychiatry.
CONCLUSION: Spirituality seems to be an important lifestyle factor, that correlates positively with (mental) health, but there is a need for better definitions, conceptualisation and recommendations based on scientific research. A multidisciplinary guideline for psychiatry seems desirable.

[Mindfulness training for psychiatrists in residency: a pilot study]. / Mindfulnesstraining voor aiossen psychiatrie: een pilotstudie.

BACKGROUND: Medical students and psychiatrists in residency run a high risk for burnout. Furthermore, while at medical school, students seem to experience a reduction in empathy; this seems to be linked to a high level of stress. Interventions based on mindfulness training appear to reduce stress and increase empathy in medical students. Trainees in psychiatric residency might also benefit from mindfulness training.
AIM: To assess the effects that a mindfulness course has on perceived stress and empathy in psychiatrists in residency.
METHOD: In this pilot study 13 trainees in psychiatric residency participated in an eight-week course in mindfulness. Before and after the training, 11 of the participants completed questionnaires relating to their empathy, perceived stress and mindfulness.
RESULTS: Participants reported experiencing considerably more empathy after their course than before it. Perceived stress also diminished, but not significantly.
CONCLUSION: The results support our suggestion that mindfulness training can be a valuable part of the curriculum for trainees in psychiatric residency.

[Protocol for complementary and alternative medicine within the Dutch mental health services]. / Protocol voor complementaire en alternatieve geneeswijzen; naar een verantwoorde toepassing binnen de ggz.

Complementary and alternative medicine (CAM) is the subject of heated debate. There are many prejudices for and against CAM. At the centre for Integrative Psychiatry (CIP) of Lentis CAM is offered alongside conventional treatments, but under strict conditions. Because of the controversy surrounding CAM and the potential health risks involved, the CIP in Lentis has formulated a protocol for CAM which is presented in this article.

Protocolo para medicina complementaria y alternativa; hacia una aplicación responsable dentro del sistema de salud mental / Protocol voor complementaire en alternatieve geneeswijzen; naar een verantwoorde toepassing binnen de ggz

Complementary and alternative medicine (cam) is the subject of heated debate. There are many prejudices for and against cam. At the centre for Integrative Psychiatry (cip) of Lentis cam is offered alongside conventional treatments, but under strict conditions. Because of the controversy surrounding cam and the potential health risks involved, the cip in Lentis has formulated a protocol for cam which is presented in this article.

[Complementary and alternative medicine and psychiatry: opinions of patients and psychiatrists]. / Complementaire en alternatieve geneeswijzen (CAG) en psychiatrie.

All over the world people are becoming increasingly interested in complementary and alternative medicine (CAM). Some would like CAM to be integrated into conventional medicine, others are strongly opposed to its integration. We distributed printed questionnaires in order to discover the views of patients and psychiatrists on CAM and to obtain information about the extent to which people actually use CAM. Patients often turn to CAM and are generally satisfied with the results and many support integration. Psychiatrists underestimate the number of times that patients use CAM. They are reluctant to support the integration of alternative medicine but are less opposed to the integration of complementary medicine. Patients and psychiatrists want more information about CAM. Asking the patients whether they use CAM seems desirable.

[Delirium in a 73-year-old man after many years of unwise use of betahistine]. / Delirium bij een 73-jarige man na jarenlang ongewijzigd gebruik van betahistine.

A 73-year-old man was admitted because of delirium that had already persisted for 5 days. The physical examination and extensive tests did not reveal any somatic pathology. The only drug he used was betahistine, taken for several years because of supposed Ménière's disease. After withdrawal of betahistine and treatment with haloperidol the patient recovered completely within a few days. A new delirium was induced when, after discharge from the hospital, betahistine was restarted because of dizziness. There was again a complete remission after betahistine was stopped and haloperidol was restarted. Betahistine is not known to induce delirium, but an investigation in side-effects databases did reveal several cases in which delirium might have been present, even though the term was not actually used. In this case, delirium was possibly caused by the combination of an elevated betahistine plasma level and a damaged blood-brain barrier due to cerebral infarctions, which were revealed by CT and MRI.