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Background:Increasing suicide rates, mental health problems and the need for intensive care have become an important health problem. Therefore, analyzing the sociodemographic and clinical characteristics of patients hospitalized in intensive care for suicide attempts is critical for developing effective intervention and prevention strategies. This study aims to analyze the sociodemographic characteristics and mental health of individuals who attempted suicide. Materials and Methods: In this retrospective descriptive study, suicide cases in the adult intensive care unit of a university hospital between 01.11.2017 and 01.11.2023 were analyzed through the hospital automation system. Results: The mean age of patients hospitalized in the intensive care unit in the last 10 years was 27.06 ± 10.15 years and 61% were female. 79.6% of the patients were admitted with a prediagnosis of suicide and 17.7% with alcohol or substance intoxication. Family pressure (32.7%), economic p roblems (17.7%) and psychiatric problems (15%) w ere the main reasons for suicide. The most common methods of suicide were drug abuse (67%), insecticide use (26%) and h anging (4%). S eventy per c ent of the patients were discharged with nausea and vomiting, 92 percent were discharged, and 8 per cent died. Suicide cases occurred mostly in July (15%) in 2017 (21%) and 2022 (18%). Suicides were frequently observed at night, especially at 23:00 (14.6%). Conclusions: This study investigated the sociodemographic and clinical characteristics of patients admitted to an intensive care unit in Turkey for suicide attempts. Results showed that most patients were young females who often attempted suicide by drug ingestion. Key contributing factors included family pressure, economic challenges, and psychiatric issues, with suicide cases peaking in the summer. These findings may aid in developing targeted prevention and intervention strategies by identifying high-risk groups and periods. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Over 450 million individuals worldwide suffer from mental illnesses, according to epidemiological data, making this one of the biggest problems facing modern medicine. People often react in a fairly discriminatory way to those with mental illness, and stigmatizing views toward those with mental illness are ubiquitous. In India, people who suffer from mental illness live with their families, and the stigma associated with mental illness has a significant impact on how effectively these people are treated over time by their families and communities. Objective: This study aims to specifically investigate how undergraduate medical students who participated in a two-week psychiatric posting and teaching program and those who did not learn about mental illness from the course curriculum or clinical experience differed in their perceived stigma toward people with mental illness. Materials and Methods: This cross-sectional study used a self-reported Perceived devaluation-discrimination scale (PDDS) questionnaire distributed via Google form to undergraduate medical students who were exposed (n = 72) to a two-week psychiatry posting and attended lectures and those who were not exposed (n = 176) to psychiatry training. Results: The results show that medical students' perceptions of the stigma associated with mental illness remain unchanged following their exposure to psychiatry training. Nonetheless, it was discovered that students' perceptions of the stigma associated with mental health patients were influenced by their urban domicile. Conclusions: Our research indicates that there was perceived stigma among medical students about patients with mental illnesses, and that this tendency was more pronounced among students belonging from rural areas. [ABSTRACT FROM AUTHOR]

BackgroundSuicide is the second most common cause of death among adolescents and young adults. In the pediatric population, gunshot wounds (GSWs) and hangings are common mechanisms of pediatric suicide. Comorbid psychiatric illness is prevalent in this population, but psychiatric resource utilization after self-inflicted traumatic injury is not well characterized.MethodsWe analyzed patients

Purpose: The main purpose of this paper is to examine whether women's empowerment and mental disorder affect each other in a one-way or two-way simultaneous relationship. Accordingly, the study fills a gap in the literature since it is the first attempt to examine the simultaneous relationship between women's empowerment and mental disorder in Egypt. To achieve this, the study aims to examine the most important dimensions of women's empowerment and mental disorder that affect each other simultaneously, and the most important determinants affecting women's empowerment and mental disorder. Design/methodology/approach: The study depends on the cross-sectional data from the "Survey of Young People in Egypt" implemented in 2014. Married women aged 14–35 are included in the analysis (N = 3052). Recursive and nonrecursive structural equation models are used to examine the simultaneous relationship between women's empowerment and mental disorder using AMOS, which stands for Analysis of Moment Structures (Version 22). Results: Women's education has a positive significant impact on women's empowerment and mental health. Violence has a positive significant impact on mental disorder, while it has a negative impact on women's empowerment. Sexual harassment has a negative impact on treatment with spouse dimension. Regarding the one-way relationship, the results show that the more empowered the woman, the better her mental health is. Considering the two-way simultaneous relationship, the findings show that there is a partial two-way simultaneous relationship. Conclusion: There is a relationship between women's empowerment and mental health, indicating that they affect each other simultaneously. Awareness of the importance of psychological counselling and treatment for mental disorders in women is needed. [ABSTRACT FROM AUTHOR]

Introduction: Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and Métis), who are highly represented in rural communities, have additional risk factors related to colonialism, and historical and ongoing trauma. Understanding how to best respond to elevated rates of psychiatric illness in rural and remote communities requires an understanding of the unique challenges these communities face in accessing and providing high quality psychiatric services. This article reports a review of published literature on prevalence of non-psychotic psychiatric conditions, as well as the risk and protective factors influencing rates and experience of mental illness in rural and remote communities in Canada to help inform approaches to prevention and treatment. Methods: This focused narrative review of literature related to rural non-psychotic psychiatric illness in rural and remote Canada published over a 20-year period (October 2001 - February 2023). A review of CINAHL, Medline and Academic Search Complete databases supplemented by gray literature (eg federal and provincial documents, position papers, and clinical practice guidelines) identified by checking reference lists of identified articles, and web searches. A textual narrative approach was used to describe the literature included in the final data set. Results: A total of 32 articles and 13 gray literature documents were identified. Findings were organized and described in relation to depression and anxiety and substance use suicidality and loss; rates for all were noted as elevated in rural communities. Different mental health strategies and approaches were described. Variability in degree of rurality, or proximity to larger metropolitan centers, and different community factors including cohesiveness and industrial basis, were noted to impact mental health risk and highlighted the need for enhancing family physician capacity and responsiveness and innovative community-based interventions, in addition to telepsychiatry. Conclusion: Further focus on representative community-based research is critical to expand our knowledge. It is also critical to consider strategies to increase psychiatric care access, including postgraduate medical training and telehealth training. [ABSTRACT FROM AUTHOR]

Background: A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training. Materials and Methods: This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data. Result: Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting. Conclusion: Opinions can change based on one’s experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

Introduction: Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and Métis), who are highly represented in rural communities, have additional risk factors related to colonialism, and historical and ongoing trauma. Understanding how to best respond to elevated rates of psychiatric illness in rural and remote communities requires an understanding of the unique challenges these communities face in accessing and providing high quality psychiatric services. This article reports a review of published literature on prevalence of non-psychotic psychiatric conditions, as well as the risk and protective factors influencing rates and experience of mental illness in rural and remote communities in Canada to help inform approaches to prevention and treatment. Methods: This focused narrative review of literature related to rural non-psychotic psychiatric illness in rural and remote Canada published over a 20-year period (October 2001 - February 2023). A review of CINAHL, Medline and Academic Search Complete databases supplemented by gray literature (eg federal and provincial documents, position papers, and clinical practice guidelines) identified by checking reference lists of identified articles, and web searches. A textual narrative approach was used to describe the literature included in the final data set. Results: A total of 32 articles and 13 gray literature documents were identified. Findings were organized and described in relation to depression and anxiety and substance use suicidality and loss; rates for all were noted as elevated in rural communities. Different mental health strategies and approaches were described. Variability in degree of rurality, or proximity to larger metropolitan centers, and different community factors including cohesiveness and industrial basis, were noted to impact mental health risk and highlighted the need for enhancing family physician capacity and responsiveness and innovative community-based interventions, in addition to telepsychiatry. Conclusion: Further focus on representative community-based research is critical to expand our knowledge. It is also critical to consider strategies to increase psychiatric care access, including postgraduate medical training and telehealth training.

Background and objectives: Investigate the frequency of psychosocial issues among teenage females residing in tribal welfare hostels. Analyse the person's sociodemographic characteristics. Research the psychiatric morbidity of this group. Look into the issues with adolescent adjusting. Methods: 150 adolescent girls who lived in the tribal area for a year had a descriptive study done to assess their psychological and social difficulties at Department of Psychiatry, Osmania Medical College/Institute of Mental Health, Hyderabad, Telangana, India, between December 2021 to November 2022. Results: Current marital status of the parent's majority are married and living together (80%). Girls adjustment in with hostel, peers of the children majority 55.3% above averagely adjusted. Mother annual income majority (46.0%) being 50,000 mean was 52000.0 with a standard deviation of 42536.995. Relationship between type of family and adolescent adjustment showed chi-square value 2.03 and p value 0.843 statistically not significant. Conclusion: 16% of tribal welfare hostel teenage females had mental problems. Most of the girls were in eighth grade and 13-15 years old. Psychiatric disorder is more common among adolescents from broken houses, according to current marital data. Single-parent children have trouble adjusting. Psychiatric illness and adjustment concerns affected school performance. This research found a high frequency of psychiatric disease among tribal welfare hostel youth, requiring careful surveillance and sufficient mental health care for treatment and evaluation. [ABSTRACT FROM AUTHOR]

Background-Patients with CKD are subjected to extremely high levels of stress on all fronts, including the physical, the psychological, the emotional, and the economical. This study was thus conducted to assess psychiatric illnesses in CKD patients and their impact on quality of life. Methodology- This study was conducted as an observational cross sectional study on patients with CKD seeking care at Department of Medicine, Gandhi Medical College, Bhopal. All the patients were subjected to detailed general and physical examination and findings were documented. Quality of life in CKD patients was assessed using WHO QoL scale. Psychiatric illness were assessed using Brief psychiatric rating scale. Results-The present study was conducted on 200 cases with CKD with mean age of 43.90±15.753 years. Overall mean quality of life irrespective of domains was 52.72±4.31. Most common psychiatric illness in patients with CKD was depressive mood(99%), and 79.5% had mild depressive mood. We observed a significantly weak negative correlation of uncooperativeness with social domain(r=-0.142; p<0.05). Environmental domain showed a weak positive correlation with guilt feeling and grandiosity(r=0.148 and 0.147 respectively; p<0.05). Conclusion-The prevalence of mental disease was substantially higher among CKD patients. Patients with CKD were more likely to experience depression followed by anxiety. Patients with a CKD diagnosis are at a much higher risk for the emergence of mental health issues. There was a statistically significant correlation between chronic renal disease and the physical, social, environmental, and psychological dimensions of quality of life in the population we examined. Quality of life was also observed to be diminished in CKD patients(QOL). [ABSTRACT FROM AUTHOR]

Background: Hansen's disease, caused by the bacteria Mycobacterium leprae, is a chronic illness that poses various challenges to affected individuals. This study aimed to assess the prevalence and types of psychiatric illnesses among leprosy patients receiving care at a tertiary health care facility in Odisha, while also examining the association between these conditions and sociodemographic and clinical factors. Methodology: A cohort of 100 leprosy patients aged 18 to 60, diagnosed and seeking treatment at the Fakhir Mohan Medical College and Hospital, Balasore, was enrolled in the study. Mental health evaluations were conducted using a specifically designed pro-forma based on the ICD-10 Mental Illness Checklist. Result: Our findings revealed that 34% of leprosy patients exhibited co-existing mental disorders. Depression emerged as the most prevalent mental illness, closely followed by anxiety. Notably, urban residents exhibited a lower prevalence of mental illness compared to their semiurban and rural counterparts. Among leprosy patients, psychiatric issues were more common in the older adult group (51–60 years), with women being more susceptible to mental health challenges than men. Additionally, patients with the lepromatous stage of leprosy demonstrated a higher likelihood of experiencing mental disorders. Conclusion: In our study underscores the significant occurrence of serious mental co-morbidities, particularly depression and anxiety, among leprosy patients. Beyond impacting patient well-being, psychiatric comorbidities also exert a detrimental influence on prognosis and overall morbidity. Timely diagnosis and intervention for these mental health conditions can play a crucial role in improving patient outcomes. [ABSTRACT FROM AUTHOR]

Background: A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training. Materials and Methods: This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data. Result: Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting. Conclusion: Opinions can change based on one's experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness. [ABSTRACT FROM AUTHOR]

Background: There are reports that pharmacogenomics, pharmacodynamics, and pharmacotherapeutics of psychiatric drugs differ significantly with sex. There is a dearth of literature on this aspect. The aim of this study is to identify sex-biased genes among common mental disorders and the influence of sex on the common drug metabolism enzymes and transporters (DMET) genes in blood transcriptomics data. Methodology: Data for this meta-analytic, in silico study, are from Gene Expression Omnibus repository with restrictions of human blood samples that measured the mRNA expression of genes of any mental disorder patients without any date limitations. The identified datasets were then entered into the online Exatlas software. Quality check of the dataset was performed and only those datasets that fulfilled were used further in this meta-analysis. DMET genes were identified from literature, and the differential expression (DE) was identified and presented. Results: In all, 239 patient samples with five common mental disorders formed the study group. Of them, there were 21139 genes, of which the number of significant genes (FDR <0.05) was 16989. In this meta-analysis of mental illness among either sex, 32 genes were identified as DE. Of these 32 genes, 23 (72%) belonged to sex chromosomes and the remaining mapped to autosomes. We identified 48 DEMT genes from literature and their DE reported. Conclusion: Within the limitation of this study, it is established that among the mentally ill, there is a measurable difference between males and females, in terms of gene expression, particularly of DMET genes. Such DE of genes can potentially alter the pharmacogenomics, pharmacodynamics, and pharmacotherapeutics of psychiatric drugs. [ABSTRACT FROM AUTHOR]

Purpose: Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.Methods: Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.Results: Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.Conclusion: Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Many psychiatric illnesses have been linked to the gut microbiome, with supplements such as probiotics showing some efficacy in alleviating the symptoms of some psychiatric illnesses. The aim of this review is to evaluate the current literature investigating the effects of adjuvant probiotic or synbiotic administration in combination with first-line treatments for psychiatric illnesses. Method: A systematic search of four databases was conducted using key terms related to treatments for psychiatric illnesses, the gut microbiome, and probiotics. All results were then evaluated based on specific eligibility criteria. Results: Eight studies met eligibility criteria and were analyzed for reported changes in outcome measures used to assess the symptoms of psychiatric illness and the tolerability of treatment. All Major Depressive Disorder (MDD) (n = 5) and Generalized Anxiety Disorder (GAD) (n = 1) studies found adjuvant probiotic or synbiotic treatment to be more efficacious in improving the symptoms of psychiatric illness than the first-line treatment alone or with placebo. The schizophrenia studies (n = 2) found adjuvant probiotic treatment to have no significant difference in clinical outcomes, but it was found to improve the tolerability of first-line antipsychotics. Discussion and conclusion: The findings of the studies included in this review suggest the use of adjuvant probiotic treatment with selective serotonin reuptake inhibitors (SSRIs) for MDD and GAD to be superior to SSRI treatment alone. Probiotic adjuvant treatment with antipsychotics could be beneficial for improving the tolerability of the antipsychotics, but these findings do not suggest that adjuvant probiotic treatment would result in improved clinical outcomes for symptoms of schizophrenia. [ABSTRACT FROM AUTHOR]

To explore the management and outcome of COVID-19 infection in mental illness at a specialized neuropsychiatric setting.A retrospective review of the clinical profile of 100 COVID-19 patients with mental illness, admitted to the Psychiatric COVID unit (PCU) from June 2020 to June 2022, was done, with a subgroup analysis of chronic institutionalized patients (n = 36).Schizophrenia, bipolar affective disorder, and schizoaffective disorder comprised 64% of the study population. Most patients (87%) were on antipsychotics. 56% of the patients had an infection of mild severity and 38% were asymptomatic. Corticosteroids and anticoagulants were given to 33.3% and 25% of the patients, respectively. 16% of the patients encountered medical complications in the PCU, and 14% were referred to a COVID-designated hospital. Patients with diabetes mellitus and/or hypertension were more likely to be referred. The chronic institutionalized patients (n = 36) had either an asymptomatic or mild infection. Three among these patients were referred to a COVID-designated hospital.Most psychiatric patients with medical illnesses, including COVID-19, pose unique challenges including complexity of symptoms, ensuring patient safety, and the need for trained professional staff to provide specialized psychiatric interventions, which can be taken care of in psychiatric care settings. [ABSTRACT FROM AUTHOR]

The impact of gut microbiota in mental health has been one of the most exciting and probably one of the most discussed topics of psychiatric research in the last decade. The gut microbiota may play an important role in the development of neuropsychiatric diseases, according to a growing body of research. Gut microbiota is a key regulator of gut-brain axis and may shape our brain physiology; thus, any change in its composition may change our behaviour due to altered psychiatric conditions. Relationship of gut microbiota with different mental illnesses is discussed in this article. [ABSTRACT FROM AUTHOR]

Introduction: Mental illness has become a global public health issue and according to WHO report in 2015, United Arab Emirates (UAE) recorded the highest level of depression among all countries at Eastern Mediterranean Region. Many people frequently suffer from mental health diseases but tend not to obtain help. Treatment delay can become life-threatening. Objectives: This study aimed to identify the barriers to seeking professional help for mental illness and the consequences of untreated mental health disorders. The study also aimed to examine outcomes in patients when help was provided by health care providers. Methods: A self-administrated survey was distributed among 377 people randomly selected from general population of three different cities at United Arab Emirates (UAE): Abu Dhabi, Dubai and Sharjah. Their perception of the barriers, consequences and outcomes was analyzed to achieve the objectives of the study. Results: Overall, 341 participants completed the survey. Wrong thought regarding mental disorders (60.1%) and being ashamed (58.9%) were identified to be the most common and significant barriers (P

The article presents a clinical case that highlights how physicians can improve the care of psychiatric patients in the emergency department (ED). A 30-year-old male with history of schizoaffective disorder is presented to the ED for intrusive command hallucinations to jump in front of a bus. It shows that psychiatric patients, awaiting placement to an inpatient psychiatric facility, deserve to be treated as soon as possible to alleviate their suffering.

Existing evidence demonstrates that coronavirus disease 2019 (COVID-19) leads to psychiatric illness, despite its main clinical manifestations affecting the respiratory system. People with mental disorders are more susceptible to COVID-19 than individuals without coexisting mental health disorders, with significantly higher rates of severe illness and mortality in this population. The incidence of new psychiatric diagnoses after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is also remarkably high. SARS-CoV-2 has been reported to use angiotensin-converting enzyme-2 (ACE2) as a receptor for infecting susceptible cells and is expressed in various tissues, including brain tissue. Thus, there is an urgent need to investigate the mechanism linking psychiatric disorders to COVID-19. Using a data set of peripheral blood cells from patients with COVID-19, we compared this to data sets of whole blood collected from patients with psychiatric disorders and used bioinformatics and systems biology approaches to identify genetic links. We found a large number of overlapping immune-related genes between patients infected with SARS-CoV-2 and differentially expressed genes of bipolar disorder (BD), schizophrenia (SZ), and late-onset major depressive disorder (LOD). Many pathways closely related to inflammatory responses, such as MAPK, PPAR, and TGF-β signaling pathways, were observed by enrichment analysis of common differentially expressed genes (DEGs). We also performed a comprehensive analysis of protein–protein interaction network and gene regulation networks. Chemical–protein interaction networks and drug prediction were used to screen potential pharmacologic therapies. We hope that by elucidating the relationship between the pathogenetic processes and genetic mechanisms of infection with SARS-CoV-2 with psychiatric disorders, it will lead to innovative strategies for future research and treatment of psychiatric disorders linked to COVID-19. [ABSTRACT FROM AUTHOR]

The authors have investigated the life, family, premorbid personality, historical background, writings, and dysfunctional behaviors of Vincent van Gogh and Jungseop Lee before hospitalization. Psychiatric symptoms at the time of hospital admission, physical and mental illness, psychodynamic approach, treatment, and artistic creativity were evaluated. The two artists showed characteristics of bipolar disorder and substance use disorder including alcoholism. Van Gogh showed possibilities of bipolar schizoaffective disorder, while Lee had signs of bipolar II disorder. The two artists showed high creative urges in hypomanic states and low creative urges in depressive states. Van Gogh was amenable to psychiatric treatment from the start. Lee, although showed resistance to treatment at first, improved with progressive treatment and continued his artistic endeavors. Artists who are diagnosed with bipolar disorder and individuals close to them require ongoing psychiatric supervision to prevent mood swings, substance abuse, and suicide and continue their artistic work. Also, any discussion related to the artist’s creativity and psychiatric disorders should not belittle the artistic achievements by overinterpreting the artist’s physical or psychiatric illness or underestimating and ignoring them altogether. The two artists’ lives represent a struggle to manifest artistic creativity and goals in life alongside the fight against psychiatric illness and hardship. [ABSTRACT FROM AUTHOR]

Introduction: Migraine is the most common cause of vascular headache with a one-year prevalence as high as 6-14.3%. Having various pathophysiological theories, it occurs in much co-morbidity with several medical as well as psychiatric disorders like mood disorders, phobia, anxiety spectrum, etc. Migraine, especially when co-morbid with psychiatric illness stands markedly burdensome economically, diagnostically, therapeutically and prognostically. Hence, needs even further research. Aim: To study patients with migraine versus other types of headache and to study psychiatric co-morbidity among patients with migraine. Materials and Methods: A total of 100 patients presenting with headache, meeting the criteria were taken up for the study and divided into two groups. Patients meeting International Headache Society (IHS) criteria for migraine were enrolled under group A and patients suffering from headache other than migraine under group B. Having subjected to detailed history and evaluation, patients were subjected to Symptom checklist-80, Hamilton's Anxiety Rating Scale (HARS) and Montgomery Asberg Depression Rating Scale (MADRS), ICD-10 criteria. The data so collected was subjected to statistical analysis and association of psychiatric morbidity with migraine patients was assessed. Results: Patients with migraine (group A) and among those too, patients having psychiatric morbidity had significantly (p<0.01) longer duration of illness (=8 years), more frequent attacks =5 attacks per month and had longer duration of each attack >24 hours compared to the other groups. Patients having migraine had significantly (p<0.01) higher psychiatric morbidity, more SCL-80 symptoms (mean score 83.05); more depressive symptoms (mean MADRS score= 31.9±9.2) and more anxiety with the mean Hamilton Anxiety score=23.3 than in patients without psychiatric morbidity. Conclusion: The data so obtained points need for a thorough evaluation of psychiatric disorders in migraine so as to propose a non segregated model of care to direct the burden and deterioration associated with psychiatric co-morbidity in migraine. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of psychiatric diseases in orthopaedic patients during the COVID-19 pandemic. Materials and Methods: This study was conducted from 20th April 2020 to 20th September 2020 at the Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi, Pakistan. Patients aged 18 years and above and belonging to either gender with Orthopaedic injuries were included. Gender, age, injury mechanism, associated trauma, site of the fracture, use of tobacco and mental health disorder was recorded. Data were analyzed using SPSS version 23. Results: The study included 210 patients with Orthopaedic injuries. The mean age of patients in the study was 40.45±12.54 years. Falls were the most common mechanism of injury (50.4%) followed by motorcycle accidents (22.8%) and motor vehicle accidents (16.7%). 70.47% of patients with Orthopaedic injuries were diagnosed with a mental health problem. There were notably higher rates of depression (33.1%) and anxiety (24.3%). Conclusion: There was a high frequency of psychiatric illnesses in Orthopaedic patients during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The last decade has witnessed the development of sophisticated biobehavioral and genetic, ambulatory, and other measures that promise unprecedented insight into psychiatric disorders. As yet, clinical sciences have struggled with implementing these objective measures and they have yet to move beyond "proof of concept." In part, this struggle reflects a traditional, and conceptually flawed, application of traditional psychometrics (i.e., reliability and validity) for evaluating them. This paper focuses on "resolution," concerning the degree to which changes in a signal can be detected and quantified, which is central to measurement evaluation in informatics, engineering, computational and biomedical sciences. We define and discuss resolution in terms of traditional reliability and validity evaluation for psychiatric measures, then highlight its importance in a study using acoustic features to predict self-injurious thoughts/behaviors (SITB). This study involved tracking natural language and self-reported symptoms in 124 psychiatric patients: (a) over 5–14 recording sessions, collected using a smart phone application, and (b) during a clinical interview. Importantly, the scope of these measures varied as a function of time (minutes, weeks) and spatial setting (i.e., smart phone vs. interview). Regarding reliability, acoustic features were temporally unstable until we specified the level of temporal/spatial resolution. Regarding validity, accuracy based on machine learning of acoustic features predicting SITB varied as a function of resolution. High accuracy was achieved (i.e., ~87%), but only when the acoustic and SITB measures were "temporally-matched" in resolution was the model generalizable to new data. Unlocking the potential of biobehavioral technologies for clinical psychiatry will require careful consideration of resolution. [ABSTRACT FROM AUTHOR]

Background: Young adults with serious mental illness (SMI) are over twice as likely to smoke cigarettes than those in the general population, but little research has evaluated the efficacy of interventions for this group. While smartphone apps are a promising tool to address this need, their usability should be evaluated among young adults with psychotic disorders, whose symptoms and cognitive impairments may be a barrier to app use. Methods: We compared usability and acceptability of National Cancer Institute apps (QuitGuide and quitSTART) between young adult smokers with SMI psychotic disorders and other SMI diagnoses. We evaluated objective app usability at the initial study visit and following 2 weeks of independent use via a video-recorded task-completion protocol. Perceptions of usability and acceptability were assessed with semi-structured interviews. Engagement was assessed with backend app use data. Results: Participants had a mean age of 29 years old (SD = 4). Of the participants without psychotic disorders (n = 10), all were diagnosed with SMI post-traumatic stress disorder (SMI-PTSD). QuitGuide objective task completion rates were high and similar between diagnosis groups, whereas quitSTART task completion was initially lower among users with psychotic disorder compared to users with SMI-PTSD at Visit 1, and improved by Visit 2. Mean app interactions, mean days of use, and median completed notifications were dramatically higher among quitSTART users compared to QuitGuide users. Compared to quitSTART users with SMI-PTSD, quitSTART users with psychotic disorders had similar daily app interactions over the first week of use (mean 3.8 ± 2.4 interactions), and numerically lower mean daily app interactions during the second week (1.9 ± 1.5 vs. 3.4 ± 2.5), whereas completed notifications remained stable among quitSTART users in both diagnosis groups over time. Qualitative comments indicated general acceptability of both apps among both diagnosis groups. Conclusions: Both QuitGuide and quitSTART were usable and appealing among young adult smokers with psychotic disorders and SMI-PTSD, although quitSTART engendered a dramatically greater level of engagement compared to QuitGuide. Initial coaching to support initiation and app notifications to promote prolonged engagement may be important for young adult smokers with psychotic disorders. Replication and efficacy testing for quitSTART is warranted. [ABSTRACT FROM AUTHOR]

Mental and substance use disorders have been identified as the leading cause of global disability, and the global burden of mental illness is concentrated among those experiencing disability due to serious mental illness (SMI). Music has been studied as a support for SMIs for decades, with promising results; however, a lack of synthesized evidence has precluded increased uptake of and access to music-based approaches. The purpose of this scoping review was to identify the types and quantity of research at intersections of music and SMIs, document evidentiary gaps and opportunities, and generate recommendations for improving research and practice. Studies were included if they reported on music's utilization in treating or mitigating symptoms related to five SMIs: schizophrenia, bipolar disorder, generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. Eight databases were searched; screening resulted in 349 included studies for data extraction. Schizophrenia was the most studied SMI, with bipolar disorder studied the least. Demographics, settings, and activity details were found to be inconsistently and insufficiently reported; however, listening to recorded music emerged as the most common musical activity, and activity details appeared to have been affected by the conditions under study. RCTs were the predominant study design, and 271 unique measures were utilized across 289 primary studies. Over two-thirds of primary studies (68.5%) reported positive results, with 2.8% reporting worse results than the comparator, and 12% producing indeterminate results. A key finding is that evidence synthesis is precluded by insufficient reporting, widely varied outcomes and measures, and intervention complexity; as a result, widespread changes are necessary to reduce heterogeneity (as feasible), increase replicability and transferability, and improve understandings of mechanisms and causal pathways. To that end, five detailed recommendations are offered to support the sharing and development of information across disciplines. [ABSTRACT FROM AUTHOR]

South Asian countries report the highest prevalence of common mental disorders (CMDs) globally. This systematic review and meta-analysis report the pooled prevalence of CMDs among the South Asian countries. Database searches were conducted in eight electronic databases. Titles, abstracts, full-text screening, and extraction of data on the event rate of 17 indicators of CMDs were performed by two independent reviewers. A total of 160 studies were included and data analysis was done using the Comprehensive Meta-analysis Software (v.3). A prevalence of depressive symptoms was 26.4% among 173,449 participants, alcohol abuse was 12.9% (n = 107,893); anxiety 25.8% (n = 70,058); tobacco smoking 18.6% (n = 84,965); PTSD 17.2% (n = 42,298); mixed anxiety and depression 28.4% (n = 11,102); suicidal behaviors 6.4% (n = 25,043); misuse of opiates 0.8% (n = 37,304); tobacco chewing 21.0% (n = 10,586); use of cannabis 3% (n = 10,977); GAD 2.9% (n = 70,058); bipolar disorder 0.6% (n = 7,197); IV drug abuse 2.5% (n = 15,049); panic disorder 0.01% (n = 28,087); stimulant use 0.9% (n = 1,414); OCD 1.6% (n = 8,784) and phobic disorders 1.8% (n = 27,754). This study reported a high prevalence of CMDs in South Asian countries; necessitating further research on psychiatric epidemiology in those contexts. It informs the need for effective policymaking and implementation of culturally appropriate multilevel interventions. [ABSTRACT FROM AUTHOR]

Mental illness has become a global public health issue and according to WHO report in 2015, United Arab Emirates (UAE) recorded the highest level of depression among all countries at Eastern Mediterranean Region. Many people frequently suffer from mental health diseases but tend not to obtain help. Treatment delay can become life-threatening. This study aimed to identify the barriers to seeking professional help for mental illness and the consequences of untreated mental health disorders. The study also aimed to examine outcomes in patients when help was provided by health care providers. A self-administrated survey was distributed among 377 people randomly selected from general population of three different cities at United Arab Emirates (UAE): Abu Dhabi, Dubai and Sharjah. Their perception of the barriers, consequences and outcomes was analyzed to achieve the objectives of the study. Overall, 341 participants completed the survey. Wrong thought regarding mental disorders (60.1%) and being ashamed (58.9%) were identified to be the most common and significant barriers (P < 0.001) that prevent people from obtaining healthcare providers' assistance. The majority of responders reported building confidence (78.9%) and improvement in relationships (73.0%) as outcomes for taking professional help in mental illness. Moreover, many individuals believed that untreated mental illness could lead to problems with family and friends (69.2%) as well as to suicidal thoughts (56.3%). This research gives some insights regarding the challenges associated with mental diseases management in the UAE. Majority of responders had a negative perception of mental health service due to a lack of awareness regarding treatment effectiveness for mental disorders. [ABSTRACT FROM AUTHOR]

Background: Psychiatric illness makes overall health weaker. Different types of psychiatric illness cause various oral changes. Thus this study aimed at assessing the oral health parameters among non-institutionalized psychiatric patients of private set up. Material and method: In this cross-sectional study 250 psychiatric patients were examined. The parameters related to psychiatric illness were documented using their medical records. A structured questionnaire including demographic details, oral hygiene practices, habits, occupation, and income was used. A thorough full mouth examination was carried out to assess the oral soft tissue changes, dryness of oral cavity, plaque, gingival and periodontal status. Results: The age of the participants ranged from 21years to 70 years with a mean age of 36 years. The majority of participants were suffering from psychiatric illness like depression, schizophrenia, mood disorders and mania respectively. Majority of the participants suffering from psychiatric illness were homemakers. This study showed a link between low income population to psychiatric illness. The participants also reported oral dryness which may be partly due to psychiatric medications. Gingival and plaque index scores showed statistically significant association to presence of mental psychiatric illness. Conclusion: Subjects with psychiatric illness were having poor oral health. Dental examination should be incorporated as a part general examination. Policymakers need to consider optimal methods of intervention for mental disorders among low-income individuals. This group of patients who are making major part of the population of the society should be attended with utmost care. [ABSTRACT FROM AUTHOR]

Background: Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm in patients with reports of safety incidents. Methods: A case–control study performed in primary health care and emergency departments in Sweden. In total, 4536 patients (cases) and 44,949 controls were included in this study. Cases included patients with reported preventable harm in primary health care and emergency departments from January 1st, 2011 until December 31st, 2016. Results: Psychiatric disease, including all psychiatric diagnoses regardless of severity, nearly doubled the risk of being a reported case of preventable harm (odds ratio, 1.96; p < 0.001). Adjusted for income and education there was still an increased risk (odds ratio, 1.69; p < 0.001). The preventable harm in this group was to 46% diagnostic errors of somatic disease. Conclusion: Patients with psychiatric illness are at higher risk of preventable harm in primary care and the emergency department. Therefore, this group needs extra attention to prevent harm. [ABSTRACT FROM AUTHOR]

Background: Poor mental health of the mother affects her physical health and the neonate's health and development. Studies from Southern India place different estimates of perinatal mental ill-health. Cultural variables affect health-seeking behaviour and are thus important to study in perinatal women with psychiatric morbidity. Methods: A total of 281 perinatal women were screened on Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Mini International Neuropsychiatric Interview version 6.0 (MINI), assisted with a clinical interview to identify psychiatric illnesses. The cultural formulation interview (CFI) of DSM-5 was applied on perinatal women having psychiatric illnesses and their caregivers. Results: A psychiatric diagnosis was present in 10.3% of perinatal women. Depression and anxiety disorders were seen in 7.12% and 1.41%, respectively. Marital discord (P < 0.0001), psychosocial stressors (P < 0.0001), and past history of psychiatric disorder (P < 0.001) were significantly higher in perinatal women with a current psychiatric diagnosis. On CFI work-related stress, the gender of the infant, low education and conflict across generations were identified as the negative aspects of the culture associated with psychiatric illness during and after pregnancy. Religion and social support were the major coping strategies, while stigma and financial problems were the major barriers to help-seeking. Conclusion: The high prevalence of psychiatric disorders and the strikingly low help-seeking are noteworthy. These findings can help in planning treatment and prevention programs for timely detection and intervention for perinatal psychiatric disorders. [ABSTRACT FROM AUTHOR]

In this paper, I address the question whether mental disorders should be understood to be brain disorders and what conditions need to be met for a disorder to be rightly described as a brain disorder. I defend the view that mental disorders are autonomous and that a condition can be a mental disorder without at the same time being a brain disorder. I then show the consequences of this view. The most important of these is that brain differences underlying mental disorders derive their status as disordered from the fact that they realize mental dysfunction and are therefore non-autonomous or dependent on the level of the mental. I defend this view of brain disorders against the objection that only conditions whose pathological character can be identified independently of the mental level of description count as brain disorders. The understanding of brain disorders I propose requires a certain amount of conceptual revision and is at odds with approaches which take the notion of brain disorder to be fundamental or look to neuroscience to provide us with a purely physiological understanding of mental illness. It also entails a pluralistic understanding of psychiatric illness, according to which a condition can be both a mental disorder and a brain disorder. [ABSTRACT FROM AUTHOR]

Aim: Resilience is rapidly gaining momentum in mental health literature. It provides a new understanding of the highly variable trajectories of mental illness, and has consistently been linked with improved mental health outcomes. The present review aims to clarify the definition of resilience and to discuss new directions for the field. Methods: After discussing the definition of resilience, this narrative review synthesizes evidence that identifies the specific protective factors involved in this process. This review also addresses the mechanisms that underlie resilience. Results: Recent literature has clarified the three core components of resilience, which are the presence of an adversity or specific risk for mental illness; the influence of protective factors that supersede this risk; and finally, a subsequently more positive outcome than expected. Now that these are largely agreed upon, the field should move on to addressing other topics. Resilience is a dynamic process by which individuals utilize protective factors and resources to their benefit. It can vary within one individual across time and circumstance. It can also refer to good functional outcomes in the context of diagnosable illness. While previous research has focused on psychological resilience, it is essential that resilience is conceptualized across modalities. Conclusions: The field should move towards the development of a multimodal model of resilience. Researchers should now focus on producing empirical research which clarifies the specific protective factors and mechanisms of the process, aligning with the core concepts of resilience. This growing, more homogeneous evidence base, can then inform new intervention strategies. [ABSTRACT FROM AUTHOR]

Individuals with serious mental illness (SMI) smoke at disproportionately higher rates than those without SMI, have lifespans 25–32 years shorter, and thus bear an especially large burden of tobacco-related morbidity and mortality. Several recent studies demonstrate that smokers with SMI can successfully quit smoking with adequate support. Further evidence shows that using technology to deliver sustained care interventions to hospitalized smokers can lead to smoking cessation up to 6 months after discharge. The current comparative effectiveness trial adapts a technology-assisted sustained care intervention designed for smokers admitted to a general hospital and tests whether this approach can produce higher cessation rates compared to usual care for smokers admitted to a psychiatric inpatient unit. A total of 353 eligible patients hospitalized for psychiatric illness are randomized by cohort into one of two conditions, Sustained Care (SusC) or Usual Care (UC), and are followed for six months after discharge. Participants assigned to UC receive brief tobacco education delivered by a hospital nurse during or soon after admission. Those assigned to SusC receive a 40-min, in-hospital motivational counseling intervention. Upon discharge, they also receive up to 8 weeks of free nicotine patches, automated interactive voice response (IVR) telephone and text messaging, and access to cessation counseling resources lasting 3 months post discharge. Smoking cessation outcomes are measured at 1-, 3- and 6-months post hospital discharge. Results from this comparative effectiveness trial will add to our understanding of acceptable and effective smoking cessation approaches for patients hospitalized with SMI. [ABSTRACT FROM AUTHOR]

The established role of caregivers is to be there for their loved one in their hard times and be able to provide for their specific needs. The task is such a tedious process that it may deplete whole lot of resources of the caregiver in every aspect like physical, emotional, financial and social. The literature aims to point out at the psychological hardships a caretaker goes through while looking after the patient, which includes, depression, anxiety, stress and so on. Lack of proper knowledge with the caregivers often leads to mismanaged guardianship which increases their stress and leaves them in despair. Hence, interventions like psycho education training and Traditional Cognitive Behaviour Therapy are being carried out to help the caregivers. Literature suggests that, Psycho education training shave empowered the lives of caregivers and 8 weeks of Traditional Cognitive Behaviour Therapy Sessions have relieved the caregivers partially from stress, anxiety and depression. Though the aim of this research is to introduce a new intervention as an aid to the caregivers which is called the fourth wave of CBT, i.e., Positive Cognitive Behaviour Therapy. The biggest gaps evident from the literature are that positive CBT hasn't been used yet. It is believed that this therapy would help caregivers not only reduce symptoms of depression, anxiety and stress but would be a positive reinforcement to their well-being. Positive Cognitive Behaviour Therapy aims at helping individual's builda more ideal future for them, where they would likely be happy to see themselves. As Bannink believes that the aim of therapy should not only be reduction of symptoms but making clients work towards a brighter future which reduces the rate of relapse. [ABSTRACT FROM AUTHOR]

Genome wide association studies (GWAS) for behavioral traits and psychiatric disorders have inspired both confident optimism and withering criticism. Although many recent findings from well powered GWAS have been replicated in independent data sets, the genes identified have pinned down few if any underlying causal mechanisms. Therefore, a key issue is whether or not the genes implicated by GWAS form a coherent story on their own and thus could in principle lead to insight into the biological mechanisms underlying the trait or disorder. We sketch here four scenarios for how genes may contribute to traits and disorders; genetic studies may help elucidate mechanisms under only two of our scenarios. We also describe here an approach to characterize, in an unbiased fashion, the molecular coherence of the gene sets implicated by GWAS of various behavioral and psychiatric phenotypes and we sketch how the four scenarios may be reflected in our molecular coherence measure. [ABSTRACT FROM AUTHOR]

Keywords: psychiatric illness; South Asia; prevalence; epidemiology; common mental disorders EN psychiatric illness South Asia prevalence epidemiology common mental disorders N.PAG N.PAG 3 11/25/20 20201120 NES 201120 In the original article, there was a mistake in Table 1 B "Pooled prevalence of mental disorders in South Asia" b as published. [Extracted from the article]

For individuals living with human immunodeficiency virus (HIV), viral suppression positively affects quality and length of life and reduces risks for HIV transmission. Men of color who have sex with men (MoCSM) who have been diagnosed with HIV have disproportionately low rates of viral suppression, with concomitant increases in incidence. We identified specific social, structural, and psychiatric factors associated with viral suppression among a sample of 155 HIV-positive MoCSM. Cigarette smoking and biological markers of recent drug use were significantly associated with detectable viral load. In contrast, individuals reporting a history of psychiatric illness during medical examination were more likely to be virally suppressed. Further analyses demonstrated that psychiatric illness may affect virologic outcomes through increased probability of being prescribed HIV medications. Alternatively, cigarette smoking and drug use appear to negatively affect subsequent HIV Care Continuum milestones such as medication adherence. Findings provide support for comprehensive intervention programs that emphasize prevention and treatment of cigarette, methamphetamine, and other drug use, and promote improved connection to psychiatric care. Continual achievement of this goal may be a crucial step to increase rates of viral suppression and slow HIV incidence in communities of MoCSM in Los Angeles and other urban areas. [ABSTRACT FROM AUTHOR]

Penetrating self-inflicted injury is a mechanism that occurs with significant frequency at many trauma centers in the United States and internationally. With high rates of unemployment and growing numbers of individuals with mental illness, we expect more and more patients to present with these injuries. Additionally, there are known to be misconceptions about the seriousness of injuries that can occur when penetrating trauma is self-inflicted, especially with stab wounds. There is also often uncertainty among surgeons regarding how to treat these patients effectively in a multidisciplinary fashion while working with psychiatry services. Our goal was to review the epidemiology, mechanisms, anatomic considerations, role of substance use, and psychiatric illness in these injuries and the approach to evaluation and treatment of these patients. [ABSTRACT FROM AUTHOR]

Abstract: The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously‐used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self‐esteem is restored. When synthesized, these themes gave rise to a main theme – a sanctuary of safety – where suffering is alleviated and dignity and self‐esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients’ recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self‐esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses’ caring expertise. [ABSTRACT FROM AUTHOR]

Purpose: Pre-existing psychiatric illness, illicit drug use, and alcohol abuse adversely impact patients with orthopaedic trauma injuries. Obesity is an independent factor associated with poorer clinical outcomes and discharge disposition, and higher hospital resource use. It is not known whether interactions exist between pre-existing illness, illicit drug use and obesity on acute trauma care outcomes.Patients and Methods: This cohort study is from orthopaedic trauma patients prospectively measured over 10 years (N = 6353). Psychiatric illness, illicit drug use and alcohol were classified by presence or absence. Body mass index (BMI) was analyzed as both a continuous and categorical measure (<30 kg/m2 [non-obese], 30-39.9 kg/m2 [obese] and ≥40 kg/m2 [morbidly obese]). Main outcomes were the number of acute care services provided, length of stay (LOS), discharge home, hospital readmissions, and mortality in the hospital.Results: Statistically significant BMI by pre-existing condition (psychiatric illness, illicit drug use) interactions existed for LOS and number of acute care services provided (β values 0.012-0.098; all p < 0.05). The interaction between BMI and psychiatric illness was statistically significant for discharge to locations other than home (β = 0.023; p = 0.001).Discussion: Obese patients with orthopaedic trauma, particularly with preexisting mental health conditions, will require more hospital resources and longer care than patients without psychiatric illness. Early identification of these patients through screening for psychiatric illness and history of illicit drug use at admission is imperative to mobilize the resources and provide psychosocial support to facilitate the recovery trajectory of affected obese patients. [ABSTRACT FROM AUTHOR]

Context: Both psychiatry as a specialty and mental illnesses carry a lot of stigmatizing attitudes. Even medical professionals are not immune to prevailing stigma. Psychiatrists are perceived to have less scientific attitude, earn less money, to be less respected, and to have less prestige. Aims: The present study was designed to know the attitude of medical students with different years of exposure to medical education, toward psychiatry as a specialty. Settings and Design: The study was conducted at JLN medical College, Ajmer. The participants were divided into two groups, undergraduate and interns, respectively. It was a cross-sectional descriptive study. Materials and Methods: Self-administered sociodemographic and Attitude Toward Psychiatry-30 items questionnaires were given to the second-year and medical intern and the scores were analyzed using appropriate statistical tools. Statistical Analysis Used: Student's t-test and Chi-square test using SPSS version 21. Results: Nearly 84% of second-year medical students and 52% of interns had positive attitude toward psychiatry (P = 0.001). Only five second-year (5%) and two intern (1.8%) students affirmatively indicated to choose psychiatry as a career choice, while 73% denied choosing psychiatry as a specialty. Conclusions: Second-year medical students showed more positive attitude than the intern group. Increasing negative attitude in higher classes might be due to poor teaching of psychiatry in under graduate training, ridiculous stereotypic comments and remarks by medical teachers and practitioners belonging to other specialty branches. [ABSTRACT FROM AUTHOR]

Background: The scarcity of human organs requires the transplant community to make difficult allocation decisions. This process begins at individual medical centers, where transplant teams decide which patients to place on the transplant waiting list. Each transplant center utilizes its own listing criteria to determine if a patient is eligible for transplantation. These criteria have historically considered preexisting affective and psychotic disorders to be relative or absolute contraindications to transplantation. While attitudes within the field appear to be moving away from this practice, there is no data to confirm that eligibility criteria have changed.Main Body: There are no nationwide guidelines detailing the manner in which affective and psychotic disorders should impact transplant eligibility. Individual transplant centers thus form their own transplant eligibility criteria, resulting in significant inter-institution variability. Data from the 1990s indicates that the majority of transplant programs considered certain psychiatric illnesses, such as active schizophrenia, to be absolute contraindications to transplantation. A review of literature reveals that no comprehensive data has been collected on the topic since that time. Furthermore, the limited data available about current practices suggests that psychiatric illness continues to be viewed as a contraindication to transplantation at some transplant centers. In light of this finding, we review psychiatric literature that examines the impact of affective and psychotic disorders on transplant outcomes and conclude that the presence of these disorders is not an accurate predictor of transplant success. We then discuss the requirements of justice as they relate to the creation of a just organ allocation system.Conclusion: We conclude that transplant eligibility criteria that exclude patients with affective and psychotic disorders on the basis of their psychiatric diagnosis alone are unjust. Just listing criteria must incorporate only those factors that have a causative effect on posttransplant morbidity and mortality. Justice also demands that we eliminate current inter-institution practice variations in favor of national transplant eligibility criteria. Given the limited data available about current practices, we call for an updated study investigating the manner in which affect and psychotic disorders impact transplant eligibility determinations. [ABSTRACT FROM AUTHOR]

Background Psychological autopsy studies consistently report that the rate of detected mental disorders among suicide decedents is below 100%. This implies three possibilities: (a) a subset of suicide decedents did not have a mental disorder at the time of death; (b) all suicide decedents suffered from a mental disorder, but some were undetected due to methodological limitations; and/or (c) suicide decedents with an undetected mental disorder displayed significant and perhaps subclinical features of a mental disorder. Objective In this article, we examined these possibilities by evaluating the differences in symptoms and stressors between suicide decedents who were undiagnosed and those diagnosed with a mental disorder at the time of death. Method We reviewed 130 case studies of community-based suicide decedents originally described in Robins' (1981) psychological autopsy study. Results Without exception, suicide decedents in Robins' sample suffered either from a clearly diagnosable mental disorder or displayed features indicative of a significant, even if subclinical, presentation of a mental disorder. Undiagnosed and diagnosed suicide decedents did not significantly differ with regards to demographics, violence of suicide method, suicide attempt history, the number and intensity of stressful life events preceding death, and whether their death was a murder-suicide. Conclusion Although clearly not all who suffer from mental disorders will die by suicide, these findings imply that all who die by suicide appear to exhibit, at minimum, subclinical psychiatric symptoms with the great majority showing prominent clinical symptoms. We conclude with clinical implications and recommendations for future study. [ABSTRACT FROM AUTHOR]

Background: The concept of quality of life (QOL) has increasingly attracted the interest of healthcare providers and is considered a valid end point for assessing the overall mental health of patients and their caregivers. Instruments with psychometric and cross-cultural validity are recommended for making accurate QOL assessments. Purpose: The aim of this study was to provide further validation of the Arabic World Health Organization (WHO)QOL-BREF for use among family caregivers of relatives with psychiatric illnesses in Jordan. Of the 26 items that constitute the scale, 24 are in the domains of physical health, psychological health, social interactions, and environment. Method: Of the 328 family caregivers approached, data for 266 respondents were kept for analysis. The Arabic WHOQOL-BREF internal consistency, item internal consistency, item discriminant validity, and construct validity were evaluated. Results: The Cronbach's alpha coefficient was ≥0.7. The 24 items constituting the evaluated domains reported an item internal consistency of ≥0.4 and met the item discriminant validity criterion of having a higher correlation with its corresponding domain than with other domains. Factor analysis revealed four strong factors that constituted the same constructs as in the WHO report. Conclusions: This study ascertains further validity of the Arabic WHOQOL-BREF scale for use among family caregivers of relatives with psychiatric illnesses in Jordan. [ABSTRACT FROM AUTHOR]

Strength-based approach in dealing with persons with psychiatric illness gained more attention in the clinical setting mainly due to its unique way of addressing clients and their issues. It is a way of conceptualising and understanding people and their circumstances from the strength point of view and clinicians try to build-up from the core strengths, towards achieving client's goals. The current article focuses on the utility of strength-based approach in a case with paranoid schizophrenia and tries to bring evidence-based case discussion in this regard. [ABSTRACT FROM AUTHOR]