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Autoerythrocyte sensitization syndrome (Gardner Diamond syndrome or GDS) is a rare syndrome characterized by painful and spontaneous purpura commonly affecting adult women, and is mostly associated with psychiatric illness. Diagnosis is mainly based on clinical presentation, exclusion of other simulating diseases, and psychiatric evaluation. Only few cases have been reported till date. We report five cases of spontaneous purpura with a normal investigation profile, except for iron deficiency anemia in 1 patient, of which three had associated underlying psychiatric illness. Autoerythrocyte sensitization test was positive in all our cases. Patients presenting with painful bruises without significant medical history such as underlying bleeding disorder or drug history or history of trauma should be considered for autoerythrocyte sensitization syndrome, and managed accordingly. The present study is a case series of patients with characteristic features of autoerythrocyte sensitization syndrome, considering the rarity of the reports on its clinical spectra.

Background: A caregiver is an individual who provides assistance and assumes the responsibility for the physical and emotional needs of another individual who is incapable of self-care. Caregiver burden is a universal phenomenon and more than half of the caregivers experience burden in their role as caregivers. There is a paucity of studies to understand the burden and coping strategies of caregivers in chronic psychiatric illness and chronic medical illnesses, especially in the Indian scenario. Aims and Objectives: (i) To compare the caregiver burden in chronic psychiatric illness and chronic medical illness (ii) To compare the caregiver efficacy in chronic psychiatric illness and chronic medical illness. Materials and Methods: The study sample included caregivers of inpatients admitted in a tertiary care hospital in South India. A total of 120 caregivers were included in the study with 60 caregivers from psychiatric ward and medicine ward, respectively. The caregivers were then assessed using the Caregiver Burden Scale and the Revised Caregiver Self-efficacy Scale Results and Conclusion: We found that majority of the caregivers were first-degree relatives and women constituted a major part of the caregiver group. Caregiver burden was significantly higher in psychiatric illnesses compared to medical illnesses. Caregiver efficacy was similar in both study groups. Interventions to reduce caregiver burden and to improve caregiver efficacy should be implemented to ensure optimal management of both patient and caregiver.

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 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.

Introduction: There is paucity of case reports that describe successful non-microscopic penile reimplantation. We report a case of a self-inflicted penile amputation in an apparently normal patient with first psychotic break. Observation: To report on a case of successful macrosurgical penile reimplantation, discuss the etiologies, surgical techniques and outcomes of world literature on penile reimplantation and an update of current trends in penile surgery. A 40 year-old male, father of 3 children and a proprietor of a nursery school with no prior pschiatric disorder was rushed to our trauma centre following a self-inflicted total penile amputation at its base with incomplete laceration of the scrotum due to command hallucination. He was immediately resuscitated and underwent a non-microscopic penile reimplantation and scrotal closure by an experienced urologist (JEM) by reattaching the dorsal vein, urethra, corporal, fascial and skin layers. A functional outcome with respect to voiding, penile erection and cosmesis was excellent. Conclusion: Self-inflicted penile amputation may manifest as first psychotic break in apparently normal subjects. Though microscopic neurovascular reconstruction is the gold standard, macrosurgical reimplantation of penis by an experienced surgeon in the absence of a microscope yields satisfactory results.

Background: Severe iron deficiency is associated with anaemia, but iron deficiency with normal haemoglobin (Hb) may also affect morbidity and quality of life and contribute to psychiatric illness onset and severity. Psychiatric presentations in adolescence are often indicative of serious long-term morbidity, and addressing contributing health risk factors, such as iron deficiency, is important. Objectives: To determine rates of iron deficiency in a South African inpatient adolescent psychiatric population and possible associations between psychiatric diagnosis and iron deficiency risk factors. Methods: We conducted a retrospective chart review of all adolescent patients (13–18 years old) who were admitted to the Adolescent Psychiatric Inpatient Unit at Tygerburg Hospital (Cape Town, South Africa) during 2016. Patient records were limited to those with haemoglobin and ferritin levels available, as well as a psychiatric disorder diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The final sample consisted of 93 patients. Results: Of all participants, 7.6% were anaemic, while 22.6% were iron deficient. We found 29% of our population to have anaemia in the absence of iron deficiency. Gender was the only statistically significant correlate, with adolescent females at particular risk of compromised iron status as indicated by a low ferritin level (45% of female sample). Conclusion: Iron deficiency rates remain a relevant health concern, and testing Hb alone is inadequate to assess iron status in this population. Ferritin is a necessary additional parameter and should be included in the usual medical workup.

Background: International studies have found high rates of psychiatric comorbidity among patients with alcohol use disorders (AUDs) and highlighted the clinical and prognostic implications of this finding. There is a paucity of information with regard to the extent of this problem within the South African context. Aim: The aim of this study was to investigate the prevalence of psychiatric comorbidity (DSM IV-TR) in treatment-seeking, alcohol-dependent South Africans. Setting: This study was conducted at the Alcohol Rehabilitation Unit (ARU), Stikland Hospital, Western Cape. Methods: This cross-sectional study was conducted over a 6-month period. The Mini-International Neuropsychiatric Interview (MINI, version 5) was used to assess psychiatric comorbidity in 101 (male, n = 65; 64.5%) alcohol-dependent patients. Interviews were conducted after the first week of admission to ward 13. Results: Most participants (n = 63, 62.4%) had a co-occurring psychiatric disorder, the most common being major depressive (n = 30, 29.7%) and anxiety disorders (n = 43, 42.6%). Of the anxiety disorders, agoraphobia without a history of panic disorder (n = 10, 9.9%) and social phobia (n = 10, 9.9%) occurred most frequently, followed by generalised anxiety disorder (n = 9, 8.9%) and post-traumatic stress disorder (n = 9, 8.9%). Thirteen patients (13%) had a comorbid substance use disorder other than AUD. Conclusion: The prevalence of psychiatric comorbidity at this unit is high, especially among female patients. The findings emphasise a need to thoroughly assess patients and provide treatment and personnel who can manage the complex needs of a dual diagnosis patient population.

BACKGROUND There is an ongoing debate concerning the connection between lunar cycle and psychiatric illness. AIMS OF THE STUDY The purpose of the present study was to evaluate the rates of admission to and discharge from psychiatric inpatient treatment, as well as the length of stay, in relation to the lunar cycle, including 20 different categories of phases of the moon. METHODS The data of 17,966 cases of people treated in an inpatient setting were analysed. Routine clinical data and data about admission and discharge were used. The lunar calendar was obtained from the website of the US Naval Observatory and was used to calculate the dates of the full moon according to the geographic location of the clinics. The clinics are located in the Canton Grisons in Switzerland. The following phases of the moon throughout the lunar cycle were defined: (a) full moon, (b) quarter waxing moon, (c) new moon, and (d) quarter waning moon. In addition, we coded one day and two days preceding every lunar phase as well as the two days following the respective phases of the moon. RESULTS The lunar cycles showed no connection with either admission or discharge rates of psychiatric inpatients, nor was there a relationship with the length of stay. CONCLUSIONS Despite the widespread belief that the moon impacts peoples’ mental health and subsequently psychiatric treatment, this study provides no evidence that our celestial neighbour influences our mental well-being.

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]

The purpose of this review was to identify the problems and needs associated with school reintegration after psychiatric hospitalization. Principles outlined by the Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre) for systematic mixed studies reviews were used to search 14 electronic databases with all possible literature from inception to September 2017. Quality was appraised by two sets of two independent reviewers using an adapted version of the Mixed Methods Appraisal Tool. Fourteen studies met the inclusion criteria. The key themes revolve around the different systems of the bioecological model: the youth ontosystem, microsystems (family, school) and mesosystems (family–hospital, family–school, school–hospital). Predominant emergent themes of each system converged toward a better communication, collaboration and coordination among all concerned actors. Many problems seem to alter school reintegration after psychiatric hospitalization and different needs are still required to be met. Future research directions and implications for intervention are discussed. [ABSTRACT FROM AUTHOR]

The association between psychiatric illness and outcomes in trauma patients in general has only recently been investigated. The aim of this study was to describe the unique characteristics, risk factors, and outcomes of patients with comorbid psychiatric illness and penetrating abdominal and pelvic injuries. This was a retrospective review of trauma patients with open injuries to the abdomen and pelvis identified in the 2010-2015 the American College of Surgeons Trauma Quality Improvement Program database. Baseline variables extracted included demographics, comorbidities, including a discrete "psychiatric illness" variable that preexisted in the database, and injury information. Outcome variables collected included in-hospital mortality, length of stay and intensive care unit stay, and complications. Categorical variables were analyzed using chi-square and Fisher's exact test. Logistic regression was used to assess independent predictors for mortality with odds ratios (ORs) and 95% confidence intervals (CIs) constructed about group differences. There were 22,053 patients identified, 6.1% of whom were diagnosed with a psychiatric comorbidity. Patients with psychiatric illnesses were more likely to be aged ≥65 y (5.4% versus 3.2%, P < 0.0001), female (25.4% versus 12.4%, P < 0.0001), and have other comorbidities. Their injuries were more likely to be self-inflicted (34.9% versus 4.9%) and of a cut or piercing mechanism (33.7% versus 24.1%). Psychiatric comorbidity was an independent predictor of intensive care unit admission (OR 1.32, 95% CI 1.14-1.53) and was independently associated with decreased odds of mortality (OR 0.42, 95% CI 0.32-0.55) despite increased complication rates. The presence of a psychiatric comorbidity may be independently associated with trauma patients' complications and outcomes. Patients with psychiatric comorbidities have a unique set of risk factors and health needs that must be recognized and addressed by multidisciplinary care teams. [ABSTRACT FROM AUTHOR]

Background: Psoriasis and biologic therapies have been associated with psychiatric illnesses.Objective: To determine if persons with psoriasis or those exposed to biologics are more likely to develop a psychiatric illness.Methods: Retrospective electronic medical records cohort study.Results: Individuals with psoriasis were significantly more likely to have a history of several medical (eg, cardiovascular illnesses) and psychiatric (eg, depression, suicide) illnesses than those without psoriasis. Those with psoriasis who were prescribed a biologic therapy were significantly less likely than those with psoriasis not prescribed a biologic agent to receive a psychiatric illness diagnosis (hazard ratio for any psychiatric illness 0.52, 95% confidence interval 0.51-0.53, P < .0001). With respect to any psychiatric illness, this finding was confirmed when comparing biologic therapy versus methotrexate treatment (0.80, 95% confidence interval 0.76-0.84, P < .0001).Limitations: These findings were likely attributable to treatment selection bias.Conclusion: Individuals with psoriasis have an increased risk of several medical and psychiatric illnesses. Individuals with psoriasis prescribed biologic agents are less likely than those not prescribed biologic agents to develop psychiatric illnesses. Most likely because of treatment selection, individuals with psoriasis prescribed biologic therapy are not currently at increased risk of a psychiatric outcome. [ABSTRACT FROM AUTHOR]

Mental illness is a pressing public health concern, particularly when the onset is during childhood or adolescence. Many youth admitted to hospital-based psychiatric care experience school-related difficulties. The purpose of this report was to explore the associations of academic difficulties, school avoidance and school engagement to total psychological difficulties and emotional problems. Youth completed surveys that included standardized measures of school-related factors and the Strengths and Difficulties Questionnaire while in hospital. Psychiatrists provided the primary diagnosis and diagnosis most responsible for the current admission. In total, 161 patients participated in this study (mean age 15 years, SD 1.4; 75% female). All three school-related variables were significantly associated with emotional problems; however, only school avoidance and academic difficulties were associated with total difficulties. School-related concerns were significantly associated with the severity of mental health symptoms. Patients may benefit from attention to school-related difficulties before discharge from psychiatric care that continues beyond school reintegration. [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]

Background and Objectives  There is limited access to specialized mental health care in countries such as India with a wide treatment gap for psychiatric illnesses. Integrating mental health delivery with primary health-care services is vital. The clinical schedules for primary care psychiatry (CSP) was designed for training primary care doctors (PCDs) to identify and diagnose psychiatric illness in patients presenting to primary care settings. This study aims to study the validity and reliability of the CSP and its hypothesis is that the CSP would help PCDs to identify psychiatric caseness. Methods  The study was conducted at three primary health centers of Karnataka. Consented PCDs were briefly trained in the use of CSP and screened patients who were later interviewed by a psychiatrist using a semistructured interview and confirmed by International Statistical Classification of Diseases and Related Health Problems 10th edition (ICD-10) symptom checklist. The appropriate statistical analysis was performed. Results  A total of 180 patients were included. Agreement was found between diagnoses made by PCDs and psychiatrist for 142 (78. 9%) patients with a Cohen's kappsychiatry pa (K) = 0. 57. The sensitivity was 91. 1% and specificity was 68. 3%. The interrater reliability showed K = 0. 7. Conclusion  The CSP helps PCDs to make psychiatric diagnoses. It has a relatively high sensitivity with reasonably high specificity but mayneed clinical training. [ABSTRACT FROM AUTHOR]

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Much of what Western medicine classifies as psychiatric illness is understood by Tibetan thought as associated with imbalance of rlung (wind, breath). Rlung has a dual origin in Indian thought, combining elements from Ayurvedic medicine and Tantric Buddhism. Tibetan theories of rlung seem to correspond in significant ways with Western concepts of the autonomic nervous system (ANS), and Western medicine too has associated psychiatric issues with ANS problems. But what is involved in relating Tibetan ideas of rlung to Western ideas of the emotions and the ANS? The article presents elements of the two systems and then explores similarities and differences between them. It asks whether the similarities could be the basis for a productive encounter between Tibetan and Western modes of understanding and treating psychiatric illness. What could Western psychiatry learn from Tibetan approaches in this area? [ABSTRACT FROM AUTHOR]

Abstract Takotsubo syndrome (TS) is a condition of transient regional ventricular systolic dysfunction, usually presenting with acute chest pain and/or dyspnea, that is increasingly recognized especially in post-menopausal women following a psychological or physical stress. Initially considered as a benign condition with an isolated and self-limiting episode, it is now recognized that it is associated with a significant risk of in-hospital mortality and of recurrence. We herein describe a case of a 61-year-old female with left ventricular non-compaction cardiomyopathy (LVNC) who experienced a recurrence of TS, highlighting the potential pathophysiological role for LVNC in predisposing this syndrome and its recurrence. Moreover, we underscored possible therapeutic implications deriving from this case. Highlights • Takotsubo syndrome (TS) is an acute form of neurocardiogenic stunning. • Altered autonomic-limbic processing supports brain-heart axis in TS. • Sympathetic activation with catecholamine release, causes myocardial toxicity and/or coronary microvascular dysfunction. • Left ventricular non-compaction cardiomyopathy (LVNC) is a rare disease characterized by a subverted myocardial architecture. • LVNC may predispose to TS because associated with coronary microvascular and autonomic dysfunction. [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]

Copyright of Psychiatria Hungarica is the property of Hungarian Psychiatric Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The advent and uptake of effective antiviral therapies has transformed HIV/AIDS into a chronic manageable illness. The majority of Americans living with HIV are now ages 50 and older. Given the confluence of aging and HIV, chronic pain among older persons living with HIV/AIDS (PLWHA) has emerged as an area of clinical importance. Treatment of pain among this population is complex due to the prevalence of substance abuse and psychiatric illness in the population as well as the challenges of disentangling how inflammation associated with aging and HIV interact to predispose pain. Through a review of the extant literature we examine the complex associations between substance use, mental health, psychosocial issues, and chronic pain using a biopsychosocial framework in order to provide a means of addressing the aging-chronic pain link in older PLWHA. Using this frame, we then consider treatment implications for the population. [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]

Background: This is an analytical-descriptive study aimed to evaluate the relations of self-esteem, demographic variables, psychiatric diagnosis, and Frequency of hospitalization with mental illness stigma in psychiatric patients of Ghods hospital of Sanandaj, 2014. Method: Among all patient who have the inclusion criteria, those who admit informed consent (152 participant), complete questionnaires and other needed information’s. Then other necessary data’s were gives from the psychiatric documentations of the patients. Measures are Rosenberg’s self-esteem Scale, Stigma scale. The 20th version of SPSS software was used to analyzing data’s and it did through these statistical analyses: Pearson’s Coloration Coefficient, independent T test, and One-way ANOVA. Findings: The results shows that it doesn’t any significant relations between age, gender, vocation, psychiatric diagnosis, duration and also frequency of hospitalization with stigma of mental illness but a significant negative correlation (-0/42) find between self-esteem and stigma. Conclusion: It seems that stigma is a cultural variable and has a little associations with variables such as age, gender, vocation, psychiatric diagnosis, duration and also frequency of hospitalization. It may be that have other determinants that correlated with negative self-esteem.

Introduction: Chronic diseases are diseases that affect the quality of life of the person for three months or longer and are an important factor in deaths in the COVID-19 pandemic. The data obtained suggested that the disease is more common and more mortal in individuals with chronic diseases. Among the risk factors are advanced age, male gender, chronic diseases such as diabetes (DM), chronic obstructive pulmonary disease (COPD), hypertension (HT), coronary artery disease (CAD). Studies evaluating patients with psychiatric diagnoses as potential risk factors for COVID-19 are limited. Materials and Methods: The study was conducted between 10.05.2021 and 10.11.2021, in the adult anesthesia intensive care unit of a pandemic hospital, with 20 cases [20% (n=4) female and 60% (n=16) male] in total. Patients were evaluated in two groups as psychiatry-normal population. Ethics committee approval decision numbered (2021-07-26) was taken from Bakırköy Dr. Sadi Konuk Training and Research Hospital Ethics Committee. Results: In our study, there was no increase in mortality in psychiatric disorders in COVID-19 patients. According to APACHE, the expected mortality in psychiatric patients was 30.5%, the actual mortality was 30%, while the expected mortality in the normal population was 14%, the actual mortality was calculated as 50%. Again, although it was not statistically significant in psychiatric patients, the number of days on which they were connected to the ventilator and the number of days of hospitalization in the intensive care unit were calculated to be low. In our study, there was no statistically significant difference in lymphocyte, D-dimer, Fibrinogen, CRP, Ferritin, Procalcitonin values, horowit ratio, PO2 and PCO2 values between the groups. Conclusion: The high mortality rate of psychiatric patients was reported by Bell in 1849, and it was observed that sudden death rates were higher than the general population. In 2009, Amy Kilbourne et al. They observed that patients with mental disorders had a higher rate of heart disease and the age of death was 25 years earlier than the normal population. In our study, we observed that psychiatric comorbidities did not increase mortality negatively, unlike other chronic diseases, but due to the limited number of cases, more studies are needed on this subject. [ABSTRACT FROM AUTHOR]

Therapeutic outcome of Wilson's disease significantly depends upon its early recognition. As Wilson's disease is a rare disorder with protean manifestations, its diagnosis and subsequent treatment are often delayed. We elaborate here the case of a young boy who had initially presented with psychiatrc symptoms suggestive of dissociative fugue followed by withdrawn behaviour and was treated by a psychiatrist with minimal response. This was associated with symptoms of tremors, hypersalivation, and slowness of movements. This case highlights the delay in diagnosing Wilson's disease when faced with the case of a young adult with psychiatric manifestations. It is extremely important for physicians, psychiatrists and health professionals at primary care level to recognize and diagnose this treatable disease at an early stage.

Background: The relationship between skin diseases and psychiatric illnesses is bi-directional and is manifested as cause and effect. Psychiatric disorders such as stress, anxiety, and depression are seen to be instrumental in the development and progression of dermatological diseases on one hand, while on the other hand, cosmetic disfigurement caused by dermatological diseases is responsible for psychological distress in patients. The present study was conducted to investigate the spectrum of dermatological disorders in psychiatric patients to offer them holistic treatment and provide them with a better quality of life., Methods: This cross-sectional, observational study was conducted at a tertiary medical care center. A total of 170 psychiatric patients referred to the dermatology department for different dermatological manifestations were enrolled in the study. A demographic profile of the patients was done, and an association between dermatological diseases and psychiatric illnesses was done., Results:  Out of 170 study participants, 88 (51.8%) were females, and the rest (82, 48.2%) were males. A total of 13 major types of dermatological conditions were noted; among them, fungal infection (43, 25.3%) was the most common, followed by eczema (18, 10.6%), parasitic infestation (17, 10.0%), pigmentary disorder (13, 7.6%), acne (11, 6.5%), bacterial infection (11, 6.5%), pruritic disorder (11, 6.5%), hair disorder (9, 5.3%), drug reaction (9, 5.3%), papulosquamous disorder (7, 4.1%), and viral infection (6, 3.5%). Skin conditions other than the above-mentioned were present in 15 (8.8%) patients. The most common psychiatric illness in the present study was major depressive disorder (41, 24.1%), followed by generalized anxiety disorder (38, 22.4%) and psychosis not otherwise specified (34, 20.0%). Other psychiatric illnesses included in the study were bipolar affective disorder (22, 12.9%), schizophrenia (18, 10.6%), obsessive-compulsive disorder (12, 7.1%), and mixed anxiety depressive disorder (5, 2.9%)., Conclusion: The findings of the present study depict that psychiatric patients with dermatological manifestations show a spectrum of dermatological conditions, primarily of infectious (fungal, parasitic, or viral) nature. This might be associated with a relatively poor hygienic status of psychiatric patients and thus their increased susceptibility to these disorders. Most of the time, the susceptibility to these skin conditions seemed to be opportunistic and unaffected by the type, duration, and level of control of psychiatric illness., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Tripathi et al.)

Patients frequently present to the emergency department (ED) with acute suicidal and homicidal thoughts. These patients require timely evaluation, with determination of disposition by either voluntary or involuntary hospitalization or discharge with appropriate outpatient follow-up. Safety concerns should be prioritized for patients as well as ED staff. Patient dignity and autonomy should be respected throughout the process., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and M&eacute;tis), 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.