Relevant bibliographies by topics / Psychiatric care

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Psychiatric care'

Author: Grafiati
Published: 4 June 2021
Last updated: 29 January 2023

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Journal articles on the topic "Psychiatric care"

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Agyapong, Vincent I. O. "Continuing Care for Mentally Stable Psychiatric Patients in Primary Care: Patients' Preferences and Views." International Journal of Family Medicine 2012 (July 11, 2012): 1–5. http://dx.doi.org/10.1155/2012/575381.

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Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.
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Agyapong, V. I. O., T. B. Thekiso, and A. Guerandel. "The discharge of patients with enduring mental health problems into primary care: Patients’ preferences and views." European Psychiatry 26, S2 (March 2011): 1696. http://dx.doi.org/10.1016/s0924-9338(11)73400-9.

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ObjectivesTo investigate the preferences of psychiatric patients regarding attendance for their continued mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting.Methods150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semi-structures questionnaire designed to assess the objectives of the study.Results145 patients completed the questionnaire giving a response rate of 97%. The majority of patients had a general practitioner (GP, 132, 94.3%) and most attended their GP every 3 months (68, 48.6%). Ninety-eight patients (70.0%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason was fear of substandard quality of psychiatric care from their GPs (68.4%), followed by inability to afford a GP appointment (23, 23.5%) and not having a GP (9, 9.2%). Thirty two patients (22.9%) preferred to attend their GP. Reasons for this included confidence in GPs providing same level of care as psychiatrist for mental illness (18, 56.3%), the advantage of managing both mental and physical health by GPs (13, 40.6%) and less stigma (28.1%).ConclusionAlthough most patients attended their GP more frequently than the psychiatry clinic, they preferred attending specialized psychiatric services once mentally stable than primary care with most reasons revolving around fears of inadequate psychiatric care from GPs.
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Bastiaens, Lucie. "alternatief voor het krankzinnigengesticht? Psychiatrische zorg in Maastricht en de lange aanloop naar een bureau voor psychiatrische voor- en nazorg (1937)." Studies over de sociaaleconomische geschiedenis van Limburg/Jaarboek van het Sociaal Historisch Centrum voor Limburg 65 (December 2, 2022): 76–107. http://dx.doi.org/10.58484/ssegl.v65i.12886.

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The care for psychiatric patients outside mental asylums developed in the Netherlands during the first decades of the twentieth century. In Maastricht, a psychiatric pre- and after care facility opened in 1937, but little is known about its history. This paper attempts to unravel this history and analyses to what extent causes which stimulated psychiatric care outside the mental asylum on a national level also played a role in Maastricht. It becomes clear that Maastricht had its own local dynamic; overcrowding of the mental asylum was never an issue here, growing costs of hospitalization in mental asylums did not encourage the local government in Maastricht to search for alternatives and due to the absence of a psychiatrist no new perspectives on hospitalization and psychiatric care in society came into being. Furthermore, it is likely that family members and philanthropic associations played an important role in taking care of and supporting psychiatric patients. It thus seems that in Maastricht there was no strong sense of urgency or need to develop new forms of psychiatric care outside the mental asylum. The provincial cross society initiated a psychiatric pre- and after care facility. This however could only be realized because of the presence of a psychiatrist in Maastricht since 1936, who supported this new facility. The Maastricht ‘case’ broadens our view and understanding of the development of psychiatric care in society in the Netherlands.
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Frey, R., D. Winkler, A. Naderi-Heiden, S. Strnad, E. Winkler-Pjrek, J. Scharfetter, and S. Kasper. "JS02-01 - Psychiatric intensive care." European Psychiatry 26, S2 (March 2011): 1999. http://dx.doi.org/10.1016/s0924-9338(11)73702-6.

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Psychiatric disorders per se or treatment resistance can cause life-threatening conditions. More than 25 years have passed since the term “psychiatric intensive care unit” (PICU) was introduced in the United Kingdom. This system is comprised of security units for psychiatric patients with suicidal or violent behaviour, providing a locked environment with more resources regarding personnel and care. The PICU concept at the Department of Psychiatry and Psychotherapy in Vienna, Austria, represents a progress towards optimal care of patients with serious psychiatric illnesses who also have critical somatic illnesses. One third of the patients are transferred from inpatient facilities of medical departments such as internal medicine, emergency medicine, trauma surgery or anesthesiology. Our PICU is dedicated to somatically, critically ill patients who have psychiatric symptoms (e.g., agition, aggression, impulsivity, delusions, catatonia, confusion, reduced consciousness, impaired self-reliance) complicating recovery from their critical, somatic condition. Generally, the dosages for antipsychotics are not higher than those at normal psychiatric wards. Benzodiazepine dosages of about 30mg diazepam equivalents per day are frequently used. In the years 2008 and 2009, 10% of all patients at the Viennese PICU were treated with electroconvulsive therapy. Delirium requires immediate therapy of underlying intracerebral pathologies, extracerebral illnesses or toxic features. Involuntary commitment, physical restraints and urinary catheterization were applied in approximately 50% of the patients, nasogastric tube or central venous catheter in 20%. In every case, intensive care nursing, monitoring of vital functions and specific experience at the interface between psychiatry and somatic medicine are required.
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Mitchell, A. R. K. "Participating in primary care." Psychiatric Bulletin 13, no. 3 (March 1989): 135–37. http://dx.doi.org/10.1192/pb.13.3.135.

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Traditionally, general practitioners and psychiatrists relate to one another through a system of cross referrals, from primary care to secondary care and back again, the referral being initiated by the GP through a request for a domiciliary visit or more usually for an out-patient assessment of the clinical problem. However, in the mid-1960s, individual psychiatrists began to report a new way of working, which consisted of the psychiatrist going by invitation into GPs' surgeries or health centres to work directly with the general practitioners and with other members of the primary health care team. A survey undertaken by Strathdee & Williams of the General Practice Research Unit of the Institute of Psychiatry, showed that by 1984 in England and Wales, one psychiatric consultant in five, sometimes with, sometimes without, junior staff, spent some time in a general practice setting. At the College meeting in Cambridge (April 1988), Pullen reported that in Scotland a similar survey showed that as many as 40 to 50% of psychiatric consultants spent some time in primary care settings.
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Beber, Elizabeth, Nicola M. Bailey, and Sally-Ann Cooper. "Health gain for epilepsy associated with learning disabilities psychiatric care." Irish Journal of Psychological Medicine 16, no. 2 (June 1999): 46–50. http://dx.doi.org/10.1017/s0790966700005140.

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AbstractObjectives: The establishment of a learning disabilities psychiatric service for people living in north Northamptonshire presented the opportunity to measure the clinical effectiveness of epilepsy care provided by learning disabilities psychiatrists.Method: Baseline and one year outcome health measurements were made on a group of adults with learning disabilities and epilepsy who received learning disabilities psychiatric care (n = 42), and also on a group of adults with learning disabilities and epilepsy who did not receive care from learning disabilities psychiatry -(n = 12). Comparisons were made between baseline and outcome measurements for those who did, compared to those who did not receive psychiatric care. The comparison group was included as conducting a baseline health assessment may itself improve the quality of healthcare by raising awareness of the issue (in a way that is unconnected to care provided by the psychiatrist).Results: Learning disabilities psychiatric care was found to effect reduced seizure frequency, with a reduced frequency of drug side-effects and reduced frequency of polypharmacy. The type of the person's seizures was more likely to be determined, medical reviews and appropriate blood test monitoring conducted and active interventions made to improve seizure control and to withdraw unnecessary drugs, if the person was receiving learning disabilities psychiatric care. Almost all of these results were highly statistically significant.Conclusion: It is important that learning disabilities psychiatric care is available to this group, as it has been demonstrated to effect health gain.
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Farhat, Nada M., Jolene R. Bostwick, and Stuart D. Rockafellow. "Improving Ambulatory Care Resident Training: Preparing for Opportunities to Treat Mental Illness in the Primary Care Setting." Journal of Pharmacy Practice 31, no. 5 (September 11, 2017): 497–502. http://dx.doi.org/10.1177/0897190017729598.

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Purpose: The development of an outpatient psychiatry clinical practice learning experience for PGY2 ambulatory care pharmacy residents in preparation for the treatment of psychiatric disorders in the primary care setting is described. Summary: With the increased prevalence of psychiatric disorders, significant mortality, and limited access to care, integration of mental health treatment into the primary care setting is necessary to improve patient outcomes. Given the majority of mental health treatment occurs in the primary care setting, pharmacists in patient-centered medical homes (PCMHs) are in a unique position with direct access to patients to effectively manage these illnesses. However, the increased need for pharmacist education and training in psychiatry has prompted a large, Midwestern academic health system to develop an outpatient psychiatry learning experience for PGY2 (Postgraduate Year 2) ambulatory care pharmacy residents in 2015. The goal of this learning experience is to introduce the PGY2 ambulatory care residents to the role and impact of psychiatric clinical pharmacists and to orient the residents to the basics of psychiatric pharmacotherapy to be applied to their future practice in the primary care setting. Conclusion: The development of an outpatient psychiatry learning experience for PGY2 ambulatory care pharmacy residents will allow for more integrated and comprehensive care for patients with psychiatric conditions, many of whom are treated and managed in the PCMH setting.
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Brittlebank, Andrew. "Strain and stress in palliative care." Psychiatric Bulletin 16, no. 5 (May 1992): 282–83. http://dx.doi.org/10.1192/pb.16.5.282.

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The Royal College of Psychiatrists' Guidelines for Training in Liaison Psychiatry (1988) recommend that trainee psychiatrists have the opportunity of working closely with an individual ward or department. Such an attachment may involve the trainee psychiatrist in staff support. This paper describes the involvement of a psychiatric trainee in the development of support structures in a hospice during a liaison attachment. The project not only shed light on the causes of staff strain in palliative care settings, but also provided an opportunity to participate in management.
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Butler, Dennis J., Dominique Fons, Travis Fisher, James Sanders, Sara Bodenhamer, Julie R. Owen, and Marc Gunderson. "A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting." International Journal of Psychiatry in Medicine 53, no. 5-6 (August 22, 2018): 415–26. http://dx.doi.org/10.1177/0091217418791456.

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A significant percentage of patients with psychiatric disorders are exclusively seen for health-care services by primary care physicians. To address the mental health needs of such patients, collaborative models of care were developed including the embedded psychiatry consult model which places a consultant psychiatrist on-site to assist the primary care physician to recognize psychiatric disorders, prescribe psychiatric medication, and develop management strategies. Outcome studies have produced ambiguous and inconsistent findings regarding the impact of this model. This review examines a primary care-embedded psychiatric consultation service in place for nine years in a family medicine residency program. Psychiatric consultants, family physicians, and residents actively involved in the service participated in structured interviews designed to identify the clinical and educational value of the service. The benefits and limitations identified were then categorized into physician, consultant, patient, and systems factors. Among the challenges identified were inconsistent patient appointment-keeping, ambiguity about appropriate referrals, consultant scope-of-practice parameters, and delayed follow-up with consultation recommendations. Improved psychiatric education for primary care physicians also appeared to shift referrals toward more complex patients. The benefits identified included the availability of psychiatric services to underserved and disenfranchised patients, increased primary care physician comfort with medication management, and improved interprofessional communication and education. The integration of the service into the clinic fostered the development of a more psychologically minded practice. While highly valued by respondents, potential benefits of the service were limited by residency-specific factors including consultant availability and the high ratio of primary care physicians to consultants.
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Amin, Malik Awais, Muhammad Kamran, Shehzad Rauf, Sumaira Bukhsh, Isbah Gul, and Ahmed Shoaib Tabassum. "PSYCHIATRIC DISORDERS IN CHILDREN: PATTERN AND CORRELATES AMONG THOSE REPORTING TO A TERTIARY CARE HOSPITAL." PAFMJ 71, no. 3 (June 30, 2021): 924–28. http://dx.doi.org/10.51253/pafmj.v71i3.2527.

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Objective: To determine the pattern of psychiatric disorders among children reporting to the Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi. Study Design: Comparative cross sectional study. Place and Duration of Study: Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi, from Feb to Aug 2018. Methodolgy: A total of 100 children, aged between 6-12 years of age, both male and female, meeting the selection criteria of the study, presenting to the Psychiatry department at Pakistan Naval Ship Shifa Hospital, were enrolled for this study. Informed consent was taken from the parents. The consultant psychiatrist interviewed the patients and diagnosed any psychiatric disorders based on international classification of diseases version 10. The data was recorded on the study proforma. Results: Out of a total of 100 children, 66 (66%) were male, while 34 (34%) were female. The mean age of the participating children was 8.66 + 1.97 years. The most common psychiatric disorder was attention deficit hyperactivity disorder 44 (44%), followed by depression 30 (30%). Other diagnoses included oppositional defiant disorder 12 (12%), conduct disorder 9 (9%) and separation anxiety disorder 5 (5%). Conclusion: Attention deficit hyperactivity disorder and depression are amongst the quite prevalent psychiatric disorders, than that was considered earlier.
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Dissertations / Theses on the topic "Psychiatric care"

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Omérov, Majda. "Violence in psychiatric inpatient care /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-850-5/.

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Brown, Christine S. H. "Pathways into High Security Psychiatric Care." Thesis, University of Exeter, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486662.

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Bekele, Yilma Yitayew. "Pathways to psychiatric care in Ethiopia." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/10132.

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Includes bibliographical references.
It is recognized that the pathways patients take en route to psychiatric services vary between countries and socio-cultural groups. Delay along the pathway to care is not a mere reflection of organization of health care and referral systems but also of availability and accessibilty of services. Studies have shown associations between delay and various sociodemographic, clinical and service related factors. Understanding the pathway to psychiatric care, and recognition od delay points along the pathway, is a crucial step for the development of intervention programs geared at improving the provision of mental health care.
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Vaaler, Arne E. "Effects of a Psychiatric Intensive Care Unit in an Acute Psychiatric Ward." Doctoral thesis, Norwegian University of Science and Technology, Department of Neuroscience, 2007. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-1190.

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The psychiatric acute departments are intensive units serving patients with a broad spectrum of psychiatric conditions. Patients with the most florid psychiatric symptoms are admitted to Psychiatric Intensive Care Units (PICUs). These units are supposed to provide the necessary diagnostic and acute therapeutic help, control inappropriate behaviours, and provide the services in an environment which assists the patients’ recovery and is acceptable to patients, health workers and the general society. PICUs are criticised for poor environments, high levels of coercion and lack of evidence base from controlled trials or post occupancy evaluations. Long term studies of the rate of seclusion indicate no decrease in spite of changing political attitudes and hospital environments. There is a need fo new methods to treat violent or threatening incidents in psychiatric wards. Norwegian PICUs use segregation nursing with the patients placed in separately locked areas with staff. This model may be an alternative to seclusion. Controlled trials regarding effects of principles and facilities for such treatment are lacking. The general aim of the present study was to investigate effects of facilities for segregation, and several assumed risk factors in a Norwegian PICU.

The current thesis is based on data from 118 consecutively admitted patients to the PICU at St. Olavs University Hospital, Trondheim, Norway. The thesis has the following conclusions:

Main conclusions

1: Interior and furnishing like an ordinary home in the PICU create an environment with comparable treatment outcomes to the traditional dismal interior and has positive effects on many patients’ well being. Patient selfrating were significantly in favour of the ordinary home interior compared to the traditional interior

2: The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents. The changes in assessments of behaviour measured by differences in BVC ratings from baseline (admittance) to day 3 were significantly in favour of segregating the patients in the PICU compared to not segregating the patients in the same area. There were significantly lower reported incidents of violent or threatening incidents when using the PICU as a segregation area compared to not using the PICU as a segregation area.

3: In PICUs substance use is associated with favourable outcomes compared to patients not using substances. There was a significant difference in the changes of GAF-S –symptom ratings from admittance (baseline) to day three between the patient groups with or without a substance use diagnosis. The largest increase was in the patient group with a substance use diagnosis indicating more reduction of symptoms.

4: Threatening and violent incidents are not common acute manifestations of recent substance use in PICU populations. There was no significant difference in the number of threatening or violent incidents between the patient groups with or without a substance use diagnosis.

5: Substance use predicts shorter length of inpatient stay in PICU populations. The mean length of stay in the PICU was significantly shorter in the patient group with a substance use diagnosis compared to the patient group without a substance use diagnosis.

6: In PICUs prediction of short-term aggressive and threatening incidents should be based on clinical global judgement, and instruments designed to predict short-term aggression in psychiatric inpatients. In the hierarchical multiple linear regression analysis the global clinical evaluation from the physician on duty, the nurse clinicians’ global evaluation of “intensity of testing out and pushing limits”, and the observer rated scale scoring behaviours predicting imminent violence in psychiatric inpatients (BVC), were the factors positively associated with short-term threatening and violent incidents.

7: The predictive properties for BVC in the PICU-setting are satisfactory for the first three days after a single rating at admittance.

Additional conclusions:

1: Patients who have experienced segregation settings like seclusion have desires for alternative treatment conditions. These desires are to a large extent met by Norwegian PICUs. These PICUs are effective.

2: In the architecture and design of PICUs it is important to take into consideration the possibilities for segregation of patients.


Paper III reprinted with kind permission of Elsevier ScienceDirect.com
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Thomas, Benjamin Lawrance. "The improvement of care planning documentation in acute psychiatric care." Thesis, King's College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405733.

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Daremo, Åsa. "Participation in occupational therapy in psychiatric care /." Linköping : Department of Social and Welfare Studies, Linköping University, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-53776.

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Daremo, Åsa. "Participation in occupational therapy in psychiatric care." Licentiate thesis, Linköping University, Linköping University, Department of Social and Welfare Studies, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-53776.

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One of the most important challenges of health and medical care is to strength the role of the patient in the treatment. In psychiatric care the patient must be seen as a resource and should be given the opportunity to participate in his treatment. The overall aim of the thesis was to investigate and describe how patients in psychiatric care perceive participation, and how existing assessments support participation.

Study I describes how patients in psychiatric institutional care perceived their opportunities to be active and to participate in their own treatment. The ICF (International Classification of Functioning Disability and Health) inspired the study. By means of a questionnaire, 61 patients reported their opinions of the value of received care, highlighting concepts such as activity and participation. Ten of those patients were then selected for a semi-structured interview. The study showed that patients who were treated according to compulsory care (LPT) were generally more dissatisfied with their opportunities to be active and participate in their own care than patients treated according to the law of health and medical care (HSL). Younger patients in particular were more dissatisfied. Some important factors in the environment were continuity and reception from the staff. Facilitating factors for activity and participation were agreement between patient and staff about the treatment plan, discussions about expectations, and creating conditions for engagement in activities and or responsibility.

Study II investigates if there is harmony between the CPRS-S-A (Comprehensive Psychopathological Rating Scale-Self-Assessment), the OCAIRS–S (Occupational Circumstances Interview and Rating Scale) and the OSA (Occupational Self Assessment), and if they can replace each other when the occupational therapist collects information about the patient. Another aim was to investigate how occupational therapist uses the collected information in the treatment plan process. Fourteen patients with depression disorders took part in the study. The study showed that even if the symptoms of the disease were improved at the end of the treatment period the patients still had problems with occupational performance, reduced self-confidence and the structure of their day. Consequently the assessments cannot replace each other. The study emphasized the importance of using both interview and self-assessments when collecting information about the patient, since these methods complement each other in identifying the needs and goals of the treatment. Many problems were related to the patient’s social environment but this was not reflected in the treatment plan; few goals were identified in this area.

In conclusion, occupational therapists should use self-assessments and interviews in order to support the patient’s participation in psychiatric care. Furthermore, it is important to use assessments for both occupational performance and medical symptoms when identifying the patient’s needs and goals of treatment since there is a discrepancy between the two areas; symptoms are reduced earlier than perceived problems in occupational performance. Regardless of what kind of law the patient is treated under, all patients have the right to participate in their own treatment. This thesis also shows that the social environment is important in enabling the participation of patients in their psychiatric care.


En av de viktigaste utmaningarna inom hälso- och sjukvården är att stärka patientens ställning i behandlingen. Inom psykiatrisk vård så måste patienten ses som en resurs och ges möjlighet att vara delaktig i sin behandling. Det övergripande syftet med denna avhandling var att undersöka och beskriva hur patienter inom psykiatrisk vård uppfattar delaktighet och hur existerande instrument stödjer delaktighet.

Studie I beskriver hur patienter inom psykiatrisk slutenvård uppfattar sina möjligheter till aktivitet och delaktighet under vårdtiden. ICF (Klassifikation av funktionstillstånd, funktionshinder och hälsa ) inspirerade studien. Genom en enkät svarade 61 patienter på värdet av den vård som de erhöll, där begrepp som aktivitet och delaktighet belystes. Tio patienter valdes sedan ut för en semistrukturerad intervju. Studien visar på att patienter som vårdats utifrån Lagen om Psykiatrisk Tvångsvård (LPT) var generellt mer missnöjda än de patienter som vårdats utifrån Hälso- och Sjukvårdslagen (HSL). Även yngre patienter var mer missnöjda. Några viktiga faktorer i miljön som påverkar möjlighet till delaktighet var kontinuitet och bemötande från personalen. Underlättande faktorer för aktivitet och delaktighet var att det fanns en samstämmighet mellan patient och personal i vårdplaneringen, att förväntningar diskuterades, att förutsättningar till engagemang i aktiviteter gavs och att patienten fick möjlighet att ta eget ansvar.

Studie II undersöker om det finns harmoni mellan CPRS-S-A (Comprehensive Psychopathological Rating Scale-Self-Asessment), OCAIRS-S (Occupational Circumstances Interview and Rating Scale) och OSA (Occupational Self Assessment) och om de kan ersätta varandra när arbetsterapeuten samlar information kring patienten. Ett annat syfte var att undersöka hur arbetsterapeuten använder den insamlade informationen i behandlingsplanen. Fjorton patienter med depressionssjukdom deltog i studien. Studien visar att även om de medicinska symptomen förbättras i slutet av behandlingen så har patienten fortfarande problem i aktivitetsutförande, nedsatt självkänsla och struktur på dagarna. Bedömningsinstrumenten kan inte ersätta varandra. Studien betonar vikten av att använda både intervju och självskattning vid datainsamling kring patienten, då de kompletterar varandra vid identifiering av behov och mål i behandlingen. Många problem var relaterade till patientens sociala miljö, dock saknades detta i behandlingsplanerna; få mål och åtgärder identifierades inom detta område.

Sammanfattningsvis, arbetsterapeuten bör använda självskattningar och intervjuer i syfte att stödja delaktighet inom psykiatrisk vård. Dessutom är det betydelsefullt att använda bedömningsinstrument både för aktivitetsutförande och medicinska symptom för att identifiera patientens behov och mål i behandlingen då det är en diskrepans mellan dessa två områden; medicinska symptomen reduceras tidigare än upplevda problem i aktivitetsutförandet. Oavsett vilken lag som styr vårdformen så har alla patienter rätt till delaktighet i sin egen behandling. Denna avhandling visar också på att den sociala miljön är viktigt för delaktighet för patienter inom psykiatrisk vård.

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Timlin, U. (Ulla). "Adolescent's adherence to treatment in psychiatric care." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526208039.

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Abstract The purpose of this study was to investigate treatment adherence among adolescents receiving mental health care, with a special focus on psychiatric inpatient treatment. Key goals were to derive a general definition of adherence suitable for this purpose and to assess adolescents’ adherence to medication and non-pharmacological treatments. This study had two phases; phase one involved conducting systematic literature reviews, and phase two was based on empirical research in which data were collected by analyzing notes on hospital patients. The aim of the reviews were to review current research evidence into treatment adherence in adolescents and factors relating adherence among adolescents receiving mental health care (original publication n=15 and original publication n=17). Phase two was part of a clinical follow-up project called STUDY-70 conducted at the Department of Psychiatry at Oulu University Hospital in Finland. This phase yielded two further original publications – papers III and IV. Paper III examined adherence among adolescents receiving psychiatric inpatient care (n=72), focusing on both medication and non-pharmacological treatments. Paper IV examined factors affecting treatment adherence among these 72 inpatient adolescents, including family- and clinic-related variables. The systematic reviews demonstrated that many different definitions of adherence have been used in the literature. A concept synthesis was applied to these definitions to establish a basis for empirical research. The main factors that were found to correlate positively with treatment adherence among adolescents were the patients’ own will to be treated and positive sentiments, but family also played an important role. Factors that correlated negatively with adherence included negative feelings, a lack of cooperation with treatment, and adverse mental symptoms. Adolescent who has received special support at school was found to favor treatment adherence, whereas involuntary treatment, self-mutilative behavior and a close maternal relationship were all linked to non-adherence. Treatment adherence is an ongoing process, and achieving high levels of adherence should be an important goal in all treatment processes. It is important for clinical staff to be aware of factors influencing adherence in order to support the provision of effective and high-quality care for adolescents
Tiivistelmä Tutkimuksen tarkoituksena oli selvittää mielenterveyspalveluita käyttävien nuorien hoitoon sitoutumista ja erityisesti psykiatrisessa osastohoidossa olevan nuoren sitoutumista hoitoon. Keskeisinä tavoitteina oli kuvata hoitoon sitoutumisen määrittelyä ja arvioida nuoren sitoutumista lääke- ja ei-lääkinnälliseen hoitoon. Tutkimus sisälsi kaksi vaihetta: vaihe yksi systemaattiset kirjallisuuskatsaukset sekä vaihe kaksi empiirisen tutkimuksen, jossa tieto kerättiin analysoimalla potilasasiakirjoja. Systemaattisen kirjallisuuskatsauksen tarkoituksena oli selvittää nuoren hoitoon sitoutumista ja siihen yhteydessä olevia tekijöitä (alkuperäisjulkaisu I n=15, alkuperäisjulkaisu II n=17). Vaihe kaksi oli osa Oulun yliopistollisen sairaalan psykiatrian klinikan projektia, STUDY-70, joka tuotti kaksi osajulkaisua. Alkuperäisjulkaisun III tarkoituksena oli tutkia osastohoidossa olevan nuoren sitoutumista lääke- sekä ei lääkinnälliseen hoitoon (n=72). Alkuperäisjulkaisussa IV selvitettiin näiden nuoren sitoutumista hoitoon ja erityinen mielenkiinto tässä tutkimuksessa oli perhe- ja kliinisillä tekijöillä sitoutuminen (n=72). Systemaattisen kirjallisuuskatsauksen perusteella sitoutumisen määrittelyt vaihtelivat. Tästä huolimatta käsitteen määrittelyjen synteesi oli mahdollinen ja se loi pohjan empiiriselle tutkimukselle. Tämän tutkimuksen perusteella nuoren oma tahto ja positiivinen asenne olivat positiivisesti yhteydessä hoitoon sitoutumiseen. Myös perheen toiminta vaikutti hoitoon sitoutumiseen. Nuoren negatiiviset tunteet, yhteistyökyvyttömyys ja mielenterveysoireet vaikuttivat negatiivisesti sitoutumiseen. Lisäksi nuoren saamat erityispalvelut koulussa tukivat osastohoidossa olevan nuoren hoitoon sitoutumista. Vastentahtoinen hoito, viiltely sekä läheinen ja kestävä äitisuhde olivat yhteydessä sitoutumattomuuteen. Hoitoon sitoutuminen on kokonaisvaltainen prosessi ja yksi hoidon tavoitteista, joka voidaan saavuttaa. Hoitoon sitoutumisen edistämiseksi henkilökunnan tulee tiedostaa ne tekijät, jotka vaikuttavat hoitoon sitoutumiseen. Näin voidaan suunnitella ja toteuttaa laadukasta ja vaikuttavaa hoitoa
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Papageorgiou, Alexia. "Evaluation of advance statements in psychiatric care." Thesis, University College London (University of London), 2006. http://discovery.ucl.ac.uk/1445000/.

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Background: An advance statement in psychiatric care is a statement of a person's preferences for treatment, should he or she lose capacity to make treatment decisions in the future. The underlying principle for implementing these instruments is the promotion of patients' self-determination and autonomy.;Objective: To evaluate whether use of advance statements by patients with severe mental illness leads to lower rates of compulsory readmission to hospital.;Design: Randomised controlled trial. Setting Two inner city psychiatric hospitals in North London.;Participants: One hundred and fifty six in-patients about to be discharged from compulsory treatment under the Mental Health Act were recruited. To be included, participants had to be 18 years old and over, with mental capacity, able to read and write English and on section 2, 3 or 4 of the Mental Health Act.;Intervention: The preference for care group and the control group both received standard psychiatric care plus a number of standardised questionnaires at baseline and a year after discharge from section. In addition to that the preference for care group received the psychiatric advance statement at baseline.;Outcome measures: The main outcome measure was the rate of compulsory re-admission. Other outcome measures involved: the patients' self-efficacy and satisfaction with psychiatric services, their mental health status assessment, their views about the usefulness of the advance statements, assessment of the content of the statement and the views of mental health professionals in relation to the usefulness of the statement.;Results: Fifteen patients (19%) in the intervention group and 16 (21%) in the control group were readmitted compulsorily within 1 year of discharge. There was no difference in the numbers of compulsory readmissions, numbers of patients readmitted voluntarily, self-efficacy or satisfaction with psychiatric services. Patients with severe and enduring mental health problems were capable of drawing up advance statements with their views in relation to signs of lapses and relapses, and their preferences and refusals on certain aspects of their treatment and needs whilst hospitalised. Patients did not use the advance statements as an opportunity to refuse all subsequent treatment. Although 40% of patients did not find the advance statements useful, this may have occurred because the professionals involved in their care did not refer to or take account of them. Most mental health professionals who returned questionnaires did not find the advance statements useful in the management of the patients.;Conclusion: Users' advance statements for psychiatric care had little observable impact on the outcome of care at twelve months. Even if rates of compulsory treatment were not affected, one cannot rule out possible beneficial effects such as improvement of therapeutic alliance and communication with mental health professionals. Thus, the impact of advance statements on other aspects of care requires further study.
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Nehlin, Gordh Christina. "Alcohol Use and Secondary Prevention in Psychiatric Care." Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-179175.

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Although alcohol plays an important role in psychiatric morbidity, there is a general lack of strategies within psychiatric care to intervene at alcohol problems in an early stage (secondary prevention). The aim of this thesis was to increase knowledge of adequate forms of secondary alcohol prevention in psychiatric care.   The capacity of three brief screening instruments was investigated in a psychiatric outpatient sample (n=1811). The results indicate that the HED (heavy episodic drinking) screener, strongly recommended for health care settings, is not sufficiently sensitive in a psychiatric setting. Instead, the full AUDIT (Alcohol Use Disorders Identification Test) is recommended. The knowledge and attitudes of psychiatric staff members to problem-drinking patients were studied and the effects of a three-hour training course were investigated. Confidence in self-perceived capacity to intervene in more severe alcohol problems was raised among all staff after training. Awareness of early signs of problem drinking was raised among psychologists and social workers. The therapeutic attitude of the psychiatric staff was higher when compared with primary care staff. Two forms of brief intervention were delivered by clinical psychiatric staff. At 12 months, 29% of all participants had improved their drinking habits, moving from hazardous to non-hazardous level (21%) or from harmful to hazardous level (8%). In the improved group, mean AUDIT score was reduced from 11.0 points at baseline to 5.5 points. Differences in outcome between the two interventions could not be identified. Nine high-risk drinking young female psychiatric patients were interviewed, focusing on reasons for excessive drinking and factors facilitating a change in drinking habits. Alcohol played an important role in the lives of the young women. It made them feel social and helped them deal with unbearable emotions. It was also used as a means of self-harm, representing the first stage in an escalating self-harm process. They expressed a need for help from their caregivers in addressing the underlying reasons for drinking. Secondary alcohol prevention strategies including appropriate screening methods, staff training and the elaboration of tailored interventions are urgently needed in psychiatric care. The findings of this thesis can be used when forming such strategies.
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Books on the topic "Psychiatric care"

1

Claudette, Potter, ed. Psychiatric primary care. St. Louis: Mosby, 1997.

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Psychiatric home care. Gaithersburg, Md: Aspen Publishers, 1997.

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Dominic, Beer M., Pereira Stephen M, and Paton Carol, eds. Psychiatric intensive care. London: Greenwich Medical Media, 2001.

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Wilson, Huelskoetter M. Marilyn, ed. Psychiatric mental health nursing: Giving emotional care. 3rd ed. Norwalk, Conn: Appleton & Lange, 1991.

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Wilson, Huelskoetter M. Marilyn, ed. Psychiatric/mental health nursing: Giving emotional care. 2nd ed. Norwalk, Conn: Appleton & Lange, 1987.

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A, Holoday-Worret Patricia, ed. Psychiatric nursing care plans. 5th ed. St. Louis, Mo: Mosby/Elsevier, 2007.

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Fortinash, Katherine M. Psychiatric nursing care plans. St. Louis: Mosby-Year Book, 1991.

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Intensive psychiatric care units. Edinburgh: NHS Quality Improvement Scotland, 2010.

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A, Holoday-Worret Patricia, ed. Psychiatric nursing care plans. 3rd ed. St. Louis: Mosby, 1999.

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Smith, Joseph T. Medical malpractice -- psychiatric care. Colorado Springs, Colo: Shepard's/Mcgraw Hill, 1986.

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Book chapters on the topic "Psychiatric care"

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Charlot, Lauren R. "Inpatient Psychiatric Care." In Health Care for People with Intellectual and Developmental Disabilities across the Lifespan, 1655–76. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-18096-0_131.

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Travaini, G., R. Zanardi, L. Fregna, F. Martini, D. Pratesi, A. Sarzetto, G. Perrozzi, and C. Colombo. "Psychiatric Legislation and Forensic Psychiatry." In Fundamentals of Psychiatry for Health Care Professionals, 441–56. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-07715-9_14.

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Cavanagh, Stephen J. "Care Study: Community Psychiatric Care." In Orem’s Model in Action, 104–17. London: Macmillan Education UK, 1991. http://dx.doi.org/10.1007/978-1-349-11909-7_7.

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Loitman, Jane E., and Teresa Deshields. "Psychiatric Palliative Care Issues." In Palliative Care, 19–27. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-590-3_4.

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Lynn, Rachel Y., and Alan D. Valentine. "Psychiatric Emergencies." In Psychopharmacology in Oncology and Palliative Care, 317–30. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-40134-3_17.

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Papadopoulos, John. "Psychiatric Disorders." In Pocket Guide to Critical Care Pharmacotherapy, 119–23. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-1853-9_12.

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Munk-Jørgensen, Povl, and Niels Okkels. "Psychiatric case registers." In Improving Mental Health Care, 264–80. Chichester, UK: John Wiley & Sons, 2013. http://dx.doi.org/10.1002/9781118337981.ch17.

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Brough, D. I., N. Bouras, and J. P. Watson. "Towards Community Psychiatric Care." In Epidemiology and Community Psychiatry, 373–77. Boston, MA: Springer US, 1985. http://dx.doi.org/10.1007/978-1-4684-4700-2_55.

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Sarvet, Barry, and John Sargent. "Integrating Child Psychiatric Care." In Integrated Care in Psychiatry, 143–56. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-0688-8_9.

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Nordstrom, Kimberly, Glenn W. Currier, Michael H. Allen, and Seth Powsner. "Modern Psychiatric Emergency Care." In Psychiatry, 2473–78. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781118753378.ch122.

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Conference papers on the topic "Psychiatric care"

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ROJAS, GRACIELA, YOLANDA VARAS, PATRICIOM OLIVOS, FERNANDO LOLAS, and EUGEN WOLPERT. "THE CHILEAN PSYCHIATRIC CARE SYSTEM." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0243.

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LOPEZ HARTMANN, RODOLFO G., LLANOS ROBERTO, and EUGEN M. WOLPERT. "MODERN AND TRADITIONAL PSYCHIATRIC CARE SYSTEMS IN PERU." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0241.

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Aziz, Ayesha, and Nashi Khan. "PERCEPTIONS PERTAINING TO STIGMA AND DISCRIMINATION ABOUT DEPRESSION: A FOCUS GROUP STUDY OF PRIMARY CARE STAFF." In International Psychological Applications Conference and Trends. inScience Press, 2021. http://dx.doi.org/10.36315/2021inpact013.

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"The present study was conducted to explore the perception and views of primary care staff about Depression related Stigma and Discrimination. The Basic Qualitative Research Design was employed and an In-Depth Semi-Structured Discussion Guide consisted of 7 question was developed on the domains of Pryor and Reeder Model of Stigma and Discrimination such as Self-Stigma, Stigma by Association, Structural Stigma and Institutional Stigma, to investigate the phenomenon. Initially, Field Test and Pilot study were conducted to evaluate the relevance and effectiveness of Focus Group Discussion Guide in relation to phenomena under investigation. The suggestions were incorporated in the final Discussion Guide and Focus Group was employed as a data collection measure for the conduction of the main study. A purposive sampling was employed to selected a sample of Primary Care Staff (Psychiatrists, Medical Officers, Clinical Psychologists and Psychiatric Nurses) to elicit the meaningful information. The participants were recruited from the Department of Psychiatry of Pakistan Medical and Dental Council (PMDC) recognized Private and Public Sector hospitals of Lahore, having experience of 3 years or more in dealing with patients diagnosed with Depression. However, for Medical Officers, the experience was restricted to less than one year based on their rotation. To maintain equal voices in the Focus Group, 12 participants were approached (3 Psychiatrist, 3 Clinical Psychologists, 3 Medical Officers and 3 Psychiatric Nurses) but total 8 participants (2 Psychiatrists, 2 Medical Officers, 3 Clinical Psychologists And 1 Psychiatric Nurse) participated in the Focus Group. The Focus Group was conducted with the help of Assistant Moderator, for an approximate duration of 90 minutes at the setting according to the ease of the participants. Further, it was audio recorded and transcribed for the analysis. The Braun and Clarke Reflexive Thematic Analysis was diligently followed through a series of six steps such as Familiarization with the Data, Coding, Generating Initial Themes, Reviewing Themes, Defining and Naming Themes. The findings highlighted two main themes i.e., Determining Factors of Mental Health Disparity and Improving Treatment Regimen: Making Consultancy Meaningful. The first theme was centered upon three subthemes such as Lack of Mental Health Literacy, Detached Attachment and Components of Stigma and Discrimination. The second theme included Establishing Contact and Providing Psychoeducation as a subtheme. The results manifested the need for awareness-based Stigma reduction intervention for Primary Care Staff aims to provide training in Psychoeducation and normalization to reduce Depression related Stigma and Discrimination among patients diagnosed with Depression."
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Vaughan, Laurene. "Care and the Design of a Psychiatric Hospital Environment." In Nordes 2017: Design and Power. Nordes, 2017. http://dx.doi.org/10.21606/nordes.2017.064.

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Aini, Khusnul, and Mariyati Mariyati. "Psychiatric Intensive Care Unit Nurse Experience in Providing Nursing Care to Mental Patients with Suicide Risk at A Psychiatric Hospital, Central Java." In The 5th Intenational Conference on Public Health 2019. Masters Program in Public Health, Universitas Sebelas Maret, 2019. http://dx.doi.org/10.26911/theicph.2019.01.56.

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GARCíA-RODRIGUEZ, FERNANDO, Lucero Ochoa-Alderete, Antonio López-Rangel, Daniela Padilla, Ana Villarreal-Trevino, María Eugenia Corral Trujillo, Ana Cecilia Arana Guajardo, et al. "AB0976 PSYCHIATRIC DISORDERSDURING TRANSITION CARE IN ADOLESCENTS WITH RHEUMATIC DISEASES." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.8095.

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MEZZICH, JUAN ENRIQUE, JOSÉ TRINIDAD CALDERA, and CARLOS ENRIQUE BERGANZA. "PSYCHIATRIC DIAGNOSIS IN PRIMARY CARE AND THE PERSONAL HEALTH SCALE." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0047.

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ISOHANNI, MATTI. "THE THERAPEUTIC COMMUNITY METHOD IN PSYCHIATRIC AND GERIATRIC CARE: AN OVERVIEW." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0219.

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Gibson, Molly, Magne Halvorsen, Mikkel Angelo Anchissi Joner, Mari Lehne, Elise Rabassa Stautland, Gustaf Svensson, Hanna Thevik, Georgia Fehler, and Stefan Hochwarter. "Pilot Testing and Evaluation of Participatory Patient Record in Psychiatric Care." In 18th Scandinavian Conference on Health Informatics. Linköping University Electronic Press, 2022. http://dx.doi.org/10.3384/ecp187039.

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DI GIANNANTONIO, M., S. FAVETTA, D. LEONETTI, C. MENCACCI, and M. BASSI. "THE BURNOUT SYNDROME IN HELPING PROFESSIONS: THE “STRESSING” CARE IN PSYCHIATRIC SERVICES." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0309.

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Reports on the topic "Psychiatric care"

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NAPICU. National minimum standards for psychiatric intensive care in general adult services. NAPICU, 2014. http://dx.doi.org/10.20299/napicu.2017.001.

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Currie, Janet, Paul Kurdyak, and Jonathan Zhang. Socioeconomic Status and Access to Mental Health Care: The Case of Psychiatric Medications for Children in Ontario Canada. Cambridge, MA: National Bureau of Economic Research, October 2022. http://dx.doi.org/10.3386/w30595.

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Fortney, Johny, and Jürgen Unützer. Comparing Two Telehealth Approaches for Treating Complex Psychiatric Disorders in Primary Care -- The SPIRIT Study. Patient-Centered Outcomes Research Institute® (PCORI), August 2022. http://dx.doi.org/10.25302/08.2022.pcs.140619295.

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Jauny, Ray, and John Parsons. Delirium Assessment and Management: A qualitative study on aged-care nurses’ experiences. Unitec ePress, November 2017. http://dx.doi.org/10.34074/ocds.72017.

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Aged residential care (ARC) residents with morbid health conditions frequently experience delirium. This condition is associated with diminished quality of life, preventable morbidity and untimely death. It is challenging and costly to manage delirium because of the complex interplay of physical and psychiatric symptoms associated with this condition in both primary and secondary services. With awareness of risk factors and knowledge about delirium, ARC nurses can play a vital role in early identification, assessment and treatment, but most importantly in preventing delirium in aged-care residents as well as improving health outcomes. Focus groups were carried out with ARC nurses to ascertain their opinions on how they assess and manage delirium in ARC facilities in South Auckland, New Zealand. Findings identified that there were strengths and weaknesses, as well as gaps in assessment and management of delirium. Nurses would benefit from delirium education, appropriate tools and adequate resources to help them manage delirium. Issues with diagnosing delirium, anxiety about challenging behaviours, family dynamics, lack of training and absence of IV treatment were noticeable features in this study.
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Madu, Laura, Jacqueline Sharp, and Bobby Bellflower. Efficacy of Integrating CBT for Mental Health Care into Substance Abuse Treatment in Patients with Comorbid Disorders of Substance Abuse and Mental Illness. University of Tennessee Health Science Center, April 2021. http://dx.doi.org/10.21007/con.dnp.2021.0004.

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Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It is a retrospective chart review. The review examines CBT's efficacy for engaging individuals with co-occurring mood and substance u se disorders in treatment by enhancing adherence and preventing disengagement and relapse. Methods: Forty adults aged 26-55 with a DSM-IV diagnosis of a mood disorder of Major Depressive Disorder and/or anxiety and concurrent substance use disorder (at least weekly use in the past month). Participants received 12 sessions of individual integrated CBT treatment delivered with case management over a 12-week period. Results: The intervention was associated with significant improvements in mood disorder, substance use, and coping skills at 4, 8, and 12 weeks post-treatment. Conclusions: These results provide some evidence for the effectiveness of the integrated CBT intervention in individuals with co-occurring disorders. Of note, all psychotherapies are efficacious; however, it would be more advantageous to develop a standardized CBT that identifies variables that facilitate treatment outcomes specifically to comorbid disorders of substance use and mood disorders. It is concluded that there is potentially more to be gained from further studies using randomized controlled designs to determine its efficacy.
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Leavy, Michelle B., Costas Boussios, Robert L. Phillips, Jr., Diana Clarke, Barry Sarvet, Aziz Boxwala, and Richard Gliklich. Outcome Measure Harmonization and Data Infrastructure for Patient-Centered Outcomes Research in Depression: Final Report. Agency for Healthcare Research and Quality (AHRQ), June 2022. http://dx.doi.org/10.23970/ahrqepcwhitepaperdepressionfinal.

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Objective. The objective of this project was to demonstrate the feasibility and value of collecting harmonized depression outcome measures in the patient registry and health system settings, displaying the outcome measures to clinicians to support individual patient care and population health management, and using the resulting measures data to support patient-centered outcomes research (PCOR). Methods. The harmonized depression outcome measures selected for this project were response, remission, recurrence, suicide ideation and behavior, adverse effects of treatment, and death from suicide. The measures were calculated in the PRIME Registry, sponsored by the American Board of Family Medicine, and PsychPRO, sponsored by the American Psychiatric Association, and displayed on the registry dashboards for the participating pilot sites. At the conclusion of the data collection period (March 2020-March 2021), registry data were analyzed to describe implementation of measurement-based care and outcomes in the primary care and behavioral health care settings. To calculate and display the measures in the health system setting, a Substitutable Medical Apps, Reusable Technology (SMART) on Fast Healthcare Interoperability Resource (FHIR) application was developed and deployed at Baystate Health. Finally a stakeholder panel was convened to develop a prioritized research agenda for PCOR in depression and to provide feedback on the development of a data use and governance toolkit. Results. Calculation of the harmonized outcome measures within the PRIME Registry and PsychPRO was feasible, but technical and operational barriers needed to be overcome to ensure that relevant data were available and that the measures were meaningful to clinicians. Analysis of the registry data demonstrated that the harmonized outcome measures can be used to support PCOR across care settings and data sources. In the health system setting, this project demonstrated that it is technically and operationally feasible to use an open-source app to calculate and display the outcome measures in the clinician’s workflow. Finally, this project produced tools and resources to support future implementations of harmonized measures and use of the resulting data for research, including a prioritized research agenda and data use and governance toolkit. Conclusion. Standardization of outcome measures across patient registries and routine clinical care is an important step toward creating robust, national-level data infrastructure that could serve as the foundation for learning health systems, quality improvement initiatives, and research. This project demonstrated that it is feasible to calculate the harmonized outcome measures for depression in two patient registries and a health system setting, display the results to clinicians to support individual patient management and population health, and use the outcome measures data to support research. This project also assessed the value and burden of capturing the measures in different care settings and created standards-based tools and other resources to support future implementations of harmonized outcome measures in depression and other clinical areas. The findings and lessons learned from this project should serve as a roadmap to guide future implementations of harmonized outcome measures in depression and other clinical areas.
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Rudd, Ian. Leveraging Artificial Intelligence and Robotics to Improve Mental Health. Intellectual Archive, July 2022. http://dx.doi.org/10.32370/iaj.2710.

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Artificial Intelligence (AI) is one of the oldest fields of computer science used in building structures that look like human beings in terms of thinking, learning, solving problems, and decision making (Jovanovic et al., 2021). AI technologies and techniques have been in application in various aspects to aid in solving problems and performing tasks more reliably, efficiently, and effectively than what would happen without their use. These technologies have also been reshaping the health sector's field, particularly digital tools and medical robotics (Dantas & Nogaroli, 2021). The new reality has been feasible since there has been exponential growth in the patient health data collected globally. The different technological approaches are revolutionizing medical sciences into dataintensive sciences (Dantas & Nogaroli, 2021). Notably, with digitizing medical records supported the increasing cloud storage, the health sector created a vast and potentially immeasurable volume of biomedical data necessary for implementing robotics and AI. Despite the notable use of AI in healthcare sectors such as dermatology and radiology, its use in psychological healthcare has neem models. Considering the increased mortality and morbidity levels among patients with psychiatric illnesses and the debilitating shortage of psychological healthcare workers, there is a vital requirement for AI and robotics to help in identifying high-risk persons and providing measures that avert and treat mental disorders (Lee et al., 2021). This discussion is focused on understanding how AI and robotics could be employed in improving mental health in the human community. The continued success of this technology in other healthcare fields demonstrates that it could also be used in redefining mental sicknesses objectively, identifying them at a prodromal phase, personalizing the treatments, and empowering patients in their care programs.
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Leavy, Michelle B., Danielle Cooke, Sarah Hajjar, Erik Bikelman, Bailey Egan, Diana Clarke, Debbie Gibson, Barbara Casanova, and Richard Gliklich. Outcome Measure Harmonization and Data Infrastructure for Patient-Centered Outcomes Research in Depression: Report on Registry Configuration. Agency for Healthcare Research and Quality (AHRQ), November 2020. http://dx.doi.org/10.23970/ahrqepcregistryoutcome.

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Background: Major depressive disorder is a common mental disorder. Many pressing questions regarding depression treatment and outcomes exist, and new, efficient research approaches are necessary to address them. The primary objective of this project is to demonstrate the feasibility and value of capturing the harmonized depression outcome measures in the clinical workflow and submitting these data to different registries. Secondary objectives include demonstrating the feasibility of using these data for patient-centered outcomes research and developing a toolkit to support registries interested in sharing data with external researchers. Methods: The harmonized outcome measures for depression were developed through a multi-stakeholder, consensus-based process supported by AHRQ. For this implementation effort, the PRIME Registry, sponsored by the American Board of Family Medicine, and PsychPRO, sponsored by the American Psychiatric Association, each recruited 10 pilot sites from existing registry sites, added the harmonized measures to the registry platform, and submitted the project for institutional review board review Results: The process of preparing each registry to calculate the harmonized measures produced three major findings. First, some clarifications were necessary to make the harmonized definitions operational. Second, some data necessary for the measures are not routinely captured in structured form (e.g., PHQ-9 item 9, adverse events, suicide ideation and behavior, and mortality data). Finally, capture of the PHQ-9 requires operational and technical modifications. The next phase of this project will focus collection of the baseline and follow-up PHQ-9s, as well as other supporting clinical documentation. In parallel to the data collection process, the project team will examine the feasibility of using natural language processing to extract information on PHQ-9 scores, adverse events, and suicidal behaviors from unstructured data. Conclusion: This pilot project represents the first practical implementation of the harmonized outcome measures for depression. Initial results indicate that it is feasible to calculate the measures within the two patient registries, although some challenges were encountered related to the harmonized definition specifications, the availability of the necessary data, and the clinical workflow for collecting the PHQ-9. The ongoing data collection period, combined with an evaluation of the utility of natural language processing for these measures, will produce more information about the practical challenges, value, and burden of using the harmonized measures in the primary care and mental health setting. These findings will be useful to inform future implementations of the harmonized depression outcome measures.
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9

Lee, Hee Jin, Min Cheol Chang, Yoo Jin Choo, and Sae Yoon Kim. The Associations between Headache (Migraine and Tension-type Headache) and Psychotic Symptoms (Depression and Anxiety) in Pediatrics: A Systematic Review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2022. http://dx.doi.org/10.37766/inplasy2022.10.0078.

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Review question / Objective: The purpose of this study was to investigate the association with specific psychiatric symptoms such as depression and anxiety in pediatric patients suffering from migraine and TTH. In our meta-analysis for a detailed evaluation of depression and anxiety, we attempted to review the research using various psychodiagnostic tools. Eligibility criteria: The detailed inclusion criteria for the network meta-analysis were studies with (1) inclusion of pediatric patients; (2) patients with migraine and TTH; (3) evaluation of association between headache (migraine or TTH) and psychotic symptoms (depression and anxiety); (4) comparison between group with headache (migraine or TTH) and control group; (5) using tools for evaluating degree of depression or anxiety; and (6) written in English. Review articles, case reports, letters, and studies with insufficient data or results were excluded.
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10

Viswanathan, Meera, Jennifer Cook Middleton, Alison Stuebe, Nancy Berkman, Alison N. Goulding, Skyler McLaurin-Jiang, Andrea B. Dotson, et al. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions. Agency for Healthcare Research and Quality (AHRQ), April 2021. http://dx.doi.org/10.23970/ahrqepccer236.

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Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.
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