Background: Infant Mental Health (IMH) is a topic of current interest that emerged over the past decades, concerned with alleviating suffering and enhancing the social and emotional competence of young children. Worldwide there is increasing recognition of infant psychopathology meriting intervention. However, there are still limited data regarding the prevalence of psychiatric disorders and sociodemographic characteristics of these youngest of patients in clinical settings. Aim: This large, descriptive study aims at presenting the socio-demographic and clinical characteristics of infants referred consecutively to three outpatient Infant Mental Health teams in the Netherlands between September 2000 and July 2013. Methods: The medical records of 783 infants were retrospectively examined and the data were collected from paper and electronic patient files. Clinical and socio-demographic characteristics were categorized in child factors, developmental milestones, family factors and clinical outcome measures (DSM-IV, DC:0-3R, WIPPSI-III, SON-R 2½-7). Results: Our sample showed significantly more boys (543, 69%) than girls (240, 31%) being referred to the Infant Mental Health teams. Most children were referred when they were four or five years of age, both boys and girls. Mean duration of treatment was about a year and a half (20.34 months, SD 18.87) and most reported diagnoses were ADHD/behavioral disorders, ASS and disorder in infancy/childhood NOS. Familial psychiatric disorders were reported in 242 families (41%). These findings are discussed in the light of earlier research.
Mental disorders are the leading cause of disability as measured by Years Lived with Disability; however, 40.5% of this burden is attributable to major depression [1]. Recent estimates of the prevalence of major depression indicate that 16.6% of adults in the US have been depressed at some point in their lifetime [2]. Symptoms of major depression include low mood, changes in appetite, sleep, or energy, and feelings of guilt or worthlessness [3]. Current medical treatments for major depression primarily involve synthetic antidepressants (e.g., monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs)) and psychological interventions (e.g., cognitive behavioral therapy, interpersonal therapy) [3,4]. However, psychological interventions may not be available for patients in need [4], and antidepressants may not effectively treat all depressed patients, with non-response rates of up to 50% [5]. Additionally, adverse effects, such as weight gain, insomnia, headache, anxiety and sexual dysfunction, occur frequently with antidepressant medication [6-8].
Caring for the entire person, including their physical, psychological, social and spiritual well-being, is a tenet of family medicine. There are many interventions being undertaken to continuously improve the health of our patients across all these dimensions. However, physicians, nurses, students and other healers who practice in family medicine may find themselves so consumed by the stresses of the job that burnout is a real possibility [1]. There are many negative consequences of burnout, including inattention to detail, poor communication with patients increased medical errors [2] and early retirement or leaving the field of medicine [3]. The same spiritual care which helps our patients heal from mental or physical illness can also promote greater physician resiliency and less burnout. This paper aims to describe several interventions which can improve the spiritual care of family medicine providers and patients. Some of these suggestions require significant time and planning to implement. Others can be adopted immediately. The reader is encouraged to consider which of these might be appropriate in his or her work environment.
Qualitative research has demonstrated that transition from military to civilian life involves narrative identity reconstruction among service members. The reformulation of narrative identities may prove to become an existential quest for service members since the questions of who I am, where I am going, and what is my place in the world need to be (re)answered by the self in a new cultural context. Thus, a reorganization of stories also corresponds to a reorganization of I-positions in the self. This article presents the case study of Lieutenant Maria, one participant derived from a larger longitudinal research project designed to explore this process of transition, and aims to demonstrate new ways of understanding self-identity work in transition through a Dialogical Self Theory approach. The analysis of the case study suggests that self-reorganization was necessary for adaptation to a civilian cultural context that shaped alternate identities. Four types of factors were observed to have major influence upon the self-identity evolution: contextual promoters, a dialogical self-attitude, meta-cognitive activities, and a group of cooperative positions in the self which could evolve in a new context and through emerging identities. MeSh Headings/
Schizophrenia is a chronic and debilitating neuropsychiatric disorder, characterized by heterogeneous symptoms, including positive symptoms (e.g., delusions, hallucinations, and disorganized thoughts) and negative symptoms (e.g., flattened affect, poverty of speech, and social withdrawal) [1]. Patients with Schizophrenia typically have poor grooming and self-care skills, which affect their social relationships and their chances of successful incorporation into their communities [2,3]. The characteristics of a negative syndrome in schizophrenic patients are blunted or restricted affect, poverty of speech, loss of drive, social and emotional withdrawal, and apathy. These are what are known as primary negative symptoms, and are a direct manifestation of the pathologic process. Poor grooming and impaired social relationships are secondary negative symptoms [4]. Personal hygiene is an important part of a cleansing process, and is the basis for establishing healthy relationships with family members and friends.
The identification and effective treatment of depression in primary care settings is at the forefront of current health care reform efforts in the United States. Historically, primary care services have accounted for the highest percentage of the prescription of psychiatric medications, especially antidepressants [1]. Yet primary care has typically lacked the appropriate mental health expertise to provide psychiatric care in an effective fashion. Through the combination of federal parity legislation passed in 2008 and the comprehensive health care reform efforts outlined in the 2010 Patient Protection and Affordable Care Act (ACA), this situation may change dramatically. As a result, primary care settings may begin to experience a significant influx of behavioral health professionals with appropriate training and expertise so that care for mental health and substance use disorders can be provided, in terms of both accessibility and effectiveness, on par with all other medical care [2,3].
I am happy to share an important discovery in the field of psychology with the with the Mental Health in Family Medicine Journal. Direct scientific proof is now available which demonstrates that Emotional Core Therapy is the most effective psychological model available worldwide for mental health and medical professionals. Why? Only the Emotional Core Therapy Flowchart and model can identify and treat the root cause of stress that psychiatrists and psychotherapists and their patients face emotionally. Scientific proof can be done with the naked eye so any person can learn and apply the eight-step flowchart to their own situational stress and see for themselves how this revolutionary new model can help reduce psychological pain. Typically, people try and process 20 to 30 or more stressful events through the flowchart to demonstrate scientific evidence of effectiveness. Since each person perceives stress uniquely, it is important that when trying the model, you look for repeated results of effectiveness.
BWCs are used internationally by police officers. A randomized controlled field trial carried out in the USA suggested that police BWCs reduce the prevalence of use-of-force by the police as well as the incidence of citizens’ complaints against them [2]. In England, an evaluation of their use in Hampshire and the Isle of Wight also showed a reduction in complaints, and a decrease in occurrences and crimes [3]. In their 2015 report regarding the use of body worn cameras in health care settings, the International Association for Healthcare Security and Safety (IAHSS) Foundation [1] describe some examples in the United Kingdom which claim that the use of BWCs on security officers can decrease violence in health facilities [4]. However, there are no published evaluations available to support these claims. A report from the Greater London Authority in 2014 [5], found that nearly 66,000 frontline workers, including nurses, were recipients of physical or verbal attacks in the past three years and recommended the trial of body worn cameras to see if they assist in reducing crimes against workers.
During 1841-1875, Hong Kong, as a Crown colony, was still a small fishing port where British, American, and other expatriates engaged in commercial and trade activities, its population was small and social facilities were under-developed. In old Hong Kong Chinese society, mental patients were considered a disgrace to the family. Relatives would tolerate the burden of looking after a mentally disturbed member and would try to keep the patient inside the family [1]. Under these conditions, the Hong Kong Government had no intention of building any asylum for mental patients [2]. So, before 1875, there was no government institution existed in Hong Kong for the lunatics. In 1873, the European lunatics were sent to Central Police Station Victoria Gaol (Figure 1) in Old Baily Street until they were repatriated to their own countries while the Chinese lunatics were sent to Tung Wah Hospital (Figure 2), the first charity hospital for Chinese in Hong Kong, opened in 1872. Tung Wah hospital had special insanity ward with special restraining clothes, where they were "confined in dark and dreary cell under Chinese native doctor’s supervision and those who were violent were chained like wild beasts " [3,4]. AbstrAct
In this society much attention has been paid to infidelity. Newspapers report on the infidelities of celebrities, politicians, etc. every other day. Researchers explore the question of why people are unfaithful. The present survey examines the opposite situation. Why are people faithful? Given the many opportunities in society to stray, why do people remain faithful to their partner? This paper examines the Shadow Script of Infidelity-Fidelity. A study was performed with 204 participants. The findings indicate that several traits were prevalent in those who remained faithful. These findings are then woven into the stories of couples that experienced affairs. A Narrative therapeutic approach is used which explores the meanings that incidents, behaviors, and encounters have for couples. These meanings emerge from social interactions. In this paper, therapy involves exploring meaning systems as the therapist uncovers the layers of the clients’ stories. First the couple’s pre-counseling experience is presented. The self of the therapist is then explored. A five step narrative therapeutic approach was proposed. The shadow script of fidelity was interwoven in the therapeutic options for couples experiencing infidelity.
This article is a review of three cases of menopausal transition first episode psychosis that occurred at our institution. Possible explanations for this second wave of schizophrenia during the menopausal transition and early menopause may be from hormonal changes, specifically hypoestrogenism, that can be the catalyst in women with an underlying risk for schizophrenia. Other mental illnesses, such as preexisting unipolar depression and bipolar affective disorder can worsen during menopausal transition. Other hypoestrogenic periods, including postpartum and menstruation, have been shown to have increased risk of psychosis onset or symptom exacerbation for some women. This highlights a possible hormonal connection between menopausal transition and schizophrenia onset. Additionally, the physiologic changes that occur during this period, including hot flushes (vasomotor symptoms) and sleep deprivation may be particular stressors that exacerbate mental illness. Possible women’s health interventions may have a particular benefit in women with new onset psychosis during menopausal transition or menopause.
Introduction: Most of neurodegenerative diseases have cognitive impairment as early signs or consequence of the evolution of these diseases. Early detection appears unavoidable if, clinicians and researchers expect to win this war. Methods: Demographic and clinical data, well-being, drugs usage associated with cognitive impairments, gender, level of education, family history disorders, memory deficiency and cognitive disorders were collected. Mc Nair score was calculated using the short version with 15 items. Results: Simultaneous combination of complex medical history associated with family's medical disease with cognitive problems, exhibited a specific profile of subject at risk of future brain disorders. Discussion: Monitoring the mental state contributes both to prevention and; monitoring initial symptoms of cognitive decline will decrease considerably memory complaints and prevent the onset of neurodegenerative diseases. We also strongly state early detection of cognitive impairment will delay dementia and associated illness.
During the present decade matters of ethics have been increasingly the focus of European National Psychiatric Associations and on the agenda of the European Psychiatric Association (EPA). Discussions in the association’s ethical committee have scrutinized the problems and elucidated the range of ethical dilemmas. A questionnaire sent by the Committee in 2011 to the National European Psychiatric Associations has given a panorama of the ethical problems in European Psychiatry and shown their diversity and even communalities. This overview has been presented at different meetings of the EPA and has recently been reviewed, updated and additionally commented by all committed European national associations. Hereby, new problems in European psychiatry have emerged or became again underlined e.g. the demand on psychiatry’s ethical involvement in end of life issues as well as the consequences of financing routines in times of resource limitations and changed prioritizations within medical care and mental health support systems implied by an ever more predominant market economy. Other re-emerged problems are questions and problems in contact with private sectors of users’ organizations, care providers or pharmaceutical industries and the need and strategies for multidisciplinary involvement in psychiatric education and research support. In this article these newly emerged ethical challenges will be elucidated and some positions of national psychiatric associations and their recently updated priorities regarding ethical challenges will be reviewed. Activities and structures regarding a continuous ethical sensitization as well as needs of a sustainable ethical agenda in European psychiatry are addressed.
