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Guideline And Psychiatry

Helio Gomes Rocha Neto, Carlos Eduardo Estellita-Lins, José Luiz Martins Lessa, Maria Tavares Cavalcanti
Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades...
2019: Frontiers in Psychiatry
Ana Filipce, Zorica Naumovska, Aleksandra Kapedanovska Nestorovska, Zoran Sterjev, Katerina Brezovska, Jasmina Tonic-Ribarska, Aleksandra Grozdanova, Ljubica Suturkova, Marija Raleva
Atypical antipsychotic risperidone is widely used first-line monotherapy in schizophrenia and combined therapy in bipolar disorders. Therapeutic plasma concentrations of risperidone and its active moiety are directly influenced by genetic variations in metabolic CYP450 enzymes (CYP2D6 and CYP3A4/5) and transporter (ABCB1) protein and additional environmental factors. Since active metabolite 9-OH risperidone has a greater percentage of the pharmacologically active fraction and is equipotent to the parent drug risperidone, it is assumed that it contributes significantly to therapeutic and adverse effects...
December 1, 2018: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Jose M Menchon, Julio Bobes, Cecilio Alamo, Pino Alonso, María Paz García-Portilla, Ángela Ibáñez, Eva Real, Manuel Bousoño, Maria Dolores Saiz-Gonzalez, Jeronimo Saiz-Ruiz
Despite the existence of effective evidence-based treatments for the management of obsessive-compulsive disorder (OCD), the therapeutic approach to this disease remains suboptimal. The availability of a therapeutic pharmacological guideline for OCD could help to improve the management of the disease in our setting and to reduce the burden of disease for the patient. With the sponsorship of the Spanish Society of Psychiatry, a group of experts has developed a guideline for the pharmacological treatment of OCD based on the recommendations of existing guidelines and following the methodology of the ADAPTE Collaboration...
March 5, 2019: Revista de Psiquiatrí́a y Salud Mental
Gerard Leavey, Sheena McGrellis, Trisha Forbes, Annette Thampi, Gavin Davidson, Michael Rosato, Brendan Bunting, Natalie Divin, Lynette Hughes, Alicia Toal, Moli Paul, Swaran P Singh
BACKGROUND: Poor transitions to adult care from child and adolescent mental health services may increase the risk of disengagement and long-term negative outcomes. However, studies of transitions in mental health care are commonly difficult to administer and little is known about the determinants of successful transition. The persistence of health inequalities related to access, care, and outcome is now well accepted including the inverse care law which suggests that those most in need of services may be the least likely to obtain them...
March 6, 2019: Social Psychiatry and Psychiatric Epidemiology
Freda F Liu, Molly C Adrian
OBJECTIVE: Despite advances in evidence-based treatments for youth depression in recent decades, overall treatment effects are modest at best, with 30-50% of youth being non-responders. Practice parameters consistently recommend systematic assessment and routine monitoring of depressive symptoms, or measurement-based care (MBC), to enhance youth depression treatment. However, the literature offers few guidelines on how to use assessment results to inform care decisions or detect real and clinically meaningful change...
February 27, 2019: Journal of the American Academy of Child and Adolescent Psychiatry
Matthew A Schreiber, Stephanie C Armstrong, Jesse D Markman
Objective: To address a gap in the literature for concise recommendations on psychotropic medication monitoring geared to prescribers in primary care psychiatry. Data Sources: Large institutional guidelines from the United States, United Kingdom, Canada, and Australia/New Zealand combined with manual searches for psychiatric medication monitoring consensus and other recommendations up to January 31, 2018. Study Selection: Any available guidelines and consensus statements making psychotropic medication monitoring recommendations for treatment of adults and published in English...
February 21, 2019: Primary Care Companion to CNS Disorders
L O Roebroek, J Bruins, H Knegtering, R Bruggeman, P H Delespaul, S Castelein
Use of decision aids in mental health care is increasing and will also be introduced in the Dutch mental healthcare system. We describe the context of this development and discuss how decision aids could facilitate evidence-based psychiatry.<br/> AIM: To describe the development of the decision aid TReatment E-Assist (TREAT) in the Dutch mental healthcare system that aims to optimize treatment of people with a psychotic illness.<br/> METHOD: We describe how the TREAT application works and discuss its potential contribution to the treatment of people with a psychotic illness...
2019: Tijdschrift Voor Psychiatrie
A Maiese, M dell'Aquila, S Romano, A Santurro, A De Matteis, M Scopetti, M Arcangeli, R La Russa
The freedom-restraining measures used during Involuntary Health Treatment (IHT) are highly criticized in the medical community. Physical restraint techniques are currently largely used worldwide in Psychiatry. The use of restraints against the patient's will can be considered a serious intrusion of basic human rights and even an act of violence against the patient. In all cases, the restraint should not lead to injuries or damage to the patient's health and should be implemented with a respect of the human rights and dignity...
January 2019: La Clinica Terapeutica
Agustina Longobardi, Pierre Bonmarchand
The authors present a case in which they describe the challenges posed by the diagnosis of epileptic patients who suffer a psychotic episode. They also give a detailed account of current practice guidelines in French psychiatry, as well as a discussion regarding the art of everyday clinical practice.
September 2018: Vertex: Revista Argentina de Psiquiatriá
F Markus Leweke, Dusan Hirjak, Claus Staudter, Doris Borgwedel, Maria Coenen-Daniel, Marco Heser, Katrin Erk, Georg Juckel, Andreas Beivers, Andreas Meyer-Lindenberg
During the past decades, important progress was made in the treatment of patients with mental disorders. Nevertheless, the guideline-based treatment still represents a significant challenge that must take into account novel diagnostic and therapeutic possibilities as well as recent social development and the economic framework. Therefore, there is a need for further improvement of care in inpatient, day-care and outpatient hospital units. An effective and economic over-arching treatment setting may be the so called "Track-unit"...
February 14, 2019: Fortschritte der Neurologie-Psychiatrie
Sarah Wakefield, Manish Aligeti, Vivekananda Rachamallu, Regina Baronia, Ram Aynampudi, Ankit Parmar, Phyllis Peterson, Kanak Masodkar
BACKGROUND: Antipsychotic drug use in children has doubled from 2001 to 2007 with concomitant increase in obesity. Second-generation antipsychotic (SGA) medication use is associated with weight gain, metabolic derangements, and blood sugar and lipid abnormalities in children. The American Psychiatric Association and the American Diabetes Association have recommended metabolic monitoring guidelines for patients using SGA. STUDY QUESTION: The study objective was to investigate and compare metabolic monitoring for SGA medications in psychiatry (PSY), and pediatrics and family medicine [primary care providers (PCP)] outpatient clinics of a university medical center...
February 7, 2019: American Journal of Therapeutics
Nicola S Klein, Ben F M Wijnen, Joran Lokkerbol, Erik Buskens, Hermien J Elgersma, Gerard D van Rijsbergen, Christien Slofstra, Johan Ormel, Jack Dekker, Peter J de Jong, Willem A Nolen, Aart H Schene, Steven D Hollon, Huibert Burger, Claudi L H Bockting
BACKGROUND: As depression has a recurrent course, relapse and recurrence prevention is essential.AimsIn our randomised controlled trial (registered with the Nederlands trial register, identifier: NTR1907), we found that adding preventive cognitive therapy (PCT) to maintenance antidepressants (PCT+AD) yielded substantial protective effects versus antidepressants only in individuals with recurrent depression. Antidepressants were not superior to PCT while tapering antidepressants (PCT/-AD)...
January 2019: BJPsych Open
Magdalena Romanowicz, Kathryn M Schak, Jennifer L Vande Voort, Jonathan G Leung, Beth R Larrabee, Brian A Palmer
This study aimed to understand prescribing practices during acute psychiatric hospitalization in a large cohort of patients (N = 569) with borderline personality disorder (BPD) at a tertiary care psychiatry unit from January 1, 2013, through January 1, 2015. The mean number of hospitalizations per patient was 1.5 (range, 1-7). The odds of being prescribed antidepressants, antipsychotics, mood stabilizers, hypnotics, or anxiolytics were higher at discharge than at admission. The rate of psychotropic prescriptions was also higher at discharge than at admission (incidence rate ratio, 1...
February 11, 2019: Journal of Personality Disorders
Samuele Cortese, Anneka Tomlinson, Andrea Cipriani
OBJECTIVE: Network meta-analyses (NMAs) are gaining traction as the preferred method for evidence synthesis of intervention studies. This review aimed to summarize the basics of NMAs and conduct a meta-review of available NMAs on the treatment of child and adolescent psychiatric disorders by appraising their quality. METHOD: PubMed (Medline), PsycInfo, Embase, Ovid Medline, and Web of Knowledge were systematically searched (last update January 9, 2018). The quality of each included NMA was appraised using the AMSTAR-2 tool and the PRISMA-NMA checklist, which includes specific items for NMAs...
February 2019: Journal of the American Academy of Child and Adolescent Psychiatry
Nadia Ortiz, Marie My Lien Rebetez, Christel Alberque, Guido Bondolfi
In order to meet the needs of patients suffering from eating disorders and to follow the guidelines of experts, the specialised program for eating disorders of Liaison psychiatry and crisis intervention service in Geneva University Hospitals (HUG) has developed a detailed evaluation (multifactorial and multidisciplinary) and a program with a continuum between outpatient treatment, day care and hospitalisations. The psychotherapy is individualized and goals are regularly assessed. Somatic factors are part of evaluation and care in collaboration with general practitioners but weight (gain or loss) is not the only improvement target...
February 6, 2019: Revue Médicale Suisse
Schaub Annette, Falkai Peter
The Sixth Kraepelin Symposium was held at the Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich in October 2018, covering reports from 12 working groups (Keith H. Nuechterlein, Ph.D., University of California, Los Angeles; Kim T. Mueser, Ph.D., Center for Psychiatric Rehabilitation, Boston University, U.S.A.; Dominic Dwyer, Ph.D, Hospital LMU, Munich; David Fowler, Ph.D. University of Sussex, Brighton, U.K.; Martin Hautzinger, Ph.D., University of Tübingen; Nikolaos Koutsouleris, M...
February 5, 2019: Schizophrenia Bulletin
D Bennabi, A Yrondi, T Charpeaud, J-B Genty, S Destouches, S Lancrenon, N Allaili, F Bellivier, T Bougerol, V Camus, O Doumy, J-M Dorey, F Haesebaert, J Holtzmann, C Lançon, M Lefebvre, F Moliere, I Nieto, C Rabu, R Richieri, L Schmitt, F Stephan, G Vaiva, M Walter, M Leboyer, W El-Hage, B Aouizerate, E Haffen, P-M Llorca, P Courtet
BACKGROUND: Recommendations for pharmacological treatments of major depression with specific comorbid psychiatric conditions are lacking. METHOD: The French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of depression based on the RAND/UCLA Appropriatneness Method. Recommendations for lines of treatment are provided by the scientific committee after data analysis and interpretation of the results of a survey of 36 psychiatrist experts in the field of major depression and its treatments...
January 30, 2019: BMC Psychiatry
Katja Koelkebeck, Britta Brouwer, Helmut Ahrens, Jan-Carl Becker, Markus Weih, Bernhard Marschall, Volker Arolt, Patricia Ohrmann
BACKGROUND: Medical education in the discipline of psychiatry and psychotherapy at the University of Münster was traditionally focused on the transfer of knowledge via lectures. According to the current guidelines, the medical curriculum was modified as from the winter semester 2016/2017 to be more competency-based and the changes were evaluated. OBJECTIVE: Lectures and seminars were reduced to achieve a better linkage between theoretical and practical knowledge...
January 29, 2019: Der Nervenarzt
Stacey A Bélanger, Debbi Andrews, Clare Gray, Daphne Korczak
Attention-deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder. Three position statements have been developed by the Canadian Paediatric Society, following systematic literature reviews. Statement objectives are to: 1) Summarize the current clinical evidence regarding ADHD,2) Establish a standard for ADHD care, and3) Assist Canadian clinicians in making well-informed, evidence-based decisions to enhance care of children and youth with this condition. Specific topics reviewed in Part 1, which focuses on diagnosis, include: prevalence, genetics, pathophysiology, differential diagnosis and comorbid psychiatric disorders and developmental disorders...
November 2018: Paediatrics & Child Health
Alexandra-Raluca Gatej, Audri Lamers, Lieke van Domburgh, Matty Crone, Terje Ogden, Daniel Rijo, Eeva Aronen, Ricardo Barroso, Dorret I Boomsma, Robert Vermeiren
BACKGROUND: Severe behavioural problems (SBPs1 ) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts' perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6-12 across Europe...
January 15, 2019: European Psychiatry: the Journal of the Association of European Psychiatrists
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