Mental Health

BACKGROUND: Haloperidol is the most frequently used drug to treat delirium in the critically ill patients. Yet, no systematic review has focussed on the effects of haloperidol in critically ill patients with delirium. METHODS: We conducted a systematic review with meta-analysis and Trial Sequential Analysis of randomized clinical trials (RCTs) assessing the effects of haloperidol vs any intervention on all-cause mortality, serious adverse reactions/events, days alive without delirium, health-related quality of life (HRQoL), cognitive function and delirium severity in critically ill patients with delirium...

BACKGROUND: Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care...

OBJECTIVE: Narcissistic personality disorder has received relatively little empirical attention. This study was designed to provide an empirically valid and clinically rich portrait of narcissistic personality disorder and to identify subtypes of the disorder. METHOD: A random national sample of psychiatrists and clinical psychologists (N=1,201) described a randomly selected current patient with personality pathology. Clinicians provided detailed psychological descriptions of the patients using the Shedler-Westen Assessment Procedure-II (SWAP-II), completed a checklist of axis II diagnostic criteria, and provided construct ratings for each axis II personality disorder...

Despite recent interest in how psychiatric disorders affect work outcomes, little is known about the role of personality disorders (PDs), which are poorly understood yet prevalent (15%) and impairing. We used nationally representative data for 12,457 men and 16,061 women to examine associations of PDs with any employment, full-time employment, chronic unemployment, being fired or laid off, and having trouble with a boss or co-worker. Antisocial, paranoid, and obsessive-compulsive PDs demonstrated the broadest patterns of associations with adverse outcomes...

PURPOSE OF REVIEW: After the initial enthusiasm, the study of personality disorder seems to be at a crossroad, without clear direction. This is mainly due to overlapping categorical diagnostic criteria of personality disorders. Study samples based on these criteria are inadequate and their results questionable. RECENT FINDINGS: The literature is unanimously advocating a dimensional concept of personality disorders. Four dimensions are consistently reported to underlie personality disorder symptoms...

The past decade has seen a period of extensive research into the etiology, pathophysiology, assessment, and treatment of personality disorders. Concomitantly, a group of experts in the field were brought together to form the Personality and Personality Disorder Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), charged with the responsibility of updating the diagnostic approach to personality disorders. This article is a review of some of the history of the American Psychiatry Association's approach to the recognition and diagnosis of personality disorders over the past half century, the process of developing the recommendations for a DSM-5 personality disorder diagnosis and the elimination of the multiaxial system, and how DSM-5 has left us with essentially no changes of relevance to the practice of forensic psychiatry in the process for diagnosing personality disorders or in the specific diagnoses of personality disorder...

BACKGROUND: Mild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. Earlier recognition of depression in young people has the potential to reduce the burden of depression in adulthood. However, depression in teenagers is underdiagnosed and undertreated. AIM: To assess the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY)...

CONTEXT: Chronically homeless adults with severe mental illness are heavy users of costly inpatient and emergency psychiatric services. Full-service partnerships (FSPs) provide housing and engage clients in treatment. OBJECTIVE: To examine changes in recovery outcomes, mental health service use and costs, and quality of life associated with participation in FSPs. DESIGN: A quasi-experimental, difference-in-difference design with a propensity score-matched control group was used to compare mental health service use and costs of FSP with public mental health services...