搜索结果：Psychiatry and Mental health

Deep emotional traumas in societies overwhelmed by large-scale human disasters, like, global pandemic diseases, natural disasters, man-made tragedies, war conflicts, social crises, etc., can cause massive stress-related disorders. Motivated by the ongoing global coronavirus pandemic, the article provides an overview of scientific evidence regarding adverse impact of diverse human disasters on mental health in afflicted groups and societies. Following this broader context, psychosocial impact of COVID-19 as a specific global human disaster is presented, with an emphasis on disturbing mental health aspects of the ongoing pandemic. Limited resources of mental health services in a number of countries around the world are illustrated, which will be further stretched by the forthcoming increase in demand for mental health services due to the global COVID-19 pandemic. Mental health challenges are particularly important for the Republic of Croatia in the current situation, due to disturbing stress of the 2020 Zagreb earthquake and the high pre-pandemic prevalence of chronic Homeland-War-related posttraumatic stress disorders. Comprehensive approach based on digital psychiatry is proposed to address the lack of access to psychiatric services, which includes artificial intelligence, telepsychiatry and an array of new technologies, like internet-based computer-aided mental health tools and services. These tools and means should be utilized as an important part of the whole package of measures to mitigate negative mental health effects of the global coronavirus pandemic. Our scientific and engineering experiences in the design and development of digital tools and means in mitigation of stress-related disorders and assessment of stress resilience are presented. Croatian initiative on enhancement of interdisciplinary research of psychiatrists, psychologists and computer scientists on the national and EU level is important in addressing pressing mental health concerns related to the ongoing pandemic and similar human disasters.

This year marks the 20th anniversary of the deathof Carl Rogers and the commencement of mynursing training. It was during my training that Iwas first formally introduced to the philosophy andtechniques of ‘person-centred’ counselling. Indeed,for years I thought unconditional positive regardand counselling were synonymous. Our course wassaturated with Roger’s philosophy and a number ofmy most inspiring teachers regarded Rogers withquasi-religious awe. This was the era of the grandtheory and not surprisingly the most famous NorthAmerican counsellor and philosopher influencedmost if not all theorists. Roger’s ideas relating to theactualizing tendency of people, and the conditionsfor growth and development influenced the practiceof nurse education independently and via nursingtheory. However, reflecting on Roger’s ideas inrelation to my experience working in psychiatricsettings has caused me some cognitive dissonance.The ideals of humanistic care are also sometimesat odds with the reality of psychiatric practice. Itwas against this backdrop that I eagerly agreed toreview this book, hoping that it might illuminatea path towards more humane if not humanisticmental health care.The author Rachel Freeth is a medical doctorwho detested much of her training and profes-sional culture, and felt ‘. . . disillusioned, angryand burnt out’ (p. 3) early in her psychiatric train-ing. Some 8 years ago she undertook a 1-yeardiploma in person-centred counselling butacknowledges that she has largely practiced as apsychiatrist within the National Health Service(NHS) and found it to difficult to integrate coun-selling practice within this role. Writing this book,she says, was a way to give meaning to her expe-rience of depression. The aims she said were tointroduce the person-centred approach, introduceperson-centred practitioners to the context ofpsychiatry and to explore something of what maybe involved in practising the person-centredapproach within mental health services.It is written in the first person and largely presenttense. This is a little jarring when referring to thelate Carl Rogers but it is clear that, for the author,Rogers is very much alive and deserving of rever-ence. When discussing Rogers, the style tendstowards proselytising, e.g. ‘For me, these passages. . . capture a breath-taking sensitivity and com-passion, as well as a total readiness to hear, senseand understand whatever it is a person might beexperiencing...CanI,too, embody this “way ofbeing”?’ (p. 141). In contrast, the author expressesunreserved negative regard for the NHS, its culture,management, priorities and the psycho-noxiousclimate of its facilities. This is perhaps the mostdominant thread throughout the book.The book is aimed at a wide audience. It is a slimvolume at 175 pages and 10 chapters. The first twochapters (36 pages) provide a brief introductionto notions of ‘person-centredness’ as defined byRodgers and his theory of personality development.These descriptions are brief and sketchy but thereader is referred to additional reading includingthe original texts. The next four chapters addressissues of power and expertise, the nature of andmodels of mental disorder, diagnosis and themedical model, and questions around healing andcure. These chapters are critical and sometimesaligned with anti-psychiatry sentiment. However,there is nothing new or particularly radical in thesesections for a well-read nursing audience. Indeed,these topics are routinely dealt with in a morearticulate and scholarly manner in this and manyother nursing journals. Chapters 7 to 9 loosely

Contributors. Preface. Foreword by susan beukes. Part 1. The science of Occupational Therapy. Chapter 1 Creative Ability - a Model for Psychiatric occupational Therapy. (Patricia de Witt). Chapter 2 Occupational Science as Applied to Occupational Therapy in The Mental Health Field. (Lana Van Niekerk). Chapter 3 Clinical reasoning in phychiatric occupational therapy. ( Vivyan Alers). Part 2. Specific issues in occupational Therapy. Chapter 4 HIV/AIDS in phychiatry: the moral and thical dilemmas and issues facing occupational therapists treating persons with HIV/AIDS. (Dain Van Der Reyden and Robin Joubert). Chapter 5 An occupational therapists perspective on sexually and psychosocial sexual rehabilitation. (Louise Fouche). Chapter 6 Community-based Occupational Therapy in Psychiatry and Mental Health. (Stephanie Homer). Chapter 7 Auxiliary staff in the field of psyciatry: requirements, functions and supervisions. (Dain van der Reyden). Chapter 8 Rehabillitation of the menatlly ill in long-term institutionalization. (Erla Venter and Kobie Zietsman). Chapter 9 Vocational rehabilitation in psychiatry and mental health. (Lyndsey Swart). Chapter 10 Psychiatric Occupational therapy in corporate, insurance and medicolegal sectors. (Lee Randall). Chapter 11 Forensic psychiatry and occupational therapy. (Michelle Moore). Part 3 Children and Adolescents. Chapter 12 Occupational therapy intervention with children with psychosocial disorders. (Rosemary Crouch and Vivyan Alers). Chapter 13 Interdisciplinary group therapy with children. (Marita Rademeyer and Deidre Neibaus). Chapter 14 Trauma and its effects on children, adolescents and adults: the progression from a victim to a survivor to a thriver. (Vivyan Alers and Romy Ancer). Chapter 15 A 'Bottom-up' approach: the factors influencing a child's emotional, motor and perceptual development for optimal learning. (Candace Lee Bylsma). Chapter 16 Sensory integration in mental retardation and pervasive developmental disorders. (Annamarie van Jaarsveld). Chapter 17 Specific occupational therapy intervention with adolescents. ( Louise Fouche). Part 4 Adults. Chapter 18 Post-traumatic brain injury. (Sylvia Birkhead). Chapter 19 Occupational therapy with axiety and Somatoform disorders. ( Madeleine Duncan). Chapter 20 Three approaches and processes in occupational therapy with mood disorders. (Madeleine Duncan). Chapter 21 Understanding and treating people with personality disorders in occupational therapy. (Ann Nott). Chapter 22 Aviation and psycho-education: major principles in the occupational therapists approach to schizophrenia. (Rosemary Crouch). Chapter 23 The recovering alcoholic and the occupational therapy intervention. (Rosemary Crouch). Chapter 24 Occupational therapy intervention for drug-related disorders. (Lisa Wegner). Chapter 25 Gerontology, psychiatry and occupational therapy. (Rae Labuschagne). References. Index.

The term “social psychiatry” became current in the Netherlands from the late 1920s. Its meaning was imprecise. In a general way, the term referred to psychiatric approaches of mental illness that focused on its social origins and backgrounds. In this broad interpretation social psychiatry was connected to the psycho-hygienic goal of preventing mental disorders, but also to epidemiological research on the distribution of mental illness among the population at large. The treatment called “active therapy”, introduced in Dutch mental asylums in the 1920s and geared towards the social rehabilitation of the mentally ill (especially through work), was also linked with social psychiatry. In a more narrow sense social psychiatry indicated what before the 1960s was usually called “after-care” and “pre-care”: forms of medical and social assistance for patients who had been discharged from the mental asylum or who had not yet been institutionalized. This article focuses on the twentieth-century development of Dutch social psychiatry in this more narrow sense, without, however, losing sight of its wider context: on the one hand institutional psychiatry for the insane and on the other the mental hygiene movement and several outpatient mental health facilities, which targeted a variety of groups with psychosocial and behavioural problems. In fact, the vacillating position of pre- and after-care services was again and again determined by developments in these adjacent psychiatric and mental health care domains. This overview is chronologically divided into three periods: the period between and during the two world wars, when psychiatric pre- and aftercare came into being; the post-Second World War era until 1982, when the Social-Psychiatric Services expanded and professionalized; and the 1980s and 1990s, when they became integrated in community mental health centres.

'Black and minority ethnic communities lack confidence in mental health services', according to the National Service Framework for Mental Health published by the Department of Health in 1999. Cultural Diversity, Mental Health and Psychiatry examines how and why this situation has come about, and makes specific practical, often surprising, suggestions for changing the status quo. In his latest and most critical analysis, Suman Fernando reflects on the current situation in light of his own personal experience, academic research and anecdotal reports. He weaves together themes of immense importance for the future of psychiatry and mental health services in a multi-cultural setting, exploring:* the nature of racism and its permeation into mental health services * the inside story of the struggle against racism in statutory and voluntary sectors of the mental health system* the history of psychiatry and the role of spirituality, holistic thinking, psychotherapy and Asian traditions of medicine. Trainees, practitioners, and managers of mental health services will profit from the practical application of Fernando's latest ideas, and students and academics will benefit from his theoretical guidance.

'Black and minority ethnic communities lack confidence in mental health services', according to the National Service Framework for Mental Health published by the Department of Health in 1999. Cultural Diversity, Mental Health and Psychiatry examines how and why this situation has come about, and makes specific practical, often surprising, suggestions for changing the status quo. In his latest and most critical analysis, Suman Fernando reflects on the current situation in light of his own personal experience, academic research and anecdotal reports. He weaves together themes of immense importance for the future of psychiatry and mental health services in a multi-cultural setting, exploring:* the nature of racism and its permeation into mental health services * the inside story of the struggle against racism in statutory and voluntary sectors of the mental health system* the history of psychiatry and the role of spirituality, holistic thinking, psychotherapy and Asian traditions of medicine. Trainees, practitioners, and managers of mental health services will profit from the practical application of Fernando's latest ideas, and students and academics will benefit from his theoretical guidance.

<JATS1:p>Directed to mental health professionals and graduate students in the mental health disciplines, we present a new way to augment the cost-effectiveness of current face-to-face (f2f) mental health based on talk, and, offer an alternative in primary, secondary, and tertiary prevention approaches. Distance writing (DW) and computer-assisted interventions (CAI) through the Internet opens up new vistas to those unable to be reached using traditional talk-based f2f approaches, i.e., living abroad, handicapped, the military, missionary families, Peace Corps volunteers, English speaking respondents (individuals, couples, and families), and most importantly incarcerated prisoners who do not seem to improve through conventional verbal, f2f approaches.</JATS1:p> <JATS1:p>DW and CAI vary in their structure (from high to low) and in levels of goals, content, specificity, and abstraction. Positive research evidence finds that DW and CAI is effective and actually cost-effective, with relatively healthy undergraduates, psychiatric outpatients, incarcerated felons, and physically handicapped patients supporting the use of this relatively new approach. This evolutionary step or paradigmatic shift cannot take place overnight, professionals suspicious of this new technology, will find this work a way to assuage their fears and help start this new cure on an experiential basis, utilizing structured interviews before starting to use writing and CAI at a distance. It presents an ample field of applications that will make research more cost-effective than traditional talk-based, f2f approaches.</JATS1:p> <JATS1:p>DW/CAI represents one way in which MH professionals can progress to meet managed care companies demands for accountability. Progress in most realms of business, science, education, law is based on the written record. The talking cure has occupied the last century as one of the greatest advances in how to help distressed people. By the same token, the writing cure represents the breakthrough for this coming century. Up to the present talk was conceived as the main if not the only vehicle of communication and healing. Adding DW/CAI to preventive and therapeutic armamentaria represents a distinct advance in how MH services will be delivered, to be accountable for professionals, and to conduct research economically, i. e., doing well while doing good. This work, therefore, combines theory, research, and practice to demonstrate the many advantages that DW/CAI offers as either an alternative, substitute, or supplement for talk therapy. Cyberspace is coming, instead of seeing it as a threat to traditional talk-based f2f practices, MH professionals will have to start to see the advantages of working with patients, clients, subjects, or respondents at a distance. Ethical and professional issues will present themselves in this new way, and should not detract professionals from starting this relatively new way to intervene, and to ensure that this new way to practice is delivered compassionately, responsibly, and effectively.</JATS1:p>

BACKGROUND: The COVID-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies. OBJECTIVE: As part of a research project that was cofunded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, the aim of this systematic literature review was to investigate how such uses of digital technologies have been developing. METHODS: This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was carried out in the MEDLINE (ie, PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts and then on full texts, 61 articles were included. RESULTS: The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up their experience of remote care and, thus, better identify the possibilities and limits of these digital technologies. CONCLUSIONS: New uses of such technologies essentially consist of a transition from the classic consultation model toward teleconsultation and make less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The COVID-19 health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular to promote the autonomy and empowerment of mental health service users.

OBJECTIVES: Tools based on generative artificial intelligence (AI) such as ChatGPT have the potential to transform modern society, including the field of medicine. Due to the prominent role of language in psychiatry, e.g., for diagnostic assessment and psychotherapy, these tools may be particularly useful within this medical field. Therefore, the aim of this study was to systematically review the literature on generative AI applications in psychiatry and mental health. METHODS: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted across three databases, and the resulting articles were screened independently by two researchers. The content, themes, and findings of the articles were qualitatively assessed. RESULTS: The search and screening process resulted in the inclusion of 40 studies. The median year of publication was 2023. The themes covered in the articles were mainly mental health and well-being in general - with less emphasis on specific mental disorders (substance use disorder being the most prevalent). The majority of studies were conducted as prompt experiments, with the remaining studies comprising surveys, pilot studies, and case reports. Most studies focused on models that generate language, ChatGPT in particular. CONCLUSIONS: Generative AI in psychiatry and mental health is a nascent but quickly expanding field. The literature mainly focuses on applications of ChatGPT, and finds that generative AI performs well, but notes that it is limited by significant safety and ethical concerns. Future research should strive to enhance transparency of methods, use experimental designs, ensure clinical relevance, and involve users/patients in the design phase.

Diagnosis in psychiatry continues to struggle to fulfil its key purposes, namely to guide treatment and to predict outcome. A clinical staging model, widely used in clinical medicine, could improve the utility of diagnosis in psychiatry, especially in young people with emerging disorders. Clinical staging has immediate potential to improve the logic and timing of interventions in psychiatry, as it does in many complex and potentially serious medical disorders. Interventions could be evaluated in terms of their ability to prevent or delay progression from earlier to later stages of a disorder, and selected by consumers and clinicians on the basis of clear-cut risk-benefit criteria. This would ensure that, as treatments are offered earlier, they remain safe, acceptable and affordable, and potentially more effective. Biological variables and a range of candidate risk and protective factors could be studied within and across stages, and their role, specificity and centrality in risk, onset and progression of disorders clarified. In this way, a clinicopathological framework could be progressively constructed. Clinical staging, with restructuring across and within diagnostic boundaries and explicit operational criteria for extent and progression of disorder, should be actively explored in psychiatry as a heuristic strategy for developing and evaluating earlier, safer, and more effective clinical interventions, and for clarifying the biological basis of psychiatric disorders. Young people with emerging mental and substance use disorders could be the main beneficiaries.

The purposeful application of fermentation in food and beverage preparation, as a means to provide palatability, nutritional value, preservative, and medicinal properties, is an ancient practice. Fermented foods and beverages continue to make a significant contribution to the overall patterns of traditional dietary practices. As our knowledge of the human microbiome increases, including its connection to mental health (for example, anxiety and depression), it is becoming increasingly clear that there are untold connections between our resident microbes and many aspects of physiology. Of relevance to this research are new findings concerning the ways in which fermentation alters dietary items pre-consumption, and in turn, the ways in which fermentation-enriched chemicals (for example, lactoferrin, bioactive peptides) and newly formed phytochemicals (for example, unique flavonoids) may act upon our own intestinal microbiota profile. Here, we argue that the consumption of fermented foods may be particularly relevant to the emerging research linking traditional dietary practices and positive mental health. The extent to which traditional dietary items may mitigate inflammation and oxidative stress may be controlled, at least to some degree, by microbiota. It is our contention that properly controlled fermentation may often amplify the specific nutrient and phytochemical content of foods, the ultimate value of which may associated with mental health; furthermore, we also argue that the microbes (for example, Lactobacillus and Bifidobacteria species) associated with fermented foods may also influence brain health via direct and indirect pathways.

This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative.

Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand.