Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed t...Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed to identify the predisposition and precipitation factors associated with the dynamics of NSSI behaviors among adolescents.Methods:This research is an explanatory research design with a cross-sectional study.Out of 4000 students,904 students from State High School and Vocational School in Central Java Province were selected as respondents using non-probability sampling and a purposive sampling approach.This research was carried out using Google Forms from September to November 2023.The instrument used was the Self-Harm Inventory(SHI).Data analysis in this study used the chi-squared test.Results:The results of this study indicate that the most significant predisposition factors of NSSI behaviors experienced by respondents in this study are introverted personality and the environment that supports NSSI behaviors.In contrast,the precipitation factors are bullying and deep disappointment.Otherwise,based on the data analysis,the maladaptive coping mechanism(P-value=0.029)has become a predisposition factor related to the dynamics of NSSI behaviors.In contrast,bullying(P-value=0.000)and deep disappointment(P-value=0.000)still become precipitation factors related to the dynamics of NSSI behaviors.Conclusions:The results of this study can be evidence-based for stakeholders to provide interventions,especially for the vulnerable population affected by NSSI behaviors.展开更多
CHILDHOODS MATTER.Human beings have a prodigious capacity to learn.The language we absorb at our mother’s knee is vastly complex,supple,subtle and continually in flux-but vital for social skills.And also crucial,for ...CHILDHOODS MATTER.Human beings have a prodigious capacity to learn.The language we absorb at our mother’s knee is vastly complex,supple,subtle and continually in flux-but vital for social skills.And also crucial,for that ever elusive target for which we all strive,PEACE-OF-MIND.Those of us born into confident peaceable families,unsurprisingly,face the adult world with confidence and delight.We use language to grow solid,reliable,TRUSTWORTHY social networks—which we accept without a second thought.We presume that this is normal,healthy,and the rightful desert of every human being ever born—which it is.展开更多
The forum article by Professor Xie [1] raises the broad issue of whether mental health legislation in China needs to respond to the existing realities of the community mental health services system.Given the lack of c...The forum article by Professor Xie [1] raises the broad issue of whether mental health legislation in China needs to respond to the existing realities of the community mental health services system.Given the lack of community mental health resources in China,the burden of caring for persons with mental illnesses has traditionally been borne by families and by psychiatric hospitals.As China introduces its first national mental health legislation the concern is展开更多
PHILOSOPHY and PSYCHIATRY are unusual bedfellows.Medical students,already hard pressed for time,are generally thrust into the melee of mental disorders,having spent years focussing on first dissecting and then proddin...PHILOSOPHY and PSYCHIATRY are unusual bedfellows.Medical students,already hard pressed for time,are generally thrust into the melee of mental disorders,having spent years focussing on first dissecting and then prodding human bodies,which too often leaves little room for evaluating theories about human nature,especially with respect to“Intent”or Free Will.The present writer was unusual in that having spent two years in pre-clinical medical training,he devoted a full university year to pursuing philosophical studies in up to 20 different university departments.Thus he entered his teaching hospital with a working knowledge of Hume,Kant,Sartre,Wittgenstein,Buber and others.This is not a clinical paper-it focuses on the reasoning behind psychiatric precepts-so it is perhaps inevitable that today’s prevailing ideology is shown to be grievously wanting-a case of decidedly unphilosophical,even anti-philosophical,medical practice.The notion of there ever being a“scientific”theory of psychiatry has already been discounted in a series of earlier papers-which leaves us with the responsibility for choosing the best possible option,from an infinite number of theoretical models available.The paper provides a whistle-stop tour of how mental disease looks if you start with a confident and consistent look at that pinnacle of human attributes-consciousness.It doesn’t presume to say what consciousness is,but it does assume that it has a function,like every other human asset.Indeed by cutting corners,evaluating what has worked over 60 years in psychiatry,the result is as straightforward a picture of sanity as one can reasonably expect.As such,it leaves the reader with little wriggle room-there is enough clarity here,for you to accept or reject the main proposition.However,since the flaws described tend to be lethal,acceptance entails action.Now read on.展开更多
Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,...Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,short-term memory impairment as well as faciobrachial and grand mal seizures.We aim to present a case of a 53-year-old man with positive anti-voltage-gated potassium channel(VGKC)complex antibodies who initially presented with symptoms of psychotic mania.Six weeks post-psychiatric symptomatology,he presented with neurological symptoms such as faciobrachial jerking and tonic-clonic seizure.The patient had no previous psychiatric history and was initially treated with psychotropic medications.Our experience emphasises the fact that limbic encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology than neurological symptoms.Furthermore,immunological and laboratory testing takes a rather long time to determine the diagnosis.What is more,few psychiatrists consider autoimmune nature of the neuropsychiatric presentation.Therefore,it is important to consider autoimmune encephalitis in patients with new-onset psychosis or mania who also present with neurological symptoms at some stage of their illness.Characteristic indicators of autoimmune encephalitis include neurological symptoms such as facial twitching,seizures,confusion and cognitive decline.展开更多
AIM To understand the experience of maternal depression,the factors implicated in accessing health,and the acceptability of the psychosocial intervention.METHODS The participants were recruited from the paediatrics ou...AIM To understand the experience of maternal depression,the factors implicated in accessing health,and the acceptability of the psychosocial intervention.METHODS The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi,Pakistan.The study started in December 2009 and completed in December 2010.Women with maternal depression,aged 18-44 years with children aged 0-30 mo who had received nutritional supplements,and participated in the intervention programme[called Learning through Play(LTP)plus]were included in the study.Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention.A semi structured topic guide was used to conduct the interviews.RESULTS Framework analysis procedures were used to analyse the qualitative data.Four themes emerged:(1)the women's contextual environment:Interpersonal conflicts,lack of social support and financial issues being the major barriers in assessing healthcare;(2)women's isolation and powerlessness within the environment:Sense of loneliness was identified as a restricting factor to access healthcare;(3)the impact of the intervention(LTP-Plus):Women felt"listened to"and seemed empowered;and(4)empowered transformed women within the same contextual environment:The facilitator provided a"gardening role"in nurturing the women resulting in a positive transformation within the same environment.The women's homes seemed to be more happy homes and there was a positive change in their behaviour towards their children.CONCLUSION Findings informed the further development and testing of culturally-appropriate psychosocial intervention(LTP^+)for addressing maternal depression.展开更多
The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients' personality and character ...The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients' personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking(SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person's tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independentlyassociated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients' aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients' quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders' course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients' accounts could inform clinicians when planning management and delivering individualized treatment.展开更多
The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from...The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.展开更多
<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:n...<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:normal;"></span></i>) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. <strong>Methods: </strong>To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. <strong>Results:</strong> Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. <strong>Conclusions:</strong> This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.展开更多
Sleep paralysis (SP) is a benign,transient episode of immobility and it lasts a few seconds to a few minutes.It can occur while falling asleep or on awakening.It is a condition of unknown etiology and all the skeletal...Sleep paralysis (SP) is a benign,transient episode of immobility and it lasts a few seconds to a few minutes.It can occur while falling asleep or on awakening.It is a condition of unknown etiology and all the skeletal muscles are almost ‘paralyzed’.It leads to an inability to speak or move but individual remains conscious.This review summarizes the existential clinical literature on sleep paralysis most relevant to practitioners;also summarizes the many historical and artistic manifestations of SP in different cultures.It also throws light on the available Arabic literature and others as per the aim of the review.For this review,literature search using engines was carried out,and review papers and original research articles were analyzed.We start with a review which summarizes the collection of symptoms,prevalence rate,risk factors and etiological theories,characteristics and classification of the SP over the past years up to the present time,also the management in the form of psychotherapy and pharmacotherapy as well as the cultural significances in different countries.SP plays an important role in the genesis and maintenance of many supernatural beliefs such as nocturnal alien abductions,demonic and ghost attacks in individuals with intact reality testing.展开更多
Objective: This study investigated the profile of emotion dysregulation in Bipolar Disorder (BD) and compared it to Unipolar Depression, Anxiety, and Healthy control groups. Methods: 148 euthymic patients diagnosed wi...Objective: This study investigated the profile of emotion dysregulation in Bipolar Disorder (BD) and compared it to Unipolar Depression, Anxiety, and Healthy control groups. Methods: 148 euthymic patients diagnosed with BD (n = 48), Unipolar Depressive disorder (n = 50), Anxiety disorder (n = 50), and a Healthy Control (HC) group (n = 48) were evaluated using the Difficulties in Emotion Regulation Scale (DERS). The DERS yields a total score in addition to scores on six subcomponents believed to encapsulate the emotion dysregulation construct. Results: Compared to the healthy control group, all clinical groups (BD, Unipolar Depression, and Anxiety) reported significantly greater overall difficulties in emotion regulation (Total DERS) and difficulties specific to the DERS subcomponent measures: Goals, Impulse, and Strategies. The profile of emotion dysregulation was virtually identical for the Unipolar Depression and Anxiety groups, with BD demonstrating emotion regulation difficulties intermediate between controls and the two clinical groups. Specifically, emotion regulation in the BD group was significantly less compromised in the domains of acceptance of emotions, emotional awareness, and emotional clarity compared to the depression and anxiety groups. Conclusions: Emotion regulation abilities among people with euthymic BD were significantly less compromised than Unipolar Depression and Anxiety groups with regards to emotional awareness, acceptance of emotions, and understanding of emotions. However, emotion regulation abilities pertaining to engagement in goal directed behaviour, impulse control, and access to emotion regulation strategies were similarly compromised across all three clinical groups. This profile might help enrich extant adjunct psychological interventions for BD by enlisting emotion regulation strategies with the aim of decreasing the relapse rate that characterises BD.展开更多
Background:Attention deficit hyperactivity disorder(ADHD)is a neurodevelopmental disorder manifesting in early life.These children are more vulnerable to sexual abuse as victims and offenders.Here we describe a teenag...Background:Attention deficit hyperactivity disorder(ADHD)is a neurodevelopmental disorder manifesting in early life.These children are more vulnerable to sexual abuse as victims and offenders.Here we describe a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending.Case report:According to the 14-year-old accused,he has engaged in penetrative anal intercourse with another school colleague.He also divulged past such incidents involving a teenage male relative and insertion of foreign bodies by him to his anus repeatedly.On assessment the accused had features of inattention such as difficulty in sustaining attention,failing to finish work and features of impulsivity such as difficulty waiting for his turn and intruding on others.He was diagnosed with ADHD according to DSM 5 clinical criteria which were supported by the Sinhalese adaptation of the Swanson,Nolan and Pelham questionnaire.The assessment of the non-verbal intelligence was in the normal range,but his school performance was far below the average.Discussion:Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour.It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour.Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.展开更多
Approximately 25%–50%of children with attention deficit hyperactivity disorder have sleep problems.The aim of this study is to compare the effect of horse milk with conventionally-fed cow’s milk on sleep disorders i...Approximately 25%–50%of children with attention deficit hyperactivity disorder have sleep problems.The aim of this study is to compare the effect of horse milk with conventionally-fed cow’s milk on sleep disorders in children with attention deficit hyperactivity disorder.In this randomized double-blind crossover study,30 patients with attention deficit hyperactivity disorder were randomly selected and divided into two groups.All patients underwent a 45-day period of horse milk consumption and a 45-day period of cow milk consumption and they continued their drug treatment.A one-week interval between two periods of milk consumption was considered as the washout period.The severity of sleep disorder in the studied patients was determined based on the short form of the Children’s Sleep Habits Questionnaire(CSHQ).Twenty-two(73.3%)male and eight(26.7%)female patients were included in this study.The mean age of the patients was 8.9 years.Our results showed that horse milk consumption improved the CSHQ score.For the group of patients consuming horse milk prior to cow milk,reductions of total CSHQ(P-value=0.001)and subscale 1(P-value<0.001)scores were significant.For the group of patients consuming cow milk first,in addition to the total CSHQ(P-value<0.001),subscale 3(P-value=0.001)and 4(P-value=0.009)dropped significantly.On the other hand,the results indicated that cow milk consumption increased the CSHQ score.Specifically,for the group of patients consuming horse milk first,the total CSHQ(P-value=0.001),subscale 3(P-value=0.016),and subscale 4(P-value=0.010)increased significantly.The mean values of the first,second,third,and fourth subscales of CSHQ before and after the washout period were not significantly different between the two groups.According to the study,consuming horse milk was significantly better than cow milk in improving the total score of CSHQ in children with attention deficit hyperactivity disorder.展开更多
Arachnoid cysts are uncommon benign neurological tumors,and having presentation like schizophrenia,which has been reported in association with this cyst.The presence of psychiatric disturbances of arachnoid cyst has n...Arachnoid cysts are uncommon benign neurological tumors,and having presentation like schizophrenia,which has been reported in association with this cyst.The presence of psychiatric disturbances of arachnoid cyst has not been clearly mentioned in the literature.Even though,the appearance of some of the references that focuses on a possible link between arachnoid cysts and psychotic symptoms.Here we present a case report of a 35-year-old man,characterized by the insidious onset of psychotic symptoms of varying intensity such as multiple physical assaults on people with stone.Due to organic suspicion one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation.展开更多
文摘Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed to identify the predisposition and precipitation factors associated with the dynamics of NSSI behaviors among adolescents.Methods:This research is an explanatory research design with a cross-sectional study.Out of 4000 students,904 students from State High School and Vocational School in Central Java Province were selected as respondents using non-probability sampling and a purposive sampling approach.This research was carried out using Google Forms from September to November 2023.The instrument used was the Self-Harm Inventory(SHI).Data analysis in this study used the chi-squared test.Results:The results of this study indicate that the most significant predisposition factors of NSSI behaviors experienced by respondents in this study are introverted personality and the environment that supports NSSI behaviors.In contrast,the precipitation factors are bullying and deep disappointment.Otherwise,based on the data analysis,the maladaptive coping mechanism(P-value=0.029)has become a predisposition factor related to the dynamics of NSSI behaviors.In contrast,bullying(P-value=0.000)and deep disappointment(P-value=0.000)still become precipitation factors related to the dynamics of NSSI behaviors.Conclusions:The results of this study can be evidence-based for stakeholders to provide interventions,especially for the vulnerable population affected by NSSI behaviors.
文摘CHILDHOODS MATTER.Human beings have a prodigious capacity to learn.The language we absorb at our mother’s knee is vastly complex,supple,subtle and continually in flux-but vital for social skills.And also crucial,for that ever elusive target for which we all strive,PEACE-OF-MIND.Those of us born into confident peaceable families,unsurprisingly,face the adult world with confidence and delight.We use language to grow solid,reliable,TRUSTWORTHY social networks—which we accept without a second thought.We presume that this is normal,healthy,and the rightful desert of every human being ever born—which it is.
文摘The forum article by Professor Xie [1] raises the broad issue of whether mental health legislation in China needs to respond to the existing realities of the community mental health services system.Given the lack of community mental health resources in China,the burden of caring for persons with mental illnesses has traditionally been borne by families and by psychiatric hospitals.As China introduces its first national mental health legislation the concern is
文摘PHILOSOPHY and PSYCHIATRY are unusual bedfellows.Medical students,already hard pressed for time,are generally thrust into the melee of mental disorders,having spent years focussing on first dissecting and then prodding human bodies,which too often leaves little room for evaluating theories about human nature,especially with respect to“Intent”or Free Will.The present writer was unusual in that having spent two years in pre-clinical medical training,he devoted a full university year to pursuing philosophical studies in up to 20 different university departments.Thus he entered his teaching hospital with a working knowledge of Hume,Kant,Sartre,Wittgenstein,Buber and others.This is not a clinical paper-it focuses on the reasoning behind psychiatric precepts-so it is perhaps inevitable that today’s prevailing ideology is shown to be grievously wanting-a case of decidedly unphilosophical,even anti-philosophical,medical practice.The notion of there ever being a“scientific”theory of psychiatry has already been discounted in a series of earlier papers-which leaves us with the responsibility for choosing the best possible option,from an infinite number of theoretical models available.The paper provides a whistle-stop tour of how mental disease looks if you start with a confident and consistent look at that pinnacle of human attributes-consciousness.It doesn’t presume to say what consciousness is,but it does assume that it has a function,like every other human asset.Indeed by cutting corners,evaluating what has worked over 60 years in psychiatry,the result is as straightforward a picture of sanity as one can reasonably expect.As such,it leaves the reader with little wriggle room-there is enough clarity here,for you to accept or reject the main proposition.However,since the flaws described tend to be lethal,acceptance entails action.Now read on.
文摘Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,short-term memory impairment as well as faciobrachial and grand mal seizures.We aim to present a case of a 53-year-old man with positive anti-voltage-gated potassium channel(VGKC)complex antibodies who initially presented with symptoms of psychotic mania.Six weeks post-psychiatric symptomatology,he presented with neurological symptoms such as faciobrachial jerking and tonic-clonic seizure.The patient had no previous psychiatric history and was initially treated with psychotropic medications.Our experience emphasises the fact that limbic encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology than neurological symptoms.Furthermore,immunological and laboratory testing takes a rather long time to determine the diagnosis.What is more,few psychiatrists consider autoimmune nature of the neuropsychiatric presentation.Therefore,it is important to consider autoimmune encephalitis in patients with new-onset psychosis or mania who also present with neurological symptoms at some stage of their illness.Characteristic indicators of autoimmune encephalitis include neurological symptoms such as facial twitching,seizures,confusion and cognitive decline.
文摘AIM To understand the experience of maternal depression,the factors implicated in accessing health,and the acceptability of the psychosocial intervention.METHODS The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi,Pakistan.The study started in December 2009 and completed in December 2010.Women with maternal depression,aged 18-44 years with children aged 0-30 mo who had received nutritional supplements,and participated in the intervention programme[called Learning through Play(LTP)plus]were included in the study.Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention.A semi structured topic guide was used to conduct the interviews.RESULTS Framework analysis procedures were used to analyse the qualitative data.Four themes emerged:(1)the women's contextual environment:Interpersonal conflicts,lack of social support and financial issues being the major barriers in assessing healthcare;(2)women's isolation and powerlessness within the environment:Sense of loneliness was identified as a restricting factor to access healthcare;(3)the impact of the intervention(LTP-Plus):Women felt"listened to"and seemed empowered;and(4)empowered transformed women within the same contextual environment:The facilitator provided a"gardening role"in nurturing the women resulting in a positive transformation within the same environment.The women's homes seemed to be more happy homes and there was a positive change in their behaviour towards their children.CONCLUSION Findings informed the further development and testing of culturally-appropriate psychosocial intervention(LTP^+)for addressing maternal depression.
文摘The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients' personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking(SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person's tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independentlyassociated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients' aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients' quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders' course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients' accounts could inform clinicians when planning management and delivering individualized treatment.
文摘The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.
文摘<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:normal;"></span></i>) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. <strong>Methods: </strong>To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. <strong>Results:</strong> Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. <strong>Conclusions:</strong> This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.
文摘Sleep paralysis (SP) is a benign,transient episode of immobility and it lasts a few seconds to a few minutes.It can occur while falling asleep or on awakening.It is a condition of unknown etiology and all the skeletal muscles are almost ‘paralyzed’.It leads to an inability to speak or move but individual remains conscious.This review summarizes the existential clinical literature on sleep paralysis most relevant to practitioners;also summarizes the many historical and artistic manifestations of SP in different cultures.It also throws light on the available Arabic literature and others as per the aim of the review.For this review,literature search using engines was carried out,and review papers and original research articles were analyzed.We start with a review which summarizes the collection of symptoms,prevalence rate,risk factors and etiological theories,characteristics and classification of the SP over the past years up to the present time,also the management in the form of psychotherapy and pharmacotherapy as well as the cultural significances in different countries.SP plays an important role in the genesis and maintenance of many supernatural beliefs such as nocturnal alien abductions,demonic and ghost attacks in individuals with intact reality testing.
文摘Objective: This study investigated the profile of emotion dysregulation in Bipolar Disorder (BD) and compared it to Unipolar Depression, Anxiety, and Healthy control groups. Methods: 148 euthymic patients diagnosed with BD (n = 48), Unipolar Depressive disorder (n = 50), Anxiety disorder (n = 50), and a Healthy Control (HC) group (n = 48) were evaluated using the Difficulties in Emotion Regulation Scale (DERS). The DERS yields a total score in addition to scores on six subcomponents believed to encapsulate the emotion dysregulation construct. Results: Compared to the healthy control group, all clinical groups (BD, Unipolar Depression, and Anxiety) reported significantly greater overall difficulties in emotion regulation (Total DERS) and difficulties specific to the DERS subcomponent measures: Goals, Impulse, and Strategies. The profile of emotion dysregulation was virtually identical for the Unipolar Depression and Anxiety groups, with BD demonstrating emotion regulation difficulties intermediate between controls and the two clinical groups. Specifically, emotion regulation in the BD group was significantly less compromised in the domains of acceptance of emotions, emotional awareness, and emotional clarity compared to the depression and anxiety groups. Conclusions: Emotion regulation abilities among people with euthymic BD were significantly less compromised than Unipolar Depression and Anxiety groups with regards to emotional awareness, acceptance of emotions, and understanding of emotions. However, emotion regulation abilities pertaining to engagement in goal directed behaviour, impulse control, and access to emotion regulation strategies were similarly compromised across all three clinical groups. This profile might help enrich extant adjunct psychological interventions for BD by enlisting emotion regulation strategies with the aim of decreasing the relapse rate that characterises BD.
文摘Background:Attention deficit hyperactivity disorder(ADHD)is a neurodevelopmental disorder manifesting in early life.These children are more vulnerable to sexual abuse as victims and offenders.Here we describe a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending.Case report:According to the 14-year-old accused,he has engaged in penetrative anal intercourse with another school colleague.He also divulged past such incidents involving a teenage male relative and insertion of foreign bodies by him to his anus repeatedly.On assessment the accused had features of inattention such as difficulty in sustaining attention,failing to finish work and features of impulsivity such as difficulty waiting for his turn and intruding on others.He was diagnosed with ADHD according to DSM 5 clinical criteria which were supported by the Sinhalese adaptation of the Swanson,Nolan and Pelham questionnaire.The assessment of the non-verbal intelligence was in the normal range,but his school performance was far below the average.Discussion:Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour.It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour.Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.
基金This study was supported by Shahid Sadoughi University of Medical Sciences,Yazd,Iran.
文摘Approximately 25%–50%of children with attention deficit hyperactivity disorder have sleep problems.The aim of this study is to compare the effect of horse milk with conventionally-fed cow’s milk on sleep disorders in children with attention deficit hyperactivity disorder.In this randomized double-blind crossover study,30 patients with attention deficit hyperactivity disorder were randomly selected and divided into two groups.All patients underwent a 45-day period of horse milk consumption and a 45-day period of cow milk consumption and they continued their drug treatment.A one-week interval between two periods of milk consumption was considered as the washout period.The severity of sleep disorder in the studied patients was determined based on the short form of the Children’s Sleep Habits Questionnaire(CSHQ).Twenty-two(73.3%)male and eight(26.7%)female patients were included in this study.The mean age of the patients was 8.9 years.Our results showed that horse milk consumption improved the CSHQ score.For the group of patients consuming horse milk prior to cow milk,reductions of total CSHQ(P-value=0.001)and subscale 1(P-value<0.001)scores were significant.For the group of patients consuming cow milk first,in addition to the total CSHQ(P-value<0.001),subscale 3(P-value=0.001)and 4(P-value=0.009)dropped significantly.On the other hand,the results indicated that cow milk consumption increased the CSHQ score.Specifically,for the group of patients consuming horse milk first,the total CSHQ(P-value=0.001),subscale 3(P-value=0.016),and subscale 4(P-value=0.010)increased significantly.The mean values of the first,second,third,and fourth subscales of CSHQ before and after the washout period were not significantly different between the two groups.According to the study,consuming horse milk was significantly better than cow milk in improving the total score of CSHQ in children with attention deficit hyperactivity disorder.
文摘Arachnoid cysts are uncommon benign neurological tumors,and having presentation like schizophrenia,which has been reported in association with this cyst.The presence of psychiatric disturbances of arachnoid cyst has not been clearly mentioned in the literature.Even though,the appearance of some of the references that focuses on a possible link between arachnoid cysts and psychotic symptoms.Here we present a case report of a 35-year-old man,characterized by the insidious onset of psychotic symptoms of varying intensity such as multiple physical assaults on people with stone.Due to organic suspicion one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation.
