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d-Cycloserine Facilitation of Exposure Therapy Improves Weight Regain in Patients With Anorexia Nervosa: A Pilot Randomized Controlled Trial
Levinson, Cheri A.; Rodebaugh, Thomas L.; Fewell, Laura; Kass, Andrea E.; Riley, Elizabeth N.; Stark, Lynn; McCallum, Kimberly; Lenze, Eric J.
Objective Exposure therapy in anorexia nervosa has preliminarily been shown to be effective for increasing food intake. d-Cycloserine is a glutamatergic N-methyl-d-aspartate receptor agonist that has been shown to facilitate the benefits of exposure therapy for anxiety disorders by enhancing the emotional learning in the exposures; therefore, we examined d-cycloserine–facilitation of exposure therapy to increase body mass index (BMI) in patients with anorexia nervosa. Method Participants (N = 36) with anorexia nervosa (diagnosed via DSM-IV) were recruited from a partial hospitalization eating disorder clinic between February 2013 and November 2013. Participants were randomly assigned to receive exposure therapy plus d-cycloserine (n = 20) or placebo (n = 16). Participants completed psychoeducation and 4 sessions of exposure therapy, with medication (d-cycloserine vs placebo) given prior to the first 3 exposure sessions. They also completed a 1-month follow-up. Results As hypothesized, participants in the d-cycloserine group showed a significantly greater increase in BMI than those in the placebo group (Wilk Λ = 0.86, F3,32 = 2.20, P = .043, ηp2 = 0.12). d-Cycloserine participants gained 3 pounds relative to 0.5 pounds in the placebo group. Both groups experienced significantly decreased anxiety over the course of therapy (Wilk Λ = 0.80, F3,32 = 3.32, P = .023, ηp2 = 0.20). Conclusions This study preliminarily demonstrates that d-cycloserine facilitates exposure therapy for anorexia nervosa, leading to increased weight gain. A potential mechanism is that participants who receive d-cycloserine may generalize learning from within-session exposures to food intake during other similar meals, resulting in sustained increases in BMI. Further research is needed to confirm these findings and test the putative mechanism that generalized learning from exposure therapy can increase BMI and stabilize a healthy weight. Trial Registration ClinicalTrials.gov identifier: NCT
Carbamazepine-Induced Hyponatremia in Patients with Mental Retardation.
ERIC Educational Resources Information Center
Kastner, Ted; And Others
This study of 40 patients with mental retardation receiving carbamazepine found hyponatremia in only 5 percent of these patients and found a statistically, but not clinically, significant decrease in serum sodium levels in patients receiving anticonvulsant polytherapy. Results support the use of this drug with patients with mental retardation and…
Weight Regain Following Sleeve Gastrectomy-a Systematic Review.
Lauti, Melanie; Kularatna, Malsha; Hill, Andrew G; MacCormick, Andrew D
Sleeve gastrectomy (SG) is a commonly performed bariatric procedure. Weight regain following SG is a significant issue. Yet the defining, reporting and understanding of this phenomenon remains largely neglected. Systematic review was performed to locate articles reporting the definition, rate and/or cause of weight regain in patients at least 2 years post-SG. A range of definitions employed to describe weight regain were identified in the literature. Rates of regain ranged from 5.7 % at 2 years to 75.6 % at 6 years. Proposed causes of weight regain included initial sleeve size, sleeve dilation, increased ghrelin levels, inadequate follow-up support and maladaptive lifestyle behaviours. Bariatric literature would benefit from standardising definitions used to report weight regain and its rate in clinical series. Larger prospective studies are required to further understand mechanisms of weight regain following SG.
Sparing of Spatial Mental Imagery in Patients with Hippocampal Lesions
ERIC Educational Resources Information Center
Kim, Soyun; Borst, Grégoire; Thompson, William L.; Hopkins, Ramona O.; Kosslyn, Stephen M.; Squire, Larry R.
In four experiments, we explored the capacity for spatial mental imagery in patients with hippocampal lesions, using tasks that minimized the role of learning and memory. On all four tasks, patients with hippocampal lesions performed as well as controls. Nonetheless, in separate tests, the patients were impaired at remembering the materials that…
Metabolic syndrome in patients with severe mental illness in Gorgan
Kamkar, Mohammad Zaman; Sanagoo, Akram; Zargarani, Fatemeh; Jouybari, Leila; Marjani, Abdoljalal
Background: Metabolic syndrome is commonly associated with cardiovascular diseases and psychiatric mental illness. Hence, we aimed to assess the metabolic syndrome among severe mental illness (SMI). Materials and Methods: The study included 267 patients who were referred to the psychiatric unit at 5th Azar Education Hospital of Golestan University of Medical Sciences in Gorgan, Iran. Results: The mean waist circumference, systolic and diastolic blood pressure, triglyceride and fasting blood glucose levels were significantly higher in the SMI with metabolic syndrome, but the high density lipoprotein (HDL)-cholesterol was significantly lower. The prevalence of metabolic syndrome in SMI patients was 20.60%. There were significant differences in the mean of waist circumference, systolic (except for women) and diastolic blood pressure, triglyceride, HDL-cholesterol and fasting blood glucose in men and women with metabolic syndrome when compared with subjects without metabolic syndrome. The prevalence of metabolic syndrome in SMI women was higher than men. The most age distribution was in range of 30-39 years old. The most prevalence of metabolic syndrome was in age groups 50-59 years old. The prevalence of metabolic syndrome was increased from 30 to 59 years old. Conclusion: The prevalence of metabolic syndrome in patients with SMI in Gorgan is almost similar to those observed in Asian countries. The prevalence of metabolic syndrome was lower than western countries. These observations may be due to cultural differences in the region. It should be mention that the families of mental illness subjects in our country believe that their patients must be cared better than people without mental illness. These findings of this study suggest that mental illness patients are at risk of metabolic syndrome. According to our results, risk factors such as age and gender differences may play an important role in the presence of metabolic syndrome. In our country, women do less
Digital vasodilatation during mental stress in patients with Raynaud's disease.
Halperin, J L; Cohen, R A; Coffman, J D
Fingertip blood flow was measured by venous occlusion plethysmography before and during a stressful mental task consisting of rapid serial arithmetic calculations in a 25 degrees C room. Significant rises in heart rate and blood pressure indicated that stress was actually induced in all individuals. During mental stress in normal subjects, blood flow decreased (46.4 +/- 6.2 to 22.4 +/- 4.9 ml X min-1 per 100 ml tissue; P less than 0.01) and vascular resistance increased (2.1 +/- 0.4 to 7.6 +/- 2.2 units; P less than 0.01). Patients with Raynaud's disease unexpectedly increased blood flow (15.4 +/- 4.2 to 21.6 +/- 5.7; P = 0.05) and decreased vascular resistance (9.7 +/- 2.3 to 7.1 +/- 1.4; P = 0.05). Ten additional normal subjects were studied in a cool room (20 degrees C). Their digits remained vasoconstricted during stress, as blood flow (7.4 +/- 2.9 to 5.1 +/- 1.3) and vascular resistance (31.5 +/- 11.1 to 34.4 +/- 8.2) varied insignificantly (P greater than 0.10). The digital vasodilatation which occurs during mental stress in patients with Raynaud's disease was not altered by pretreatment with oral indomethacin, with intra-arterial propranolol or atropine, or by digital nerve block. These findings suggest the existence of an active digital vasodilatory mechanism in patients with Raynaud's disease.
Intrusive mental imagery in patients with persecutory delusions.
Schulze, Katja; Freeman, Daniel; Green, Catherine; Kuipers, Elizabeth
Recent theoretical and experimental work indicates a close connection between anxiety and paranoia. Cognitive processes that lead to the persistence of anxiety disorders may have a similar role in persecutory fears. One factor identified as important in anxiety disorders are intrusive mental images. These negative images are common in anxiety disorders, and associated with symptom persistence. The aim of the current study was to examine intrusive mental images in individuals with persecutory delusions. The prevalence and characteristics of self-reported paranoia-related intrusive images, and relationships between image ratings and clinical symptoms were examined in 40 patients with persecutory delusions. It was found that 73% (n = 29) of patients reported paranoia-related, recurrent intrusive images (e.g. being attacked with a knife). The degree to which the images provoked anxiety was associated both with greater general anxiety and with more distressing persecutory delusions. It is concluded that intrusive images may be relatively common in patients with persecutory delusions and may contribute to the distress of paranoid experiences. Re-scripting such images and their associated memories might be a way of developing cognitive behavioural therapy for psychosis.
Mental status in patients with chronic bacterial prostatitis
Banyra, Oleg; Ivanenko, Olha; Nikitin, Oleg
Introduction Chronic prostatitis is a widespread urological disease with a lengthy course and a propensity to frequent recurrences. Adequate response to anti–inflammatory therapy is lacking in a high percentage of patients, which causes them to seek medical advice from different doctors. Thus, the physicians are challenged to look for other reasons causing the pathological symptoms. Material and methods We have reviewed the patients with treatment–resistant chronic bacterial prostatitis (CBP) from the perspective of psychosomatic medicine. For the evaluation of primary mental status and treatment control we used standard approved questionnaires. All 337 CBP patients initially underwent therapy aimed at pathogen eradication. If psychopathological symptoms were evident and dominated over urological ones, the patients were referred to psychiatric evaluation and treatment. Results The frequency of concomitant psychosomatic disorders (PSD) in patients with CBP was 28.2% and neurotic disorders – 26.4%. Adequate multimodal anti–inflammatory therapy followed by a few sessions of psychotherapy decreased the manifestations of PSD in 30.5%, neurotic disorders in 51.7%, and premature ejaculation in 60.5% of patients with CBP. The addition of pharmacotherapy to psychotherapy is effective in treatment–resistant cases. However, after multimodal treatment, 31.5% of pts. with PSD and 13.5% of pts. with neurotic disorders still remain treatment–resistant and required in–depth long–term psychiatric care. Conclusions A significant portion of CBP patients were diagnosed with neurotic, psychosomatic, and/or depressive disorders. Antibacterial and anti–inflammatory therapy, when followed by appropriate psychotherapy and pharmacotherapy, significantly decrease the manifestations of mental disorders in CBP patients. PMID:24579003
Narayanan, H.S.; Girimaji, S.R.; Gandhi, D.H.; Raju, K. Maruthai; Rao, P. Madhu; Nardev, G.
SUMMARY A novel programme of intervention - brief inpatient family intervention - was formulated to impart the training skills to the parents of mentally retarded children to optimise the development of their retarded child. During the period of this study. 106 mentally retarded children with different socio-demographic backgrounds and degrees of handicap participated in this programme, with encouraging results. The individualised management plan, spread over 2 weeks of inpatient stay, included intensive counselling, training of the parents in techniques of multisensory stimulation, speech, motor, and self-help skills training, behaviour modification and medical management, as required. The programme could serve as a suitable model for professionals working with the mentally retarded, to implement with limited resources. PMID:21927322
Evaluation of body esteem and mental health in patients with breast cancer after mastectomy
Heidari, Mohammad; Shahbazi, Sara; Ghodusi, Mansureh
Introduction: Mastectomy in patients with breast cancer can severely affect their body esteem. It also changes the emotions and attitudes of patients toward their body and causes psychological reactions such as depression, anxiety, and stress. Aims: This study was conducted with the aim of assessing correlation between body esteem and mental health in patients with breast cancer after mastectomy. Materials and Methods: This study is a descriptive study. One hundred patients with breast cancer after mastectomy were selected by convenience sampling from Seyed Al Shohada Hospital in Isfahan. Data gathering tools were questionnaires of body esteem and SCL-25 mental health and were analyzed by SPSS-PC (v.17). Results: According to the score of body esteem (2.80) and the overall average score for body esteem (36.46), patients had low body esteem. About dimensions of the mental health, the highest average was associated with depressive disorders. According to the results of the Spearman correlation coefficient, there was a direct linear relationship between body esteem and mental health. Conclusion: Considering the impact of mastectomy on body esteem and mental health and the relationship between the variables, nurses take steps for identifying and referring patients to the counseling centers to prevent psychological disorder aspects. PMID:26903758
Dose-dependent valproate-induced alopecia in patients with mental disorders.
Tomita, Takashi; Goto, Hidekazu; Yoshida, Tadashi; Tanaka, Katsuya; Sumiya, Kenji; Kohda, Yukinao
Drug-induced hair loss may occur as a side effect in patients treated with valproate. However, few studies have reported a relationship between the blood levels of valproate and the occurrence of hair loss. We report three cases of alopecia that occurred in patients who received sodium valproate for mental disorders. In all three cases, alopecia appeared after long-term valproate exposure with a plasma concentration of 100 µg/ml approximately. However, the alopecia resolved in all cases after dose reduction or treatment discontinuation. Therefore, alopecia may develop in patients with chronic exposure to high plasma concentrations of valproate. Based on these findings, we believe that patients with high plasma concentrations of valproate should be closely monitored for the occurrence of side effects, particularly alopecia.
The Perceived Stigma in Patients with Alopecia and Mental Disorder: A Comparative Study
Kacar, Seval Dogruk; Soyucok, Ethem; Bagcioglu, Erman; Ozuguz, Pınar; Coskun, Kerem Senol; Asık, Ahmet Hakki; Mayda, Hasan
Aim: We aimed to measure the perceived stigma, especially in patients with alopecia areata (AA) and to compare the results with patients with mental disorder (MD). Materials and Methods: This study included forty patients with AA who were consecutively recruited from dermatology outpatient clinic and 42 patients with MD who were consecutively recruited from psychiatric outpatient clinic. The presence of a MD was assessed by the Diagnostic and Statistical Manual of Mental Disorder Fourth Edition. All participants were asked to complete the 28 items modified stigmatization questionnaire. Results: Total and all subscale scores of stigmatization questionnaire scale were higher in the group of patients with AA than in the patients with MD. Conclusion: AA is a condition that leads to more self-stigmatization than MD. PMID:27625566
Detection of mental imagery and attempted movements in patients with disorders of consciousness using EEG
Horki, Petar; Bauernfeind, Günther; Klobassa, Daniela S.; Pokorny, Christoph; Pichler, Gerald; Schippinger, Walter; Müller-Putz, Gernot R.
Further development of an EEG based communication device for patients with disorders of consciousness (DoC) could benefit from addressing the following gaps in knowledge—first, an evaluation of different types of motor imagery; second, an evaluation of passive feet movement as a mean of an initial classifier setup; and third, rapid delivery of biased feedback. To that end we investigated whether complex and/or familiar mental imagery, passive, and attempted feet movement can be reliably detected in patients with DoC using EEG recordings, aiming to provide them with a means of communication. Six patients in a minimally conscious state (MCS) took part in this study. The patients were verbally instructed to perform different mental imagery tasks (sport, navigation), as well as attempted feet movements, to induce distinctive event-related (de)synchronization (ERD/S) patterns in the EEG. Offline classification accuracies above chance level were reached in all three tasks (i.e., attempted feet, sport, and navigation), with motor tasks yielding significant (p < 0.05) results more often than navigation (sport: 10 out of 18 sessions; attempted feet: 7 out of 14 sessions; navigation: 4 out of 12 sessions). The passive feet movements, evaluated in one patient, yielded mixed results: whereas time-frequency analysis revealed task-related EEG changes over neurophysiological plausible cortical areas, the classification results were not significant enough (p < 0.05) to setup an initial classifier for the detection of attempted movements. Concluding, the results presented in this study are consistent with the current state of the art in similar studies, to which we contributed by comparing different types of mental tasks, notably complex motor imagery and attempted feet movements, within patients. Furthermore, we explored new venues, such as an evaluation of passive feet movement as a mean of an initial classifier setup, and rapid delivery of biased feedback. PMID:25566029
Mental Rotation as an Indicator of Motor Representation in Patients with Mild Cognitive Impairment
Bourrelier, Julien; Kubicki, Alexandre; Rouaud, Olivier; Crognier, Lionel; Mourey, France
This internal representation of movement of part(s) of the body is involved during Implicit Motor Imagery tasks (IMI); the same representations are employed in the laterality judgment task. Few studies have looked at the consequences of aging, Alzheimer's disease (AD) and mild cognitive impairment (MCI) on the processes of motor preparation but none showed evidence of an alteration of action representation in patient with amnestic MCI. In the present study, the IMI task was used to assess the action representation abilities in MCI patients and healthy counterparts. A total of 24 elderly participants aged between 65 and 90 years old (12 women, 73.4 ± 6 years, mean ± S.D.) were recruited: 12 patients with MCI (MCI group) and 12 healthy aged adults (HAA group). The results showed that MCI patients have significantly a greater response time (RT) than HAA subjects only in IMI task and more precisely when performing their mental rotation at the challenging conditions. Furthermore, the IMI task related to the non-dominant hand induced a significant increase of RT only in MCI subjects. At the light of these results, we assume that MCI patients are able to engage themselves in IMI processes, still showing a compelling impairment of this mental ability across its complexity. PMID:26779010
Mental health and quality of life in patients with chronic otitis media.
Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk
The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p < 0.001), interpersonal sensitivity (p < 0.001), depression (p < 0.001), phobic anxiety (p < 0.001), and other subscores, and also global severity index score (p < 0.001) were significantly high in patient group when compared to the control group. The patients with COM reported significantly lower levels of QoL in terms of physical role difficulty (p < 0.001), general health perception (p < 0.004), social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests.
Cigarette smoking is associated with thinner cingulate and insular cortices in patients with severe mental illness
Jørgensen, Kjetil Nordbø; Psychol, Cand; Skjærvø, Ingeborg; Mørch-Johnsen, Lynn; Haukvik, Unn Kristin; Lange, Elisabeth Heffermehl; Melle, Ingrid; Andreassen, Ole Andreas; Agartz, Ingrid
Background Magnetic resonance imaging (MRI) studies show reduced cortical thickness in patients with schizophrenia and bipolar disorder. These subtle brain abnormalities may provide insight into illness mechanisms. However, environmental and lifestyle-related factors, such as cigarette smoking, may contribute to brain structure changes. Cigarette smoking is highly prevalent in patients with severe mental illness. In nonpsychiatric samples, smoking has been associated with reduced thickness in the anterior (ACC) and posterior cingulate cortices, the insular cortex (INS), the dorsolateral prefrontal cortex and the orbitofrontal cortex. Methods We examined MRI scans from patients with schizophrenia, other psychotic disorders or bipolar disorder and healthy controls using FreeSurfer. Results We included 506 patients (49% smokers) and 237 controls (20% smokers) in our study. We found reduced cortical thickness in the left rostral ACC and the left INS in smoking patients compared with nonsmoking patients, but this difference was not found among healthy controls. No dose–response relationship was found between amount of smoking and cortical thickness in these regions. Among patients, maps of thickness along the whole cortical surface revealed reduced insular thickness but no effects in other regions. Among healthy controls, similar analyses revealed increased age-related cortical thinning in the left occipital lobe among smokers compared with nonsmokers. Limitations The causal direction could not be determined owing to the cross-sectional design and lack of detailed data on smoking addiction and smoking history. Conclusion The effect of cigarette smoking should be considered in MRI studies of patients with severe mental illness. PMID:25672482
Overextended sarcomeres regain filament overlap following stretch.
Panchangam, Appaji; Herzog, Walter
Sarcomere overextension has been widely implicated in stretch-induced muscle injury. Yet, sarcomere overextensions are typically inferred based on indirect evidence obtained in muscle and fibre preparations, where individual sarcomeres cannot be observed during dynamic contractions. Therefore, it remains unclear whether sarcomere overextensions are permanent following injury-inducing stretch-shortening cycles, and thus, if they can explain stretch-induced force loss. We tested the hypothesis that overextended sarcomeres can regain filament overlap in isolated myofibrils from rabbit psoas muscles. Maximally activated myofibrils (n=13) were stretched from an average sarcomere length of 2.6±0.04μm by 0.9μm sarcomere(-1) at a speed of 0.1μm sarcomere(-1)s(-1) and immediately returned to the starting lengths at the same speed (sarcomere strain=34.1±2.3%). Myofibrils were then allowed to contract isometrically at the starting lengths (2.6μm) for ∼30s before relaxing. Force and individual sarcomere lengths were measured continuously. Out of the 182 sarcomeres, 35 sarcomeres were overextended at the peak of stretch, out of which 26 regained filament overlap in the shortening phase while 9 (∼5%) remained overextended. About 35% of the sarcomeres with initial lengths on the descending limb of the force-length relationship and ∼2% of the sarcomeres with shorter initial lengths were overextended. These findings provide first ever direct evidence that overextended sarcomeres can regain filament overlap in the shortening phase following stretch, and that the likelihood of overextension is higher for sarcomeres residing initially on the descending limb.
Social functioning as a predictor of the use of mental health resources in patients with severe mental disorder.
Bellido-Zanin, Gloria; Pérez-San-Gregorio, María Ángeles; Martín-Rodríguez, Agustín; Vázquez-Morejón, Antonio J
Previous studies have tried to determine the factors causing greater use of health resources by patients with mental disorders. These studies have essentially focused on socio-economic variables. Nevertheless, many other variables, such as social functioning, have not yet been explored. This study aims to assess the effect of social functioning on mental health service use in a sample of patients with severe mental disorder (schizophrenia, other psychotic disorders or bipolar affective disorder) in an area of Spain. The Social Functioning Scale (SFS) was administered to 172 family members of patients with a severe mental disorder who were receiving care at a community mental health unit. Analysis of bivariate logistic regression identified specific areas as predictors of the use of mental health resources over a 12-month follow-up period. The overall social functioning score predicted need for hospital admissions. In addition, interpersonal behaviour had a major role in the number of outpatient visits, while social isolation significantly predicted the need for hospitalization. These results point out the necessity for including psychosocial variables, such as social functioning in current mental health resource use models.
Prevalence and Clinical Characteristics of Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease
Jiang, Wei; Samad, Zainab; Boyle, Stephen; Becker, Richard C.; Williams, Redford; Kuhn, Cynthia; Ortel, Thomas L.; Rogers, Joseph; Kuchibhatla, Maragatha; O'Connor, Christopher; Velazquez, Eric J.
Objectives The goal of this study was to evaluate the prevalence and clinical characteristics of mental stress–induced myocardial ischemia. Background Mental stress–induced myocardial ischemia is prevalent and a risk factor for poor prognosis in patients with coronary heart disease, but past studies mainly studied patients with exercise-induced myocardial ischemia. Methods Eligible patients with clinically stable coronary heart disease, regardless of exercise stress testing status, underwent a battery of 3 mental stress tests followed by a treadmill test. Stress-induced ischemia, assessed by echocardiography and electrocardiography, was defined as: 1) development or worsening of regional wall motion abnormality; 2) left ventricular ejection fraction reduction ≥8%; and/or 3) horizontal or downsloping ST-segment depression ≥1 mm in 2 or more leads lasting for ≥3 consecutive beats during at least 1 mental test or during the exercise test. Results Mental stress–induced ischemia occurred in 43.45%, whereas exercise-induced ischemia occurred in 33.79% (p = 0.002) of the study population (N = 310). Women (odds ratio [OR]: 1.88), patients who were not married (OR: 1.99), and patients who lived alone (OR: 2.24) were more likely to have mental stress–induced ischemia (all p < 0.05). Multivariate analysis showed that compared with married men or men living with someone, unmarried men (OR: 2.57) and married women (OR: 3.18), or living alone (male OR: 2.25 and female OR: 2.72, respectively) had higher risk for mental stress-induced ischemia (all p < 0.05). Conclusions Mental stress-induced ischemia is more common than exercise-induced ischemia in patients with clinically stable coronary heart disease. Women, unmarried men, and individuals living alone are at higher risk for mental stress-induced ischemia. (Responses of Myocardial Ischemia to Escitalopram Treatment [REMIT]; NCT00574847) PMID:23410543
Laboratory services: regaining and maintaining control.
Lee, Graham R; Fitzgibbon, Maria C; O'Shea, Paula
Purpose - After implementing an internal quality control (IQC) programme, the purpose of this paper is to maintain the requisite analytical performance for clinical laboratory staff, thereby safeguarding patient test results for their intended medical purpose. Design/methodology/approach - The authors address how quality can be maintained and if lost, how it can be regained. The methodology is based on the experience working in clinical laboratory diagnostics and is in accord with both international accreditation requirements and laboratory best practice guidelines. Findings - Monitoring test performance usually involves both prospective and retrospective IQC data analysis. The authors present a number of different approaches together with software tools currently available and emerging, that permit performance monitoring at the level of the individual analyser, across analysers and laboratories (networks). The authors make recommendations on the appropriate response to IQC rule warnings, failures and metrics that indicate analytical control loss, that either precludes further analysis, or signifies deteriorating performance and eventual unsuitability. The authors provide guidance on systematic troubleshooting, to identify undesirable performance and consider risk assessment preventive measures and continuous quality improvement initiatives; e.g., material acceptance procedures, as tools to help regain and maintain analytical control and minimise potential for patient harm. Practical implications - The authors provide a template for use by laboratory scientific personnel that ensures the optimal monitoring of analytical test performance and response when it changes undesirably. Originality/value - The proposed template has been designed to meet the International Organisation for Standardisation for medical laboratories ISO15189:2012 requirements and therefore includes the use of External Quality Assessment and patient results data, as an adjunct to IQC data.
The effects of physical exercises to mental state and quality of life in patients with schizophrenia.
Acil, A A; Dogan, S; Dogan, O
The purpose of this study was to examine the effects of 10 weeks of physical exercises programme on mental states and quality of life (QOL) of individuals with schizophrenia. The study involved 30 inpatients or outpatients with schizophrenia who were assigned randomly into aerobic exercise (n = 15) group and control (n = 15) group, participated to the study voluntarily. There were no personal differences such as age, gender, disorder duration, medication use between the both groups. An aerobic exercise programme was applied to the subject group, the periods of 10 weeks as 3 days in a week. Data were collected by using the Brief Symptom Inventory, the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and to the both group before and after the exercise programme. After the 10-week aerobic exercise programmes the subjects in the exercise programme showed significantly decreases in the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and the Brief Symptom Inventory points and their World Health Organization Quality of Life Scale-Turkish Version points were increased than controls. These results suggest that mild to moderate aerobic exercise is an effective programme for decreasing psychiatric symptoms and for increasing QOL in patients with schizophrenia.
Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the Mini-Mental State Examination
Background This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS) using the Mini Mental State Examination (MMSE). Methods We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP) or mixed pain (MP) selected from a larger prospective study. Results FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1) than either NeP (27.3; 95% CI 27.2-27.4) or MP (27.3; 27.2-27.5). The percentage of patients with congnitive impairment (adjusted MMSE ≤ 26) was numerically higher in FMS (15%; 95% CI 6.3-29) compared with NeP (5%; 95% CI 1.8-12.2) or MP (5%; 95% CI 1.8-12.2) and higher than in the same age stratum of the general population (0.05%). Conclusions Compared with the population reference value, patients with FMS showed high frequency of cognitive impairment. PMID:20025750
Variation in dose and plasma level of lamotrigine in patients discharged from a mental health trust
Douglas-Hall, Petrina; Dzahini, Olubanke; Gaughran, Fiona; Bile, Ahmed; Taylor, David
Background: The objectives of this study were to investigate the dose of lamotrigine when prescribed with an enzyme inhibitor or enzyme inducer in patients discharged from a mental health trust and to determine the corresponding lamotrigine plasma concentrations and the factors that may affect these. Methods: All patients discharged on lamotrigine between October 2007 and September 2012 were identified using the pharmacy dispensing database. We recorded demographic details, lamotrigine dose and plasma levels and coprescribed medication. Results: During the designated period, 187 patients were discharged on lamotrigine of whom 117 had their plasma levels recorded. The mean lamotrigine daily dose was 226.1 mg (range 12.5–800 mg) and the mean plasma level 5.9 mg/l (range 0.8–18.1 mg/l). Gender, ethnicity, diagnosis and smoking status had no significant effect on dose or plasma levels. Patients taking an enzyme-inducing drug (n = 6) had significantly lower plasma levels [mean (SD) 3.40 (1.54) mg/l] than those not taking enzyme inducers [n = 111; 6.03 (3.13) mg/l; p = 0.043]. Patients taking an enzyme-inhibiting drug (n = 23) had significantly higher levels [7.47 (3.99) mg/l] than those not taking an inhibitor [n = 94; 5.52 (2.75) mg/l; p = 0.035]. No significant difference was found between the doses of lamotrigine in patients taking an enzyme inhibitor and those not taking one (p = 0.376). No significant difference was found between the doses of lamotrigine in patients taking an enzyme-inducing drug and those not taking any (p = 0.574). Conclusions: Current dosing recommendations indicate that lamotrigine doses should be halved in individuals taking enzyme inhibitors and doubled in those on enzyme inducers. In our survey these recommendations were rarely followed with the consequence that patients received too high or too low a dose of lamotrigine, respectively. PMID:28101320
The development of recovery competencies for in-patient mental health providers working with people with serious mental illness.
Chen, Shu-Ping; Krupa, Terry; Lysaght, Rosemary; McCay, Elizabeth; Piat, Myra
Delivering recovery-oriented services is particularly challenging in in-patient settings. The purpose of this study was to identify the most salient recovery competencies required of in-patient providers. Established methods for the development of competencies were used. Data collection included interviews with multiple stakeholders and a literature review. Data analysis focused on understanding how characteristics of the in-patient context influence recovery-enabling service delivery and the competencies associated with addressing these issues. Eight core competencies with four to ten sub-competencies were identified based on a tension-practice-consequence model. The competency framework can serve as a tool for tailoring workforce education.
Weight regain after gastric bypass: etiology and treatment options
Gudaitytė, Rita; Petereit, Rūta; Venclauskas, Linas; Veličkienė, Džilda
Roux-en-Y gastric bypass (RYGB) is one of the most common operations performed for the patients with morbid obesity. Weight regain (WR) is a complication that may decrease efficiency of the surgical treatment and demand further interventions. Different factors including lifestyle, mental health, hormonal/metabolic and surgical plays role in WR after RYGB. Various treatment options have been proposed for WR. Conservative treatment is less effective than surgery. Endoscopic refashioning of gastric pouch/stoma fails to achieve sustainable weight loss. Surgical reduction of pouch has acceptable short-term results, but WR after 3 years is substantial. Banded gastric bypass achieves good short-term results, but long-term follow-up data are needed. Distalization of RYGB has a high risk of protein calorie malnutrition (PCM) and conversion to BP diversion (BPD)/duodenal switch (DS) is a technically demanding procedure. Both procedures achieve sustainable long-term weight loss. More studies are needed to explore long-term results of various surgical interventions for WR after RYGB. PMID:28149808
The Mechanics of Regaining Balance in Pirouettes
NASA Astrophysics Data System (ADS)
Lott, Melanie B.
All forms of dance incorporate examples of the human body in motion or standing in an aesthetically appealing pose. While balancing in a static position, dancers make small adjustments to avoid toppling. Balancing when the body is rotating around a vertical axis with one supporting foot at the floor (a pirouette) is more complex. Dancers are often taught to perform pirouettes by beginning the movement as close to balanced as possible and holding the body rigid throughout the turn. Theoretically, if the body is initially perfectly balanced, the number of revolutions will be limited only by friction. However, the research reported here demonstrates that dancers who perform pirouettes without making adjustments to correct for loss of balance will likely be unable to complete more than a two- or three-turn pirouette. The topple angle (theta) as a function of time was predicted for a model of a rigid body dancer. When theta becomes large enough, dancers must compensate for loss of balance or end the turn. That limiting angle was determined experimentally and set as the upper limit to theta. It was found that performing more than a three-turn, rigid-body pirouette requires the dancer to begin unreasonably close to perfectly balanced (theta <0.1°). To successfully perform more than a three turn pirouette, dancers must employ one of three strategies for regaining balance: (1) Return the center of mass (CM) to a location vertically above the supporting foot (SF), which requires a horizontal force on the body from the floor; (2) Hop the SF to a position vertically under the CM, which compromises the aesthetic of the movement; or (3) slide the SF under the CM, which moves the area of support and produces a horizontal force to move the CM to a revised location. An experimental analysis of dancers' pirouettes was performed in order to determine what adjustment mechanisms were successfully employed to regain balance. Sliding the SF was the most common and effective technique
Improving Physical Health in Patients with Chronic Mental Disorders: 12-Month Results from a Randomized Controlled Collaborative Care Trial
Kilbourne, Amy M.; Barbaresso, Michelle M.; Lai, Zongshan; Nord, Kristina M.; Bramlet, Margretta; Goodrich, David E.; Post, Edward P.; Almirall, Daniel; Bauer, Mark S.
Objective Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. Method This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a mid-western Veterans Affairs urban outpatient mental health clinic. Patients (N=293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least one cardiovascular disease risk factor were consented and randomized (02/24/10 to 04/29/15) to Life Goals (N=146) or usual care (N=147). A total of 287 completed baseline assessments and 245 completed 12-month follow-up assessments. Life Goals included five weekly sessions that provided semi-structured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (VR-12 physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Results Among patients completing baseline and 12-month outcomes assessments (N=245), the mean age was 55.3 (SD=10.8; range 28-75 years) and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient=3.21;p=0.01). Conclusion Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. PMID:27780336
Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.
Toussaint, Loren L; Whipple, Mary O; Vincent, Ann
Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.
Insulin sensitivity as a predictor of weight regain.
Wing, R R
A recent study found that increases in insulin sensitivity following weight loss and stabilization were strongly related to subsequent weight regain. The present paper analyzed this relationship in two behavioral weight-loss programs. In the first study, 125 nondiabetic subjects were followed over 30 months; weight losses averaged 10 kg at six months, and subjects had regained 8 kg of their weight loss by their 30-month follow-up. Neither fasting insulin levels at six months nor changes in fasting insulin from zero to six months were related to subsequent weight regain. Similarly, insulin levels measured two hours after a 75 g glucose load were unrelated to subsequent weight regain. The second study followed 33 individuals with Type II diabetes, treated with behavior modification, and either a low calorie diet or a very low calorie diet. Weight losses averaged 18 kg at six months, and subjects had regained 10 kg by their 24-month follow-up. The Bergman minimal model was used to assess insulin sensitivity at 6-month intervals. Initial analyses suggested that changes in insulin sensitivity from zero to six months were related to subsequent weight regain, but this effect was strongly influenced by an outlier. After removing this individual, there were no significant relationships between the changes in insulin sensitivity that accompanied weight loss and future weight regain. Likewise, insulin sensitivity at 12 months did not predict weight regain from 12 to 24 months. These data do not support the hypothesis that increases in insulin sensitivity with weight loss are associated with subsequent weight regain.
Environment and object mental images in patients with representational neglect: two case reports.
Palermo, Liana; Nori, Raffaella; Piccardi, Laura; Giusberti, Fiorella; Guariglia, Cecilia
The aim of this study was to shed light on the nature of the imagery deficits in two patients with representational neglect and to determine whether representational neglect is affected by the content of the mental images the patients have to generate, inspect and manipulate. In particular, we submitted two patients with different types of representational neglect to a battery of visual mental imagery tests to assess the different kinds of imagery processes. We found that Patient 1, whose performance was asymmetrical on the O'Clock Test, performed poorly on tasks involving the mental generation, inspection and manipulation of objects but showed no deficit on tasks involving the mental generation, inspection and manipulation of environments. On the other hand, Patient 2, whose performance was asymmetrical on the Familiar Squares Description Test, performed poorly on tasks involving the mental generation, inspection and manipulation of environments, but not on tasks involving the mental generation, inspection and manipulation of objects. Our results demonstrate that environments and objects in the imagery domain can be represented separately and can be selectively affected by damage following brain lesions.
Mental rotation of body parts and non-corporeal objects in patients with idiopathic cervical dystonia.
Fiorio, Mirta; Tinazzi, Michele; Ionta, Silvio; Fiaschi, Antonio; Moretto, Giuseppe; Edwards, Mark J; Bhatia, Kailash P; Aglioti, Salvatore M
Mental rotation of body parts is performed through inner simulation of actual movements, and is likely to rely upon cortical and subcortical systems (e.g. motor and premotor areas and basal ganglia) involved in motor planning and execution. Studies indicate that sensory and motor deficits, such as for example pain, limb amputation or focal hand dystonia, bring about a specific impairment in mental rotation of the affected body parts. Here we explored the ability of patients affected by idiopathic cervical dystonia (CD) to mentally rotate affected (neck) and unaffected (hands and feet) body districts. The experimental stimuli consisted of realistic photos of left or right hands or feet and the head of a young men with a black patch on the left or the right eye. As non-corporeal stimulus the front view of a car with a black patch on the left or the right headlight was used. The stimuli were presented at six different degrees of orientations. Twelve CD patients and 12 healthy participants were asked to verbally report whether the hands or feet were left or right, or whether the patch was on the left or the right eye or headlight. Reaction times and accuracy in performing the laterality tasks on the four stimuli were collected. Results showed that CD patients are slow in mental rotation of stimuli representing body parts, namely hand, foot and head. This abnormality was not due to a general impairment in mental rotation per se, since patients' ability to rotate a non-corporeal object (a car) was not significantly different from that of healthy participants. We posit that the deficit in mental rotation of body parts in CD patients may derive from a defective integration of body- and world-related knowledge, a process that is likely to allow a general representation of "me in the external world".
Perceived Social Support and Its Impact on Mental Fatigue in Patients with Mild Traumatic Brain Injury
Zeng, En quan; Zeng, Ben qiang; Tian, Jing lun; Du, Bing; Tian, Xiao bing; Chen, Hong
Background: Although mental fatigue was well-recognized as one of the long-term consequences following mild traumatic brain injury (MTBI) that required ongoing support, evidences for the optimal management remained inadequate. Aims: To investigate the temporal profile of mental fatigue during the first year after MTBI and examine the impact of perceived social support on the recovery from post-MTBI fatigue. Study Design: Observational case-control study. Methods: This study was conducted among post-MTBI patients admitted to the emergency department in a tertiary-care hospital in Sichuan, China. During four waves of assessments at 1 week, 3, 6 and 12 months, mental fatigue was assessed through Mental Fatigue Scale (MFS) whereas social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Results: There were 65.1%, 37.1%, 34.8% and 32.5% individuals being identified as those with mental fatigue at 1 week, 3, 6 and 12 months, respectively. The scores of MFS didn't change substantially since 3 months post-injury. Compared to non-fatigued MTBI patients, those with long-lasting post- MTBI fatigue reported extremely lower level of perceived social support. Moreover, improved social support at 1 week was negatively associated with the occurrence of long-lasting fatigue. Conclusion: Sufficient social support could significantly decrease the occurrence of long-lasting mental fatigue among MTBI cases. It seemed of great importance to modify the emphasis of rehabilitation to include assessment and improvement of perceived social support at earlier stages after injury. PMID:27403383
[Preventive and cessation therapy of mental disorders in patients with the acute coronary syndrome].
Medvedev, V E; Epifanov, A V; Zverev, K V
An open prospective trial of 93 inpatients divided into two main groups (61 patients) - with mental disorders (31) and without mental disorders (30) and a comparison group (32 patients) was carried out. All patients survived the acute coronary syndrome (myocardial infarction, unstable angina). The efficacy and safety of both preventive and cessation therapy with pantogam active in mean doses 1.8 and 1.2 g /daily, respectively, was demonstrated in respect of heterogeneous depressive, anxiety and somatoform disorders of the neurotic level.
Clinical versus Actuarial Predictions of Violence in Patients with Mental Illness.
ERIC Educational Resources Information Center
Gardner, William; And Others
Compared accuracy of an actuarial procedure for the prediction of community violence by patients with mental illnesses to accuracy of clinicians' concern ratings of patient violence. Data came from a study of 357 pairs of patients seen in a psychiatric emergency room. Actuarial predictions based only on patients' histories of violence were more…
The Dexamethasone Suppression Test as an Indication of Depression in Patients with Mental Retardation.
ERIC Educational Resources Information Center
Mattes, Jeffrey A.; Amsell, Loren
Administration of the Dexamethasone Suppression Test (DST) for three groups of institutionalized patients with severe/profound mental retardation found that the 12 depressed patients more frequently (though not significantly) had positive DSTs and significantly higher cortisol levels compared with nondepressed patients with and without other…
Excess Mortality in Patients with Severe Mental Disorders in 1996-2010 in Finland.
Lumme, Sonja; Pirkola, Sami; Manderbacka, Kristiina; Keskimäki, Ilmo
Unselected population-based nationwide studies on the excess mortality of individuals with severe mental disorders are scarce with regard to several important causes of death. Using comprehensive register data, we set out to examine excess mortality and its trends among patients with severe mental disorders compared to the total population. Patients aged 25-74 and hospitalised with severe mental disorders in 1990-2010 in Finland were identified using the national hospital discharge register and linked individually to population register data on mortality and demographics. We studied mortality in the period 1996-2010 among patients with psychotic disorders, psychoactive substance use disorders, and mood disorders by several causes of death. In addition to all-cause mortality, we examined mortality amenable to health care interventions, ischaemic heart disease mortality, disease mortality, and alcohol-related mortality. Patients with severe mental disorders had a clearly higher mortality rate than the total population throughout the study period regardless of cause of death, with the exception of alcohol-related mortality among male patients with psychotic disorders without comorbidity with substance use disorders. The all-cause mortality rate ratio of patients with psychotic disorders compared to the total population was 3.48 (95% confidence interval 2.98-4.06) among men and 3.75 (95% CI 3.08-4.55) among women in the period 2008-10. The corresponding rate ratio of patients with psychoactive substance use disorders was 5.33 (95% CI 4.87-5.82) among men and 7.54 (95% CI 6.30-9.03) among women. Overall, the mortality of the total population and patients with severe mental disorders decreased between 1996 and 2010. However, the mortality rate ratio of patients with psychotic disorders and patients with psychoactive substance use disorders compared to the total population increased in general during the study period. Exceptions were alcohol-related mortality among
Excess Mortality in Patients with Severe Mental Disorders in 1996-2010 in Finland
Lumme, Sonja; Pirkola, Sami; Manderbacka, Kristiina; Keskimäki, Ilmo
Unselected population-based nationwide studies on the excess mortality of individuals with severe mental disorders are scarce with regard to several important causes of death. Using comprehensive register data, we set out to examine excess mortality and its trends among patients with severe mental disorders compared to the total population. Patients aged 25–74 and hospitalised with severe mental disorders in 1990–2010 in Finland were identified using the national hospital discharge register and linked individually to population register data on mortality and demographics. We studied mortality in the period 1996–2010 among patients with psychotic disorders, psychoactive substance use disorders, and mood disorders by several causes of death. In addition to all-cause mortality, we examined mortality amenable to health care interventions, ischaemic heart disease mortality, disease mortality, and alcohol-related mortality. Patients with severe mental disorders had a clearly higher mortality rate than the total population throughout the study period regardless of cause of death, with the exception of alcohol-related mortality among male patients with psychotic disorders without comorbidity with substance use disorders. The all-cause mortality rate ratio of patients with psychotic disorders compared to the total population was 3.48 (95% confidence interval 2.98–4.06) among men and 3.75 (95% CI 3.08–4.55) among women in the period 2008–10. The corresponding rate ratio of patients with psychoactive substance use disorders was 5.33 (95% CI 4.87–5.82) among men and 7.54 (95% CI 6.30–9.03) among women. Overall, the mortality of the total population and patients with severe mental disorders decreased between 1996 and 2010. However, the mortality rate ratio of patients with psychotic disorders and patients with psychoactive substance use disorders compared to the total population increased in general during the study period. Exceptions were alcohol
Performance-based education: Regaining engineering judgment
Dooley, G.D. ); Knief, R.A. )
During the past two decades, a subtle, but major change has occurred in the way engineers are prepared for their profession by their college studies. Pocket calculators, advanced computers, and engineering software have each contributed to this change. The result is a generation of engineers that appears to have [open quotes]lost touch[close quotes] with the physical nature of their profession. Traditional university engineering education focuses on knowledge-based instruction, which assumes that as the student gains knowledge, that knowledge will automatically be translated into desired behaviors. In the past, development of an engineer's understanding of the design process was based on coincident development of the engineer's mental models of the physical world. The student-engineer's mental models of physical systems were developed through direct exposure in hands-on laboratories and work-study assignments. Through the combination of classroom instruction and physical experiences, the student-engineer began to build an understanding of engineering systems and physical processes that is required to develop [open quotes]sound engineering judgment[close quotes]. Performance-based instruction, with its emphasis on developing training and educational programs from observed performance deficiencies, provides a potential approach to resolving this problem. Performance-based training has a strong record of achievement in a variety of military and industrial settings, including the commercial nuclear industry. Several specific formulations exist for performance-based training and education, such as instructional system design, training system design or development, or the systematic approach to training. However, each generally includes the concepts embodied in the four (arbitrary) elements; analysis, design/development, implementation, and evaluation/feedback.
Needs, Perceived Support, and Hospital Readmissions in Patients with Severe Mental Illness.
Guzman-Parra, Jose; Moreno-Küstner, Berta; Rivas, Fabio; Alba-Vallejo, Mercedes; Hernandez-Pedrosa, Javier; Mayoral-Cleries, Fermin
People with severe mental illness have multiple and complex needs that often are not addressed. The purpose of this study was to analyse needs and support perceived and the relationship with hospital readmission. We assessed 100 patients with severe mental illness at discharge from an acute inpatient unit in terms of needs (Camberwell Assessment of Needs), clinical status (The Brief Psychiatric Rating Scale), and social functioning (Personal and Social Performance); we also followed up these patients for 1 year. The group of patients who were readmitted had more total needs than did the non-readmitted, in addition to more unmet needs, although the differences were not significant. The highest risk factor for rehospitalisation was the number of previous admissions. In addition, the help of informal carers in alleviating psychological distress was associated with the risk of readmission. The main conclusion concerns the role of the psychological support provided by informal networks in preventing readmission.
Treatment of post-traumatic stress disorder in patients with severe mental illness: a review.
Mabey, Linda; van Servellen, Gwen
Although the prevalence of post-traumatic stress disorder (PTSD) is high among those with severe mental illness, little is known about the use of interventions to lessen the burden of PTSD in this population. Currently, there are limited data about safe and effective interventions to treat these individuals. This systematic published work review presents the scientific published work reporting studies of psychological treatment approaches for individuals with comorbid PTSD and severe mental illness. A secondary aim of this study was to identify the specific models implemented and tested, and their impact upon patient outcomes. A review of the published work from January 2001 through January 2012 of English-language publications retrieved from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and the American Psychological Association generated abstracts (PsycINFO) databases was conducted. Six studies met the inclusion criteria for the review. The treatment programs described were cognitive-behavioural therapy, psychoeducation, exposure-based cognitive-behavioural therapy, and eye movement desensitization and reprocessing. Evidence of the effectiveness of these programs is examined. Data to support the use of these interventions are limited, indicating the need for further research and efficacy trials. Future areas of research and implications for nursing are discussed.
Risperidone-associated urinary incontinence in patients with autistic disorder with mental retardation.
Kumazaki, Hirokazu; Watanabe, Koichiro; Imasaka, Yasushi; Iwata, Kazuhiko; Tomoda, Akemi; Mimura, Masaru
We report several cases in which patients with autistic disorder with mental retardation who received risperidone experienced urinary incontinence. We retrospectively investigated the medical records of patients housed in facilities for patients with autistic disorder with mental retardation. Those who had undergone a medical examination at a hospital in Tokyo from April 1999 to March 2009 were included in the study.Retrospective data were gathered including age, sex, IQ, birth weight, dosage of risperidone, urinary density, as well as existence of urinary and fecal incontinence. We divided the participants into those who did and did not experience urinary incontinence after taking risperidone and compared the 2 groups. Risperidone had been prescribed to 35 patients. In spite of the fact that no patient had a history of urinary incontinence, 14 patients experienced urinary incontinence after receiving risperidone. Moreover, 4 of these 14 patients also had fecal incontinence. Among the variables we examined, the only significant difference between groups was in sex, with significantly more women experiencing incontinence compared with men. When the dose of risperidone was reduced or the patients switched to other drugs, urinary incontinence of the patients improved.Hence, risperidone may have a casual relationship with urinary incontinence. Further research is needed to understand the pathophysiology of possible effect.
[Process of change in patients with concurrent substance use - mental health problems].
Acier, Didier; Nadeau, Louise; Landry, Michel
This paper is a retrospective study with a five year follow-up which examines the variations in substance use and the determinants of these variations. This exploratory research studied a sub-sample of 22 participants, selected from an initial sample of 197 patients with concurrent substance use and other mental health disorders. At the quantitative level, the statistical analysis shows an improvement in the problematic use of alcohol and drugs but no change in psychological state, health, family and interpersonals relations, as well as employment. At the qualitative level, the analysis of the participant's subjective view indicates that the two main elements of progression in substance use are the effects and the availability of substances. The main elements of reduction in substance use are the use of services, the personal techniques developed by participants, the family network, physical health, lack of financial resources, "occupational" activities, and a process of maturation.
Role of cortisol in patients at risk for psychosis mental state and psychopathological correlates: A systematic review.
Karanikas, Evangelos; Garyfallos, Giorgos
During recent decades, much evidence has been accumulated concerning the neuroendocrine basis of schizophrenia. Recently, research has focused on stress hormones, with cortisol being the most widely researched, during the prodromal phase of psychosis. Thus, the present study aims to systematically review the evidence concerning the role of cortisol in patients at risk for psychosis mental state and its associations with psychopathological correlates. We systematically reviewed the published reports referring to both 'at clinical risk for psychosis' and 'at genetic risk for psychosis' mental state. Sixteen studies were identified. A trend towards increased cortisol levels in saliva emerged. Findings concerning cortisol levels in the blood were minimal and less consistent. The longitudinal studies, though with divergent results, hinted towards upregulation of cortisol secretion prior to psychotic conversion. Regarding cortisol's reactivity, evaluated through neuroendocrine, psychosocial and naturalistic stressors, the findings were minimal and divergent. The hypothesized relation of psychotic symptomatology with cortisol in subjects at risk for psychosis was not confirmed by the majority of the studies. On the contrary, the anxiety parameter and stress-intolerance index were both positively associated with cortisol. In conclusion, the published reports related to the evaluation of cortisol levels/function at prodrome are hitherto minimal. Although the evidence favors cortisol's participation in the pathophysiology of psychosis, the exact cause-effect sequence and the intertwining of cortisol with psychopathology are still unclear.
40 CFR 7.135 - Procedure for regaining eligibility.
Code of Federal Regulations, 2014 CFR
... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Procedure for regaining eligibility. 7.135 Section 7.135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL ASSISTANCE FROM THE ENVIRONMENTAL PROTECTION...
40 CFR 7.135 - Procedure for regaining eligibility.
Code of Federal Regulations, 2012 CFR
... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Procedure for regaining eligibility. 7.135 Section 7.135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL ASSISTANCE FROM THE ENVIRONMENTAL PROTECTION...
40 CFR 7.135 - Procedure for regaining eligibility.
Code of Federal Regulations, 2013 CFR
... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Procedure for regaining eligibility. 7.135 Section 7.135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL ASSISTANCE FROM THE ENVIRONMENTAL PROTECTION...
40 CFR 7.135 - Procedure for regaining eligibility.
Code of Federal Regulations, 2011 CFR
... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Procedure for regaining eligibility. 7.135 Section 7.135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL ASSISTANCE FROM THE ENVIRONMENTAL PROTECTION...
Physiological adaptations to weight loss and factors favouring weight regain
Greenway, F L
Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an 'obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their
FTO predicts weight regain in the Look AHEAD Clinical Trial
McCaffery, Jeanne; Papandonatos, George D.; Huggins, Gordon S.; Peter, Inga; Kahn, Steven E.; Knowler, William C.; Hudnall, Gina Evans; Lipkin, Edward; Kitabchi, Abbas E.; Wagenknecht, Lynne E.; Wing, Rena R.
Background Genome-wide association studies have provided new insights into the genetic factors that contribute to the development of obesity. We hypothesized that these genetic markers would also predict magnitude of weight loss and weight regain after initial weight loss. Methods Established obesity risk alleles available on the Illumina CARe iSelect (IBC) chip were characterized in 3,899 overweight or obese participants with type 2 diabetes from the Look AHEAD (Action for Health in Diabetes), a randomized trial to determine the effects of intensive lifestyle intervention (ILI) and Diabetes Support and Education (DSE) on cardiovascular morbidity and mortality. Primary analyses examined the interaction between 13 obesity-risk polymorphisms in 8 genes and randomized treatment arm in predicting weight change at year 1, and weight regain at year 4 among individuals who lost 3% or more of their baseline weight by year 1. Results No SNPs were significantly associated with magnitude of weight loss or interacted with treatment arm at year 1. However, FTO rs3751812 predicted weight regain within DSE (1.56 kg per risk allele, p = 0.005), but not ILI (p = 0.761), resulting in SNP×treatment arm interaction (p = 0.009). In a partial replication of prior research, the obesity risk (G) allele at BDNF rs6265 was associated with greater weight regain across treatment arms (0.773 kg per risk allele), although results were of borderline statistical significance (p=0.051). Conclusions Variations in the FTO and BDNF loci may contribute risk of weight regain after weight loss. PMID:23628854
[Oral health and perceptions regarding dental care in patients with mental disorders living in therapeutic residences].
Jamelli, Silvia Regina; Mendonça, Maria Cristina; Diniz, Maria das Graças; Andrade, Felipe Bravo Machado de; Melo, Júlia Figueirêdo de; Ferreira, Sergilene Rodrigues; Silva, Polliana Vilaça
Patients with mental disorders have considerable difficulty in access to dental care, including the refusal of oral health professionals to offer care to this clientele and the inadequate professional training of oral health professionals regarding this issue. The present study was carried out in therapeutic residences in order to assess the oral health conditions of the residents as well as their perceptions regarding the dental care they have received. Thirty-eight individuals participated in the study. Data were collected through clinical examinations and a semi-structured interview. Data analysis revealed a high number of caries and the need for dentures, with 42.5% of the individuals needing complete dentures and 30.3% needing partial dentures. Regarding periodontal conditions, 28.5% of the dental elements exhibited losses of over 4 mm of periodontal insertion. Data from the interviews were submitted to content analysis, which enabled the establishment of two categories: the association of pain with the presence of teeth and mutilating dental care. Oral health was associated to dental extraction, which was considered the only solution to oral health disturbances, indicating that, for this population, oral health signifies not having teeth.
Decreased fragile X mental retardation protein (FMRP) is associated with lower IQ and earlier illness onset in patients with schizophrenia.
Kovács, Tamás; Kelemen, Oguz; Kéri, Szabolcs
The purpose of this study was to investigate Fragile X Syndrome (FXS)-related mechanisms in schizophrenia, including CGG triplet expansion, FMR1 mRNA, and fragile X mental retardation protein (FMRP) levels in lymphocytes. We investigated 36 patients with schizophrenia and 30 healthy controls using Southern blot analysis, mRNA assay, and enzyme-linked immunosorbent assay (ELISA). General intellectual functions were assessed with the Wechsler Adult Intelligence Scale-III, and the clinical symptoms were evaluated with the Positive and Negative Syndrome Scale. Results revealed that, relative to healthy controls, CGG triplet size and FMR1 mRNA were unaltered in patients with schizophrenia. However, the FMRP level was significantly reduced in patients compared with controls. We found an association between lower FMRP levels, reduced IQ, and earlier illness onset in schizophrenia. Chlorpromazine-equivalent antipsychotic dose did not correlate with FMRP levels. These results raise the possibility of impaired translation of FMR1 mRNA, altered epigenetic regulation, or increased degradation of FMRP in schizophrenia, which may play a role in dysfunctional neurodevelopmental processes and impaired neuroplasticity.
Working Alliance in Patients with Severe Mental Illness Who Need a Crisis Intervention Plan.
Ruchlewska, Asia; Kamperman, Astrid M; van der Gaag, Mark; Wierdsma, André I; Mulder, Niels C L
Working alliance has been characterized as an important predictor of positive treatment outcomes. We examined whether illness insight, psychosocial functioning, social support and locus of control were associated with working alliance as perceived by both patient and clinician. We assessed 195 outpatients with psychotic or bipolar disorders. Our findings indicated that patients rated the alliance more positively when they experienced a greater need for treatment, fewer behavioral and social problems, and more psychiatric symptoms. Clinicians rated the alliance more positively in patients who reported fewer social problems and better illness insight. Patients' demographic characteristics, including being female and married, were also positively related to the clinician-rated alliance. Our results suggest that patients and clinicians have divergent perceptions of the alliance. Clinicians may need help developing awareness of the goals and tasks of patients with certain characteristics, i.e., singles, men, those with poor illness insight and those who report poor social functioning.
Strategies to improve anxiety and depression in patients with COPD: a mental health perspective
Tselebis, Athanasios; Pachi, Argyro; Ilias, Ioannis; Kosmas, Epaminondas; Bratis, Dionisios; Moussas, Georgios; Tzanakis, Nikolaos
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities. PMID:26929625
Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state
Rausch, Franziska; Mier, Daniela; Eifler, Sarah; Fenske, Sabrina; Schirmbeck, Frederike; Englisch, Susanne; Schilling, Claudia; Meyer-Lindenberg, Andreas; Kirsch, Peter; Zink, Mathias
Background Patients with schizophrenia display metacognitive impairments, such as hasty decision-making during probabilistic reasoning — the "jumping to conclusion" bias (JTC). Our recent fMRI study revealed reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in patients with schizophrenia. It is unclear whether these functional alterations occur in the at-risk mental state (ARMS). Methods We administered the classical beads task and fMRI among ARMS patients and healthy controls matched for age, sex, education and premorbid verbal intelligence. None of the ARMS patients was treated with antipsychotics. Both tasks request probabilistic decisions after a variable amount of stimuli. We evaluated activation during decision-making under certainty versus uncertainty and the process of final decision-making. Results We included 24 AMRS patients and 24 controls in our study. Compared with controls, ARMS patients tended to draw fewer beads and showed significantly more JTC bias in the classical beads task, mirroring findings in patients with schizophrenia. During fMRI, ARMS patients did not demonstrate JTC bias on the behavioural level, but showed a significant hypoactivation in the right VS during the decision stage. Limitations Owing to the cross-sectional design of the study, results are constrained to a better insight into the neurobiology of risk constellations, but not pre-psychotic stages. Nine of the ARMS patients were treated with antidepressants and/or lorazepam. Conclusion As in patients with schizophrenia, a striatal hypoactivation was found in ARMS patients. Confounding effects of antipsychotic medication can be excluded. Our findings indicate that error prediction signalling and reward anticipation may be linked to striatal dysfunction during prodromal stages and should be examined for their utility in predicting transition risk. PMID:25622039
Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece
Peritogiannis, Vaios; Manthopoulou, Thiresia; Mavreas, Venetsanos
Introduction: Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited. Materials and Methods: Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015) was obtained from our database. Results: From the total of 77 engaged patients, 30 (39%) were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval. Conclusions: A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients. PMID:28163499
Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines.
Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P
Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy
The level of associated depression and anxiety traits improves during weight regain in eating disorder patients.
Sala, L; Mirabel-Sarron, C; Gorwood, P; Pham-Scottez, A; Blanchet, A; Rouillon, F
We assessed whether re-nutrition and weight gain have an influence on comorbid depression and anxiety in patients hospitalised for chronic eating disorders (ED). Seventy-five inpatients agreed to participate by completing the Eating Attitudes Test (EAT-40), the Beck Depression Inventory (BDI-13), and the State-Trait Anxiety Inventory (STAI-Y) before, during and after three months of treatment. Patients suffering from either anorexia nervosa or bulimia nervosa successfully regained weight during treatment. This weight gain was accompanied by statistically significant reductions in ED symptoms. Anxiety and, to a lesser extent, depressive symptoms diminished, but remained at pathological levels, with between diagnostic subtype differences. Improvement of depressive (r=0.77) and anxiety (r=0.64) levels were significantly (p<0.001) and positively correlated with the reduction of eating attitudes (EAT). These results are discussed in the context of re-orienting the therapeutic strategies aimed at reducing emotional suffering in patients with ED.
The (homo)sexual temptation in Milton's Paradise regained.
Summers, C J
While the sexual temptation of Paradise Regained is tactful, it is also characteristically Miltonic in its daring. Despite its decorous presentation, the temptation is exceedingly bold in that it is not merely a heterosexual temptation but a homosexual one as well. Acknowledgement of the homosexual lure in the brief epic is essential to understanding the dynamics of the celebrated banquet scene and to appreciating the comprehensiveness of Milton's trial of the Son's humanity. Such a recognition also helps place in perspective the alleged misogyny of Paradise Regained, even as it also reveals the complexity of Milton's poetic technique, particularly his ability to work by indirection and implication and to exploit classical and biblical sources. Although Jesus rejects the homosexual temptation (as He does the heterosexual one), He does not condemn homosexuality. Milton's incorporation of a homosexual temptation provides evidence of his sophisticated recognition of the range of fully human sexual responses.
Influence of sleep disorders on somatic symptoms, mental health, and quality of life in patients with chronic constipation
Jiang, Ya; Tang, Yu-Rong; Xie, Chen; Yu, Ting; Xiong, Wen-Jie; Lin, Lin
Abstract Background: Sleep disturbance is a common symptom in CC patients, and it is positively related to greater somatic and psychiatric symptoms. Methods: The participants were 126 adult outpatients with CC. The measures were: constipation—Constipation Scoring System (CSS) and Patient Assessment of Constipation-Symptoms (PAC-SYM); sleep—Pittsburgh Sleep Quality Index (PSQI); anxiety—General Anxiety Disorder-7 (GAD-7); depression—Patient Health Questionnaire-9 (PHQ-9); and QOL—Patient Assessment of Constipation Quality of Life (PAC-QOL) and SF-36. Patients were divided into sleep-disorder and normal-sleep groups by their PSQI scores. Results: The sleep-disorder group had significantly higher rates of incomplete defecation and blockage and higher CSS scores, PAC-SYM total scores, and PAC-SYM rectal-item scores than the normal-sleep group. GAD-7 and PHQ-9 scores were significantly higher in patients with poor sleep. Furthermore, sleep disorders, depression, and anxiety were all positively correlated with constipation severity. "Worry/anxiety" score of PAC-QOL scale was significantly higher and scores for seven SF-36 subscales were significantly lower in patients with poor sleep. In addition, correlation analyses showed significant negative relations between QOL and constipation, sleep disturbance, anxiety as well as depression. However, multiple regression revealed that PAC-QOL was positively associated with severe constipation and SF-36 was negatively associated with anxiety and depression. But sleep disturbance was not the independent risk factor for QOL of CC patients. Conclusion: Sleep disorders may worsen the physical- and mental health of CC patients. Sleep disturbance may lower CC patients' QOL indirectly through the combined effects of anxiety, depression, and constipation. PMID:28207519
Mental toughness, sleep disturbances, and physical activity in patients with multiple sclerosis compared to healthy adolescents and young adults
Sadeghi Bahmani, Dena; Gerber, Markus; Kalak, Nadeem; Lemola, Sakari; Clough, Peter J; Calabrese, Pasquale; Shaygannejad, Vahid; Pühse, Uwe; Holsboer-Trachsler, Edith; Brand, Serge
Background Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, afflicting both the body and mind. The risk of suffering from MS is 2.5–3.5 times greater in females than in males. While there is extant research on fatigue, depression, and cognitive impairment in patients with MS during its clinical course, there is a lack of research focusing on sleep, psychological functioning, and physical activity (PA) at the point of disease onset. The aims of the present study were therefore, to assess the markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), and PA among patients at the moment of disease onset and to compare these with the corresponding values for healthy adolescents and young adults. Methods A total of 23 patients with MS at disease onset (mean age =32.31 years; 91% females), 23 healthy adolescents (mean age =17.43 years; 82% females), and 25 healthy young adults (mean age =20.72 years; 80% females) took part in the study. They completed questionnaires covering sociodemographic data, MT, SD, and PA. Results Patients with MS had similar scores for MT traits as those in healthy adolescents and healthy young adults, and equivalent levels of moderate-intensity PA and SD as young adults. MS patients reported lower levels of vigorous PA compared to both healthy adolescents and young adults. Conclusion The pattern of the results of the present study suggests that the onset of MS is not associated with poor MT, poor sleep, or reduced moderate-intensity PA. Lower levels of vigorous PA were observed in MS patients. Low levels of vigorous PA may lead to decreased cardiorespiratory fitness in patients with MS and, in the long run, to reduced cardiovascular health and degraded psychological functioning. PMID:27390520
Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter
Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals' perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients' anxiety is "possibly" or "definitely" a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p's > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662
Regaining momentum for international climate policy beyond Copenhagen
The 'Copenhagen Accord' fails to deliver the political framework for a fair, ambitious and legally-binding international climate agreement beyond 2012. The current climate policy regime dynamics are insufficient to reflect the realities of topical complexity, actor coalitions, as well as financial, legal and institutional challenges in the light of extreme time constraints to avoid 'dangerous' climate change of more than 2°C. In this paper we analyze these stumbling blocks for international climate policy and discuss alternatives in order to regain momentum for future negotiations. PMID:20525341
In one type of duct efficiency retrofit, additional insulation is added to a duct system that is already insulated. For example, a layer of R-4 insulation might be: added to a duct system that already has R-4 installed. It is possible that--either by chance or by design--the add-on layer, while not stopping duct leaks, might cause the leakage air to flow longitudinally for a distance, parallel to the duct, before it finds a way out of the newly added outer layer. This could happen by chance if the outer and inner layers of insulation have seams at different locations. Perhaps more usefully, if such longitudinal displacement of the leakage air turned out to be useful, it might be designed into the makeup of the outer insulation layer intended to be used in the retrofit. It is plausible that this leakage air might serve a useful function in keeping the insulation layer warmer (or, in the air-conditioning mode, cooler) than it would be in the absence of the leakage. By being held close to the ducts for a while, it might establish an artificially warmer (or cooler, in air conditioning) zone around the ducts. To the extent that this effect would reduce the heat losses from the ducts, the leakage should be credited with a ''thermal regain'' in the same way that leakage into buffer zones is credited with thermal regain when the leakage air warms (or cools) the buffer zone relative to the temperature it would have in the absence of such duct leakage. The purpose of this report is to investigate whether and to what extent such thermal regain exists. The model developed below applies to a situation where there are two distinct layers of insulation around the duct, with leakage air moving between them in a longitudinal direction for a distance before it finds its way out from the outer insulation layer. It may also apply approximately where there is a single insulation layer with an air barrier on the outside. Leakage air may pass into the insulation itself and thence
[Chosen problems of mental functioning in patients with chronic systemic connective tissue diseases base on example of rheumatoid arthritis].
Nasiłowska-Barud, Alicja; Żuk, Mariola
Disorders in mental functioning are indicated as the cause of all connective tissue diseases and also as their consequences. That is why psychologist's help may be very important for patients with rheumatoid arthritis. Psychological observations of patients with chronic systemic connective tissue diseases show a number of negative emotional states such as fear, anxiety, insecurity, depressed mood, depression, impatience, anger and a sense of loss These patients constantly experience pain of varying intensity and location. In many of them progressive disease leads to the advancement of mental crisis. Methods of psychological therapy must be focused on strenghtening mental resilience and helping in surviving mental crisis. Psychological therapy should concentrate on raising self-esteem, training interpersonal skills and teaching relaxation techniques to cope better with pain and suffering. Psychological therapy should support the patient in struggling with the problems caused by the disease and developing ways of adapting to life with the disease.
Disturbed Mental Imagery of Affected Body-Parts in Patients with Hysterical Conversion Paraplegia Correlates with Pathological Limbic Activity
Saj, Arnaud; Raz, Noa; Levin, Netta; Ben-Hur, Tamir; Arzy, Shahar
Patients with conversion disorder generally suffer from a severe neurological deficit which cannot be attributed to a structural neurological damage. In two patients with acute conversion paraplegia, investigation with functional magnetic resonance imaging (fMRI) showed that the insular cortex, a limbic-related cortex involved in body-representation and subjective emotional experience, was activated not only during attempt to move the paralytic body-parts, but also during mental imagery of their movements. In addition, mental rotation of affected body-parts was found to be disturbed, as compared to unaffected body parts or external objects. fMRI during mental rotation of the paralytic body-part showed an activation of another limbic related region, the anterior cingulate cortex. These data suggest that conversion paraplegia is associated with pathological activity in limbic structures involved in body representation and a deficit in mental processing of the affected body-parts. PMID:24961768
Effects of Neurosurgical Treatment and Severity of Head Injury on Cognitive Functioning, General Health and Incidence of Mental Disorders in Patients With Traumatic Brain Injury
Rezaei, Sajjad; Asgari, Karim; Yousefzadeh, Shahrokh; Moosavi, Heshmat-Allah; Kazemnejad, Ehsan
Background Neurosurgical treatment and the severity of head injury (HI) can have remarkable effect on patients' neuropsychiatric outcomes. Objectives This research aimed to study the effect of these factors on cognitive functioning, general health and incidence of mental disorders in patients with a traumatic brain injury (TBI). Patients and Methods In this descriptive, longitudinal study, 206 TBI patients entered the study by consecutive sampling; they were then compared according to neurosurgery status and severity of their HI. Both groups underwent neurosurgical and psychological examinations. The mini mental state examination (MMSE) and general health questionnaire–28 items (GHQ-28) were administered to the study participants. At follow-up, four months later, the groups underwent a structured clinical interview by a psychiatrist based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria regarding the presence of mental disorders. Results Analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) were performed and adjusted for the effect of confounding variables (age, gender, Glasgow outcome scale (GOS) , and level of education). The severity of HI had the most significant effect for the following variables; cognitive functioning and physical symptoms (P < 0.05). The effect of the neurosurgical treatment factor was not significant; however, the interaction effect of the two variables on social dysfunction, and total score of the GHQ-28 questionnaire appeared to be significant (P < 0.05). Fisher's exact test indicated that after a four month follow-up period, no significant differences were seen between the two groups (with or without neurosurgery) in the incidence of mental disorders, while χ2 Test showed that having a more severe HI is significantly correlated with the incidence of mental disorders (P < 0.01). Conclusions The implications of this study should be discussed with an
Impact of weight regain on metabolic disease risk: a review of human trials.
Kroeger, Cynthia M; Hoddy, Kristin K; Varady, Krista A
Dietary restriction interventions are effective for weight loss and reduction of chronic disease risk. Unfortunately, most people tend to regain much of this lost weight within one year after intervention. While some studies suggest that minor degrees of weight regain have no effect on metabolic disease risk parameters, other studies demonstrate a complete reversal in metabolic benefits. In light of these conflicting findings, it is of interest to determine how complete weight maintenance versus mild weight regain affects key risk parameters. These findings would have important clinical implications, as they could help identify a weight regain threshold that could preserve the metabolic benefits of weight loss. Accordingly, this review examined the impact of no weight regain versus mild regain on various metabolic disease risk parameters, including plasma lipids, blood pressure, glucose, and insulin concentrations, in adult subjects.
Remaining Visual Field and Preserved Subjective Visual Functioning Prevent Mental Distress in Patients with Visual Field Defects
Gall, Carolin; Brösel, Doreen; Sabel, Bernhard A.
Background: Patients with visual field defects after visual pathway lesion may experience reduced vision-related quality of life (vrQoL). It has not been clarified how vrQoL impairments contribute to vision-related mental distress. Methods: One hundred and eight subjects with visual field defects caused by optic neuropathies (age M = 57.6; SD = 13.7 years) answered the National Eye Institute Visual-Functioning Questionnaire 39 (NEI-VFQ) for vrQoL and the SF-12 Short Form Health Survey for health-related quality of life. A 10 item composite of NEI-VFQ "visual functioning" and 5 items of "mental-health symptoms due to vision problems" were subjected to Rasch analysis. The test battery comprised static and High Resolution Perimetry (HRP). Regression and path analysis were used to investigate associations between QoL, mental distress, and perimetry results. Results: A higher level of "visual functioning" was associated with monocular impairment and a larger remaining visual field compared to binocular impairment. Subjective "visual functioning" but not visual field parameters predicted "mental-health symptoms due to vision problems" which was the only variable associated with the SF-12 mental component score. The SF-12 physical component score was less strongly associated with "mental-health symptoms due to vision problems." Here, reaction time in HRP and mean threshold in perimetry were additional significant variables. Path analysis revealed a significant path from remaining visual field via visual functioning on mental health. Conclusion: Subjective consequences of visual impairments in everyday life impact mental health rather than "objective" visual function loss as measured by perimetry. Since a higher extent of vrQoL was related to lower levels of mental distress, the maintenance of vrQoL could reduce and prevent mental distress due to vision problems. Patients with persisting visual field defects may benefit from
Screening for type 2 diabetes mellitus in patients with mental illness: application of a self-assessment score for diabetes mellitus risk.
Shin, Jinah K; Shortridge-Baggett, Lillie M; Sachmechi, Issac; Barron, Charles; Chiu, Ya-Lin; Bajracharya, Bhavana; Bang, Heejung
Various methods for diabetes risk assessment have been developed over a decade, but they were not evaluated in patients with mental illness. This study examined the feasibility and utility of a self-assessment score for type 2 diabetes mellitus (DM2) risk among patients with mental illness. DM2 risk was assessed by patients with mental illness as well as clinicians via a self-assessment questionnaire, and the resulting scores were compared to each other as well as with actual diagnosis. Of 100 patients, nine patients were newly revealed to have DM2 and 34 patients have pre-DM2. Patients tended to underreport risk factors - obesity and physical activity - so perceived to have lower risk. Sensitivity of the self-assessment score was different when used by patients and by clinicians despite correlation coefficient of 0.82. Based on positive predictive values, we may expect one out of two patients who have high scores actually have DM2 or pre-DM2. Also, the discrimination capability was reasonably high (AUC=0.79), comparable to its performance observed in general populations. The self-assessment score has potential as a simple and adjunct tool to identify a high risk group of DM2/pre-DM2 among persons with mental illness, especially, when used together with health care providers.
Quality of life and mental health in patients with chronic diseases who regularly practice yoga and those who do not: a case-control study.
Cramer, Holger; Lauche, Romy; Langhorst, Jost; Dobos, Gustav; Paul, Anna
While clinical trials have shown evidence of efficacy of yoga in different chronic diseases, subjective health benefits associated with yoga practice under naturalistic conditions have not yet been investigated. The aim of this study was to investigate associations of regular yoga practice with quality of life and mental health in patients with chronic diseases. Using a case-control design, patients with chronic diseases who regularly practiced yoga were selected from a large observational study and compared to controls who did not regularly practice yoga and who were matched individually to each case on gender, main diagnosis, education, and age (within 5 years). Patients' quality of life (SF-36 questionnaire), mental health (Hospital Anxiety and Depression Scale), life satisfaction, and health satisfaction (Questionnaire for Life Satisfaction) were assessed. Patients who regularly practiced yoga (n = 186) had a better general health status (P = 0.012), a higher physical functioning (P = 0.001), and physical component score (P = 0.029) on the SF-36 than those who did not (n = 186). No group differences were found for the mental scales of the SF-36, anxiety, depression, life satisfaction, or health satisfaction. In conclusion, practicing yoga under naturalistic conditions seems to be associated with increased physical health but not mental health in chronically diseased patients.
Sex Differences in Platelet Reactivity and Cardiovascular and Psychological Response to Mental Stress in Patients With Stable Ischemic Heart Disease
Samad, Zainab; Boyle, Stephen; Ersboll, Mads; Vora, Amit N.; Zhang, Ye; Becker, Richard C.; Williams, Redford; Kuhn, Cynthia; Ortel, Thomas L.; Rogers, Joseph G.; O'Connor, Christopher; Velazquez, Eric J.; Jiang, Wei
BACKGROUND Although emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified. OBJECTIVES We aimed to study the differential psychological and cardiovascular responses to mental stress between male and female patients with stable IHD. METHODS Patients with stable IHD enrolled in the REMIT (Responses of Mental Stress–Induced Myocardial Ischemia to Escitalopram) study underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after 3 mental stress tasks. Mental stress–induced myocardial ischemia (MSIMI) was defined as the development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8% by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during 1 or more of the 3 mental stress tasks. RESULTS In the 310 participants with known IHD (18% women, 82% men), most baseline characteristics were similar between women and men (including heart rate, blood pressure, and LVEF), although women were more likely to be nonwhite, living alone (p < 0.001), and unmarried (p < 0.001); they also had higher baseline depression and anxiety (p < 0.05). At rest, women had heightened platelet aggregation responses to serotonin (p = 0.007) and epinephrine (p = 0.004) compared with men. Following mental stress, women had more MSIMI (57% vs. 41%, p < 0.04), expressed more negative (p = 0.02) and less positive emotion (p < 0.001), and demonstrated higher collagen-stimulated platelet aggregation responses (p = 0.04) than men. Men were more likely than women to show changes in traditional physiological measures, such as blood pressure (p < 0.05) and double product. CONCLUSIONS In this exploratory analysis, we identified clear, measurable, and differential responses to mental stress in women and men
Safe and effective sofosbuvir-based therapy in patients with mental health disease on hepatitis C virus treatment
Tang, Lydia Shuk Yee; Masur, Jack; Sims, Zayani; Nelson, Amy; Osinusi, Anu; Kohli, Anita; Kattakuzhy, Sarah; Polis, Michael; Kottilil, Shyam
and without MHD groups treated with sofosbuvir-based therapy. Among patients treated with sofosbuvir-based therapy, the percentage of patients with MHD who achieved SVR was the same as those without (SPARE: 60.9% of those MHD compared to 67.6% in those without, P = 0.78; SYNERGY-A: 100% of both groups; ERADICATE: 100% compared to 97.1%). There was no statistically significant difference in pill counts, adherence to study visits between groups, nor mean serum concentrations of GS-331007 for each group at week 2 of treatment (P = 0.72). Among patients with HIV co-infection, pre-treatment BDI scores were similar among patients treated with sofosbuvir, and those treated with interferon (sofosbuvir-based 5.24, IFN-based 6.96; P = 0.14); however, a dichotomous effect on was observed during treatment. Among participants treated with directly acting antiviral (DAA)-based therapy, mean BDI scores decreased from 5.24 (pre-treatment) to 3.28 during treatment (1.96 decrease, P = 0.0034) and 2.82 post-treatment. The decrease in mean score from pre- to post-treatment was statistically significant (-2.42, P = 0.0012). Among participants treated with IFN-based therapy, mean BDI score increased from 6.96 at pre-treatment to 9.19 during treatment (an increase of 2.46 points, P = 0.1), and then decreased back to baseline post-treatment (mean BDI score 6.3, P = 0.54). Overall change in mean BDI scores from pre-treatment to during treatment among participants treated with DAA-based and IFN-therapy was statistically significant (-1.96 and +2.23, respectively; P = 0.0032). This change remained statistically significant when analysis was restricted to participants who achieved SVR (-2.0 and +4.36, respectively; P = 0.0004). CONCLUSION Sofosbuvir-based therapy is safe and well tolerated in patients with MHD. A decline in BDI associated with sofosbuvir-based HCV treatment suggests additional MHD benefits, although the duration of these effects is unknown. PMID:27872683
Mental Health and Substance Use Characteristics of Flight Attendants Enrolled in an In-Patient Substance Abuse Treatment Program
ERIC Educational Resources Information Center
Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald
The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…
[Public health policies in Chile: seeking to regain trust].
Cuadrado, Cristóbal
Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies.
Aesthetic Essentiality Regained Using Implant- A Case Report
Rai, Rathika; Rathee, Suprabha; Chirom, Babina; V, Menaga
The goal of implant therapy is to provide patients with a predictable, aesthetically and functionally satisfying treatment outcome with a low risk of aesthetic complications. Dental implants have been utilized by mankind for thousands of years, but only recently they have achieved widespread acceptance from the profession. Anterior sites are more likely related to aesthetic expectations and often represent a considerable challenge for involved clinicians and dental technicians, since various local risk factors have the potential to compromise the predictability of the result. In recent years, substantial efforts have been made to increase the appeal of implant therapy by shortening the overall treatment time and minimizing the number of surgical intervention. According to traditional protocol, a 12 month healing after extraction was suggested, but over the past few years alternative approaches have been proposed, such as immediate implant placement at the time of extraction or early implant placement following weeks of soft tissue healing. Common to all of these approaches is the requirement of adequate remaining bone volume. If there is no adequate bone volume, techniques like guided bone regeneration (GBR) are used for ridge augmentation before implant placement. The present case has utilized an endosteal root form implant and the advantage of guided bone regeneration technique in regaining aesthetic demands of the patient. PMID:25300892
IL1RAPL1 is associated with mental retardation in patients with complex glycerol kinase deficiency who have deletions extending telomeric of DAX1.
Zhang, Yao-Hua; Huang, Bing-Ling; Niakan, Kathy K; McCabe, Linda L; McCabe, Edward R B; Dipple, Katrina M
IL1RAPL1 (interleukin-1 receptor accessory protein-like, gene 1) has recently been shown to be mutated in patients with X-linked mental retardation. Clinical experience has suggested that patients with the contiguous gene syndrome, complex glycerol kinase deficiency (cGKD), will have mental retardation (MR) if they have deletions extending from the GK gene into the DMD gene and/or involving a significant extension telomeric from DAX1. We examined cell lines from patients with cGKD whose clinical features would be informative and would allow us to determine if IL1RAPL1 deletions can help to explain the MR in patients with deletions extending telomeric from DAX1. Our results showed that nearly all patients with deletions involving DAX1, but not DMD, had MR if IL1RAPL1 was deleted. If ILIRAPLI and DMD were intact, the patients with DAX1 deletions only rarely had normal development. Deletions in DNA from patients with cGKD who exhibited MR and had normal IL1RAPL1 all involved the GK and DMD genes. Our data are consistent with the association of IL1RAPL1 gene deletion and MR in the majority of patients with cGKD and deletions extending telomeric from DAX1.
Substance Use, Depression and Mental Health Functioning in Patients Seeking Acute Medical Care in an Inner-City ED
Walton, Maureen A.; Barry, Kristin L.; Cunningham, Rebecca M.; Chermack, Stephen T.; Blow, Frederic C.
The study investigated the behavioral health of a consecutive sample of 5,641 adult emergency department (ED) patients aged 19 through 60 presenting for medical care in a large, inner-city hospital emergency department. Twenty-three percent met criteria for major depression; average mental health functioning, as measured by the mental health component of the SF-12, was half of a standard deviation lower than in the general population; 15% met criteria for alcohol or drug abuse/dependence in the past year. Comorbidity was high. These behavioral health disorders may complicate treatment and diagnosis of the chief presenting complaint. These findings, coupled with the high rates of these disorders, suggest the importance of screening and either beginning appropriate treatment or offering appropriate referral for such disorders in ED settings. PMID:21086057
Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder
Patel, Rashmi; Shetty, Hitesh; Jackson, Richard; Broadbent, Matthew; Stewart, Robert; Boydell, Jane; McGuire, Philip; Taylor, Matthew
Background Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare. Method Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay), and time to the start of appropriate therapy (treatment delay). Results The median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay. Conclusions Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify
Regaining familiarity with own body after treatment for operable lung cancer - a qualitative longitudinal exploration.
Missel, M; Pedersen, J H; Hendriksen, C; Tewes, M; Adamsen, L
Little is known about the experiences of operable lung cancer patients during treatment in a clinical setting based on fast-track surgery. The study aimed to explore (1) the embodied meaning of illness in patients with operable lung cancer during treatment to 4 months after surgery and (2) patterns of change over time that may affect the patients' daily lives. Twenty patients referred for lung cancer surgery were interviewed three times, corresponding to potential critical transition points following surgery: hospitalisation; hospital-to-home transition; and resumption of daily life activities. Data collection, analysis and interpretation followed a phenomenological hermeneutical approach inspired by Ricoeur and the theoretical framework was grounded in Merleau-Ponty's phenomenology of perception. The findings reveal the process patients went through in regaining familiarity with their own body after lung cancer treatment. Through the post-operative trajectory the patients' resumption of daily activities involved adjusting to a new awareness of everyday life, physical restrictions and their perception of themselves. The findings are expressed in four sub-themes: (1) perceptions of embodied alterations; (2) transformation of embodied structures in the transition from hospital to home was unexpectedly challenging; (3) embodied perceptions of the intersubjective world; and (4) transforming embodied disruptions into bodily awareness. Patients experienced a smooth treatment trajectory regarding physical consequences of illness and treatment which might be due to the fast-track surgery. Clinicians should be aware of patients' experiences of illness to facilitate patient reconstitution of own identity.
How does thinking in Black and White terms relate to eating behavior and weight regain?
Palascha, Aikaterini; van Kleef, Ellen; van Trijp, Hans C M
This study explores the role of dichotomous thinking on eating behavior and its association with restraint eating and weight regain in a wide range of people. In a web-based survey with 241 adults, dichotomous thinking and behavioral outcomes related to eating (restraint eating, weight regain, body mass index, dieting) were assessed. Results showed that eating-specific dichotomous thinking (dichotomous beliefs about food and eating) mediates the association between restraint eating and weight regain. We conclude that holding dichotomous beliefs about food and eating may be linked to a rigid dietary restraint, which in turn impedes people's ability to maintain a healthy weight.
Preoperative mental health status may not be predictive of improvements in patient-reported outcomes following an anterior cervical discectomy and fusion.
Mayo, Benjamin C; Massel, Dustin H; Bohl, Daniel D; Narain, Ankur S; Hijji, Fady Y; Long, William W; Modi, Krishna D; Basques, Bryce A; Yacob, Alem; Singh, Kern
achieving a minimum clinically important difference at 6 months did not differ between the bottom and top MCS score halves (p > 0.05 for each). CONCLUSIONS The results of this study suggest that better preoperative mental health status is associated with lower perceived preoperative disability but is not associated with severity of preoperative neck or arm pain. In contrast to other studies, the present study was unable to demonstrate that preoperative mental health is predictive of improvement in patient-reported outcomes at any postoperative time point following an ACDF.
[First two Mexican cases of monosomy 1p36: possible diagnosis in patients with mental retardation and dysmorphism].
Villarroel, Camilo E; Álvarez, Rosa M; Gómez-Laguna, Laura; Ramos, Sandra; González-Del Ángel, Ariadna
It is calculated that distal deletion of the short arm of chromosome 1 occurs in one out of every 5000 live births and causes approximately 1.2% of cases of mental retardation of unknown origin. This alteration usually cannot be detected in the standard karyotype, requiring molecular cytogenetic techniques for the diagnosis. In addition to the neurological manifestations, it may cause internal organs malformations, such as congenital heart disease, and a characteristic facial phenotype. This report describes the clinical and cytogenetic findings from the first two cases diagnosed in Mexico, confirmed by fluorescence in situ hybridization test, and compares them to those described in the literature. The probable subdiagnosis of this entity, the importance of improves its recognition and the useful data for the clinical suspicion are also discussed.
Structural chromosomal abnormalities in patients with mental retardation and/or multiple congenital anomalies: a new series of 24 patients.
Tos, T; Karaman, A; Aksoy, A; Tukun, A
Chromosomal abnormalities are a major cause of mental retardation and/or multiple congenital anomalies (MCA/MR). Screening for these chromosomal imbalances has mainly been done by standard karyotyping. The objective of this study was to report standard chromosome analysis and FISH screening of a series of 24 patients with MCA/MR. Structural chromosomal abnormalities were detected in 24 alterations and included 5 deletions, 2 duplications, 6 unbalanced translocations, 3 inversions, 2 insertions, 3 derivative chromosomes, 2 marker chromosomes and 1 isochromosome. We confirm that a high percentage of MCA/MR cases hitherto considered idiopathic is caused by chromosomal imbalances. We conclude that patients with MCA/MR should be routinely karyotyped.
Pathways from dieting to weight regain, to obesity and to the metabolic syndrome: an overview.
Dulloo, A G; Montani, J-P
Every year, scores of millions of people - as diverse as obese and lean, teenagers and older adults, sedentary and elite athletes, commoners and celebrities - attempt to lose weight on some form of diet. They are often encouraged by their parents, friends, health professionals, training coaches, a media that promotes a slim image and a diet-industry that in Europe and United States alone has an annual turnover in excess of $150 billion. Weight regain is generally the rule, with one-third to two-thirds of the weight lost being regained within 1 year and almost all is regained within 5 years. With studies of the long-term outcomes showing that at least one-third of dieters regain more weight than they lost, together with prospective studies indicating that dieting during childhood and adolescence predicts future weight gain and obesity, there is concern as to whether dieting may paradoxically be promoting exactly the opposite of what it is intended to achieve. Does dieting really make people fatter? How? Does dieting increase the risks for cardiometabolic diseases as many go through repeated cycles of intentional weight loss and unintentional weight regain, i.e. through yo-yo dieting or weight cycling? What's new in adipose tissue biology pertaining to the mechanisms that drive weight regain? Why does exercise not necessarily work in concert with dieting to achieve weight loss and prevent weight regain? What 'lessons' are we learning from bariatric surgery about the mechanisms by which long-term weight loss seems achievable? It is these questions, against a background of preoccupation with dieting, that recent advances and controversies relevant to the theme of 'Pathways from dieting to weight regain, to obesity and to the metabolic syndrome' are addressed in this overview and the eight review articles in this supplement reporting the proceedings of the 7th Fribourg Obesity Research Conference.
Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care.
DE Hert, Marc; Correll, Christoph U; Bobes, Julio; Cetkovich-Bakmas, Marcelo; Cohen, Dan; Asai, Itsuo; Detraux, Johan; Gautam, Shiv; Möller, Hans-Jurgen; Ndetei, David M; Newcomer, John W; Uwakwe, Richard; Leucht, Stefan
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 - August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI.
Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 – August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI. PMID:21379357
The metabolic syndrome and risk of coronary artery disease in patients with chronic schizophrenia or schizoaffective disorder in a chronic mental institute.
Tseng, Ping-Tao; Wang, Hung-Yu; Cheng, Yu-Shian; Shen, Feng-Chih; Lin, Pao-Yen; Wu, Ching-Kuan
The prevalence rate of metabolic syndrome (MS) and coronary artery disease (CAD) has been found to be high in patients with chronic schizophrenia. Current evidence shows that CAD is underdiagnosed in this group. Our study evaluated the prevalence of MS and the risk of CAD in patients with chronic schizophrenia in a chronic care mental hospital in southern Taiwan. We included all patients with the diagnosis of schizophrenia or schizoaffective disorder. We collected all laboratory, physical examination, psychiatric interview, and chart review data. We also evaluated the risk of CAD in these patients using the Framingham point system. There was no significant age difference in the MS prevalence rate in these patients. The young patients with schizophrenia in our study tended to have a higher prevalence of MS than the general population. In addition, female patients had a higher prevalence rate of MS than males. Based on the Framingham point system, we found the 10-year risk of CAD to be higher among the patients with schizophrenia than in the general population. Our study highlights the importance of the high risk of MS in both younger and older patients with schizophrenia, without a significant relationship to the use of antipsychotics. More complete cohort studies are needed to confirm these findings. Psychiatrists may want to establish more specific and detailed clinical guidelines for patients with chronic schizophrenia with comorbid physical diseases, especially MS and CAD.
Cardiovascular Reactivity in Patients With Major Depressive Disorder With High- or Low-Level Depressive Symptoms: A Cross-Sectional Comparison of Cardiovascular Reactivity to Laboratory-Induced Mental Stress.
Wang, Mei-Yeh; Chiu, Chen-Huan; Lee, Hsin-Chien; Su, Chien-Tien; Tsai, Pei-Shan
Depression increases the risk of adverse cardiac events. Cardiovascular reactivity is defined as the pattern of cardiovascular responses to mental stress. An altered pattern of cardiovascular reactivity is an indicator of subsequent cardiovascular disease. Because depression and adverse cardiac events may have a dose-dependent association, this study examined the differences in cardiovascular reactivity to mental stress between patients with major depressive disorder (MDD) with high depression levels and those with low depression levels. Moreover, autonomic nervous system regulation is a highly plausible biological mechanism for the pattern of cardiovascular reactivity to mental stress. The association between cardiovascular reactivity and parameters of heart rate variability (HRV), an index for quantifying autonomic nervous system activity modulation, was thus examined. This study included 88 patients with MDD. HRV was measured before stress induction. The Stroop Color and Word Test and mirror star-tracing task were used to induce mental stress. We observed no significant association between depressive symptom level and any of the cardiovascular reactivity parameters. Cardiovascular reactivity to mental stress was comparable between patients with MDD with high-level depressive symptoms and those with low-level depressive symptoms. After adjusting for confounding variables, the high-frequency domain of HRV was found to be an independent predictor of the magnitude of heart rate reactivity (β = -.33, p = .002). In conclusion, the magnitude of cardiovascular reactivity may be independent of depression severity in patients with MDD. The autonomic regulation of cardiovascular responses to mental stress primarily influences heart rate reactivity in patients with MDD.
Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment
Yakoot, Mostafa; Salem, Amel; Helmy, Sherine
Background Mild cognitive impairment encompasses the clinical continuum between physiologic age-related cognitive changes and dementia. A variety of medications, including herbal preparations (in particular Ginkgo biloba and Panax ginseng), have been advocated as treatments for cognitive impairment in the elderly. In this study, we investigated the effect of an already marketed dietary supplement (Memo®) combining 750 mg of lyophilized royal jelly with standardized extracts of G. biloba 120 mg and P. ginseng 150 mg on Mini-Mental State Examination (MMSE) scores in patients with mild cognitive impairment. Methods Sixty-six subjects presenting with forgetfulness and satisfying the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) clinical criteria for mild cognitive impairment were randomly divided into an experimental group treated with one Memo capsule before breakfast daily for 4 weeks and a control group who took placebo. The mean change in MMSE score from baseline and reported adverse effects were compared between the two groups. Results The mean change in MMSE score in the group treated with Memo for 4 weeks was significantly greater than in the control group (+2.07 versus +0.13, respectively) by the Student's t-test (t = 6.485, P < 0.0001). This was also true after adjusting for age as a covariate and educational level as a factor nested within the treatment groups in a general linear model (analysis of covariance, F = 9.675 [corrected model], P < 0.0001). Conclusion This combined triple formula may be beneficial in treating the cognitive decline that occurs during the aging process as well as in the early phases of pathologic cognitive impairment typical of insidious-onset vascular dementia and in the early stages of Alzheimer's disease. Larger-sized studies with longer treatment durations are needed to confirm this. PMID:23950642
Persistent microbiome alterations modulate the rate of post-dieting weight regain.
Thaiss, Christoph A; Itav, Shlomik; Rothschild, Daphna; Meijer, Mariska; Levy, Maayan; Moresi, Claudia; Dohnalová, Lenka; Braverman, Sofia; Rozin, Shachar; Malitsky, Sergey; Dori-Bachash, Mally; Kuperman, Yael; Biton, Inbal; Gertler, Arieh; Harmelin, Alon; Shapiro, Hagit; Halpern, Zamir; Aharoni, Asaph; Segal, Eran; Elinav, Eran
In tackling the obesity pandemic, significant efforts are devoted to the development of effective weight reduction strategies, yet many dieting individuals fail to maintain a long-term weight reduction, and instead undergo excessive weight regain cycles. The mechanisms driving recurrent post-dieting obesity remain largely elusive. Here, we identify an intestinal microbiome signature that persists after successful dieting of obese mice, which contributes to faster weight regain and metabolic aberrations upon re-exposure to obesity-promoting conditions and transmits the accelerated weight regain phenotype upon inter-animal transfer. We develop a machine-learning algorithm that enables personalized microbiome-based prediction of the extent of post-dieting weight regain. Additionally, we find that the microbiome contributes to diminished post-dieting flavonoid levels and reduced energy expenditure, and demonstrate that flavonoid-based 'post-biotic' intervention ameliorates excessive secondary weight gain. Together, our data highlight a possible microbiome contribution to accelerated post-dieting weight regain, and suggest that microbiome-targeting approaches may help to diagnose and treat this common disorder.
Perception of exercise difficulty predicts weight regain in formerly overweight women.
Brock, David W; Chandler-Laney, Paula C; Alvarez, Jessica A; Gower, Barbara A; Gaesser, Glenn A; Hunter, Gary R
It has been previously reported that overweight and obese individuals perceive exercise as more difficult than their lean counterparts, and this difference may not be solely attributed to physiological differences. Therefore, we tested the hypothesis that individual differences in the perception of exercise difficulty during exercise, independent of concurrently measured physiological markers of exertion, are predictive of weight regain, after completion of a weight loss program. A total of 113 formerly overweight women who had previously completed a weight-loss program to achieve a normal body weight (BMI <25 kg/m(2)) underwent a submaximal aerobic exercise task while measures of physiological and perceived exertion (rating of perceived exertion (RPE)) were recorded. Weight gain was assessed following a subsequent 1-year free-living period. Average weight regain 1 year following the intervention was 5.46 +/- 3.95 kg. In regression modeling, RPE (beta = 0.21, P = 0.01), but not physiological exertion (beta = 0.02, P = 0.81), during the submaximal exercise task was positively associated with 1-year weight regain following weight loss in premenopausal women, independent of measured confounding variables. The association between RPE and weight regain suggests that perception of exercise difficulty is an important predictor of weight regain following a weight-loss intervention.
One step behind to step ahead - femoral approach to stabilize and to extract functional pacing lead to regain venous access.
Maciąg, Aleksander; Syska, Paweł; Kuśmierski, Krzysztof; Broy, Beata; Sterliński, Maciej
Transvenous lead extraction can be a method to regain venous access. We present the case of a man, aged 67, with indications to upgrade an ICD to a resynchronization therapy device. Since innominate vein occlusion was diagnosed and extraction of an abandoned ventricular pacing lead did not provide lumen regain, a functional atrial lead was extracted with the femoral approach to stabilization and venous access was regained. Asymptomatic vein wall damage but no other complications were recorded. The simultaneous application of different techniques to regain venous access may allow success of the final procedure in system upgrading.
Apple Seeks To Regain Its Stature in World of Academic Computing.
ERIC Educational Resources Information Center
Young, Jeffrey R.; Blumenstyk, Goldie
Managers of Apple Computer, the company that pioneered campus personal computing and later lost most of its share of the market, are again focusing energies on academic buyers. Campus technology officials, even those fond of Apples, are greeting the company's efforts with caution. Some feel it may be too late for Apple to regain a significant…
Internal disinhibition predicts 5‐year weight regain in the National Weight Control Registry (NWCR)
Thomas, J. G.; Niemeier, H.; Wing, R. R.
Summary Background Maintenance of weight loss remains elusive for most individuals. One potential innovative target is internal disinhibition (ID) or the tendency to eat in response to negative thoughts, feelings or physical sensations. Individuals high on ID do worse on average in standard behavioural treatment programmes, and recent studies suggest that disinhibition could play a significant role in weight regain. Purpose The purpose of the current study was to examine whether ID was associated with weight change over 5 years of follow‐up in the National Weight Control Registry, a registry of individuals who have successfully lost weight and maintained it. Methods From the National Weight Control Registry, 5,320 participants were examined across 5 years. Weight data were gathered annually. The disinhibition subscale of the Eating Inventory was used to calculate internal disinhibition and External Disinhibition (ED) and was collected at baseline, year 1, year 3 and year 5. Linear mixed models were used to estimate the weight loss maintained across follow‐up years 1 to 5 using ID and ED as baseline and prospective predictors. Results Internal disinhibition predicted weight regain in all analyses. ED interacted with ID, such that individuals who were high on ID showed greater weight regain if they were also higher on ED. Conclusions The ID scale could be a useful screening measure for risk of weight regain, given its brevity. Improved psychological coping could be a useful target for maintenance or booster interventions. PMID:27812382
Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study
Shibamoto, Yuta Baba, Fumiya; Oda, Kyota; Hayashi, Shinya; Kokubo, Masaki; Ishihara, Shun-Ichi; Itoh, Yoshiyuki; Ogino, Hiroyuki; Koizumi, Masahiko
Purpose: To determine the incidence of brain atrophy and dementia after whole-brain radiotherapy (WBRT) in patients with brain metastases not undergoing surgery. Methods and Materials: Eligible patients underwent WBRT to 40 Gy in 20 fractions with or without a 10-Gy boost. Brain magnetic resonance imaging or computed tomography and Mini-Mental State Examination (MMSE) were performed before and soon after radiotherapy, every 3 months for 18 months, and every 6 months thereafter. Brain atrophy was evaluated by change in cerebrospinal fluid-cranial ratio (CCR), and the atrophy index was defined as postradiation CCR divided by preradiation CCR. Results: Of 101 patients (median age, 62 years) entering the study, 92 completed WBRT, and 45, 25, and 10 patients were assessable at 6, 12, and 18 months, respectively. Mean atrophy index was 1.24 {+-} 0.39 (SD) at 6 months and 1.32 {+-} 0.40 at 12 months, and 18% and 28% of the patients had an increase in the atrophy index by 30% or greater, respectively. No apparent decrease in mean MMSE score was observed after WBRT. Individually, MMSE scores decreased by four or more points in 11% at 6 months, 12% at 12 months, and 0% at 18 months. However, about half the decrease in MMSE scores was associated with a decrease in performance status caused by systemic disease progression. Conclusions: Brain atrophy developed in up to 30% of patients, but it was not necessarily accompanied by MMSE score decrease. Dementia after WBRT unaccompanied by tumor recurrence was infrequent.
Performance of the Modified Mini-Mental State Examination (3MS) in Assessing Specific Cognitive Function in Patients Undergoing Peritoneal Dialysis
Li, Yi; Tian, Xue; Xiong, Zu-Ying; Liao, Jin-Lan; Hao, Li; Liu, Gui-Ling; Ren, Ye-Ping; Wang, Qin; Duan, Li-Ping; Zheng, Zhao-Xia; Quan, Wen-Xiang; Dong, Jie
Purpose While Cognitive impairment (CI) has been identified as an independent risk factors for mortality in patients undergoing peritoneal dialysis (PD), it is inadequately assessed. We evaluated the applicability of the Modified Mini-Mental State Examination (3MS) in assessing specific cognitive function and compared it to a detailed neuropsychological test battery as the reference standard. Methods In this multicentric cross-sectional study, we enrolled 445 clinically stable patients from five PD units, who were undergoing PD for at least 3 months. The 3MS was evaluated for general cognitive function. A detailed neuropsychological battery including domains of immediate memory, delayed memory, executive function, language, and visuospatial ability were evaluated as reference standards. Sensitivity and specificity of the 3MS was determined by using receiver operating characteristic (ROC) analysis. Results The CI prevalence evaluated by 3MS was 23.6%. PD patients with CI performed worse in all cognitive domains. The 3MS correlated well with specific cognitive domains. However, 18.5%, 57.4%, 12.6%, 8.8%, and 41.2% of patients whom were idendified as normal by 3MS still showed executive dysfunction, immediate memory impairment, delayed memory impairment, and language-ability and visuospatial-ability impairment, respectively. The 3MS identified patients having specific cognitive dysfunction with varied extent of diagnostic value, with 0.50, 0.42, 0.35, 0.34, and 0.26 of Youden index in executive function, delayed memory, language ability, immediate memory, and visuospatial ability, respectively. Conclusions The 3MS is not a comprehensive instrument for major cognitive domains in PD patients. It could, however, be used for executive dysfunction and delayed memory impairment screening. PMID:27911914
Adaptations of leptin, ghrelin or insulin during weight loss as predictors of weight regain: a review of current literature
Strohacker, K; McCaffery, JM; MacLean, PS; Wing, RR
Numerous laboratory studies involving both animal and human models indicate that weight loss induces changes in leptin, ghrelin and insulin sensitivity, which work to promote weight regain. It is unclear, however, whether these biological changes serve as a biomarker for predicting weight regain in free-living humans in which biological, behavioral and environmental factors are likely at play. We identified 12 studies published between January 1995 and December 2011 that reported changes in leptin, ghrelin or insulin during intentional weight loss with a follow-up period to assess regain. Two of the nine studies examining leptin suggested that larger decreases were associated with greater regain, three studies found the opposite (smaller decreases were associated with greater regain), whereas four studies found no significant relationship; none of the studies supported the hypothesis that increases in ghrelin during weight loss were associated with regain. One study suggested that improvements in insulin resistance were associated with weight gain, but five subsequent studies reported no association. Changes in leptin, ghrelin or insulin sensitivity, taken alone, are not sufficient to predict weight regain following weight loss in free-living humans. In future studies, it is important to include a combination of physiological, behavioral and environmental variables in order to identify subgroups at greatest risk of weight regain. PMID:23801147
[Energy and emotion in mental health through martial arts].
Gandon, Julien
A patient's arrival in a mental health unit corresponds to a profound malaise in their life. Admission to hospital leads the patient to be cut off from their environment but is also the opportunity for thinking and reconstruction. A workshop based on martial arts enables patients to rediscover their body, verbalise their suffering and regain self-confidence.
Kinetics of refolding of completely reduced human-serum albumin. Regain of immunochemical reactivity.
Wichman, A; Svenson, A; Andersson, L O
The kinetics of refolding of completely reduced human serum albumin has been studied by various methods including immunological techniques. The decrease in thiol content is very rapid in the beginning of the reoxidation process and rather slow in the later stages. Polyacrylamide gel electrophoresis studies show that, in the earlier stages of refolding, the main part of the albumin is present as various oligomers and that a slow conversion to monomer occurs as reoxidation proceeds. Rocket immunoelectrophoresis shows that the completely reduced protein is devoid of native albumin antigenic determinants but that a rapid regain of immunoprecipitability is obtained upon reoxidation. A new 'consumption' rocket immunoelectrophoretic method has been used to estimate the total regain of antigenicity. The data obtained indicate that there is a preferential rapid folding to native structure in certain parts of the molecule but that areas with wrong or incomplete foldings exist a considerable time after the inital refolding period.
[Acupuncture therapy for regaining consciousness in terms of acupoint location, needle insertion and needle manipulation].
Meng, Xianggang; Gu, Wenlong; Ma, Fen; Du, Yuzheng; Zhao, Qi
Acupuncture therapy for regaining consciousness activates soreness, numbness, distention, heaviness, radiating and moving, electric shock and ant climbing sensations at the specific acupoints in the stroke patients. Radiating and moving sensations are the summary of needling sensations such as soreness, numbness and twitching presenting during lifting and thrusting manipulation. These sensations are the essential factors of the therapeutic effect of regaining consciousness. Radiating sensation refers to the conduction along meridians and radiation of soreness and numbness. Moving sensation refers to the local muscular twitching at acupoints and the involuntary movement of limbs, joints and the distal. Acupuncture at the specific acupoints achieves radiating and moving sensations for promoting the circulation in meridians, regulating qi and mind and balancing yin and yang in stroke patients. This therapy was introduced in the paper in view of acupoint location, needle insertion and manipulation.
Symmetrization in jellyfish: reorganization to regain function, and not lost parts.
Abrams, Michael J; Goentoro, Lea
We recently reported a previously unidentified strategy of self-repair in the moon jellyfish Aurelia aurita. Rather than regenerating lost parts, juvenile Aurelia reorganize remaining parts to regain essential body symmetry. This process that we called symmetrization is rapid and frequent, and is not driven by cell proliferation or cell death. Instead, the swimming machinery generates mechanical forces that drive symmetrization. We found evidence for symmetrization across three other species of jellyfish (Chrysaora pacifica, Mastigias sp., and Cotylorhiza tuberculata). We propose reorganization to regain function without recovery of initial morphology as a potentially broad class of self-repair strategy beyond radially symmetrical animals, and discuss the implications of this finding on the evolution of self-repair strategies in animals.
Byting Back. Regaining Information Superiority Against 21st-Century Insurgents
the low likelihood that handsets can be subsidized by high monthly service charges. One approach may be to make a mass initial purchase (e.g., in...engagement decisions, the threshold for high confidence would probably be quite different . 124 Byting Back—Regaining Information Superiority...peer review to ensure high standards for research quality and objectivity. Prepared for the Office of the Secretary of Defense Approved for public
Delayed regaining of gait ability in a patient with brain injury
Jang, Sung Ho; Kwon, Hyeok Gyu
Abstract Background: Little is known about delay in regaining gait ability at a chronic stage after brain injury. In this study, we report on a single patient who regained the gait ability during 2 months of intensive rehabilitation starting 2 years after a brain injury. Methods and results: A 40-year-old male patient diagnosed with viral encephalitis underwent comprehensive rehabilitation until 2 years after onset. However, he could not even sit independently and presented with severe physical deconditioning and severe ataxia. To understand his neurological state, 4 neural tracts related to gait function were reconstructed, and based on the state of these neural tracts, we decided that the patient had the neurological potential to walk independently. Therefore, we assumed that the main reasons for gait inability in this patient were severe physical deconditioning and truncal ataxia. Consequently, the patient underwent the following intensive rehabilitative therapy: administration of drugs for control of ataxia (topiramate, clonazepam, and propranolol) and movement therapy for physical conditioning and gait training. As a result, after 2 months of rehabilitation, he was able to walk independently on an even floor, with improvement of severe physical deconditioning and truncal ataxia. Conclusion: We described the rehabilitation program in a single patient who regained the gait ability during 2 months of intensive rehabilitation starting 2 years after a brain injury. PMID:27661035
Is the right frontal cortex really crucial in the mentalizing network? A longitudinal study in patients with a slow-growing lesion.
Herbet, Guillaume; Lafargue, Gilles; Bonnetblanc, François; Moritz-Gasser, Sylvie; Duffau, Hugues
Assessing the subjective experience of others in terms of mental states, a brain function referred to as mentalizing, is achieved in the brain through a set of low-level perceptual and high-level inference-based processes. Because of its recurrent implication in fMRI studies, the right frontal cortex, especially in its inferolateral and dorsomesial parts, is posited to be a "core system" in the sustenance of these neurocognitive mechanisms. In this context, we reasoned that if the right frontal cortex is really crucial for mentalizing, its surgical resection, following diffuse low-grade glioma invasion, should induce irreversible impairments. To test this hypothesis, we designed a longitudinal experimental setup in which ten patients harboring a low-grade glioma in right frontal areas were assessed just before, immediately after and three months after a brain surgery. Two well-validated behavioral tasks, thought to evaluate both aspects of mentalizing, were administered. The results obtained provide evidence that widespread surgical excisions of the right prefrontal cortex do not induce a long-term worsening of both aspects of mentalizing, although some transitory effects are observed immediately after the surgery. They suggest also for the first time in the same sample of patients a possible double functional dissociation between low-level perceptual (posterior inferolateral prefrontal) and high-level inference-based (dorsomesial prefrontal) mentalizing processes. This overall finding challenges the traditional view according to which the right frontal cortex is an "essential cortical node" in the mentalizing network since it might be expected that massive surgical excisions of this brain area would have induced more definitive impairments.
The impact of supervised weight loss and intentional weight regain on sex hormone binding globulin and testosterone in premenopausal women
Aubuchon, Mira; Liu, Ying; Petroski, Gregory F.; Thomas, Tom R.; Polotsky, Alex J.
What is the impact of intentional weight loss and regain on serum androgens in women? We conducted an ancillary analysis of prospectively collected samples from a randomized controlled trial. The trial involved supervised 10% weight loss (8.5 kg on average) with diet and exercise over 4–6 months followed by supervised intentional regain of 50% of the lost weight (4.6 kg on average) over 4–6 months. Participants were randomized prior to the partial weight regain component to either continuation or cessation of endurance exercise. Analytic sample included 30 obese premenopausal women (mean age of 40 ± 5.9 years, mean baseline body mass index (BMI) of 32.9 ± 4.2 kg/m2) with metabolic syndrome. We evaluated sex hormone binding globulin (SHBG), total testosterone (T), free androgen index (FAI), and high molecular weight adiponectin (HMWAdp). Insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI), and visceral adipose tissue (VAT) measured in the original trial were reanalyzed for the current analytic sample. Insulin, HOMA, and QUICKI improved with weight loss and were maintained despite weight regain. Log-transformed SHBG significantly increased from baseline to weight loss, and then significantly decreased with weight regain. LogFAI and logVAT decreased similarly and increased with weight loss followed by weight regain. No changes were found in logT and LogHMWAdp. There was no significant difference in any tested parameters by exercise between the groups. SHBG showed prominent sensitivity to body mass fluctuations, as reduction with controlled intentional weight regain showed an inverse relationship to VAT and occurred despite stable HMWAdp and sustained improvements with insulin resistance. FAI showed opposite changes to SHBG, while T did not change significantly with weight. Continued exercise during weight regain did not appear to impact these findings. PMID:27192090
The Immune System in Tissue Environments Regaining Homeostasis after Injury: Is "Inflammation" Always Inflammation?
Inflammation is a response to infections or tissue injuries. Inflammation was once defined by clinical signs, later by the presence of leukocytes, and nowadays by expression of "proinflammatory" cytokines and chemokines. But leukocytes and cytokines often have rather anti-inflammatory, proregenerative, and homeostatic effects. Is there a need to redefine "inflammation"? In this review, we discuss the functions of "inflammatory" mediators/regulators of the innate immune system that determine tissue environments to fulfill the need of the tissue while regaining homeostasis after injury. PMID:27597803
Association of weight regain with specific methylation levels in the NPY and POMC promoters in leukocytes of obese men: a translational study.
Crujeiras, Ana B; Campion, Javier; Díaz-Lagares, Angel; Milagro, Fermin I; Goyenechea, Estíbaliz; Abete, Itziar; Casanueva, Felipe F; Martínez, J Alfredo
Specific methylation of appetite-related genes in leukocytes could serve as a useful biomarker to predict weight regain after an energy restriction program. We aimed to evaluate whether the pre-intervention DNA methylation patterns involved in the epigenetic control of appetite-regulatory genes in leukocytes are associated with the weight regain process. Eighteen men who lost ≥5% of body weight after an 8-week nutritional intervention were categorized as "regainers" (≥10% weight regain) and "non-regainers" (<10% weight regain) 32weeks after stopping dieting. At baseline, leukocytes were isolated and DNA was analyzed for epigenetic methylation patterns of appetite-related gene promoters by MALDI-TOF mass spectrometry. Regainers showed higher methylation levels than non-regainers in proopiomelanocortin (POMC) CpG sites +136bp and +138bp (fold change from non-regainers=26%; p=0.020) and lower methylation of the whole analyzed region of neuropeptide Y (NPY; fold change from non-regainers=-22%; p=0.033), as well as of several individual NPY-promoter CpG sites. Importantly, total baseline NPY methylation was associated with weight-loss regain (r=-0.76; p<0.001), baseline plasma ghrelin levels (r=0.60; p=0.011) and leptin/ghrelin ratio (r=-0.52; p=0.046). Lower methylation levels of POMC CpG sites +136bp and +138bp were associated with success in weight-loss maintenance (odds ratio=0.042 [95% CI 0.01-0.57]; p=0.018), whereas lower total methylation levels in NPY promoter were associated with higher risk of weight regain (odds ratio=14.0 [95% CI 1.13-172]; p=0.039). Therefore, the study of leukocyte methylation levels reflects a putative epigenetic regulation of NPY and POMC, which might be implicated in the weight regain process and be used as biomarkers for predicting weight regain after dieting.
Exploratory analysis of the French version of the beliefs about medicines questionnaire in patients with severe mental disorders: Factorial structure and reliability in specific populations of schizophrenic, bipolar and depressive patients
Samalin, Ludovic; de Chazeron, Ingrid; Belzeaux, Raoul; Llorca, Pierre-Michel
Objectives The aims of our study were to explore the factor structure and psychometric properties of the French version of the Beliefs about Medicines Questionnaire (BMQ) in patients with severe mental illness and in specific populations of patients with schizophrenia, bipolar disorder and major depressive disorder. Methods A cross-sectional study including patients with schizophrenia, bipolar disorder and major depressive disorder was conducted (n = 150). Principal component analysis (PCA), reliability and validity of the French version of the BMQ were performed. Results PCA revealed a two-factor structure similar to the original structure for the BMQ-Specific scale but only a one-component solution for the BMQ-General scale in both the total sample and the three subgroups. These subscales have satisfactory internal consistency. Validity was supported by the significant correlations of all BMQ subscales with the Drug Attitude Inventory. Conclusion The French version of the BMQ appears as a three-dimensional scale and presents satisfactory psychometric properties for use in patients with severe mental illness as well as specific populations of patients with schizophrenia, bipolar disorder and major depressive disorder. PMID:28257447
Recovery-oriented care in a secure mental health setting: "striving for a good life".
McKenna, Brian; Furness, Trentham; Dhital, Deepa; Park, Malcolm; Connally, Fiona
Recovery-oriented care acknowledges the unique journey of the consumer to regain control of his or her life in order to live a good life. Recovery has become a dominant policy-directed model of mental health service delivery. Even services that have traditionally been institutional and custodial have been challenged to embrace a recovery-oriented model. The aim of this qualitative study was to provide a description of service delivery in a secure in-patient mental health service, which has developed a self-professed recovery-oriented model of service delivery. An in-depth case study of the secure in-patient service using an exploratory research design was undertaken to meet the aim of this study. Qualitative data was gathered from interviews with consumers and staff (n = 15) and a focus group with carers (n = 5). Data were analyzed using a content analysis approach. Ethical approval for the study was obtained. The stakeholders readily described the secure service within recovery domains. They described a common vision; ways to promote hope and autonomy; examples of collaborative partnership which enhanced the goal of community integration; a focus on strength-based, holistic care; and the management of risk by taking calculated risks. Discrepancies in the perceptions of stakeholders were determined. This case study research provides a demonstrable example of recovery-in-action in one secure mental health service in Australia. It is intended to assist mental health services and clinicians seeking guidance in developing strategies for building and maintaining partnerships with consumers and carers in order for secure services to become truly recovery-oriented.
Comparison between the effect of liothyronine and piracetam on personal information, orientation and mental control in patients under treatment with ECT
Ghafur, Mousavi Seyed; Saadat, Mohammad; Maraci, Mohamad Reza; Bagherian, Reza S.; Mazaheri, Mina
Objective: The study aimed to compare the effect of liothyronine and piracetam on three subscales of the Wechsler memory test on patients under treatment with ECT. Materials and Methods: In a double blind clinical trial, 60 of 99 patients between 20 and 45 years old, under treatment with ECT were studied in three groups. Patients in the allocation groups received liothyronine, piracetam, or placebo, from the first session of ECT until 1 month after the last session of ECT. Personal information, orientation, and mental control were tested in the participants at first, fourth, and last session of ECT and 1 month after the last session of ECT. Data were analyzed with Repeated measure ANOVA using SPSS 13. Results: There wasn't any significant difference among three groups in demographic characteristics before the study and number of ECT sessions (P=0.684). After intervention, a significant difference in memory scores was seen in third and fourth assessment sessions (0.002). Orientation subscales showed a significant difference among four assessment sessions (P=0.001). Personal information and mental control never decreased in the liothyronine group. There was no significant difference among three studied groups in personal information, orientation, and mental control (P>0.05). Conclusion: Memory changes due to ECT may be limited to some parts of memory like orientation. More powerful studies for comparison between the effect of liothyronine and placebo are necessary. PMID:22988323
Aeroglaze Z306 black paint for cryogenic telescope use: outgassing and water vapor regain
NASA Astrophysics Data System (ADS)
McCroskey, Doug M.; Abell, George C.; Chidester, Mike H.
This paper presents the results of an experimental investigation of Aeroglaze Z306 black paint used as a functional coating in a cryogenic telescope for the Space Based Infrared System (SBIRS) program. During ground testing of a DBIRS infrared sensor engineering test model (ETM), degradation of optical transmission was observed. Analysis showed that the degradation was caused by water vapor condensing onto sensor collection optics, which were operating at 120 to 130 K. Root cause analysis identified Aeroglaze Z306 black pain as a likely candidate source of the water vapor. Prior to ETM testing, the painted telescope housing was vacuum baked for 100 hours at 100 $DEGC. However ASTM E 595 test data show that significant water vapor regain occurs within 24 hours after vacuum bake-out. To obtain a detailed characterization of the black paint with respect to water vapor regain and subsequent removal under vacuum conditions, a test plan was developed involving a series of ASTM E 1559 test measurements. These tests improve our understanding of the processes involved and provide the basis for design of an on-orbit H2 bakeout capability for the SBIRS infrared sensor payload.
The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness.
Oliveira-Maia, Albino J; Mendonça, Carina; Pessoa, Maria J; Camacho, Marta; Gago, Joaquim
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective
The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness
Oliveira-Maia, Albino J.; Mendonça, Carina; Pessoa, Maria J.; Camacho, Marta; Gago, Joaquim
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective
Evaluation of the Housing First program in patients with severe mental disorders in France: study protocol for a randomized controlled trial
Background Recent studies in North American contexts have suggested that the Housing First model is a promising strategy for providing effective services to homeless people with mental illness. In the context of the highly generous French national health and social care system, which is easily accessible and does not require out-of-pocket payment, the French Health Ministry insists on rigorous techniques, including randomized protocols, to evaluate the impact of Housing First approaches in France. Method and design A prospective randomized trial was designed to assess the impact of a Housing First intervention on health outcomes and costs over a period of 24 months on homeless people with severe mental illness, compared to Treatment-As-Usual. The study is being conducted in four cities in France: Lille, Marseille, Paris and Toulouse. The inclusion criteria are as follows: over 18 years of age, absolutely homeless or in precarious housing, and possessing a 'high' level of need: diagnosis of schizophrenia or bipolar disorder and moderate to severe disability according to the Multnomah Community Ability Scale (score ≤ 62) and at least one of the following three criteria: 1) having been hospitalized for mental illness two or more times in any one year during the preceding five years; 2) co-morbid alcohol or substance use; and 3) having been recently arrested or incarcerated. Participants will be randomized to receiving the Housing First intervention or Treatment-As-Usual. The Housing First intervention provides immediate access to independent housing and community care. The primary outcome criterion is the use of high-cost health services (that is,, number of hospital admissions and number of emergency department visits) during the 24-month follow-up period. Secondary outcome measures include health outcomes, social functioning, housing stability and contact with police services. An evaluation of the cost-effectiveness and cost-utility of Housing First will
Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness
Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients' treatment motivation upon the patients' TE. The primary outcome is the patients' TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment
Narrative exposure therapy for posttraumatic stress disorder associated with repeated interpersonal trauma in patients with severe mental illness: a mixed methods design
Mauritz, Maria W.; Van Gaal, Betsie G. I.; Jongedijk, Ruud A.; Schoonhoven, Lisette; Nijhuis-van der Sanden, Maria W. G.; Goossens, Peter J. J.
Background In the Netherlands, most patients with severe mental illness (SMI) receive flexible assertive community treatment (FACT) provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD) are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET) within various vulnerable patient groups with repeated interpersonal trauma. Some FACT-teams provide NET for patients with comorbid PTSD, which is promising, but has not been specifically studied in SMI patients. Objectives The primary aim is to evaluate NET in SMI patients with comorbid PTSD associated with repeated interpersonal trauma to get insight into whether (1) PTSD and dissociative symptoms changes and (2) changes occur in the present SMI symptoms, care needs, quality of life, global functioning, and care consumption. The second aim is to gain insight into patients' experiences with NET and to identify influencing factors on treatment results. Methods This study will have a mixed methods convergent design consisting of quantitative repeated measures and qualitative semi-structured in-depth interviews based on Grounded Theory. The study population will include adult SMI outpatients (n=25) with comorbid PTSD and receiving NET. The quantitative study parameters will be existence and severity of PTSD, dissociative, and SMI symptoms; care needs; quality of life; global functioning; and care consumption. In a longitudinal analysis, outcomes will be analyzed using mixed models to estimate the difference in means between baseline and repeated measurements. The qualitative study parameters will be experiences with NET and perceived factors for success or failure. Integration of quantitative and qualitative results will be focused on interpreting how qualitative results enhance the
Exercise training prevents regain of visceral fat for 1-year following weight loss
Hunter, Gary R.; Brock, David W.; Byrne, Nuala M; Chandler-Laney, Paula; Coral, Pedro Del; Gower, Barbara A.
The purpose of this study was to determine what effect aerobic and resistance exercise training has on gain of visceral fat during the year following weight loss. After being randomly assigned to aerobic training, resistance training, or no exercise training, 45 European-American and 52 African-American women lost 12.3±2.5 kg on a 800 kcal/day diet. Computed tomography was used to measure abdominal subcutaneous and visceral adipose tissue while total fat and regional fat (leg, arm, and trunk) were measured by Dual Energy X-Ray Absorptiometry after weight loss and one year following the weight loss. Since not all the subjects adhered to the 2 time/week 40 minutes/day exercise training during the one year follow-up, subjects were divided into five groups for analysis; aerobic adherers, aerobic non-adherers, resistance adherers, resistance non-adherers and no exercise. No significant differences were observed between the aerobic training and resistance training adherers for any variable. However, the aerobic (3.1 kg) and resistance (3.9 kg) exercise adherers gained less weight than any of the other 3 groups (all more than 6.2 kg). In addition, the two exercise adherence groups did not significantly increase visceral fat (< 0.8%) as compared with the 38% increase for the two non-adhering exercise groups and the 25% for the non-exercise group. In conclusion, as little as 80 minutes/week aerobic or resistance training had modest positive effects on preventing weight regain following a diet induced weight loss. More importantly, both aerobic and resistance training prevented regain of potentially harmful visceral fat. PMID:19816413
Biological Mechanisms that Promote Weight Regain Following Weight Loss in Obese Humans
Ochner, Christopher N.; Barrios, Dulce M.; Lee, Clement D.; Pi-Sunyer, F. Xavier
Weight loss dieting remains the treatment of choice for the vast majority of obese individuals, despite the limited long-term success of behavioral weight loss interventions. The reasons for the near universal unsustainability of behavioral weight loss in [formerly] obese individuals have not been fully elucidated, relegating researchers to making educated guesses about how to improve obesity treatment, as opposed to developing interventions targeting the causes of weight regain. This article discusses research on several factors that may contribute to weight regain following weight loss achieved through behavioral interventions, including adipose cellularity, endocrine function, energy metabolism, neural responsivity, and addiction-like neural mechanisms. All of these mechanisms are engaged prior to weight loss, suggesting that so called "anti-starvation" mechanisms are activated via reductions in energy intake, rather than depletion of energy stores. Evidence suggests that these mechanisms are not necessarily part of a homeostatic feedback system designed to regulate body weight or even anti-starvation mechanisms per se. Though they may have evolved to prevent starvation, they appear to be more accurately described as anti-weight loss mechanisms, engaged with caloric restriction irrespective of the adequacy of energy stores. It is hypothesized that these factors may combine to create a biological disposition that fosters the maintenance of an elevated body weight and work to restore the highest sustained body weight, thus precluding the long-term success of behavioral weight loss. It may be necessary to develop interventions that attenuate these biological mechanisms in order to achieve long-term weight reduction in obese individuals. PMID:23911805
One step behind to step ahead – femoral approach to stabilize and to extract functional pacing lead to regain venous access
Maciąg, Aleksander; Syska, Paweł; Kuśmierski, Krzysztof; Broy, Beata
Transvenous lead extraction can be a method to regain venous access. We present the case of a man, aged 67, with indications to upgrade an ICD to a resynchronization therapy device. Since innominate vein occlusion was diagnosed and extraction of an abandoned ventricular pacing lead did not provide lumen regain, a functional atrial lead was extracted with the femoral approach to stabilization and venous access was regained. Asymptomatic vein wall damage but no other complications were recorded. The simultaneous application of different techniques to regain venous access may allow success of the final procedure in system upgrading. PMID:24570742
Assessment of cognitive status in patients with type 2 diabetes through the mini-mental status examination: a cross-sectional study
Background Diabetes is considered an independent risk factor for cognitive impairment and some studies observed through neuropsychological tests that cognitive disfunction affects both elderly and younger patients with diabetes. The aims of this study were to evaluate the cognitive status of outpatients with type 2 diabetes and to evaluate factors associated with impaired function. Methods A cross-sectional study was conducted in a group of type 2 diabetic outpatients. They were asked to undergo the Mini-Mental State Examination (MMSE) during routine ambulatory visits between April 2006 and January 2007, with the highest pontuation of the test being 30 points. Patients were classified as having possible dementia according to years of study. Exclusion criteria were blindness, illiterately, stroke, Alzheimer disease and psychiatric disorder. Results are presented as median (interquartile range) or mean ± SD. Results The study group was composed of 346 type 2 diabetic outpatients (216 females), aged 58,6 ± 12,1 years and with duration of diabetes of 12,3 ± 9,1 years. Hypertension was present in 77,2%. The total MMSE score achieved was 26 points (16 - 30) and was correlated with years of study (R2 = 0,39, p < 0,001) and 'per capita' income (R2 = 0,22, p < 0,0001) and duration of diabetes (R2 = - 0,13, p = 0,01). Patients who needed help to take their medications obtained worst performance in the MMSE (23,16 ± 3,55 vs 25,7 ± 2,84, p < 0,01) and were more likely to present possible dementia (p < 0,01). Forty two subjects (12.1%) had diagnosis of possible dementia and this was also associated with years of study (p = 0,045). No association was observed between possible dementia and total MMSE scores with A1C levels. Conclusions We conclude that patients with type 2 diabetes should be regularly evaluated for their cognitive function, because duration of disease could be associated with decline in cognition. The early implementation of mini mental which is a simple
Mentalization, insightfulness, and therapeutic action. The importance of mental organization.
Sugarman, Alan
Continuing debates over the relative importance of the role of interpretation leading to insight versus the relationship with the analyst as contributing to structural change are based on traditional definitions of insight as gaining knowledge of unconscious content. This definition inevitably privileges verbal interpretation as self-knowledge becomes equated with understanding the contents of the mind. It is suggested that a way out of this debate is to redefine insight as a process, one that is called insightfulness. This term builds on concepts such as mentalization, or theory of mind, and suggests that patients present with difficulties being able to fully mentalize. Awareness of repudiated content will usually accompany the attainment of insightfulness. But the point of insightfulness is to regain access to inhibited or repudiated mentalization, not to specific content, per se. Emphasizing the process of insightfulness integrates the importance of the relationship with the analyst with the facilitation of insightfulness. A variety of interventions help patients gain the capacity to reflect upon and become aware of the intricate workings of their minds, of which verbal interpretation is only one. For example, often it seems less important to focus on a particular conflict than to show interest in our patients' minds. Furthermore, analysands develop insightfulness by becoming interested in and observing our minds in action. Because the mind originates in bodily experience, mental functioning will always fluctuate between action modes of experiencing and expressing and verbal, symbolic modes. The analyst's role becomes making the patient aware of regressions to action modes, understanding the reasons for doing so, and subordinating this tendency to the verbal, symbolic mode. All mental functions work better and facilitate greater self-regulation when they work in abstract, symbolic ways. Psychopathology can be understood as failing to develop or losing the
Changes in Disability, Physical/Mental Health States and Quality of Life during an 8-Week Multimodal Physiotherapy Programme in Patients with Chronic Non-Specific Neck Pain: A Prospective Cohort Study
Cuesta-Vargas, Antonio Ignacio; González-Sánchez, Manuel
Aim The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life. Methods 175 CNSNP patients from a community-based centre were recruited to participate in this prospective study. Intervention: 60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session. Study outcomes: primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables. Results Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention. Conclusion After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical
Effects of medical and mental status on treatment modalities in patients treated under general anaesthesia at the KTU Faculty of Dentistry in Trabzon, Turkey: A comparative retrospective study.
Baygin, Ozgul; Tuzuner, Tamer; Kusgoz, Adem; Yahyaoglu, Gorkem; Yilmaz, Nagehan; Aksoy, Simge
This study evaluated the differences in dental conditions and treatment modalities between disabled and non-cooperative healthy children under general anaesthesia. The data were collected from paediatric patients between 3 and 15 years of age who received dental treatment under general anaesthesia. Patients with at least one mental/physical disturbance (group 1) and other healthy non-cooperative patients (group 2) were compared with regard to gender, age, weight, and treatment time-type. The statistical analyses were performed using Fisher's exact and Mann-Whitney U tests. No significant differences were observed between the groups with regard to gender, weight and treatment-time (p>0.05). The numbers of treated teeth (p<0.01) and extractions (p<0.001) were higher in group 1 than in group 2, whereas the frequency of advanced restorative procedures for group 1 was lower than that for group 2, including preventive-resin-restoration (p<0.001), glass-ionomer-cement (p<0.05), root-canal (p<0.001) and stainless-steel-crowns (p<0.001). This study supports the hypothesis that the general condition of the patients may alter the type of treatment provided and confirms the necessity of performing preventive procedures.
[Evaluation by statistical brain perfusion SPECT analysis on MRI findings, kana pick-out test and Mini-Mental State Examination results in patients with forgetfulness].
Nakatsuka, Hiroki; Matsubara, Ichirou; Ohtani, Haruhiko
The aim of this single photon emission computed tomography(SPECT) study was to determine the abnormality of the regional cerebral blood flow(rCBF) using a three-dimensional stereotactic surface projection (3 D-SSP) in 18 patients who were referred to the hospital because of forgetfulness. Two intergroup comparison by 3 D-SSP analysis was conducted based on MRI, kana pick-out test and Mini-Mental State Examination (MMSE) results. Of the MRI findings, in the brain atrophy group, rCBF was decreased in the posterior cingulate gyrus, medial temporal structure and parieto-temporal association cortex; these rCBF-decreased areas are similar to the Alzheimer disease pattern. In the group where the MMSE was normal but the kana pick-out test was abnormal, rCBF was decreased in the posterior cingulate gyrus and cinguloparietal transitional area. In the group where both the MMSE and kana pick-out test were abnormal, rCBF was decreased in the parieto-temporal association cortex, temporal cortex and medial temporal structure. These results suggest that 3 D-SSP analysis of the SPECT with MMSE and the kana pick-out test provides the possibility of early diagnosis of initial stage of Alzheimer's disease.
A Family and Community Focused Lifestyle Program Prevents Weight Regain in Pacific Islanders: A Pilot Randomized Controlled Trial
ERIC Educational Resources Information Center
Kaholokula, Joseph Keawe'aimoku; Mau, Marjorie K.; Efird, Jimmy T.; Leake, Anne; West, Margaret; Palakiko, Donna-Marie; Yoshimura, Sheryl R.; Kekauoha, B. Puni; Rose, Charles; Gomes, Henry
Preventing weight regain after the loss of excess weight is challenging for people, especially for ethnic minorities in the United States. A 6-month weight loss maintenance intervention designed for Pacific Islanders, called the PILI Lifestyle Program (PLP), was compared with a 6-month standard behavioral weight loss maintenance program (SBP) in a…
Clinically relevant single gene or intragenic deletions encompassing critical neurodevelopmental genes in patients with developmental delay, mental retardation, and/or autism spectrum disorders.
Mikhail, Fady M; Lose, Edward J; Robin, Nathaniel H; Descartes, Maria D; Rutledge, Katherine D; Rutledge, S Lane; Korf, Bruce R; Carroll, Andrew J
Recent studies suggest that copy number variations (CNVs) encompassing several genes involved in neurodevelopmental pathways are associated with a variety of neuropsychiatric phenotypes, including developmental delay (DD), mental retardation (MR), and autism spectrum disorders (ASDs). Here we present eight patients in a cohort of approximately 1,200 patients referred for clinical array CGH testing for various neurodevelopmental phenotypes,whowere identified to carry small (<1.0Mb with the majority <500 kb) either total gene or intragenic deletions encompassing critical synaptic and other neurodevelopmental genes. The presentations of these patients included variable degrees of DD, speech problems, learning disabilities, MR, autistic-like features, and mild non-specific dysmorphic features. These genes belong to four functional categories, including neuronal transcription factor genes (NFIA at 1p31.3, MEF2C at 5q14.3, andCAMAT1at 1p36.23p36.31), neuron-specific splicing factor genes (RBFOX1 at 16p13.2p13.3), genes involved in synapse formation and maintenance (CNTNAP2 at 7q35 and LRFN5 at 14q21.2), and genes involved in neurotransmission (CHRNA7 at 15q13.3 and IL1RAPL1 at Xp21.2p21.3). Our report expands the list of neurodevelopmental genes deleted in various neurobehavioral phenotypes, expands the phenotypes caused by haploinsufficiency of previously reported critical neurodevelopmental genes, and elucidates the clinical relevance and need for careful clinical interpretation of some small CNVs<500 kb. This report also suggests that small clinically relevant deletions encompassing critical synaptic and other neurodevelopmental genes can present clinically with various neurobehavioral phenotypes, which implies the existence of overlapping neuronal pathways in the pathogenesis of these phenotypes.
Using a combination of MLPA kits to detect chromosomal imbalances in patients with multiple congenital anomalies and mental retardation is a valuable choice for developing countries.
Jehee, Fernanda Sarquis; Takamori, Jean Tetsuo; Medeiros, Paula F Vasconcelos; Pordeus, Ana Carolina B; Latini, Flavia Roche M; Bertola, Débora Romeo; Kim, Chong Ae; Passos-Bueno, Maria Rita
Conventional karyotyping detects anomalies in 3-15% of patients with multiple congenital anomalies and mental retardation (MCA/MR). Whole-genome array screening (WGAS) has been consistently suggested as the first choice diagnostic test for this group of patients, but it is very costly for large-scale use in developing countries. We evaluated the use of a combination of Multiplex Ligation-dependent Probe Amplification (MLPA) kits to increase the detection rate of chromosomal abnormalities in MCA/MR patients. We screened 261 MCA/MR patients with two subtelomeric and one microdeletion kits. This would theoretically detect up to 70% of all submicroscopic abnormalities. Additionally we scored the de Vries score for 209 patients in an effort to find a suitable cut-off for MLPA screening. Our results reveal that chromosomal abnormalities were present in 87 (33.3%) patients, but only 57 (21.8%) were considered causative. Karyotyping detected 15 abnormalities (6.9%), while MLPA identified 54 (20.7%). Our combined MLPA screening raised the total detection number of pathogenic imbalances more than three times when compared to conventional karyotyping. We also show that using the de Vries score as a cut-off for this screening would only be suitable under financial restrictions. A decision analytic model was constructed with three possible strategies: karyotype, karyotype + MLPA and karyotype + WGAS. Karyotype + MLPA strategy detected anomalies in 19.8% of cases which account for 76.45% of the expected yield for karyotype + WGAS. Incremental Cost Effectiveness Ratio (ICER) of MLPA is three times lower than that of WGAS, which means that, for the same costs, we have three additional diagnoses with MLPA but only one with WGAS. We list all causative alterations found, including rare findings, such as reciprocal duplications of regions deleted in Sotos and Williams-Beuren syndromes. We also describe imbalances that were considered polymorphisms or rare variants, such as the new SNP
Long-term weight status in regainers after weight loss by lifestyle intervention: status and challenges.
Stelmach-Mardas, Marta; Mardas, Marcin; Walkowiak, Jarosław; Boeing, Heiner
After having participated in a weight loss trial, most participants do not stabilise the obtained weight loss but return to their initial weight. The aim of this review is to describe the main determinants of continued low weight status after weight loss, and the effectiveness of physical activity (PA), energy restriction and macronutrient composition of the diet for low long-term weight regain. Studies with intervention periods of at least 3 months duration of weight reduction measures and a follow-up at least 2 years after the intervention period were considered as eligible for the review. Owing to limited data, the studies describing the role of PA in weight management were eligible with a follow-up of 1 year only. It appears that a diet with self-regulation of dietary intake seems to be given a prominent role in the strategy of successful long-term weight loss among the obese. This measure could be combined with behaviour therapy and PA and tailored to the individual situation. However, considering available evidence it is difficult to conclude regarding unambiguous measures and to recommend a specific dietary intervention. Nevertheless, interventions should be effective in promoting intrinsic motivation and self-efficacy. The harmonisation and standardisation of data collection in the follow-up period of long-term weight loss studies is a major challenge.
Regain in Body Mass After Weigh-In is Linked to Success in Real Life Judo Competition.
Reale, Reid; Cox, Gregory R; Slater, Gary; Burke, Louise M
We examined the relationship between the regain of body mass (BM) after weigh-in and success in real-life judo competition. Eighty-six (36 females, 50 males) senior judoka volunteered for this observational study of an international judo competition. Subjects were weighed at the official weigh-in and one hour before their first competition fight (15-20 hr later). Regain in BM after weigh-in was compared between medal winners and nonmedalists, winners and losers of each fight, males and females and across weight divisions. Heavyweights were excluded from analysis. Prefight BM was greater than BM at official weigh-in for both males and females, with % BM gains of 2.3 ± 2.0 (p ≤ .0001; ES= 1.59; CI95% [1.63, 2.98]) and 3.1 ± 2.2 (p ≤ .0001; ES = 2.03; CI95% [2.30, 3.89]), respectively. No significant differences were found between weight divisions for post weigh-in BM regain. Differences in post weigh-in BM regain were significantly higher in medal winners than nonmedalists for males and females combined (1.4 ± 0.4% BM; p = .0026; ES= 0.69; CI95% [0.05, 2.34]) and for males alone (1.5 ± 0.6% BM; p = .017; ES= 0.74; CI95% [0.02, 2.64]), but not for females (1.2 ± 0.7% BM; p = .096; ES = 0.58; CI95% [-0.02, 2.31]). Differences in BM regain after weigh-in between winners and losers were significant across all fights (0.9 ± 0.3% BM; p = .0021; ES= 0.43; CI95% [0.31, 1.41]) but not for first round fights (0.8 ± 0.5% BM; p = .1386, ES = 0.38; CI95% [-0.26, 1.86]). Winners showed a greater regain in BM post weigh-in than losers. This may reflect the greater magnitude of the BM loss needed to achieve weigh-in targets which also relates to the experience level of successful athletes.
Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, post- ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play a ...
Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel and act as ... stress, relate to others, and make choices. Mental health is important at every stage of life, from ...
Neural stem cells differentiated from iPS cells spontaneously regain pluripotency.
Choi, Hyun Woo; Kim, Jong Soo; Choi, Sol; Hong, Yean Ju; Kim, Min Jung; Seo, Han Geuk; Do, Jeong Tae
Differentiated somatic cells can be reprogrammed into pluripotent stem cells by transduction of exogenous reprogramming factors. After induced pluripotent stem (iPS) cells are established, exogenous genes are silenced. In the pluripotent state, retroviral genes integrated in the host genome are kept inactive through epigenetic transcriptional regulation. In this study, we tried to determine whether exogenous genes remain silenced or are reactivated upon loss of pluripotency or on differentiation using an in vitro system. We induced differentiation of iPS cells into neural stem cells (NSCs) in vitro; the NSCs appeared morphologically indistinguishable from brain-derived NSCs and stained positive for the NSC markers Nestin and Sox2. These iPS cell-derived NSCs (iPS-NSCs) were also capable of differentiating into all three neural subtypes. Interestingly, iPS-NSCs spontaneously formed aggregates on long-term culture and showed reactivation of the Oct4-GFP marker, which was followed by the formation of embryonic stem cell-like colonies. The spontaneously reverted green fluorescent protein (GFP)-positive (iPS-NSC-GFP(+) ) cells expressed high levels of pluripotency markers (Oct4 and Nanog) and formed germline chimeras, indicating that iPS-NSC-GFP(+) cells had the same pluripotency as the original iPS cells. The reactivation of silenced exogenous genes was tightly correlated with the downregulation of DNA methyltransferases (Dnmts) during differentiation of iPS cells. This phenomenon was not observed in doxycycline-inducible iPS cells, where the reactivation of exogenous genes could be induced only by doxycycline treatment. These results indicate that pluripotency can be regained through reactivation of exogenous genes, which is associated with dynamic change of Dnmt levels during differentiation of iPS cells.
Resistant starch and exercise independently attenuate weight regain on a high fat diet in a rat model of obesity
Background Long-term weight reduction remains elusive for many obese individuals. Resistant starch (RS) and exercise may be useful for weight maintenance. The effects of RS, with or without exercise, on weight regain was examined during relapse to obesity on a high carbohydrate, high fat (HC/HF) diet. Methods Obesity-prone rats were fed ad libitum for 16 weeks then weight reduced on a low fat diet to induce a 17% body weight loss (weight reduced rats). Weight reduced rats were maintained on an energy-restricted low fat diet for 18 weeks, with or without a daily bout of treadmill exercise. Rats were then allowed free access to HC/HF diet containing low (0.3%) or high (5.9%) levels of RS. Weight regain, energy balance, body composition, adipocyte cellularity, and fuel utilization were monitored as rats relapsed to obesity and surpassed their original, obese weight. Results Both RS and exercise independently attenuated weight regain by reducing the energy gap between the drive to eat and suppressed energy requirements. Exercise attenuated the deposition of lean mass during relapse, whereas its combination with RS sustained lean mass accrual as body weight returned. Early in relapse, RS lowered insulin levels and reduced the deposition of fat in subcutaneous adipose tissue. Exercise cessation at five weeks of relapse led to increased weight gain, body fat, subcutaneous adipocytes, and decreased lean mass; all detrimental consequences to overall metabolic health. Conclusions These data are the first to show the complimentary effects of dietary RS and regular exercise in countering the metabolic drive to regain weight following weight loss and suggest that exercise cessation, in the context of relapse on a HC/HF diet, may have dire metabolic consequences. PMID:21736742
AB008. Assessment of cognitive impairment in patients with obstructive sleep apnea-hypopnea syndrome with the use of Addenbrooke, Montreal Cognitive Assessment and Mini-Mental State Examination scales
Ntafouli, Maria; Economou, Nikolaos-Tiberios; Gourgoulianis, Konstantinos; Steiropoulos, Paschalis
Background Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), may have cognitive impairment, which usually is not diagnosed, affecting negatively their daily functioning. Aim of this study was to assess the scores of Addenbrooke (ACE-R), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), three diagnostic tools for detecting neuropsychological deficits, in patients with OSAHS. Methods Included were 101 patients with OSAHS, diagnosed with polysomnography, who visited the outpatient Sleep Clinic of the University General Hospital of Larissa and General Hospital "Evangelismos" of Athens and 40 normal controls of the general population. All participants filled the ACE-R, MoCA and MMSE scales. Results The majority of patients were males (52.5%), between the ages of 51–71 years (52.4%), secondary school graduates (53.5%). Apnea hypopnea index (AHI) was not correlated with any of the scales: MMSE (P=0.657), ACE-R (P=0.773), MoCA (P=0.465), while these 3 scales correlated well with each other. Conclusions Further research is necessary to evaluate the utility of ACE-R, MoCA and MMSE neuropsychological scales in assessing cognitive impairment of OSAHS patients.
A Losing Battle: Weight Regain Does Not Restore Weight Loss-Induced Bone Loss in Postmenopausal Women
Villalon, Karen L.; Gozansky, Wendolyn S.; Van Pelt, Rachael E.; Wolfe, Pam; Jankowski, Catherine M.; Schwartz, Robert S.; Kohrt, Wendy M.
Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m2. They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (−1.7 ± 3.5%; P = 0.002) and hip (−0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (−0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: −3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss. PMID:21852813
Analyzing cost-effectiveness of ulnar and median nerve transfers to regain forearm flexion.
Wali, Arvin R; Park, Charlie C; Brown, Justin M; Mandeville, Ross
OBJECTIVE Peripheral nerve transfers to regain elbow flexion via the ulnar nerve (Oberlin nerve transfer) and median nerves are surgical options that benefit patients. Prior studies have assessed the comparative effectiveness of ulnar and median nerve transfers for upper trunk brachial plexus injury, yet no study has examined the cost-effectiveness of this surgery to improve quality-adjusted life years (QALYs). The authors present a cost-effectiveness model of the Oberlin nerve transfer and median nerve transfer to restore elbow flexion in the adult population with upper brachial plexus injury. METHODS Using a Markov model, the authors simulated ulnar and median nerve transfers and conservative measures in terms of neurological recovery and improvements in quality of life (QOL) for patients with upper brachial plexus injury. Transition probabilities were collected from previous studies that assessed the surgical efficacy of ulnar and median nerve transfers, complication rates associated with comparable surgical interventions, and the natural history of conservative measures. Incremental cost-effectiveness ratios (ICERs), defined as cost in dollars per QALY, were calculated. Incremental cost-effectiveness ratios less than $50,000/QALY were considered cost-effective. One-way and 2-way sensitivity analyses were used to assess parameter uncertainty. Probabilistic sampling was used to assess ranges of outcomes across 100,000 trials. RESULTS The authors' base-case model demonstrated that ulnar and median nerve transfers, with an estimated cost of $5066.19, improved effectiveness by 0.79 QALY over a lifetime compared with conservative management. Without modeling the indirect cost due to loss of income over lifetime associated with elbow function loss, surgical treatment had an ICER of $6453.41/QALY gained. Factoring in the loss of income as indirect cost, surgical treatment had an ICER of -$96,755.42/QALY gained, demonstrating an overall lifetime cost savings due to
Low-carbohydrate high-fat diets: regulation of energy balance and body weight regain in rats.
Caton, Samantha J; Yinglong, Bai; Burget, Lukas; Spangler, Lothar J; Tschöp, Matthias H; Bidlingmaier, Martin
The aim of the current investigations was to examine the effects of a low-carbohydrate high-fat diet (LC-HFD) on body weight, body composition, growth hormone (GH), IGF-I, and body weight regain after stopping the dietary intervention and returning the diet back to standard laboratory chow (CH). In study one, both adolescent and mature male Wistar rats were maintained on either an isocaloric LC-HFD or CH for 16 days before having their diet switched. In study two, mature rats were maintained on either LC-HFD or CH for 16 days to determine the effects of the LC-HFD on fat pad weight. LC-HFD leads to body weight loss in mature rats (P < 0.01) and lack of body weight gain in adolescent rats (P < 0.01). Despite less body weight, increased body fat was observed in rats maintained on LC-HFD (P < 0.05). Leptin concentrations were higher (P < 0.05), and IGF-I (P < 0.01) concentrations were reduced in the LC-HFD rats. When the diet was returned to CH following LC-HFD, body weight regain was above and beyond that which was lost (P < 0.01). The LC-HFD resulted in increased body fat and had a negative effect upon both GH and IGF-I concentrations, which might have implications for the accretion and maintenance of lean body mass (LBM), normal growth rate and overall metabolic health. Moreover, when the LC-HFD ceases and a high-carbohydrate diet follows, more body weight is regained as compared to when the LC-HFD is consumed, in the absence of increased energy intake.
Variation in extracellular matrix genes is associated with weight regain after weight loss in a sex-specific manner.
Roumans, Nadia J T; Vink, Roel G; Gielen, Marij; Zeegers, Maurice P; Holst, Claus; Wang, Ping; Astrup, Arne; Saris, Wim H; Valsesia, Armand; Hager, Jörg; van Baak, Marleen A; Mariman, Edwin C M
The extracellular matrix (ECM) of adipocytes is important for body weight regulation. Here, we investigated whether genetic variation in ECM-related genes is associated with weight regain among participants of the European DiOGenes study. Overweight and obese subjects (n = 469, 310 females, 159 males) were on an 8-week low-calorie diet with a 6-month follow-up. Body weight was measured before and after the diet, and after follow-up. Weight maintenance scores (WMS, regained weight as percentage of lost weight) were calculated based on the weight data. Genotype data were retrieved for 2903 SNPs corresponding to 124 ECM-related genes. Regression analyses provided us with six significant SNPs associated with the WMS in males: 3 SNPs in the POSTN gene and a SNP in the LAMB1, COL23A1, and FBLN5 genes. For females, 1 SNP was found in the FN1 gene. The risk of weight regain was increased by: the C/C genotype for POSTN in a co-dominant model (OR 8.25, 95 % CI 2.85-23.88) and the T/C-C/C genotype in a dominant model (OR 4.88, 95 % CI 2.35-10.16); the A/A genotype for LAMB1 both in a co-dominant model (OR 18.43, 95 % CI 2.35-144.63) and in a recessive model (OR 16.36, 95 % CI 2.14-124.9); the G/A genotype for COL23A1 in a co-dominant model (OR 3.94, 95 % CI 1.28-12.10), or the A-allele in a dominant model (OR 2.86, 95 % CI 1.10-7.49); the A/A genotype for FBLN5 in a co-dominant model (OR 13.00, 95 % CI 1.61-104.81); and the A/A genotype for FN1 in a recessive model (OR 2.81, 95 % CI 1.40-5.63). Concluding, variants of ECM genes are associated with weight regain after weight loss in a sex-specific manner.
Selective regain of egfr gene copies in CD44+/CD24-/low breast cancer cellular model MDA-MB-468
Background Increased transcription of oncogenes like the epidermal growth factor receptor (EGFR) is frequently caused by amplification of the whole gene or at least of regulatory sequences. Aim of this study was to pinpoint mechanistic parameters occurring during egfr copy number gains leading to a stable EGFR overexpression and high sensitivity to extracellular signalling. A deeper understanding of those marker events might improve early diagnosis of cancer in suspect lesions, early detection of cancer progression and the prediction of egfr targeted therapies. Methods The basal-like/stemness type breast cancer cell line subpopulation MDA-MB-468 CD44high/CD24-/low, carrying high egfr amplifications, was chosen as a model system in this study. Subclones of the heterogeneous cell line expressing low and high EGF receptor densities were isolated by cell sorting. Genomic profiling was carried out for these by means of SNP array profiling, qPCR and FISH. Cell cycle analysis was performed using the BrdU quenching technique. Results Low and high EGFR expressing MDA-MB-468 CD44+/CD24-/low subpopulations separated by cell sorting showed intermediate and high copy numbers of egfr, respectively. However, during cell culture an increase solely for egfr gene copy numbers in the intermediate subpopulation occurred. This shift was based on the formation of new cells which regained egfr gene copies. By two parametric cell cycle analysis clonal effects mediated through growth advantage of cells bearing higher egfr gene copy numbers could most likely be excluded for being the driving force. Subsequently, the detection of a fragile site distal to the egfr gene, sustaining uncapped telomere-less chromosomal ends, the ladder-like structure of the intrachromosomal egfr amplification and a broader range of egfr copy numbers support the assumption that dynamic chromosomal rearrangements, like breakage-fusion-bridge-cycles other than proliferation drive the gain of egfr copies. Conclusion
Human Cardiovascular Disease IBC Chip-Wide Association with Weight Loss and Weight Regain in the Look AHEAD Trial
McCaffery, Jeanne M.; Papandonatos, George D.; Huggins, Gordon S.; Peter, Inga; Erar, Bahar; Kahn, Steven E.; Knowler, William C.; Lipkin, Edward W.; Kitabchi, Abbas E.; Wagenknecht, Lynne E.; Wing, Rena R.
Background/Aims The present study identified genetic predictors of weight change during behavioral weight loss treatment. Methods Participants were 3,899 overweight/obese individuals with type 2 diabetes from Look AHEAD, a randomized controlled trial to determine the effects of intensive lifestyle intervention (ILI), including weight loss and physical activity, relative to diabetes support and education, on cardiovascular outcomes. Analyses focused on associations of single nucleotide polymorphisms (SNPs) on the Illumina CARe iSelect (IBC) chip (minor allele frequency >5%; n = 31,959) with weight change at year 1 and year 4, and weight regain at year 4, among individuals who lost ≥ 3% at year 1. Results Two novel regions of significant chip-wide association with year-1 weight loss in ILI were identified (p < 2.96E-06). ABCB11 rs484066 was associated with 1.16 kg higher weight per minor allele at year 1, whereas TNFRSF11A, or RANK, rs17069904 was associated with 1.70 kg lower weight per allele at year 1. Conclusions This study, the largest to date on genetic predictors of weight loss and regain, indicates that SNPs within ABCB11, related to bile salt transfer, and TNFRSF11A, implicated in adipose tissue physiology, predict the magnitude of weight loss during behavioral intervention. These results provide new insights into potential biological mechanisms and may ultimately inform weight loss treatment. PMID:24081232
Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.
Elfhag, K; Rössner, S
Weight loss is difficult to achieve and maintaining the weight loss is an even greater challenge. The identification of factors associated with weight loss maintenance can enhance our understanding for the behaviours and prerequisites that are crucial in sustaining a lowered body weight. In this paper we have reviewed the literature on factors associated with weight loss maintenance and weight regain. We have used a definition of weight maintenance implying intentional weight loss that has subsequently been maintained for at least 6 months. According to our review, successful weight maintenance is associated with more initial weight loss, reaching a self-determined goal weight, having a physically active lifestyle, a regular meal rhythm including breakfast and healthier eating, control of over-eating and self-monitoring of behaviours. Weight maintenance is further associated with an internal motivation to lose weight, social support, better coping strategies and ability to handle life stress, self-efficacy, autonomy, assuming responsibility in life, and overall more psychological strength and stability. Factors that may pose a risk for weight regain include a history of weight cycling, disinhibited eating, binge eating, more hunger, eating in response to negative emotions and stress, and more passive reactions to problems.
... Myths and Facts Recovery is Possible What Is Mental Health? Mental health includes our emotional, psychological, and social ... mental health problems and where to find help . Mental Health and Wellness Positive mental health allows people to: ...
Self-reported changes in dietary calcium and energy intake predict weight regain following a weight loss diet in obese women.
Ochner, Christopher N; Lowe, Michael R
This study examined relationships between changes in dietary calcium intake, energy intake, and body weight following a weight loss diet. One hundred three overweight or obese women lost weight over 22 wk. Dietary calcium and energy intake were assessed using the Block 98 FFQ (Block) and 5-d food records (FR) at intervention end and 6- and 18-mo follow-up. Pearson correlations were used to relate changes in dietary calcium to energy intake. We used regression analyses to examine relationships between changes in dietary calcium, energy intake, and weight regain. Changes in dietary calcium and energy intake were correlated (r = 0.32; P = 0.033), but neither variable alone predicted weight regain. From 6- to 18-mo follow-up, greater dietary calcium intake inversely predicted weight regain when controlling for changes in energy intake (P = 0.048 Block and 0.025 FR), whereas higher energy intake positively predicted weight regain when controlling for changes in dietary calcium intake (P = 0.009 Block and 0.049 FR) (combined R(2) = 0.153 Block and 0.178 FR). Dietary calcium may oppose weight regain, reducing the effect of greater energy intake. Our results encourage future research on the potential relationship between dietary calcium and weight loss maintenance and suggest that controlling for dietary calcium may increase the ability of energy intake to predict weight change.
... Video Games Video Sharing Sites Webcasts/ Webinars Widgets Wikis Follow Us on New Media Virtual Office Hours ... mental health should be part of your complete medical evaluation before starting antiretroviral medications. And you should ...
... you think you may hurt yourself or attempt suicide, get help right away: Call 911 or your ... immediately. Call your mental health specialist. Call a suicide hotline number — in the U.S., call the National ...
Maintain and Regain Well Clear: Maneuver Guidance Designs for Pilots Performing the Detect-and-Avoid Task
NASA Technical Reports Server (NTRS)
Monk, Kevin J.; Roberts, Zachary
In order to support the future expansion and integration of Unmanned Aircraft Systems (UAS), ongoing research efforts have sought to produce findings that inform the minimum display information elements required for acceptable UAS pilot response times and traffic avoidance. Previous simulations have revealed performance benefits associated with DAA displays containing predictive information and suggestive maneuver guidance tools in the form of banding. The present study investigated the impact of various maneuver guidance display configurations on detect-and-avoid (DAA) task performance in a simulated airspace environment. UAS pilots ability to maintain DAA well clear was compared between displays with either the presence or absence of green DAA bands, which indicated conflict-free flight regions. Additional display comparisons assessed pilots ability to regain DAA well clear with two different guidance presentations designed to aid in DAA well clear recovery during critical encounters. Performance implications and display considerations for future UAS DAA systems are discussed.
A Novel Approach to Regain Anterior Space Using Modified 2 by 3 Fixed Appliance: A Report of Two Cases.
Mohammad, Ziauddin; Cheruku, Sampath Reddy; Penmetcha, Sarada; Bagalkotkar, Apeksha; Kumari, Surabhi
Early loss of permanent anterior teeth in growing children has a psychological impact on the child. Anterior teeth are important both aesthetically and functionally. When a permanent tooth is lost, the teeth adjacent to the created space tend to migrate into the space resulting in the space loss. Management of regaining space with the removable appliance always depends on child cooperation for using the appliance as well as for the recall visits. The advantages of fixed appliances over the removable appliances are minimal discomfort, reduced need for patient cooperation and increased control of tooth movements in all three directions of space. Thus, a short course of fixed appliance like the modified 2 by 3 fixed appliance followed by fixed functional space maintainer could be an ideal treatment option for such cases.
Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women.
Kramer, F M; Jeffery, R W; Forster, J L; Snell, M K
Maintenance of weight loss continues to be a critical concern in behavioral treatment programs. Problems with the acquisition and/or application of behavioral skills are a likely contributor to relapse. However, biological models, especially the hypothesis of a body weight setpoint, are being offered increasingly as alternative explanations for maintenance failure. Within the context of these sometimes opposing viewpoints the present study describes long-term weight outcomes for 114 men and 38 women assessed annually for 4 or 5 years following completion of a 15 week behavioral weight loss program. Although significant mean weight loss was evident at long-term follow-up, a negatively accelerating pattern of weight regain was the predominant outcome. Less than 3 percent of the subjects were at or below their posttreatment weight on all follow-up visits. Consistent sex differences were found, with women having better weight loss maintenance than men. Implications and potential future directions are discussed.
Regional versus General Anesthesia for Promoting Independence after Hip Fracture (REGAIN): protocol for a pragmatic, international multicentre trial
Neuman, Mark D; Ellenberg, Susan S; Sieber, Frederick E; Magaziner, Jay S; Feng, Rui; Carson, Jeffrey L
Introduction Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery. Methods The REGAIN trial (Regional vs General Anesthesia for Promoting Independence after Hip Fracture) is an international, multicentre, pragmatic randomised controlled trial. 1600 previously ambulatory patients aged 50 and older will be randomly allocated to receive either general or spinal anaesthesia for hip fracture surgery. The primary outcome is a composite of death or new inability to walk 10 feet or across a room at 60 days after randomisation, which will be assessed via telephone interview by staff who are blinded to treatment assignment. Secondary outcomes will be assessed by in-person assessment and medical record review for in-hospital end points (delirium; major inpatient medical complications and mortality; acute postoperative pain; patient satisfaction; length of stay) and by telephone interview for 60-day, 180-day and 365-day end points (mortality; disability-free survival; chronic pain; return to the prefracture residence; need for new assistive devices for ambulation; cognitive impairment). Ethics and dissemination The REGAIN trial has been approved by the ethics boards of all participating sites. Recruitment began in February 2016 and will continue until the end of 2019. Dissemination plans include presentations at scientific conferences, scientific publications, stakeholder engagement efforts and presentation to the public via lay media outlets. Trial registration number NCT02507505, Pre-results. PMID:27852723
ERIC Educational Resources Information Center
Baumeister, Alfred A., Ed.
Thirteen papers by different authors consider the application of research findings and theoretical formulations to the practical appraisal and treatment of mental retardation. All suggest methods for shaping appropriate and adaptive behaviors in retarded individuals. The papers include "Definition, Diagnosis, and Classification" by D.W. Brison,…
Genetic Predisposition to Weight Loss and Regain With Lifestyle Intervention: Analyses From the Diabetes Prevention Program and the Look AHEAD Randomized Controlled Trials
Papandonatos, George D.; Pan, Qing; Pajewski, Nicholas M.; Delahanty, Linda M.; Peter, Inga; Erar, Bahar; Ahmad, Shafqat; Harden, Maegan; Chen, Ling; Fontanillas, Pierre; Wagenknecht, Lynne E.; Kahn, Steven E.; Wing, Rena R.; Jablonski, Kathleen A.; Huggins, Gordon S.; Knowler, William C.; Florez, Jose C.
Clinically relevant weight loss is achievable through lifestyle modification, but unintentional weight regain is common. We investigated whether recently discovered genetic variants affect weight loss and/or weight regain during behavioral intervention. Participants at high-risk of type 2 diabetes (Diabetes Prevention Program [DPP]; N = 917/907 intervention/comparison) or with type 2 diabetes (Look AHEAD [Action for Health in Diabetes]; N = 2,014/1,892 intervention/comparison) were from two parallel arm (lifestyle vs. comparison) randomized controlled trials. The associations of 91 established obesity-predisposing loci with weight loss across 4 years and with weight regain across years 2–4 after a minimum of 3% weight loss were tested. Each copy of the minor G allele of MTIF3 rs1885988 was consistently associated with greater weight loss following lifestyle intervention over 4 years across the DPP and Look AHEAD. No such effect was observed across comparison arms, leading to a nominally significant single nucleotide polymorphism×treatment interaction (P = 4.3 × 10−3). However, this effect was not significant at a study-wise significance level (Bonferroni threshold P < 5.8 × 10−4). Most obesity-predisposing gene variants were not associated with weight loss or regain within the DPP and Look AHEAD trials, directly or via interactions with lifestyle. PMID:26253612
Creating a Global Consciousness by Embracing a World of Women: A Pedagogical Strategy Dedicated to Regaining the Momentum for Women's Rights
ERIC Educational Resources Information Center
Edmonds, Regina M.
If we are to regain some of the energy which characterized the Women's Movement during its earliest years and again during the 1960's and 1970's, we must endeavor to raise awareness among young people about the work for social justice that remains undone and we must find ways to inspire them to re-embrace activism and to develop, what Smyser…
Genetic Predisposition to Weight Loss and Regain With Lifestyle Intervention: Analyses From the Diabetes Prevention Program and the Look AHEAD Randomized Controlled Trials.
Papandonatos, George D; Pan, Qing; Pajewski, Nicholas M; Delahanty, Linda M; Peter, Inga; Erar, Bahar; Ahmad, Shafqat; Harden, Maegan; Chen, Ling; Fontanillas, Pierre; Wagenknecht, Lynne E; Kahn, Steven E; Wing, Rena R; Jablonski, Kathleen A; Huggins, Gordon S; Knowler, William C; Florez, Jose C; McCaffery, Jeanne M; Franks, Paul W
Clinically relevant weight loss is achievable through lifestyle modification, but unintentional weight regain is common. We investigated whether recently discovered genetic variants affect weight loss and/or weight regain during behavioral intervention. Participants at high-risk of type 2 diabetes (Diabetes Prevention Program [DPP]; N = 917/907 intervention/comparison) or with type 2 diabetes (Look AHEAD [Action for Health in Diabetes]; N = 2,014/1,892 intervention/comparison) were from two parallel arm (lifestyle vs. comparison) randomized controlled trials. The associations of 91 established obesity-predisposing loci with weight loss across 4 years and with weight regain across years 2-4 after a minimum of 3% weight loss were tested. Each copy of the minor G allele of MTIF3 rs1885988 was consistently associated with greater weight loss following lifestyle intervention over 4 years across the DPP and Look AHEAD. No such effect was observed across comparison arms, leading to a nominally significant single nucleotide polymorphism×treatment interaction (P = 4.3 × 10(-3)). However, this effect was not significant at a study-wise significance level (Bonferroni threshold P < 5.8 × 10(-4)). Most obesity-predisposing gene variants were not associated with weight loss or regain within the DPP and Look AHEAD trials, directly or via interactions with lifestyle.
Exercise Decreases Lipogenic Gene Expression in Adipose Tissue and Alters Adipocyte Cellularity during Weight Regain After Weight Loss
Giles, Erin D.; Steig, Amy J.; Jackman, Matthew R.; Higgins, Janine A.; Johnson, Ginger C.; Lindstrom, Rachel C.; MacLean, Paul S.
Exercise is a potent strategy to facilitate long-term weight maintenance. In addition to increasing energy expenditure and reducing appetite, exercise also favors the oxidation of dietary fat, which likely helps prevent weight re-gain. It is unclear whether this exercise-induced metabolic shift is due to changes in energy balance, or whether exercise imparts additional adaptations in the periphery that limit the storage and favor the oxidation of dietary fat. To answer this question, adipose tissue lipid metabolism and related gene expression were studied in obese rats following weight loss and during the first day of relapse to obesity. Mature, obese rats were weight-reduced for 2 weeks with or without daily treadmill exercise (EX). Rats were weight maintained for 6 weeks, followed by relapse on: (a) ad libitum low fat diet (LFD), (b) ad libitum LFD plus EX, or (c) a provision of LFD to match the positive energy imbalance of exercised, relapsing animals. 24 h retention of dietary- and de novo-derived fat were assessed directly using 14C palmitate/oleate and 3H20, respectively. Exercise decreased the size, but increased the number of adipocytes in both retroperitoneal (RP) and subcutaneous (SC) adipose depots, and prevented the relapse-induced increase in adipocyte size. Further, exercise decreased the expression of genes involved in lipid uptake (CD36 and LPL), de novo lipogenesis (FAS, ACC1), and triacylglycerol synthesis (MGAT and DGAT) in RP adipose during relapse following weight loss. This was consistent with the metabolic data, whereby exercise reduced retention of de novo-derived fat even when controlling for the positive energy imbalance. The decreased trafficking of dietary fat to adipose tissue with exercise was explained by reduced energy intake which attenuated energy imbalance during refeeding. Despite having decreased expression of lipogenic genes, the net retention of de novo-derived lipid was higher in both the RP and SC adipose of exercising
[Mental time dysfunction in Parkinson's and Alzheimer's diseases].
Honma, Motoyasu; Kuroda, Takeshi; Futamura, Akinori; Sugimoto, Azusa; Kawamura, Mitsuru
Mental time is altered by a number of factors and the underlying neural processing involved is highly complicated. Recent research suggests that mental time in patients with particular neurological diseases is perceptually shorter than in normal individuals. This review introduces mental time dysfunction and a model for processing of mental time in Parkinson's and Alzheimer's disease. Although the two diseases show the same dysfunction of mental time in behavior, we expect the underlying neural mechanism to vary in each disease. It is possible that the dysfunction of mental time in Parkinson's disease is caused by the abnormal striatum acting as a pacemaker, while that in Alzheimer's disease is caused by abnormal hippocampal memory.
Effects of high-calcium diets with different whey proteins on weight loss and weight regain in high-fat-fed C57BL/6J mice.
Pilvi, Taru K; Harala, Saara; Korpela, Riitta; Mervaala, Eero M
The aim of the study was to compare the effect of different whey protein-containing high-Ca diets on weight loss and weight regain in a model of diet-induced obesity. Obesity was induced in C57BL/6J mice with a high-fat (60 % of energy) diet. Weight loss by energy restriction was performed on four different high-Ca diets (1.8 % CaCO3) containing different whey proteins (18 % of energy): alpha-lactalbumin (ALA), beta-lactoglobulin (BLG), lactoferrin (LF) and whey protein isolate (WPI). After 7 weeks of energy restriction some of the mice were killed and the rest were fed with the same diets ad libitum for 7 weeks. The mice on the LF diet lost significantly more weight than mice on the WPI diet. The body fat content in the ALA and LF groups was significantly lower than in the WPI group (P < 0.05) and the LF group differed significantly even from the BLG group (P < 0.05). Ad libitum feeding after weight loss resulted in weight regain in all groups and only the ALA diet significantly reduced fat accumulation during weight regain. The weight regain was most pronounced in the LF group, but the adipocyte size was still significantly smaller than in the other groups. There were no differences in food intake or apparent fat digestibility between the groups. It can be concluded that a high-Ca diet with ALA significantly improves the outcome of weight loss and subsequent weight regain during the feeding of a high-fat diet in C57BL/6J mice, in comparison with WPI.
Rohwedder, Susann; Willis, Robert J.
Some studies suggest that people can maintain their cognitive abilities through "mental exercise." This has not been unequivocally proven. Retirement is associated with a large change in a person's daily routine and environment. In this paper, we propose two mechanisms how retirement may lead to cognitive decline. For many people retirement leads to a less stimulating daily environment. In addition, the prospect of retirement reduces the incentive to engage in mentally stimulating activities on the job. We investigate the effect of retirement on cognition empirically using cross-nationally comparable surveys of older persons in the United States, England, and 11 European countries in 2004. We find that early retirement has a significant negative impact on the cognitive ability of people in their early 60s that is both quantitatively important and causal. Identification is achieved using national pension policies as instruments for endogenous retirement. PMID:20975927
One-shot genitalia are not an evolutionary dead end - Regained male polygamy in a sperm limited spider species
Background Monogynous mating systems with extremely low male mating rates have several independent evolutionary origins and are associated with drastic adaptations involving self-sacrifice, one-shot genitalia, genital damage, and termination of spermatogenesis immediately after maturation. The combination of such extreme traits likely restricts evolutionary potential perhaps up to the point of making low male mating rates irreversible and hence may constitute an evolutionary dead end. Here, we explore the case of a reversion to multiple mating from monogynous ancestry in golden orb-web spiders, Nephila senegalensis. Results Male multiple mating is regained by the loss of genital damage and sexual cannibalism but spermatogenesis is terminated with maturation, restricting males to a single loading of their secondary mating organs and a fixed supply of sperm. However, males re-use their mating organs and by experimentally mating males to many females, we show that the sperm supply is divided between copulations without reloading the pedipalps. Conclusion By portioning their precious sperm supply, males achieve an average mating rate of four females which effectively doubles the maximal mating rate of their ancestors. A heritage of one-shot genitalia does not completely restrict the potential to increase mating rates in Nephila although an upper limit is defined by the available sperm load. Future studies should now investigate how males use this potential in the field and identify selection pressures responsible for a reversal from monogynous to polygynous mating strategies. PMID:21740561
Mechanism of isoproturon resistance in Phalaris minor: in silico design, synthesis and testing of some novel herbicides for regaining sensitivity.
Singh, Durg Vijay; Adeppa, Kuruba; Misra, Krishna
Isoproturon, 3-p-cumenyl-1 dimethylurea was the only herbicide controlling Phalaris minor, a major weed growing in wheat fields till the early 1980s. Since it has acquired resistance against isoproturon, like other substituted urea herbicides, where the identified target site for isoproturon is in the photosynthetic apparatus at D1 protein of Photosystem-II (PS-II). Nucleotide sequence of susceptible and resistant psbA gene of P. minor has been reported to have four point mutations. During the present work D1 protein of both susceptible and resistant biotypes of P Minor has been modeled. Transmembrane segments of amino acids were predicted by comparing with the nearest homolog of bacterial D1 protein. Volume and area of active site of both susceptible and resistant biotypes has been simulated. Isoproturon was docked at the active site of both, susceptible and resistant D1 proteins. Modeling and simulation of resistance D1 protein indicates that the resistance is due to alteration in secondary structure near the binding site, resulting in loss in cavity area, volume and change in binding position, loss of hydrogen bonds, hydrophobic interaction and complete loss of hydrophobic sites. To regain sensitivity in resistant biotype new derivatives of isoproturon molecules have been proposed, synthesized and tested. Among the 17 derivatives we found that the N-methyl triazole substituted isoproturon is a potential substitute for isoproturon.
Is the Authoritarian Trait in Mental Health Workers a Significant Predictor Variable of Patient Assault?
ERIC Educational Resources Information Center
Safian-Rush, Donna
Mental health workers may be assaulted by their violent patients. A study was conducted to examine one predictor variable of aggressive behavior in patients. It was hypothesized that authoritarian traits in the mental health worker could result in more assaults against the mental health worker by patients. Participants (N=32) were mental health…
Risk and protection: the discourse of confinement in contemporary mental health policy.
Moon, G
Confinement has regained respectability in the discourses of contemporary UK mental health policy. This development reflects concern about violent offences by people with mental health problems and is rooted in claims about the 'failure' of community care. Confinement is presented as a strategic response to the risks and dangers posed by particular fractions of the population of mental health service users. Using two key policy statements issued by the Department of Health and associated discussions in the health services management press, the confinement theme is explored and assessed. The paper notes its emergence as a consequence of the spatial impacts of deinstitutionalization and its specific origins in response to violent offences by people with mental health problems. The notion that the growing emphasis on confinement presages a return to the asylum is considered and rejected. Rather, the paper stresses the importance of discourses of protection, safety, risk and dangerousness in understanding the turn to confinement.
ERIC Educational Resources Information Center
Coleman, Toni
Increasingly, Blacks are turning to science and not assumptions to put "Africa" back in "African-American." The eagerness to reconnect is understandable. People robbed of their history innately want to know where they come from. Blacks are now using DNA testing to determine their African lineage. Veteran genealogists say the…
"Bildung": A Paradigm Regained?
ERIC Educational Resources Information Center
Prange, Klaus
"Bildung" is a key concept in the German tradition of educational theory. Originally meant to indicate a specific state of mind and ideal of perfection, it now serves as a symbol of the unity of whatever refers to the field of education, particularly to its organisational and functional aspects. The aura of "Bildung" is bestowed on its counterpart…
ERIC Educational Resources Information Center
Adler, Paul S.
A General Motors-Toyota auto assembly plant demonstrates how hierarchy and standardization can improve productivity and motivate workers. The production system is strongly committed to the social context of work and focused on standards designed by workers themselves, giving continuous improvement a specific foundation. (SK)
Regaining Strategic Competence
that defense secretary Donald Rumsfeld's intention was to overthrow Saddam Hussein and then get quickly out of Iraq.21 Unfortunately, the campaign...He (May) Conquer," The Washington Post, Sunday Outlook, September 14, 2008, pp. B1, B4. 25 Donald P. Wright, Colonel Timothy R. Reese, and the...participants have much chance to win a prize.47 Recent work by neuroscientists Mark Jung- Beeman , John Kournios and others has identified the kind of
Williams, Ruth
Three short videos exploring some of the different principles in the Mental Capacity Act 2009 are available on Social Care TV, an online channel intended mainly for the social care sector, although the films are relevant to any professionals whose work is affected by the act. The dramas, which are set in a residential home, a person's own home and a residential school for young people with learning difficulties, concern thedecision-making process and can be viewed at www.scie.org.uk/socialcaretv/topic.asp?guid=377dbe1b-de0c-4d66-bb87-22a243542db2.
Actions to alleviate the mental health impact of the economic crisis.
Wahlbeck, Kristian; McDaid, David
The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures. This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle.
Actions to alleviate the mental health impact of the economic crisis
The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures. This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle. PMID:23024664
Factors favoring regain of the lost vertical spinal height through posterior spinal fusion in adolescent idiopathic scoliosis
Shi, Benlong; Mao, Saihu; Xu, Leilei; Sun, Xu; Liu, Zhen; Zhu, Zezhang; Lam, Tsz Ping; Cheng, Jack CY; Ng, Bobby; Qiu, Yong
Height gain is a common beneficial consequence following correction surgery in adolescent idiopathic scoliosis (AIS), yet little is known concerning factors favoring regain of the lost vertical spinal height (SH) through posterior spinal fusion. A consecutive series of AIS patients from February 2013 to August 2015 were reviewed. Surgical changes in SH (ΔSH), as well as the multiple coronal and sagittal deformity parameters were measured and correlated. Factors associated with ΔSH were identified through Pearson correlation analysis and multivariate regression analysis. A total of 172 single curve and 104 double curve patients were reviewed. The ΔSH averaged 2.5 ± 0.9 cm in single curve group and 2.9 ± 1.0 cm in double curve group. The multivariate regression analysis revealed the following pre-operative variables contributed significantly to ΔSH: pre-op Cobb angle, pre-op TK (single curve group only), pre-op GK (double curve group only) and pre-op LL (double curve group only) (p < 0.05). Thus change in height (in cm) = 0.044 × (pre-op Cobb angle) + 0.012 × (pre-op TK) (Single curve, adjusted R2 = 0.549) or 0.923 + 0.021 × (pre-op Cobb angle1) + 0.028 × (pre-op Cobb angle2) + 0.015 × (pre-op GK)-0.012 × (pre-op LL) (Double curve, adjusted R2 = 0.563). Severer pre-operative coronal Cobb angle and greater sagittal curves were beneficial factors favoring more contribution to the surgical lengthening effect in vertical spinal height in AIS. PMID:27373798
American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults.
Jakicic, J M; Clark, K; Coleman, E; Donnelly, J E; Foreyt, J; Melanson, E; Volek, J; Volpe, S L
In excess of 55% of adults in the United States are classified as either overweight (body mass index = 25-29.9 kg.m(-2)) or obese (body mass index > or = 30 kg.m(-2)). To address this significant public health problem, the American College of Sports Medicine recommends that the combination of reductions in energy intake and increases in energy expenditure, through structured exercise and other forms of physical activity, be a component of weight loss intervention programs. An energy deficit of 500-1000 kcal.d-1 achieved through reductions in total energy intake is recommended. Moreover, it appears that reducing dietary fat intake to <30% of total energy intake may facilitate weight loss by reducing total energy intake. Although there may be advantages to modifying protein and carbohydrate intake, the optimal doses of these macronutritents for weight loss have not been determined. Significant health benefits can be recognized with participation in a minimum of 150 min (2.5 h) of moderate intensity exercise per week, and overweight and obese adults should progressively increase to this initial exercise goal. However, there may be advantages to progressively increasing exercise to 200-300 min (3.3-5 h) of exercise per week, as recent scientific evidence indicates that this level of exercise facilitates the long-term maintenance of weight loss. The addition of resistance exercise to a weight loss intervention will increase strength and function but may not attenuate the loss of fat-free mass typically observed with reductions in total energy intake and loss of body weight. When medically indicated, pharmacotherapy may be used for weight loss, but pharmacotherapy appears to be most effective when used in combination with modifications of both eating and exercise behaviors. The American College of Sports Medicine recommends that the strategies outlined in this position paper be incorporated into interventions targeting weight loss and the prevention of weight regain for
ERIC Educational Resources Information Center
Stock, Susan R.; Levine, Heidi
This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.
ERIC Educational Resources Information Center
Hyatt, I. Ralph
Discusses the ease with which mental labels become imprinted in our system, six basic axioms for maintaining negative mental tattoos, and psychological processes for eliminating mental tattoos and labels. (RK)
[Correlations between vocal qualities and mental retardation].
Biondi, S; Zappala, M; Amato, G; Consoli, F
This research is intended to verify the existence of vocal spectrographic alterations, with particular reference to the values of Fundamental Frequency, in patients with different levels of Mental Retardation. The results show the existence of a direct correspondence between the values of the Fundamental Frequency and the level of Mental Retardation: the spectrographic characteristics appear to be more altered in subjects with severe Mental Retardation. The spectrographics patterns are characterized by the presence of bi-phonation particularly at the onset time and at the end, and by a noise signal on constant frequency. The shifts of Fundamental Frequency and voice breakage are rarely detected.
Nutritional therapies for mental disorders
Lakhan, Shaheen E; Vieira, Karen F
According to the Diagnostic and Statistical Manual of Mental Disorders, 4 out of the 10 leading causes of disability in the US and other developed countries are mental disorders. Major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD) are among the most common mental disorders that currently plague numerous countries and have varying incidence rates from 26 percent in America to 4 percent in China. Though some of this difference may be attributable to the manner in which individual healthcare providers diagnose mental disorders, this noticeable distribution can be also explained by studies which show that a lack of certain dietary nutrients contribute to the development of mental disorders. Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries; and are exceptionally deficient in patients suffering from mental disorders. Studies have shown that daily supplements of vital nutrients often effectively reduce patients' symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders, eating disorders, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), addiction, and autism. The aim of this manuscript is to emphasize which dietary supplements can aid the treatment of the four most common mental disorders currently affecting America and other developed countries: major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD). Most antidepressants and other prescription drugs cause severe side effects, which usually discourage patients from taking their medications. Such noncompliant patients who
Mental health: everyone's business.
Dragon, Natalie
Mental health is everyone's business the Australian College of Mental Health Nurses and the Wesley Mission affirmed last month. In the midst of a burgeoning demand for mental health services, the lack of funds allocated to mental health as part of a $7.3 billion health package in the federal budget does not add up.
Evaluating the Effect of Cognitive Dysfunction on Mental Imagery in Patients with Stroke Using Temporal Congruence and the Imagined 'Timed Up and Go' Test (iTUG)
Bonnyaud, Céline; Fery, Yves-André; Bussel, Bernard; Roche, Nicolas
Background Motor imagery (MI) capacity may be altered following stroke. MI is evaluated by measuring temporal congruence between the timed performance of an imagined and an executed task. Temporal congruence between imagined and physical gait-related activities has not been evaluated following stroke. Moreover, the effect of cognitive dysfunction on temporal congruence is not known. Objective To assess temporal congruence between the Timed Up and Go test (TUG) and the imagined TUG (iTUG) tests in patients with stroke and to investigate the role played by cognitive dysfunctions in changes in temporal congruence. Methods TUG and iTUG performance were recorded and compared in twenty patients with chronic stroke and 20 controls. Cognitive function was measured using the Montreal Cognitive Assessment (MOCA), the Frontal Assessment Battery at Bedside (FAB) and the Bells Test. Results The temporal congruence of the patients with stroke was significantly altered compared to the controls, indicating a loss of MI capacity (respectively 45.11 ±35.11 vs 24.36 ±17.91, p = 0.02). Furthermore, iTUG test results were positively correlated with pathological scores on the Bells Test (r = 0.085, p = 0.013), likely suggesting that impairment of attention was a contributing factor. Conclusion These results highlight the importance of evaluating potential attention disorder in patients with stroke to optimise the use of MI for rehabilitation and recovery. However further study is needed to determine how MI should be used in the case of cognitive dysfunction. PMID:28125616
Chromosomal abnormalities and mental illness.
MacIntyre, D J; Blackwood, D H R; Porteous, D J; Pickard, B S; Muir, W J
Linkage studies of mental illness have provided suggestive evidence of susceptibility loci over many broad chromosomal regions. Pinpointing causative gene mutations by conventional linkage strategies alone is problematic. The breakpoints of chromosomal abnormalities occurring in patients with mental illness may be more direct pointers to the relevant gene locus. Publications that describe patients where chromosomal abnormalities co-exist with mental illness are reviewed along with supporting evidence that this may amount to an association. Chromosomal abnormalities are considered to be of possible significance if (a) the abnormality is rare and there are independent reports of its coexistence with psychiatric illness, or (b) there is colocalisation of the abnormality with a region of suggestive linkage findings, or (c) there is an apparent cosegregation of the abnormality with psychiatric illness within the individual's family. Breakpoints have been described within many of the loci suggested by linkage studies and these findings support the hypothesis that shared susceptibility factors for schizophrenia and bipolar disorder may exist. If these abnormalities directly disrupt coding regions, then combining molecular genetic breakpoint cloning with bioinformatic sequence analysis may be a method of rapidly identifying candidate genes. Full karyotyping of individuals with psychotic illness especially where this coexists with mild learning disability, dysmorphism or a strong family history of mental disorder is encouraged.
Exercise reduces appetite and traffics excess nutrients away from energetically efficient pathways of lipid deposition during the early stages of weight regain.
Steig, Amy J; Jackman, Matthew R; Giles, Erin D; Higgins, Janine A; Johnson, Ginger C; Mahan, Chad; Melanson, Edward L; Wyatt, Holly R; Eckel, Robert H; Hill, James O; MacLean, Paul S
The impact of regular exercise on energy balance, fuel utilization, and nutrient availability, during weight regain was studied in obese rats, which had lost 17% of their weight by a calorie-restricted, low-fat diet. Weight reduced rats were maintained for 6 wk with and without regular treadmill exercise (1 h/day, 6 days/wk, 15 m/min). In vivo tracers and indirect calorimetry were then used in combination to examine nutrient metabolism during weight maintenance (in energy balance) and during the first day of relapse when allowed to eat ad libitum (relapse). An additional group of relapsing, sedentary rats were provided just enough calories to create the same positive energy imbalance as the relapsing, exercised rats. Exercise attenuated the energy imbalance by 50%, reducing appetite and increasing energy requirements. Expenditure increased beyond the energetic cost of the exercise bout, as exercised rats expended more energy to store the same nutrient excess in sedentary rats with the matched energy imbalance. Compared with sedentary rats with the same energy imbalance, exercised rats exhibited the trafficking of dietary fat toward oxidation and away from storage in adipose tissue, as well as a higher net retention of fuel via de novo lipogenesis in adipose tissue. These metabolic changes in relapse were preceded by an increase in the skeletal muscle expression of genes involved in lipid uptake, mobilization, and oxidation. Our observations reveal a favorable shift in fuel utilization with regular exercise that increases the energetic cost of storing excess nutrients during relapse and alterations in circulating nutrients that may affect appetite. The attenuation of the biological drive to regain weight, involving both central and peripheral aspects of energy homeostasis, may explain, in part, the utility of regular exercise in preventing weight regain after weight loss.
Inhibition: Mental Control Process or Mental Resource?
ERIC Educational Resources Information Center
Im-Bolter, Nancie; Johnson, Janice; Ling, Daphne; Pascual-Leone, Juan
The current study tested 2 models of inhibition in 45 children with language impairment and 45 children with normally developing language; children were aged 7 to 12 years. Of interest was whether a model of inhibition as a mental-control process (i.e., executive function) or as a mental resource would more accurately reflect the relations among…
International Student Mental Health
ERIC Educational Resources Information Center
Prieto-Welch, Susan L.
This chapter describes the mental health status of international students in institutions of higher education, unique challenges these students face and their impact on mental health, and suggestions for ways to address these challenges.
Chronic Illness & Mental Health
... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...
Mental Health and African Americans
... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...
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Nutrition and Mental Performance
ERIC Educational Resources Information Center
Stein, Zena; And Others
Prenatal exposure to the Dutch famine of 1944-45 had no detectable effects on the adult mental performance of surviving male offspring; birth weight was not related to mental performance; and the association of social class with mental performance was strong. (AL)
Fellow travellers: Working memory and mental time travel in rodents.
Dere, Ekrem; Dere, Dorothea; de Souza Silva, Maria Angelica; Huston, Joseph P; Zlomuzica, Armin
The impairment of mental time travel is a severe cognitive symptom in patients with brain lesions and a number of neuropsychiatric disorders. Whether animals are also able to mentally travel in time both forward and backward is still a matter of debate. In this regard, we have proposed a continuum of mental time travel abilities across different animal species, with humans being the species with the ability to perform most sophisticated forms of mental time travel. In this review and perspective article, we delineate a novel approach to understand the evolution, characteristics and function of human and animal mental time travel. Furthermore, we propose a novel approach to measure mental time travel in rodents in a comprehensive manner using a test battery composed of well-validated and easy applicable tests.
Understanding the unconscious mind: Jungian psychology and mental health nursing.
Moore, Alan; Cross, Wendy
How might the unconscious part of the mind affect mental health patients' emotions or behaviour? How might the unconscious motivations of mental health nurses affect their patients? The discovery of "the unconscious" two centuries ago has allowed philosophers and scientists, such as C. G. Jung, to explore the field. Contemporary mental health care subscribes to a dominance of neurobiological approaches, neglecting the unconscious or relegating it to that of a merely biological process. Approaching this subject from the perspective of Jung, we make a case for the inclusion of theoretical concepts about the unconscious in the discourse of mental health nursing. Such awareness may help mental health nurses to better understand the mental disease, disorder, and distress found in patients. It also may help them understand their own conflicts and motivations that, in turn, can have an affect on their patients.
Tissues Use Resident Dendritic Cells and Macrophages to Maintain Homeostasis and to Regain Homeostasis upon Tissue Injury: The Immunoregulatory Role of Changing Tissue Environments
Lech, Maciej; Gröbmayr, Regina; Weidenbusch, Marc; Anders, Hans-Joachim
Most tissues harbor resident mononuclear phagocytes, that is, dendritic cells and macrophages. A classification that sufficiently covers their phenotypic heterogeneity and plasticity during homeostasis and disease does not yet exist because cell culture-based phenotypes often do not match those found in vivo. The plasticity of mononuclear phagocytes becomes obvious during dynamic or complex disease processes. Different data interpretation also originates from different conceptual perspectives. An immune-centric view assumes that a particular priming of phagocytes then causes a particular type of pathology in target tissues, conceptually similar to antigen-specific T-cell priming. A tissue-centric view assumes that changing tissue microenvironments shape the phenotypes of their resident and infiltrating mononuclear phagocytes to fulfill the tissue's need to maintain or regain homeostasis. Here we discuss the latter concept, for example, why different organs host different types of mononuclear phagocytes during homeostasis. We further discuss how injuries alter tissue environments and how this primes mononuclear phagocytes to enforce this particular environment, for example, to support host defense and pathogen clearance, to support the resolution of inflammation, to support epithelial and mesenchymal healing, and to support the resolution of fibrosis to the smallest possible scar. Thus, organ- and disease phase-specific microenvironments determine macrophage and dendritic cell heterogeneity in a temporal and spatial manner, which assures their support to maintain and regain homeostasis in whatever condition. Mononuclear phagocytes contributions to tissue pathologies relate to their central roles in orchestrating all stages of host defense and wound healing, which often become maladaptive processes, especially in sterile and/or diffuse tissue injuries. PMID:23251037
Religion and Suicide in Patients with Mental Illness or Cancer
ERIC Educational Resources Information Center
Panczak, Radoslaw; Spoerri, Adrian; Zwahlen, Marcel; Bopp, Matthias; Gutzwiller, Felix; Egger, Matthias
In Switzerland, the highest rates of suicide are observed in persons without religious affiliation and the lowest in Catholics, with Protestants in an intermediate position. We examined whether this association was modified by concomitant psychiatric diagnoses or malignancies, based on 6,909 suicides (ICD-10 codes X60-X84) recorded in 3.69 million…
Mental health parity legislation.
Smaldone, Arlene; Cullen-Drill, Mary
Although recognition and treatment of mental health disorders have become integrated into routine medical care, inequities remain regarding limits on mental health outpatient visits and higher copayments and deductibles required for mental health services when accessed. Two federal laws were passed by Congress in 2008: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and the Medicare Improvements for Patients and Providers Act. Both laws became effective on January 1, 2010. The purpose of this article is to discuss provisions of each act and provide clinical examples describing how patients are affected by lack of parity and may potentially benefit from implementation of these new laws. Using available evidence, we examine the potential strengths and limitations of mental health parity legislation from the health policy perspectives of health care access, cost, and quality and identify the important role of nurses as patient and mental health parity advocates.
[Clinical application and mechanism on the ghost points in the treatment of mental diseases].
Tao, Ying; Hou, Wenguang; Liang, Yan; Zong, Lei
In order to explore the clinical application and mechanism of the ghost points in the treatment of mental diseases, taking "the ghost points" and "mental diseases" as the theme and the key words, the literatures in recent 10 years on the treatment of mental diseases with the ghost points were collected from CNKI and Wanfang database and analyzed. It is discovered that the ghost points can treat schizophrenia, manic-depressive disorder, dementia, stroke, loss of consciousness, insomnia. anxiety, depression and hysteria and the efficacy is favorable. It is believed that the ghost points act on balancing yin and yang, regulating qi and blood, regaining consciousness and tranquilizing the mind and they achieve the very excellent effect on mental diseases. At present, the reports on this aspect are limited. Hence, it is required to promote the study on the clinical application and mechanism of the ghost points so as to enlarge the clinical indications of the ghost points and provide the powerful support on mechanism for the treatment of mental diseases.
Behere, Prakash B.; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P.
In this chapter, the relation between religion and mental health and vice versa has been described. From primitive times different religions have different beliefs and systems of worshipping. Every religion with their belief system has implications on mental health and illness. We described how Hindu system of beliefs and rituals may have an effect in causation of various mental illnesses. It is also described how religion can help an individual to sustain one's life in various domains. The relationship between different religion and symptomatology is described. The impact and outcome of religion on mental health have been highlighted. PMID:23858253
Total knee arthroplasty in patient with paraplegia after spinal cord injury.
Zietek, P; Dobiecki, K
The clinical management of paraplegic patients is more complex than in able-bodied subjects. Spinal cord injury (SCI) affects younger, active people more often than the elderly during high-energy fall or traffic accidents. In order to return to work after suffering an SCI, patients need to regain their functional independence, especially their ability to drive. The literature lacks strong evidence addressing the surgical solutions in severe knee arthrosis in paralyzed patients after SCI. We present a favourable outcome of total knee arthroplasty (TKA) of a stiff knee in extension in a man with T12 grade C paraplegia after SCI. We describe an effective rehabilitation protocol after knee arthroplasty in patient with damage to the spinal cord. Several factors should be taken into account before performing surgery: 1. ability of regaining some of spinal cord locomotor function through intensive gait rehabilitation in SCI patients, 2. presence of muscle imbalance and knee contractures combined with a risk of bone fracture resulting from intensive postoperative rehabilitation, 3. the impaired microvasculature of the skin and subcutaneous tissues and increased risk of occlusion occurrence of the capillaries and small vessels of the leg, 4. higher prevalence of secondary infections via urinary entry sites in patients after SCI, 5. patient's strong determination and willingness to undergo the arthroplasty procedure. TKA might be considered in selected paralyzed patients after SCI, especially in those with severe arthrosis as well as significant knee contractures. Our study reveals the advantage of performing TKA in improving functional state in patients with cord injury.
Mental Retardation in Perspective.
ERIC Educational Resources Information Center
Horvath, Michael; And Others
This monograph presents a general introduction to the history, classification, and characteristics of mental retardation. It begins with a discussion of the history of mental retardation from ancient Greece and Rome to the present. The beginnings of special education are traced to the early 19th century in Europe. Major influences in treatment of…
ERIC Educational Resources Information Center
Blai, Boris, Jr.
Estimates suggest that about 15% of all children have some form of mental disturbance. Potential causes can be of a physical, psychological, or environmental origin. Symptoms which indicate that a child needs professional help usually involve emotional overreaction to changes. Diagnosis of a child evidencing symptoms of mental illness should take…
Rethinking Mental Health Policy.
ERIC Educational Resources Information Center
Bartee, Edwin M.; Kelly, Jacquelyn M.
Critical reasons for frustration and circularity in the formulation and implementation of mental health policy are analyzed. The primary reason proposed is the lack of equal, systematic and structurally-reinforced participation of mental health services consumers and their communities in the planning and implementing of policy and programs. This…
ERIC Educational Resources Information Center
Nesbitt, Donna
Argues that mental timelines for learning history are analogous to mental mapping for learning geography: both visually represent abstract concepts. Describes the construction of a classroom timeline and activities for fifth- and sixth-grade students that incorporate the use of timelines. Notes reasonable expectations for student progress at this…
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Women Veterans and Mental Health
... Health > Women veterans and mental health Mental Health Women veterans and mental health Post-traumatic stress disorder ( ... hurt you. Post-traumatic stress disorder (PTSD) and women veterans PTSD can occur after you have been ...
Mental Health and Asian Americans
... Data > Minority Population Profiles > Asian American > Mental Health Mental Health and Asian Americans Suicide was the 9th leading ... Americans is half that of the White population. MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...
Neurodynamics of mental exploration.
Hopfield, John J
Thinking allows an animal to take an effective action in a novel situation based on a mental exploration of possibilities and previous knowledge. We describe a model animal, with a neural system based loosely on the rodent hippocampus, which performs mental exploration to find a useful route in a spatial world it has previously learned. It then mentally recapitulates the chosen route, and this intent is converted to motor acts that move the animal physically along the route. The modeling is based on spiking neurons with spike-frequency adaptation. Adaptation causes the continuing evolution in the pattern of neural activity that is essential to mental exploration. A successful mental exploration is remembered through spike-timing-dependent synaptic plasticity. The system is also an episodic memory for an animal chiefly concerned with locations.
Neurodynamics of mental exploration
Thinking allows an animal to take an effective action in a novel situation based on a mental exploration of possibilities and previous knowledge. We describe a model animal, with a neural system based loosely on the rodent hippocampus, which performs mental exploration to find a useful route in a spatial world it has previously learned. It then mentally recapitulates the chosen route, and this intent is converted to motor acts that move the animal physically along the route. The modeling is based on spiking neurons with spike-frequency adaptation. Adaptation causes the continuing evolution in the pattern of neural activity that is essential to mental exploration. A successful mental exploration is remembered through spike-timing-dependent synaptic plasticity. The system is also an episodic memory for an animal chiefly concerned with locations. PMID:20080534
Balcioglu, Huseyin Avni; Kocaelli, Humeyra
Context: Accessory mental foramen is a rare anatomical variation. Even so, in order to avoid neurovascular complications, particular attention should be paid to the possible occurrence of one or more accessory mental foramen during surgical procedures involving the mandible. Case report: A 3-dimensional computed tomography (3D-CT) scan of a female patient revealed an accessory mental foramen on the right side of her mandible. Conclusion: A 3D-CT scan should be obtained prior to mandibular surgeries so that the presence of accessory mental foramen can be detected, and so that the occurrence of a neurosensory disturbance or hemorrhage can be avoided. Although this anatomical variation is rare, it should be kept in mind that an accessory mental foramen may exist. PMID:22666714
The application of mental health legislation in younger children
Thomas, Victoria; Chipchase, Barry; Rippon, Lisa; McArdle, Paul
We review a case history of a young child who was admitted to an in-patient mental health unit due to extremely challenging behaviour and review the legal issues that had to be considered in ensuring that there was appropriate legal authority for the child's admission and treatment. In this particular case, the patient was detained for assessment under section 2 of the Mental Health Act 1983. This case demonstrates that all clinicians working in this area require a good understanding of the law in relation to treatment of children with mental disorder, which is extremely complex. PMID:26755991
[Mental disorders and diabetes mellitus].
Abrahamian, Heidemarie; Kautzky-Willer, Alexandra; Rießland-Seifert, Angelika; Fasching, Peter; Ebenbichler, Christoph; Hofmann, Peter; Toplak, Hermann
Psychiatric disorders and psychological problems are common in patients with diabetes mellitus. There is a twofold increase in depression which is associated with suboptimal glycemic control and increased morbidity and mortality. Other psychiatric disorders with a higher incidence of diabetes mellitus are cognitive impairment, dementia, disturbed eating behaviour, anxiety disorders, schizophrenia, bipolar disorders and borderline personality disorder. The coincidence of mental disorders and diabetes mellitus has unfavourable influences on metabolic control and micro- and macroangiopathic late complications. Improvement of therapeutic outcome is a challenge in the modern health care system. The intentions behind this position paper are to rise awareness of this special set of problems, to intensify cooperation between involved health care providers and to reduce incidence of diabetes mellitus as well as morbidity and mortality from diabetes in this patient group.
Observation of influences of mental health promotion and mental intervention on mental health status of professionals
Jiang, Shu-Qiang; Zhang, Jian-Ling
Objective: To observe the influences of mental health promotion and mental intervention on mental health status of professionals. Method: 2878 professionals for physical examination were selected and randomly divided into treatment group and control group, with 1443 professionals and 1435 professionals, respectively. Then, the difference of mental health status before and after mental intervention between two groups was compared. Results: In treatment group, the proportion of people with healthy mental and modest pressure after mental intervention was higher than that before mental intervention and that in control group after mental intervention (P<0.01); the proportion of people with psychological sub-heath and moderate pressure after mental intervention was significantly lower than that before mental intervention and that in control group after mental intervention (P<0.05). There was no significant difference in mental health status in control group before and after mental intervention (P>0.05). Mental health consciousness, health status, self pressure-relief capability, job satisfaction, and happiness index of professionals were up to 63.3%~78.8%. Conclusions: Mental health promotion and mental intervention may significantly improve mental health status of professionals. PMID:26221385
[Nosology of mental retardation].
González Castañón, Diego; Aznar, Andrea S; Wahlberg, Ernesto
The classificatory systems used through history. The analysis of their criteria for categorization allowed the authors to deduce the nosologic considerations and the paradigms underlying the conceptions of mental retardation sustained in each time period, not always from psychiatric origins. The effects of considering mental retardation as a disorder or a disability are discussed together with the correlation with the type of interventions and instituted social practices (related to mental health, social participation, education). The characteristics of the supports' paradigm and its consequences in the classifications and intervention plans are analyzed with more detail.
Madhavan, Thuppal; Narayan, Jayanthi
Epilepsy is one of the most frequently associated conditions with mental retardation which interferes with the learning process. Vie present study investigates the 1207 cases (Male -8I4, Female-393) registered at NIMH, Secunderabad, over a period of two years. Vie factors studied were the prevalence of epilepsy, degree of mental retardation, aetiology and associated factors. Ten mentally retarded persons with epilepsy were followed up longitudinally to study the effect of epilepsy on learning. It was observed that an attack of seizure resulted in a setback in the learning of skills. The results are discussed. PMID:21776089
Barton, R
Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years. Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives. The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.
Realidades Acerca de la Deficiencia Mental = Facts about Mental Retardation.
ERIC Educational Resources Information Center
Texas State Dept. of Mental Health and Mental Retardation, Austin.
This document consists of two booklets, one in Spanish and one in English, both covering the same text: the characteristics of mentally retarded individuals, the prevalence of mentally retarded persons in Texas, causes of mental retardation, prevention possibilities, and services available to mentally retarded persons in Texas. A distinction is…
Problematization of perspectives on health promotion and empowerment in mental health nursing--within the research network "MeHNuRse" and the Horatio conference, 2012.
Jönsson, Patrik D; Nunstedt, Håkan; Berglund, Inger J; Ahlström, Britt H; Hedelin, Birgitta; Skärsäter, Ingela; Jormfeldt, Henrika
Mental illness is increasing worldwide, while society's response seems to be a trend toward narrower and more specialized mental health care. This development is creating great demands on mental health nurses to include a health promotion perspective in care and support of persons with mental illness. A health promotion perspective emphasizes cooperation and communication with people who suffer from long-term mental illness, focusing on their independence and health. From a health perspective, every human being is an actor in his/her own life, with an inherent ability to make his/her own choices. However, persons who suffer from long-term mental illness are at risk of losing power and control over areas of their lives and their health. Mental health nurses are in a position to support these individuals in promoting health and in maintaining or regaining control over their lives. The emphasis of this paper is to problematize mental health nurses' responsibility to provide health-promoting nursing care in relation to empowerment by means of emancipation, self-efficacy, and self-management. We argue that mental health nurses can work from a health-promoting perspective by using these concepts and that this challenges some of the traditional ideas of health promotion in mental health nursing. The theoretical background discussions in this paper have their origin in the research network "Mental Health Nursing Research in Scandinavia" (MeHNuRse) and from the professional discussions developed during a 2012 workshop that included mental health nurses and researchers at the European Horatio Festival in Stockholm.
Superior mentalizing abilities of female patients with schizophrenia.
Abu-Akel, Ahmad; Bo, Sune
Mentalizing abilities are severely disrupted in patients with schizophrenia, but gender-related differences in this domain are virtually unexplored. Given the importance of these abilities in understanding psychopathology, social functioning and outcome, this study aimed to examine the mentalizing abilities of male and female patients with schizophrenia. The cognitive and affective mentalizing abilities of self and other of clinically stable male and female patients with schizophrenia were analyzed using the abbreviated version of the Metacognitive Assessment Scale (MAS-A). Compared to their male counterparts, the female patients demonstrated superior overall mentalizing abilities. This advantage was also evident when mentalizing about the Self or the Other. When examining cognitive versus affective mentalizing, women were significantly better in their ability to attribute and understand the affective mental states of others. These differences were unrelated to intelligence or psychopathology. The superior mentalizing abilities of female patients extend gender-related differences in schizophrenia to include social cognition. This suggests that our current knowledge of socio-cognitive abilities in schizophrenia is generalizable to male but not to female patients. The findings also provide important insights to understanding how etiological differences affect social cognition. Awareness to such differences has important implications for diagnosis and clinical treatment.
Imagining predictions: mental imagery as mental emulation
Moulton, Samuel T.; Kosslyn, Stephen M.
We argue that the primary function of mental imagery is to allow us to generate specific predictions based upon past experience. All imagery allows us to answer 'what if' questions by making explicit and accessible the likely consequences of being in a specific situation or performing a specific action. Imagery is also characterized by its reliance on perceptual representations and activation of perceptual brain systems. We use this conception of imagery to argue that all imagery is simulation—more specifically, it is a specific type of simulation in which the mental processes that 'run' the simulation emulate those that would actually operate in the simulated scenario. This type of simulation, which we label emulation, has benefits over other types of simulations that merely mimic the content of the simulated scenario. PMID:19528008
Does 'mental kinesiophobia' exist?
Schmidt, Anton J M
In this study the relevance of the concept of mental kinesiophobia (respectively cogniphobia or fear of mental exertion) for clients with chronic stress problems was explored. It was hypothesized that cognitive, chronic stress complaints, such as concentration problems or decreased problem solving abilities, could be catastrophized as signs of heightened personal vulnerability, with a chance of becoming permanent. As a consequence, mental exertion is avoided. This line of reasoning comes from the existing concept of kinesiophobia. This concept describes the avoidance behavior in chronic benign pain patients and refers to their fear of inflicting irreversible bodily damage due to physical exertion.An illustrative case of cogniphobia is presented. In an explorative pilot-study it was demonstrated that chronically stressed clients scored significantly higher on an experimental questionnaire measuring avoidance tendencies for mental exertion, compared with actively working employees. Consequences for treatment and suggestions for further study are discussed.
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Defending the Mentally Disabled.
ERIC Educational Resources Information Center
Cournos, Francine; And Others
Discusses the role of mental health and social services personnel in helping patients apply for recertification for Supplementary Security Income (SSI) benefits. Describes the appeal process and provides guidelines for professionals. (JAC)
ERIC Educational Resources Information Center
Overton, Stacy L.; Medina, Sondra L.
Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…
Mental Health, Racism, and Sexism.
ERIC Educational Resources Information Center
Willie, Charles V., Ed.; And Others
This volume, successor to the 1973 volume "Racism and Mental Health," presents a range of perspectives on mental health, prejudice, and discrimination. Contributors are of multiracial, multiethnic, and gender-diverse backgrounds. They use their existential experiences to analyze pressing mental health and mental illness issues. Contributions…
Paxion, Julie; Galy, Edith; Berthelon, Catherine
The aim of this review is to identify the most representative measures of subjective and objective mental workload in driving, and to understand how the subjective and objective levels of mental workload influence the performance as a function of situation complexity and driving experience, i.e., to verify whether the increase of situation complexity and the lack of experience increase the subjective and physiological levels of mental workload and lead to driving performance impairments. This review will be useful to both researchers designing an experimental study of mental workload and to designers of drivers' training content. In the first part, we will broach the theoretical approach with two factors of mental workload and performance, i.e., situation complexity and driving experience. Indeed, a low complex situation (e.g., highways), or conversely a high complex situation (e.g., town) can provoke an overload. Additionally, performing the driving tasks implies producing a high effort for novice drivers who have not totally automated the driving activity. In the second part, we will focus on subjective measures of mental workload. A comparison of questionnaires usually used in driving will allow identifying the most appropriate ones as a function of different criteria. Moreover, we will review the empirical studies to verify if the subjective level of mental workload is high in simple and very complex situations, especially for novice drivers compared to the experienced ones. In the third part, we will focus on physiological measures. A comparison of physiological indicators will be realized in order to identify the most correlated to mental workload. An empirical review will also take the effect of situation complexity and experience on these physiological indicators into consideration. Finally, a more nuanced comparison between subjective and physiological measures will be established from the impact on situation complexity and experience. PMID:25520678
Regaining Control Over Information Technology
ERIC Educational Resources Information Center
Goldsborough, Reid
Living in postindustrial, 21st-century society means being surrounded by the accoutrements of information technology. Information technology is in people's offices, cars and homes. One third of adults do not deal well with information technology, according to the research of Larry Rosen, psychology professor, author, and pundit. Rosen is the Paul…
Okasha, Ahmed
The concepts and management of mental health in Egypt are presented from the Pharaonic era through the Islamic Renaissance until today. Papyri from the Pharaonic period show that Soma and Psyche were not differentiated and mental disorders were described as symptoms of the heart and uterus. Although theories of causation were of a mystical nature, mental disorders were treated on a somatic basis. In the Islamic era, mental patients were neither maltreated nor tortured as a consequence of the belief that they may be possessed by a good Moslem genie. In the 14th century mental disorders was one of the four departments in Cairo's Kalawoon Hospital, a precursor of the place of psychiatry in general hospitals that was accepted in Europe six centuries later. The mental health services in Egypt today are described, and transcultural studies carried out in Egypt of the prevalence and phenomenology of anxiety, schizophrenia, depression, suicide, conversion and obsessive compulsive disorders are reviewed. The psychiatric services for children are in their infancy. Since 1983 the common and semi-accepted use of hashish has been joined by abuse by heroin and other substances.
A qualitative study of exodus graduates: family-focused residential substance abuse treatment as an option for mothers to retain or regain custody and sobriety in Los Angeles, California.
Einbinder, Susan D
In this article, 21 long-term, poly-substance abusing mothers describe how they successfully completed an 18-month family-focused residential substance abuse treatment program in southern California that helped them retain or regain custody of their children. Their stories and experiences with specific program characteristics and approaches of this rare treatment option are described, in their own voices. Policy implications for child welfare and parental substance abuse treatment are examined in light of these success stories.
Mental Health Education in Three Primary Care Specialities.
ERIC Educational Resources Information Center
Strain, James J.; And Others
The characteristics of the mental health components of residency training in traditional internal medicine, primary care internal medicine, and family practice were examined. Internal medicine programs relied on the consultation method and in-patient facilities, and used the psychiatrist as the primary teacher. Evaluation of the outcome of…
Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves.
Barghash, Z; Larsen, J O; Al-Bishri, A; Kahnberg, K-E
The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod for 30s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both in the normal anatomy and in the regenerative pattern. The mental nerve had a larger cross-sectional area including all tissue components. The mental nerve had a larger volume fraction of myelinated axons and a correspondingly smaller volume fraction of endoneurium. No differences were observed in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (somatosensory function).
Attitudes of Jordanian mental health nurses toward mental illness and patients with mental illness.
Hamdan-Mansour, Ayman M; Wardam, Lina A
The purpose of this study was to examine Jordanian mental health nurses' attitudes toward mental illness and patients with mental illness. A descriptive correlational design was utilized to collect data from 92 mental health nurses in Jordan. Data was collected on nurses' attitudes toward mental illness and patients with mental disorder and their satisfaction with nursing care delivery. The Jordanian mental health nurses who participated in this study had negative attitudes toward mental illness and toward patients with mental disorders. About 60% of the mental health nurses had perceived patients with mental illness to be dangerous, immature, dirty, cold hearted, harmful, and pessimistic. In only two descriptions-being polite and adult-did nurses have positive perception about patients with mental illness. Mental health nurse were not satisfied with nursing care delivery. More than 70% of nurses were proud to be a mental health nurse. Age and gender were significant influential factors in forming the nurses' attitudes or satisfaction. Immediate intervention is needed to improve the quality of patient care provided by mental health nurses.
Whitley, Rob
The exploration of the impact of religiosity on mental health is an enduring, if somewhat quiet, tradition. There has been virtually no exploration, however, of the influence of atheism on mental health. Though not a "religion," atheism can be an orienting worldview that is often consciously chosen by its adherents, who firmly believe in the "truth" of atheism-a phenomenon known as "positive atheism." Atheism, especially positive atheism, is currently enjoying something of a renaissance in the Western liberal democracies-a trend often referred to as the "new atheism." I argue that atheism, especially positive atheism, should be treated as a meaningful sociocultural variable in the study of mental health. I argue that atheism (just like theism) is an appropriate domain of study for social and cultural psychiatrists (and allied social scientists) interested in exploring socio-environmental stressors and buffers relating to mental health. Specifically, I argue that (1) atheism needs to be accurately measured as an individual-level exposure variable, with the aim of relating that variable to psychiatric outcomes, (2) there needs to be greater systematic investigation into the influence of atheism on psychiatry as an institution, and (3) the relation of atheism to mental health needs to be explored by examining atheistic theory and its practical application, especially as it relates to the human condition, suffering, and concepts of personhood.
Pakistan mental health country profile.
Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel
The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.
Rueve, Marie E.; Welton, Randon S.
Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients' lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, including etiology, comorbidity, risk factor management, and treatment. A psychiatrist who is well versed in the recognition and management of violence can contribute to the appropriate management of dangerous behaviors and minimize risk to patients, their families, mental health workers, and the community as a whole. PMID:19727251
Parkar, Shubhangi R.
This paper highlights the mental health needs of the elderly. It tackles the issues of their institutionalisation and community care. Rapid urbanisation in Indian society throws up special problems in elderly care. There is great evidence of a raise in morbidity, mortality, hospitalisation and loss of functional status related to common mental disorders in the elderly patients. Overlap of depression and anxiety is very common with up to almost half of the elderly patients reporting significant depressive and anxiety symptoms. Also, depression is the most common psychiatric disorder in late life. Growth in the elderly population means a direct increase in age related diseases such as dementia and poor mental health outcomes such as depression, anxiety, suicide and serious constraints on the quality of life among elderly individuals. The need to identify new and unmet problem areas and develop efficient therapeutic outcomes for this special population is stressed. PMID:25838727
Transition from the Afghanistan and Iraqi battlefields to home: an overview of selected war wounds and the federal agencies assisting soldiers regain their health.
Brown, Norman D
Occupational health nurses are encountering veterans in the workplace who have served one or more tours of duty in Afghanistan or Iraq. Soldiers making the transition from combat to civilian life may have physical and mental injuries from war. Occupational health nurses who recognize the unique nature of these injuries and are knowledgeable about resources for meeting veterans' needs will be instrumental in facilitating their return to civilian life.
[Mental disorders in puberty].
Meyer, Andreas
Puberty is characterized by a complexity of different developmental tasks. During this period of sometimes dramatic changes, the adolescent must find a new balance between personal experiences and the demands made by the environment. In this period of development, some 18% of all adolescents experience a mental crisis, and 5% need specialist treatment. Such mental disorders in puberty as anorexia nervosa, depression or suicidality can be classified on the basis of their development and course. They must be taken seriously and treated as early as possible.
Mental capacity and borderline personality disorder
Ayre, Karyn; Owen, Gareth S.; Moran, Paul
The use of the Mental Capacity Act 2005 in assessing decision-making capacity in patients with borderline personality disorder (BPD) is inconsistent. We believe this may stem from persisting confusion regarding the nosological status of personality disorder and also a failure to recognise the fact that emotional dysregulation and characteristic psychodynamic abnormalities may cause substantial difficulties in using and weighing information. Clearer consensus on these issues is required in order to provide consistent patient care and reduce uncertainty for clinicians in what are often emergency and high-stakes clinical scenarios. PMID:28184315
Mental Illness in Persons with Mental Retardation: ARC Facts.
ERIC Educational Resources Information Center
Weber, Linda R.; Wimmer, Sharon
This brief factsheet presents information on mental illness in mentally retarded persons. The most prevalent disorders found in this population are schizophrenia, organic brain syndrome, adjustment disorders, personality disorders, depression, and behavioral problems. Few standardized methods of assessment exist for the diagnosis of mental illness…
Teacher Candidate Mental Health and Mental Health Literacy
ERIC Educational Resources Information Center
Dods, Jennifer
Providing teacher candidates with a strong foundation in mental health literacy during their teacher education program is crucial in ensuring novice teachers are prepared to support the mental health needs of their students. In addition to responding to students, teacher candidates are typically at an age when mental health disorders are common…
School Mental Health Resources and Adolescent Mental Health Service Use
ERIC Educational Resources Information Center
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
Cytogenetic analysis in a large series of children with non-syndromic mental retardation
Bouhjar, Inesse Ben Abdallah; Gmidène, Abir; Mougou-Zrelli, Soumaya; Hannachi, Hanene; Soyah, Najla; Gadour, Naoufel; Harrabi, Imed; Elghezal, Hatem; Saad, Ali
Mental retardation affects 1–3% of the population. To evaluate the implication of chromosomal abnormalities in the etiology of mental retardation, 1420 patients with non-syndromic mental retardation recruited at the department of cytogenetics of Farhat Hached hospital (Sousse, Tunisia) between January 2005 and December 2009, were analyzed using standard cytogenetic techniques. Age ranged between 3 and 18 years with a median of 8 years. Chromosomal abnormalities were detected in 7.8% of patients and an increased prevalence of chromosome anomalies was observed in patients when the mental retardation is associated with a severe degree of intellectual disability, facial dysmorphic features and/or congenital malformations or epilepsy. PMID:27625819
Cytogenetic analysis in a large series of children with non-syndromic mental retardation.
Bouhjar, Inesse Ben Abdallah; Gmidène, Abir; Mougou-Zrelli, Soumaya; Hannachi, Hanene; Soyah, Najla; Gadour, Naoufel; Harrabi, Imed; Elghezal, Hatem; Saad, Ali
Mental retardation affects 1-3% of the population. To evaluate the implication of chromosomal abnormalities in the etiology of mental retardation, 1420 patients with non-syndromic mental retardation recruited at the department of cytogenetics of Farhat Hached hospital (Sousse, Tunisia) between January 2005 and December 2009, were analyzed using standard cytogenetic techniques. Age ranged between 3 and 18 years with a median of 8 years. Chromosomal abnormalities were detected in 7.8% of patients and an increased prevalence of chromosome anomalies was observed in patients when the mental retardation is associated with a severe degree of intellectual disability, facial dysmorphic features and/or congenital malformations or epilepsy.
[Correction of psycho-emotional state by the biofeedback method in patients with metabolic syndrome].
Koichubekov, B K; Shaikhin, A M; Tabagari, S I; Sorokina, M A; Omarbekova, N K
Metabolic syndrome is one of the important clinical problems of medicine. The aim of this study was to demonstrate the efficacy of heart rate variability biofeedback method in correction of mental and emotional state in patients with metabolic syndrome. For this task was set to study the dynamics of indicators of mental and emotional stress by biofeedback based hardware-software complex "Amblyocor" in patients with metabolic syndrome. Course of heart rate variability biofeedback passed 10 patients with the metabolic syndrome. During biofeedback sessions conducted tests that assess psycho-emotional state by 5 characters. Data processing was performed using software package «Statistica 8.0» and showed a statistically significant decrease in indicators of mental and emotional stress, that demonstrates the effectiveness of biofeedback in the correction of mental and emotional stress in patients with metabolic syndrome.
[Psychopharmacotherapy in patients with cardiovascular diseases].
Cordes, J; Lange-Asschenfeldt, C; Hiemke, C; Kahl, K G
Increased cardiometabolic morbidity and increased overall mortality has been observed in patients with severe mental disorders. Therefore, cardiometabolic safety is an important issue in the treatment of patients with psychiatric disorders, in particular in patients with comorbid cardiometabolic diseases. Frequent adverse side effects include disturbances of lipid and glucose metabolism, body weight changes and alterations of the QTc interval. Dependent on the particular substance used and on factors concerning individual vulnerability, these side effects vary in relative frequency. Therefore, regular monitoring is recommended including ECG. Furthermore, interactions between different medicaments may occur, either leading to enhanced or decreased drug concentrations. Prior to psychopharmacological treatment, proper cardiological treatment is recommended. The management of cardiovascular risks under psychopharmacology requires interdisciplinary cooperation between the cardiologist, general practitioner and psychiatrist.
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Older Adults and Mental Health
... and Resources Clinical Trials Share Older Adults and Mental Health Overview It's just as important for an older ... this helpline, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), to receive immediate counseling. Calling ...
Bateman, Anthony; Fonagy, Peter
The concept of mentalizing has captured the interest and imagination of an astonishing range of people—from psychoanalysts to neuroscientists, from child development researchers to geneticists, from existential philosophers to phenomenologists—all of whom seem to have found it useful. According to the Thompson Reuter maintained Web of Science, the use of the term in titles and abstracts of scientific papers increased from 10 to 2,750 between 1991 and 2011. Clinicians in particular have enthusiastically embraced the idea, and have put it to innovative use in their practices. Mentalization-based treatment (MBT)—making mentalizing a core focus of therapy—was initially developed for the treatment of borderline personality disorder (BPD) in routine clinical services delivered in group and individual modalities. Therapy with mentalizing as a central component is currently being developed for treatment of numerous groups, including people with antisocial personality disorder, substance abuse, eating disorders, and at-risk mothers with infants and children (A. Bateman & Fonagy, 2011). It is also being used with families and adolescents, in schools, and in managing social groups (Asen & Fonagy, 2011; Fonagy et al., 2009; Twemlow, Fonagy, & Sacco, 2005a, 2005b). In this article, we focus on MBT in the treatment of BPD. PMID:26157198
SmithBattle, Lee; Freed, Patricia
Psychological distress is common in teen mothers. High rates of distress are attributed to teen mothers' childhood adversities and the challenges of parenting in the context of chronic stress, cumulative disadvantage, and limited social support. We describe the prevalence of psychological distress in teen mothers; what is known about its origins and impact on mothers and children; factors that promote teen mothers' mental health and resilience; and the many barriers that make it difficult to obtain traditional mental healthcare. We also briefly review the few studies that test interventions to improve teen mothers' mental health. Because barriers to traditional mental health treatment are ubiquitous and difficult to remedy, the second article in this two-part series calls for nurses in healthcare settings, schools, and home visiting programs to screen pregnant and parenting teens for adverse childhood experiences and psychological distress, and to integrate strength-based and trauma-based principles into their practice. Creating a supportive setting where past traumas and psychological distress are addressed with skill and sensitivity builds upon teen mothers' strengths and their aspirations to be the best parents they can be. These approaches facilitate the long-term health and development of mother and child.
Koenderink, Jan; van Doorn, Andrea
Three observers performed a task designed to quantify their "pictorial relief" in visual awareness for a photograph of a piece of sculpture. In separate sessions, they were instructed to assume one of two "mental viewpoints." The main objective was to investigate whether human observers have such command. All three observers could redirect their "mental view direction" by up to 20°. These observers experience "paradoxical monocular" stereopsis, whereas a sizable fraction of the population does not. Moreover, they had some experience in assuming various "viewing modes." Whereas one cannot generalize to the population at large, these findings at least prove that it is possible to direct the mental viewpoint actively. This is of importance to the visual arts. For instance, academic drawings require one to be simultaneously aware of a "viewing" (for the drawing) and an "illumination direction" (for the shading). Being able to mentally deploy various vantage points is a crucial step from the "visual field" to the "visual space." PMID:27648221
Deafness and Mental Retardation.
ERIC Educational Resources Information Center
Stewart, Larry G., Ed.
Nine selected proceedings from a study institute discuss program alternatives for the education of deaf mentally retarded (MR) children along with such related issues as identification, size and scope of the problem, instructional approaches, curricular planning, instructional media, program funding sources, and vocational rehabilitation. The…
Selected Mental Health Audiovisuals.
ERIC Educational Resources Information Center
National Inst. of Mental Health (DHEW), Rockville, MD.
Presented are approximately 2,300 abstracts on audio-visual Materials--films, filmstrips, audiotapes, and videotapes--related to mental health. Each citation includes material title; name, address, and phone number of film distributor; rental and purchase prices; technical information; and a description of the contents. Abstracts are listed in…
Children's Mental Health Surveillance
... Children's mental disorders affect many children and families. Boys and girls of all ages, ethnic/racial backgrounds, and regions ... highest among 6 to 11 year old children. Boys were more likely than girls to have ADHD, behavioral or conduct problems, autism ...
Pennsylvania Women's Mental Health.
ERIC Educational Resources Information Center
Towns, Kathryn; And Others
Women have undergone a revolution in their self-perception and their traditional relationships to work, money, marriage, and family. These social changes have implications for every aspect of women's lives, including their mental health. Because of the special problems and conflicts confronting women today, data need to be analyzed on policies,…
Mental Recreation in Wonderland
ERIC Educational Resources Information Center
Pendlebury, Kate
The author argues that children's books are not, as commonly held, either didactic or entertaining and that successful juvenile literature teaches what Lewis Carroll, who wrote "Alice in Wonderland," termed "mental recreation." Pendlebury contends that learning and play, far from being opposites, can closely resemble one…
Nutrition and Mental Development.
ERIC Educational Resources Information Center
Crnic, Linda S.
Studies on the effects of malnutrition on mental development are reviewed and the complexity of factors (such as alternatives in maternal behavior) surrounding malnutrition in animal studies is noted. Findings are cited which suggest that environmental stimulation may in part reverse the neurological effects and remediate some behavioral effects…
ERIC Educational Resources Information Center
Walsh, Roger
Mental health professionals have significantly underestimated the importance of lifestyle factors (a) as contributors to and treatments for multiple psychopathologies, (b) for fostering individual and social well-being, and (c) for preserving and optimizing cognitive function. Consequently, therapeutic lifestyle changes (TLCs) are underutilized…
ERIC Educational Resources Information Center
Valdez, Pablo; Reilly, Thomas; Waterhouse, Jim
Cognitive performance is affected by an individual's characteristics and the environment, as well as by the nature of the task and the amount of practice at it. Mental performance tests range in complexity and include subjective estimates of mood, simple objective tests (reaction time), and measures of complex performance that require decisions to…
Audiovisuals in Mental Health.
ERIC Educational Resources Information Center
Kenney, Brigitte L.
Describes major uses of film, television, and video in mental health field and discusses problems in selection, acquisition, cataloging, indexing, storage, transfer, care of tapes, patients' rights, and copyright. A sample patient consent form for media recording, borrower's evaluation sheet, sources of audiovisuals and reviews, and 35 references…
Incompatibility and Mental Fatigue
ERIC Educational Resources Information Center
Herzog, Thomas R.; Hayes, Lauren J.; Applin, Rebecca C.; Weatherly, Anna M.
A straightforward prediction from attention restoration theory is that the level of incompatibility in a person's life should be positively correlated with that person's level of mental (or directed attention) fatigue. The authors tested this prediction by developing a new self-report measure of incompatibility in which they attempted to isolate…
ERIC Educational Resources Information Center
Osofsky, Joy D.; Thomas, Kandace
Unfortunately, the term "infant mental health" can be confusing for some people because it may be understood as translating into "mental illness." Others may not appreciate that babies and toddlers have the capacity to experience complex emotions. The Guest Editors of this issue of the Journal explore the meaning of infant mental health.
Playtherapy with the Mentally Retarded.
ERIC Educational Resources Information Center
Broekgaarden, R.; And Others
The use of play therapy with mentally retarded children and adults is examined. The lack of research on the topic is noted, and information on psychoanalytically oriented play therapy approaches are reviewed. Application of play therapy to mentally retarded clients is explored in terms of two questions: (1) at what level do mentally retarded…
Mental Health, United States, 1987.
ERIC Educational Resources Information Center
National Inst. of Mental Health (DHHS), Rockville, MD.
This document presents timely statistical information on the nation's organized mental health service delivery system. Included are: (1) "Chronic Mental Disorder in the United States" (Howard H. Goldman and Ronald W. Manderscheid); (2) "Specialty Mental Health System Characteristics" (Michael J. Witkin, Joanne E. Atay, Adele S. Fell, and Ronald W.…
The Mentally Retarded in Sweden.
ERIC Educational Resources Information Center
Grunewald, Karl
Described are residential and educational services provided for mentally retarded (MC) children and adults in Sweden. Normalization is the focus of the services which make maximum use of mental and physical capacities to reduce the handicap of mental retardation. Described are general principles, and four stages involving development of services…
Mental Health Program Reports - 5.
ERIC Educational Resources Information Center
Segal, Julius, Ed.
The volume is reported to reflect the broad range of National Institute of Mental Health activities in areas of research, development of mental health manpower, and delivery of mental health services. Twenty papers examine, respectively, relationship of life histories and biochemistry of siblings and twins to schizophrenia, training of Navaho…
Educable Mentally Retarded, Level I.
ERIC Educational Resources Information Center
Suo, Minnie Alice; Willemin, Helen
Intended for teachers of special classes of educable mentally retarded children aged 6 to 8 (mental age = 3.5 to 4.9), the guide stresses skills necessary to the development of physical, personal and social, and vocational competency. An introduction defines philosophy and goals, outlines the educable mentally retarded program and the readiness…
Mental Health Systems in Scandinavia.
ERIC Educational Resources Information Center
Vail, David J.
The guidebook is introduced by general observations on the Scandinavian countries concerning history, social policy, medicine, mental health, and psychiatric diagnosis. Discussed individually for Norway, Sweden, and Denmark are the following areas: mental health programs and statistics; mental illness programs, regional, hospital, aftercare,…
Mental Health of Indian Children.
ERIC Educational Resources Information Center
Kapur, Malavika
Children constitute nearly 40% of India's population, a significant portion of whom suffer mental ailments. Ways to sensitize those who work with children to various aspects associated with child mental health are explored in this book. The focus is not on mental handicap but on the internal or external distress which warps the psychosocial…
Improving Mental Health in Schools
ERIC Educational Resources Information Center
Rossen, Eric; Cowan, Katherine C.
Students do not leave their mental health at the front door when they come to school. From wellness to serious illness, a student's mental health status is integral to how they think, feel, interact, behave, and learn. Decades of research and experience have laid a solid foundation and framework for effectively providing mental health…
Practices of Weight Regulation Among Elite Athletes in Combat Sports: A Matter of Mental Advantage?
Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M
Context The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. Objective To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Design Qualitative study. Setting With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Patients or Other Participants Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Data Collection and Analysis Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Results Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being "a real athlete." Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Conclusions Weight regulation has mentally important functions
49 CFR 1572.109 - Mental capacity.
Code of Federal Regulations, 2014 CFR
... health facility. (b) An applicant is adjudicated as lacking mental capacity if— (1) A court, board... committed to a mental health facility if he or she is formally committed to a mental health facility by a... lacking mental capacity, mental illness, and drug use. This does not include commitment to a mental...
49 CFR 1572.109 - Mental capacity.
Code of Federal Regulations, 2010 CFR
... health facility. (b) An applicant is adjudicated as lacking mental capacity if— (1) A court, board... committed to a mental health facility if he or she is formally committed to a mental health facility by a... lacking mental capacity, mental illness, and drug use. This does not include commitment to a mental...
49 CFR 1572.109 - Mental capacity.
Code of Federal Regulations, 2013 CFR
... health facility. (b) An applicant is adjudicated as lacking mental capacity if— (1) A court, board... committed to a mental health facility if he or she is formally committed to a mental health facility by a... lacking mental capacity, mental illness, and drug use. This does not include commitment to a mental...
49 CFR 1572.109 - Mental capacity.
Code of Federal Regulations, 2012 CFR
... health facility. (b) An applicant is adjudicated as lacking mental capacity if— (1) A court, board... committed to a mental health facility if he or she is formally committed to a mental health facility by a... lacking mental capacity, mental illness, and drug use. This does not include commitment to a mental...
49 CFR 1572.109 - Mental capacity.
Code of Federal Regulations, 2011 CFR
... health facility. (b) An applicant is adjudicated as lacking mental capacity if— (1) A court, board... committed to a mental health facility if he or she is formally committed to a mental health facility by a... lacking mental capacity, mental illness, and drug use. This does not include commitment to a mental...
Foyle, M F; Beer, M D; Watson, J P
This paper reviews the historical aspects of expatriate mental health, and comments on the paucity of literature in the medical and psychiatric journals. Data obtained from 397 expatriate probands examined during overseas service are described. It was noted that there was a high incidence of affective and adjustment disorders. The results showed six areas significantly related to those with affective disorders at interview, namely a history of consultation for psychological problems in out-patient departments or with the patient's own doctor, a history of depressed mood, and a family history of suicide, psychosis or personality disorder. Subjects with adjustment disorders at interview showed a significant positive correlation with four stressors (occupational anxiety, home country anxieties, acculturation and physical ill-health), but showed a negative association with a past personal history of consultation for psychological problems at out-patient departments or with their own doctors. These findings are discussed and practical applications suggested for improving expatriate mental health.
Mental illness: psychiatry's phlogiston
Szasz, T
In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity PMID:11579183
Exercise Prevents Mental Illness
NASA Astrophysics Data System (ADS)
Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.
Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.
Mental health status can reflect disease activity in rheumatoid arthritis
Sokolovic, Sekib; Dervisevic, Vedina; Fisekovic, Saida
Objective A significant number of patients with rheumatoid arthritis (RA) link the start of illness with psychological trauma or severe stress. Impaired mental health (IMH), defined as depression and anxiety with psychoneuroimmunological factors, can play a significant role in RA. The main objective of this research was to investigate the mutual correlation of IMH and RA activity, estimated by the laboratory and clinical parameters in RA patients. Material and Methods An open clinical prospective study that lasted for 6 months was designed. There were 72 patients included, 58 women and 14 men, aged 34 to 80 years and screened for mental health status. The study population was randomized following the Brief Symptoms Inventory (BSI) scale, comprised of 53 questions with a range from 0 (no symptoms) to 4 (severe). This mental test was done only once during the study. Following the results from the BSI scale, RA patients were divided into mentally stable and mentally unstable patients to investigate the influence of RA activity on mental health. The following laboratory and clinical parameters were analyzed: sex, age, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibody, and disease activity score (DAS28). All RA patients did not express extra-articular manifestations or Sjögren's syndrome. The chi-square test, ANOVA, Pearson's coefficient, and IBM Statistics - SPSS v19 were used. Results From a total of 72 RA patients, there were 44 mentally stable and 28 mentally unstable patients. All patients had either moderate or severe active disease. The only significant correlation of IMH and activity of RA was found in CRP and DAS28, but no significance was observed in ESR, RF, and anti-CCP. The DAS28 showed high disease activity with an average of 5.3 and CRP of 20.9 mg/L in patients with unstable mental health compared to stable mental health patients, where RA was associated with
Mental defeat is linked to interference, distress and disability in chronic pain.
Tang, Nicole K Y; Goodchild, Claire E; Hester, Joan; Salkovskis, Paul M
Mental defeat is a psychological construct that has recently been applied to characterize the experience of chronic pain. Elevated levels of mental defeat have been identified in patients with chronic pain, and while its presence distinguishes treatment seeking from non-treatment seeking individuals, the link between mental defeat and disability in chronic pain is yet to be established. The current study investigated the extent to which mental defeat is associated with pain-related interference, distress and disability. A total of 133 participants completed the Pain Self Perception Scale that assessed mental defeat in relation to pain. Moreover, the participants were asked to complete a set of questionnaires that measured pain interference, distress, disability and other demographic (age, body mass index), clinical (pain intensity) and psychological (catastrophizing, worry, rumination and health anxiety) predictors of disability. Mental defeat was found to be strongly correlated with pain interference, sleep disturbance, anxiety, depression, functional disability and psychosocial disability. These correlations remained significant even when pain intensity and demographic variables were partialled out. Relative to chronic pain patients with lower levels of mental defeat, those with higher levels of mental defeat reported greater degree of pain interference, distress and disability. In a series of regression analyses, mental defeat emerged as the strongest predictor of pain interference, depression and psychosocial disability, whereas catastrophizing was the best predictor of sleep interference, anxiety and functional disability. These findings suggest that mental defeat may be an important mediator of distress and disability in chronic pain. Theoretical and clinical implications are discussed.
[The diagnostic value of tests for mental control].
Lindeboom, J; Koene, T; Matto, D
Designated as Mental Control, the recitation of word lists and arithmetic progressions is often used for a cursory examination of attention and concentration in elderly patients. We studied the psychometric properties of the EMCT (Expanded Mental Control Test), which consists of 12 mental control tasks. The test was given to 174 residents of rest homes and semi-independent housing projects (aged 68 to 94) and 74 neurologic patients (aged 65 to 87) who had been referred for neuropsychological assessment. The reliability of the EMCT was satisfactory. Performance was related to education level but not to sex or age. In healthy subjects the EMCT score was associated with the backward digit span score. The correlations between the EMCT and subtests of the Amsterdam Dementia Screening (Ads6) in patients appeared to depend on the complexity of the target behavior. Performance on the EMCT may reflect the functioning of the Supervisory Attentional System postulated by Shallice.
Spirituality and mental health clients.
O'Reilly, Mary Linda
Spirituality is an important part of human existence but is often overlooked in the conceptualization of the person as a biopsychosocial entity. This article examines spirituality as a concept, relates it to the experience of mental health clients, proposes spiritual assessments and interventions within the role of advanced practice mental health nurses, and discusses the necessity of including spiritual interventions to support healing and wholeness for mental health clients.
New Roles for Pharmacists in Community Mental Health Care: A Narrative Review
Rubio-Valera, Maria; Chen, Timothy F.; O'Reilly, Claire L.
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists' role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists' attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma. PMID:25337943
New roles for pharmacists in community mental health care: a narrative review.
Rubio-Valera, Maria; Chen, Timothy F; O'Reilly, Claire L
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists' role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists' attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.
Objective assessment of thirst recovery in patients with adipsic diabetes insipidus.
Sinha, A; Ball, S; Jenkins, A; Hale, J; Cheetham, T
Adipsic diabetes insipidus (ADI) is characterised by impaired thirst and defective AVP secretion. We have assessed the thirst response to graded osmotic stimulation using a visual analog scale (VAS) in patients with a history of ADI following surgery for a craniopharyngioma. The patients were thought to be regaining their thirst response but we wanted to confirm that this was the case objectively before relaxing their strict fluid balance regimen. Three patients with adipisa in the presence of hypernatremia following surgery for a craniopharyngioma are described. Their median age at surgery was 13 years (range 11-15 years). All patients had previously demonstrated no desire to drink despite a serum osmolality in excess of 300 mOsmol/kg. Fluid balance was maintained postoperatively with a regimen involving a fixed daily fluid intake and DDAVP dose together with daily weights and regular assessment of capillary sodium concentrations. Patients were thought to be regaining thirst sensation and so were assessed by hypertonic saline infusion (HSI) with thirst measured using a VAS. Patients underwent a HSI test 4, 6 and 9 months post surgery. All had abnormally low AVP production at raised plasma osmolalities but the visual analogue scale confirmed partial or complete thirst recovery. The intensive regimen used to maintain stable serum sodium concentrations was relaxed without the patients subsequently developing a significant hyperosmolar state. We have shown objective recovery of thirst perception in patients with adipsia within 9 months of surgery, despite persistence of cranial diabetes insipidus. These observations indicate that both osmoreceptors regulating thirst and their efferent pathways demonstrate more plasticity than those regulating AVP production. The HSI and thirst VAS are an objective way of assessing patients known to have ADI who are thought to be recovering thirst perception.
Changing Roles of Mental Health Professionals.
ERIC Educational Resources Information Center
Garai, Josef E.
The roles that mental health professionals must play to facilitate the prevention of mental illness and the introduction of mentally healthy attitudes in our society is discussed. Mental health professionals must re-examine the meaning of mental health in the context of the current world situation and ask themselves to what extent they are…
Mental Health and Mental Retardation Services in Nevada.
ERIC Educational Resources Information Center
Kakalik, J. S.; And Others
Summarized are the findings and recommendations of a 2-year study of all major mental health, and mental retardation, alcohol, and drug abuse services and programs in Nevada. Fourteen chapters are given to the following topics (sample subtopics are in parentheses): description of the survey (scope of the project); summary and recommendations…
Mental Retardation Is Dead: Long Live Mental Retardation!
ERIC Educational Resources Information Center
Goode, David
This commentary discusses whether the American Association on Mental Retardation should change its name. The history of the term "mental retardation" is reviewed and it is argued that any new term will take on similar risks. The need to involve self-advocates in any terminology change is stressed. (Contains 5 references.) (CR)
A Bibliography for Schools on Mental Health/Mental Illness.
ERIC Educational Resources Information Center
Kupper, Lisa, Ed.
This bibliography for schools lists 49 print resources on mental health and mental illness published from 1989 through 1994. Resources are listed alphabetically by author within the categories of directories and bibliographies, and other print resources. The names, addresses, and telephone numbers of publishers are provided at the end of the…
A Bibliography for Families on Mental Health/Mental Illness.
ERIC Educational Resources Information Center
Kupper, Lisa, Ed.
This bibliography for families lists 44 print resources on mental health and mental illness published from 1987 through 1994. The list is organized into the following categories: directories and bibliographies, other print resources, and information in Spanish. The names, addresses, and telephone numbers of publishers are provided at the end of…
Experiences in Rural Mental Health. VI; Programming School Mental Health.
ERIC Educational Resources Information Center
Hollister, William G.; And Others
Based on a North Carolina feasibility study (1967-73) which focused on development of a pattern for providing comprehensive mental health services to rural people, this guide deals with programming school mental health in Vance and Franklin counties. Detailing both successes and failures, this booklet presents the following program activities: (1)…
Classification of mental disorders*
Stengel, E.
One of the fundamental difficulties in devising a classification of mental disorders is the lack of agreement among psychiatrists regarding the concepts upon which it should be based: diagnoses can rarely be verified objectively and the same or similar conditions are described under a confusing variety of names. This situation militates against the ready exchange of ideas and experiences and hampers progress. As a first step towards remedying this state of affairs, the author of the article below has undertaken a critical survey of existing classifications. He shows how some of the difficulties created by lack of knowledge regarding pathology and etiology may be overcome by the use of "operational definitions" and outlines the basic principles on which he believes a generally acceptable international classification might be constructed. If this can be done it should lead to a greater measure of agreement regarding the value of specific treatments for mental disorders and greatly facilitate a broad epidemiological approach to psychiatric research. PMID:13834299
Purpose in life in patients with rheumatoid arthritis.
Verduin, Pieter J M; de Bock, Geertruida H; Vliet Vlieland, Theodora P M; Peeters, Andreas J; Verhoef, John; Otten, Wilma
To evaluate the role of purpose in life among people with rheumatoid arthritis (RA), a questionnaire comprising the Purpose in Life test (PIL) and the purpose in life dimension of the Psychological Well-Being test (PWB-pil) was sent to a random sample of 300 patients with RA. Additional questions comprised sociodemographic and disease characteristics, physical, mental and social functioning, coping (Coping with rheumatic stressors questionnaire), and quality of life (RAND-36). Associations between sociodemographic and disease characteristics, physical, mental and social functioning, and coping on the one side and the two measures of purpose in life on the other side and associations between the two purpose of life measures and physical and mental dimensions of quality of life were assessed by means of univariate and multivariate regression analyses. The response rate was 156 of 300 (52%). The median PIL and PWB-pil scores were 103 (range 63-131) and 82 (41-110), respectively. A lower age, a better mental health status, and an optimistic coping style were significantly associated with both higher PIL and PWB-pil scores, whereas more participation in leisure and/or social activities was associated with a higher PIL score. It was found that the PIL and PWB-pil contributed independently and significantly to the mental component summary scale of the RAND-36. In RA patients, lower age, a better mental health status, an optimistic coping style, and participation in leisure and/or social activities were significantly associated with more sense of purpose in life. Purpose in life pays a significant and independent contribution to the mental component of quality of life. These findings highlight the significance of the concept of purpose in life in patients with RA.
Impaired mental rotation in benign paroxysmal positional vertigo and acute vestibular neuritis
Candidi, Matteo; Micarelli, Alessandro; Viziano, Andrea; Aglioti, Salvatore M.; Minio-Paluello, Ilaria; Alessandrini, Marco
Vestibular processing is fundamental to our sense of orientation in space which is a core aspect of the representation of the self. Vestibular information is processed in a large subcortical–cortical neural network. Tasks requiring mental rotations of human bodies in space are known to activate neural regions within this network suggesting that vestibular processing is involved in the control of mental rotation. We studied whether mental rotation is impaired in patients suffering from two different forms of unilateral vestibular disorders (vestibular neuritis – VN – and Benign Paroxysmal positional Vertigo – BPPV) with respect to healthy matched controls (C). We used two mental rotation tasks in which participants were required to: (i) mentally rotate their own body in space (egocentric rotation) thus using vestibular processing to a large extent and (ii) mentally rotate human figures (allocentric rotation) thus using own body representations to a smaller degree. Reaction times and accuracy of responses showed that VN and BPPV patients were impaired in both tasks with respect to C. Significantly, the pattern of results was similar in the three groups suggesting that patients were actually performing the mental rotation without using a different strategy from the control individuals. These results show that dysfunctional vestibular inflow impairs mental rotation of both own body and human figures suggesting that unilateral acute disorders of the peripheral vestibular input massively affect the cerebral processes underlying mental rotations. PMID:24324422
Coupling of Temperament with Mental Illness in Four Age Groups.
Trofimova, Irina; Christiansen, Julie
Studies of temperament profiles in patients with mental disorders mostly focus on emotionality-related traits, although mental illness symptoms include emotional and nonemotional aspects of behavioral regulation. This study investigates relationships between 12 temperament traits (9 nonemotionality and 3 emotionality related) measured by the Structure of Temperament Questionnaire and four groups of clinical symptoms (depression, anxiety, antisociality, and dominance-mania) measured by the Personality Assessment Inventory. The study further examines age differences in relationships among clinical symptoms and temperament traits. Intake records of 335 outpatients and clients divided into four age groups (18-25, 26-45, 46-65, and 66-85) showed no significant age differences on depression scales; however, the youngest group had significantly higher scores on Anxiety, Antisocial Behavior, Dominance, and Thought Disorders scales. Correlations between Personality Assessment Inventory and Structure of Temperament Questionnaire scales were consistent with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, descriptors showing strong concurrent validity. Several age differences on temperament scales are also reported. Results show the benefits of differentiation between physical, social-verbal, and mental aspects of activities, as well as differentiation between dynamical, orientational, and energetic aspects in studying mental illness and temperament.
Approach to risk identification in undifferentiated mental disorders
Silveira, José; Rockman, Patricia; Fulford, Casey; Hunter, Jon
Abstract Objective To provide primary care physicians with a novel approach to risk identification and related clinical decision making in the management of undifferentiated mental disorders. Sources of information We conducted a review of the literature in PubMed, CINAHL, PsycINFO, and Google Scholar using the search terms diagnostic uncertainty, diagnosis, risk identification, risk assessment/methods, risk, risk factors, risk management/methods, cognitive biases and psychiatry, decision making, mental disorders/diagnosis, clinical competence, evidence-based medicine, interviews as topic, psychiatry/education, psychiatry/methods, documentation/methods, forensic psychiatry/education, forensic psychiatry/methods, mental disorders/classification, mental disorders/psychology, violence/prevention and control, and violence/psychology. Main message Mental disorders are a large component of practice in primary care and often present in an undifferentiated manner, remaining so for prolonged periods. The challenging search for a diagnosis can divert attention from risk identification, as diagnosis is commonly presumed to be necessary before treatment can begin. This might inadvertently contribute to preventable adverse events. Focusing on salient aspects of the patient presentation related to risk should be prioritized. This article presents a novel approach to organizing patient information to assist risk identification and decision making in the management of patients with undifferentiated mental disorders. Conclusion A structured approach can help physicians to manage the clinical uncertainty common to risk identification in patients with mental disorders and cope with the common anxiety and cognitive biases that affect priorities in risk-related decision making. By focusing on risk, functional impairments, and related symptoms using a novel framework, physicians can meet their patients' immediate needs while continuing the search for diagnostic clarity and long
Facts About: College Mental Health.
ERIC Educational Resources Information Center
National Inst. of Mental Health (DHEW), Rockville, MD.
Facts about college mental health are presented in response to frequently asked questions. Areas of concern include common conditions interfering with student effectiveness, why students seek help and where they can get it, the frequency of severe mental illness in college students, the suicide problem, the limitations of nonprofessional help, the…
Tips for Mental Health Interpretation
ERIC Educational Resources Information Center
Whitsett, Margaret
This paper offers tips for working with interpreters in mental health settings. These tips include: (1) Using trained interpreters, not bilingual staff or community members; (2) Explaining "interpreting procedures" to the providers and clients; (3) Addressing the stigma associated with mental health that may influence interpreters; (4) Defining…
Mental Models: A Robust Definition
ERIC Educational Resources Information Center
Rook, Laura
Purpose: The concept of a mental model has been described by theorists from diverse disciplines. The purpose of this paper is to offer a robust definition of an individual mental model for use in organisational management. Design/methodology/approach: The approach adopted involves an interdisciplinary literature review of disciplines, including…
Psychiatric-Mental Health Nursing.
ERIC Educational Resources Information Center
Reighley, Joan
A description is provided of a course, "Psychiatric-Mental Health Nursing," designed to teach students at Level 3 of a two-year college nursing program about the role of the nurse in a psychiatric setting and about concepts of mental health and psychiatric disorders, using both classroom and clinical instruction. The first section of the course…
Mental Health & the Career Clusters.
ERIC Educational Resources Information Center
Welch, Marty
This supplement to ninth grade mental health units relates mental health to the following occupational clusters: agribusiness and natural resources, environment, health, marine science, communications and media, business and office, marketing and distribution, public service, transportation, personnel services, consumer and homemaking education,…
International Collaboration in Mental Health.
ERIC Educational Resources Information Center
Brown, Bertram S., Ed.; Torrey, E. Fuller, Ed.
Presented in five parts on research, services, training, drug abuse, and alcohol abuse are 31 reports of mental health studies and programs supported by the U.S. and other countries. Explained in the introduction are reasons the National Institute of Mental Health (NIMH) has supported international collaboration. The following are among subjects…
Children's Knowledge of Mental Retardation.
ERIC Educational Resources Information Center
Budoff, Milton; And Others
A survey of 1,142 normal students in grades 4 through 12 indicated that they knew very little about mental retardation and the mentally retarded. Only about half of the respondents made reference to "subaverage general intellectual functioning," while references to physical impairment were frequent. (DLS)
Mental Health, United States, 2000.
ERIC Educational Resources Information Center
Manderscheid, Ronald W., Ed.; Henderson, Marilyn J., Ed.
In recent years, the mental health community has made great strides in understanding more about the delivery of mental health services, improving efficiency and quality in services, and also about how to build strengths and resilience in the face of lifes stresses. This volume adds to the knowledge base so that the important task of system change…
Mental Health Screening in Schools
ERIC Educational Resources Information Center
Weist, Mark D.; Rubin, Marcia; Moore, Elizabeth; Adelsheim, Steven; Wrobel, Gordon
Background: This article discusses the importance of screening students in schools for emotional/behavioral problems. Methods: Elements relevant to planning and implementing effective mental health screening in schools are considered. Screening in schools is linked to a broader national agenda to improve the mental health of children and…
ERIC Educational Resources Information Center
International Students and Mental Health
ERIC Educational Resources Information Center
Forbes-Mewett, Helen; Sawyer, Anne-Maree
Since the early 2000s, reports of increased rates of mental ill health among young people worldwide have received much attention. Several studies indicate a greater incidence of mental health problems among tertiary students, compared with the general population, and higher levels of anxiety, in particular, among international students compared…
Schizophrenia in the Mentally Retarded.
ERIC Educational Resources Information Center
Menolascino, Frank J.
The relationship between schizophrenia and mental retardation is examined. Historical associations between symptoms of the two disorders are reviewed, and a 3-year study of the incidence (14%) of mental illness in 798 retarded individuals in a community based program is described. Information on the etiological, developmental, and phenomenological…
ERIC Educational Resources Information Center
Moore, Jay
Psychologists and philosophers have long been interested in two questions: (a) What do mental terms mean? and (b) what role do mental terms play in explanations of behavior? In the current sketch I review how mediational neobehaviorism, cognitive psychology, and the radical behaviorism of B. F. Skinner address these questions. In so doing, I seek…
The Nevada mental health courts.
Palermo, George B
The deinstitutionalization of the mentally ill which started in the 1960s greatly contributed to the overcrowding of judicial systems throughout the world. In the ensuing years, the actors involved in the adversarial system present in United States courts, a system that is primarily interested in assessing the culpability of the offender, have come to realize that the system is lacking therapeutic and reintegrative approaches to offenders, especially those who are mentally ill. Therapeutic jurisprudence, an interdisciplinary science, addresses this problematic situation of the mentally ill. It offers a fresh insight into the potentially beneficial and detrimental effects of legal decisions and views one of the roles of law as that of a healing agent. At present, many states have instituted mental health courts based on these concepts, incorporating previous drug court experiences. Their goal is to avoid the criminalization of the mentally ill and their recidivism through the creation of special programs. This article describes the mental health court programs of Washoe County and Clark County, Nevada, their organization, their therapeutic goals, and their success in keeping mentally ill offenders out of the correctional system, while improving their mental condition. In so doing, the program has lightened the load of the overburdened courts and has greatly diminished the financial burden incurred for court trials and jail and prison stays.
Juvenile justice mental health services.
Thomas, Christopher R; Penn, Joseph V
As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth [58]. The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services [59]. Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system
Nutritional Factors Affecting Mental Health
Lim, So Young; Kim, Eun Jin; Kim, Arang; Lee, Hee Jae; Choi, Hyun Jin
Dietary intake and nutritional status of individuals are important factors affecting mental health and the development of psychiatric disorders. Majority of scientific evidence relating to mental health focuses on depression, cognitive function, and dementia, and limited evidence is available about other psychiatric disorders including schizophrenia. As life span of human being is increasing, the more the prevalence of mental disorders is, the more attention rises. Lists of suggested nutritional components that may be beneficial for mental health are omega-3 fatty acids, phospholipids, cholesterol, niacin, folate, vitamin B6, and vitamin B12. Saturated fat and simple sugar are considered detrimental to cognitive function. Evidence on the effect of cholesterol is conflicting; however, in general, blood cholesterol levels are negatively associated with the risk of depression. Collectively, the aims of this review are to introduce known nutritional factors for mental health, and to discuss recent issues of the nutritional impact on cognitive function and healthy brain aging. PMID:27482518
[Anomie and public mental health].
Parales-Quenza, Carlos J
This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.
Fellinger, Johannes; Holzinger, Daniel; Pollard, Robert
Deafness is a heterogeneous condition with far-reaching effects on social, emotional, and cognitive development. Onset before language has been established happens in about seven per 10,000 people. Increased rates of mental health problems are reported in deaf people. Many regard themselves as members of a cultural minority who use sign language. In this Review, we describe discrepancies between a high burden of common mental health disorders and barriers to health care. About a quarter of deaf individuals have additional disabilities and a high probability of complex mental health needs. Research into factors affecting mental health of deaf children shows that early access to effective communication with family members and peers is desirable. Improved access to health and mental health care can be achieved by provision of specialist services with professionals trained to directly communicate with deaf people and with sign-language interpreters.
[Mentalization and theory of mind].
Wyl, Agnes
Both concepts, mentalization and the theory of mind, describe metacognitive processes. Mentalization mainly concerns the reflection of affective mental states. In contrast, theory of mind focuses on epistemic states such as beliefs, intentions and persuasions. Gender differences have proved to be relevant for both, the development of mentalization and the theory of mind. However, there are few studies and findings are inconsistent. In an own study, we investigated the relationship between early competences in metacognition (tested in a false-belief-task second order) and narrative skills of kindergarten children. Results show that children who had successfully passed the theory of mind test tended to face conflicts more directly in the stories. In consequence, these children showed less narrative avoidance. However, differences were only found in girls and not in boys. The precise understanding of developmental differences in metacognition between girls and boys may be an important aspect with regards to improving mentalization based therapy of children.
Smartphone Applications for Mental Health.
Radovic, Ana; Vona, Pamela L; Santostefano, Antonella M; Ciaravino, Samantha; Miller, Elizabeth; Stein, Bradley D
Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.
[Mentalization and attachment transmission].
Böhmann, Johann; Fritsch, Sophia; Lück, Monika; Stumpe, Anna; Taubner, Svenja; Vesterling, Christina
The present study was investigating the predictive role of maternal mentalizing and general as well as depressive symptom burden for attachment security at the end of the first year on a sample of 44 mother-child-dyads from a low-risk community study. Maternal mentalizing was assessed in a multidimensional way as Reflective Functioning (off-line) and Mind-Mindedness (on-line). The design was longitudinal measuring maternal Mind-Mindedness from a videotaped mother-child-play-interaction at the age of three months. General and depressive symptom burden was assessed using the SCL-90-R when the children were nine months old. Maternal attachment and Reflective-Functioning, using the Adult-Attachment-Interview, as well as children's attachment behavior, using the Strange-Situation-Test, were investigated at the age of twelve months. Secure maternal attachment was associated with higher Reflective Functioning, higher frequency of Mind-Mindedness and lower general and depressive symptom burden. A moderation-analysis showed a statistical trend (p = .08) that the interaction of the frequency of mind-related comments, general symptom severity and maternal attachment has a predictive value for infantile attachment security. Results can be tentatively interpreted that mothers with insecure attachment who had a lower general symptom burden and who related to their three-months old babies with a high frequency of mind-related-comments were more likely to have securely attached children. Thus, results may serve as a groundwork for projects aiming to prevent the transmission of insecure attachment by strengthening maternal Mind-Mindedness and working on the reduction of maternal general symptom burden.
Mental stress and human cardiovascular disease.
Esler, Murray
The London physician and neuroanatomist Thomas Willis in the 17th century correctly attributed the source of emotions to the brain, not the heart as believed in antiquity. Contemporary research documents the phenomenon of "triggered" heart disease, when the autonomic nervous system control of the heart by the brain goes awry, producing heart disease of sudden onset, precipitated by acute emotional upheaval. This can take the form of, variously, cardiac arrhythmias, myocardial infarction, Takotsubo cardiomyopathy and sudden death. Chronic psychological distress also can have adverse cardiovascular consequences, in the causal linkage of depressive illness to heart disease, and in the probable causation of atherosclerosis and hypertension by chronic mental stress. In patients with essential hypertension, stress biomarkers are present. The sympathetic nervous system is the usual mediator between these acute and chronic psychological substrates and cardiovascular disease.
[Lobotomy and leucotomy in Brazilian mental hospitals].
Masiero, André Luis
Lobotomy and leucotomy were used in Brazilian mental institutions from 1936 to 1956. Also called psycho-surgeries, they were operations that separated the right and left frontal lobes and pre-frontal lobes from the rest of the brains, aiming at modifying behavior or curing mental diseases. The technique, created by the Portuguese neurologist Egas Moniz in 1935 and developed by Walter Freeman from the United States, arrived in Brazil through the hands of Aloysio Mattos Pimenta, neurologist from Hospital PsiquiátricoJuquely in São Paulo. Soon, many doctors followed suit. These procedures were used on more than a thousand in-patients aiming at not only healing results, but also the technical improvement of the surgical technique, since preliminary experiments with animals were quite rare at the time. In Brazil, the technique was used until 1956, when it was considered as going against the 1947 Nuremberg Code, whose objective was to detain and regulate the medical experiments with human beings made during the Second World War.
Mental health and family planning.
David, H P
It is known that unwanted pregnancies have damaging consequences. Despite the fact that 97% of fecund U.S. women have used or expect to use contraception, more than 1/2 of the births were reported by married couples in 1965 as unplanned. The circular relationship between excess fertility and conditions of poverty and their relevance for mental health has been studied; results have shown that in large families there is a great likelihood that the last-born child is unwanted. It is also true that in families with 4 or more children, those in the last half of the birth order are more likely to develop mental illness than their older siblings. One way to reduce unwanted pregnancies is to enable couples to have children only with their own informed consent. Induced abortion must be among the available alternatives for the women desiring it. The role of unregulated fertility in the etiology of mental disorder is seldon explored. Systematic observations of the mental health consequences of unwanted pregnancies are rare. Similarly, the appropriateness of applying family planning concepts in preventive mental health programs has received little attention. Sex education and contraceptive information should be introduced when a girl reaches menarche. Closer work between mental health association, medical schools, general practitioners, etc., is needed urgently. The author maintains that the prevalence of unwanted pregnancies and the appalling numbers of unwanted births in the U.S today represent a mental health problem of undefined but clearly immense proportions.
Disaster Management: Mental Health Perspective
Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C.
Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health. PMID:26664073
Development and neurophysiology of mentalizing.
Frith, Uta; Frith, Christopher D
The mentalizing (theory of mind) system of the brain is probably in operation from ca. 18 months of age, allowing implicit attribution of intentions and other mental states. Between the ages of 4 and 6 years explicit mentalizing becomes possible, and from this age children are able to explain the misleading reasons that have given rise to a false belief. Neuroimaging studies of mentalizing have so far only been carried out in adults. They reveal a system with three components consistently activated during both implicit and explicit mentalizing tasks: medial prefrontal cortex (MPFC), temporal poles and posterior superior temporal sulcus (STS). The functions of these components can be elucidated, to some extent, from their role in other tasks used in neuroimaging studies. Thus, the MPFC region is probably the basis of the decoupling mechanism that distinguishes mental state representations from physical state representations; the STS region is probably the basis of the detection of agency, and the temporal poles might be involved in access to social knowledge in the form of scripts. The activation of these components in concert appears to be critical to mentalizing. PMID:12689373
Somali Refugees' Perceptions of Mental Illness.
Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie
Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.
Economic Stress and Mental Health
Butts, Hugh F.
This paper correlates economic stress with minority status, resource allocations for mental health programs, and vulnerability to mental disability. Several hypotheses are advanced: 1. A major and recurring psychological pattern of the American national character is prowhite, antiblack paranoia. 2. Mental health fiscal allocations and programmatic determinations in ghetto, lower socioeconomic, minority-populated urban areas are predicated on political and racist considerations, the underlying motivation being to keep minorities at greater risk of mental disability. 3. Economic privation and stress increase vulnerability to mental illness, especially in a minority population for whom health, mental health, educational, and social services are grossly inadequate. 4. Poverty and economic stress combine with health systems that are unresponsive to the needs of blacks and other minorities, resulting in the perpetuation of disabilities and other conditions in blacks that are potentially preventable. 5. Health and mental health resources should be increased rather than diminished during periods of economic stress, especially in the public sector. 6. In order to provide each citizen with access to quality health and mental health care regardless of race and/or economic status, there must be enacted a national health insurance program based on tax-levy monies that will cover all aspects of health and mental health care. 7. Racism and social status will continue to be powerful determinants of the quality of service that white professionals render to black patients and to poor white patients, unless our training institutions mount a massive campaign to train appropriately and to include significant numbers of minority candidates and trainees in the effort. To date this effort is virtually nonexistent. PMID:439171
Mental Health: Overcoming the Stigma of Mental Illness
... social activities or trouble finding housing Bullying, physical violence or harassment Health insurance that doesn't adequately cover your mental illness treatment The belief that you'll never be ...
Mental illness and criminal violence.
Tehrani, J A; Brennan, P A; Hodgins, S; Mednick, S A
This article examines the relationship between criminal violence and mental illness. Our data suggest that mentally ill persons tend to have an increased risk for committing violent offenses, and that the violent offending by these individuals tends to be recidivistic. Our findings suggest that parents who have both committed violent offenses and experienced a psychiatric hospitalization increase the risk of violent offending among their offspring. We propose the hypothesis that mentally ill parents transmit a biological characteristic which may genetically predispose their child towards criminal violence. Prenatal disturbances during critical periods of fetal development may provide clues regarding the etiology of criminal violence.
Promoting Mental Health and Preventing Mental Illness in General Practice.
Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona
This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.
Promoting Mental Health and Preventing Mental Illness in General Practice
Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona
Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821
Are developments in mental scanning and mental rotation related?
Wimmer, Marina C.; Robinson, Elizabeth J.; Doherty, Martin J.
The development and relation of mental scanning and mental rotation were examined in 4-, 6-, 8-, 10-year old children and adults (N = 102). Based on previous findings from adults and ageing populations, the key question was whether they develop as a set of related abilities and become increasingly differentiated or are unrelated abilities per se. Findings revealed that both mental scanning and rotation abilities develop between 4- and 6 years of age. Specifically, 4-year-olds showed no difference in accuracy of mental scanning and no scanning trials whereas all older children and adults made more errors in scanning trials. Additionally, the minority of 4-year-olds showed a linear increase in response time with increasing rotation angle difference of two stimuli in contrast to all older participants. Despite similar developmental trajectories, mental scanning and rotation performances were unrelated. Thus, adding to research findings from adults, mental scanning and rotation appear to develop as a set of unrelated abilities from the outset. Different underlying abilities such as visual working memory and spatial coding versus representing past and future events are discussed. PMID:28207810
Cognitive mapping in mental time travel and mental space navigation.
Gauthier, Baptiste; van Wassenhove, Virginie
The ability to imagine ourselves in the past, in the future or in different spatial locations suggests that the brain can generate cognitive maps that are independent of the experiential self in the here and now. Using three experiments, we asked to which extent Mental Time Travel (MTT; imagining the self in time) and Mental Space Navigation (MSN; imagining the self in space) shared similar cognitive operations. For this, participants judged the ordinality of real historical events in time and in space with respect to different mental perspectives: for instance, participants mentally projected themselves in Paris in nine years, and judged whether an event occurred before or after, or, east or west, of where they mentally stood. In all three experiments, symbolic distance effects in time and space dimensions were quantified using Reaction Times (RT) and Error Rates (ER). When self-projected, participants were slower and were less accurate (absolute distance effects); participants were also faster and more accurate when the spatial and temporal distances were further away from their mental viewpoint (relative distance effects). These effects show that MTT and MSN require egocentric mapping and that self-projection requires map transformations. Additionally, participants' performance was affected when self-projection was made in one dimension but judgements in another, revealing a competition between temporal and spatial mapping (Experiment 2 & 3). Altogether, our findings suggest that MTT and MSN are separately mapped although they require comparable allo- to ego-centric map conversion.
[Face recognition in patients with schizophrenia].
Doi, Hirokazu; Shinohara, Kazuyuki
It is well known that patients with schizophrenia show severe deficiencies in social communication skills. These deficiencies are believed to be partly derived from abnormalities in face recognition. However, the exact nature of these abnormalities exhibited by schizophrenic patients with respect to face recognition has yet to be clarified. In the present paper, we review the main findings on face recognition deficiencies in patients with schizophrenia, particularly focusing on abnormalities in the recognition of facial expression and gaze direction, which are the primary sources of information of others' mental states. The existing studies reveal that the abnormal recognition of facial expression and gaze direction in schizophrenic patients is attributable to impairments in both perceptual processing of visual stimuli, and cognitive-emotional responses to social information. Furthermore, schizophrenic patients show malfunctions in distributed neural regions, ranging from the fusiform gyrus recruited in the structural encoding of facial stimuli, to the amygdala which plays a primary role in the detection of the emotional significance of stimuli. These findings were obtained from research in patient groups with heterogeneous characteristics. Because previous studies have indicated that impairments in face recognition in schizophrenic patients might vary according to the types of symptoms, it is of primary importance to compare the nature of face recognition deficiencies and the impairments of underlying neural functions across sub-groups of patients.
Nizamie, S. Haque; Katshu, Mohammad Zia Ul Haq; Uvais, N. A.
Human experience in, health and disease, always has a spiritual dimension. pirituality is accepted as one of the defining determinants of health and it no more remains a sole preserve of religion and mysticism. In recent years, pirituality has been an area of research in neurosciences and both in the nderstanding of psychiatric morbidity and extending therapeutic interventions it seems to be full of promises. Sufism has been a prominent spiritual tradition in Islam deriving influences from major world religions, such as, Christianity and Hinduism and contributing substantially toward spiritual well-being of a large number of people within and outside Muslim world. Though Sufism started in early days of Islam and had many prominent Sufis, it is in the medieval period it achieved great height culminating in many Sufi orders and their major proponents. The Sufism aims communion with God through spiritual realization; soul being the agency of this communion, and propounding the God to be not only the cause of all existence but the only real existence. It may provide a vital link to understand the source of religious experience and its impact on mental health. PMID:23858257
Nizamie, S Haque; Katshu, Mohammad Zia Ul Haq; Uvais, N A
Human experience in, health and disease, always has a spiritual dimension. pirituality is accepted as one of the defining determinants of health and it no more remains a sole preserve of religion and mysticism. In recent years, pirituality has been an area of research in neurosciences and both in the nderstanding of psychiatric morbidity and extending therapeutic interventions it seems to be full of promises. Sufism has been a prominent spiritual tradition in Islam deriving influences from major world religions, such as, Christianity and Hinduism and contributing substantially toward spiritual well-being of a large number of people within and outside Muslim world. Though Sufism started in early days of Islam and had many prominent Sufis, it is in the medieval period it achieved great height culminating in many Sufi orders and their major proponents. The Sufism aims communion with God through spiritual realization; soul being the agency of this communion, and propounding the God to be not only the cause of all existence but the only real existence. It may provide a vital link to understand the source of religious experience and its impact on mental health.
Behavior Rhythms in Mental Hospitals
ERIC Educational Resources Information Center
Melbin, Murray
Research supported by a Russell Sage Foundation Residency Fellowship, National Science Foundation grant GL0919, National Institute of Mental Health grant M-5702(A), and National Institutes of Health grant RO2-NU-00251.
Warning Signs of Mental Illnesses
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Student Attitudes Toward Mental Illness
ERIC Educational Resources Information Center
Hare-Mustin, Rachel T.; Garvine, Richard
Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)
The Burden of Mental Disorders
Eaton, William W.; Martins, Silvia S.; Nestadt, Gerald; Bienvenu, O. Joseph; Clarke, Diana; Alexandre, Pierre
In the last decade, there has been an increase in interest in the burden of chronic and disabling health conditions that are not necessarily fatal, such as the mental disorders. This review systematically summarizes data on the burden associated with 11 major mental disorders of adults. The measures of burden include estimates of prevalence, mortality associated with the disorders, disabilities and impairments related to the disorders, and costs. This review expands the range of mental disorders considered in a report on the global burden of disease, updates the literature, presents information on the range and depth of sources of information on burden, and adds estimates of costs. The purpose is to provide an accessible guide to the burden of mental disorders, especially for researchers and policy makers who may not be familiar with this subfield of epidemiology. PMID:18806255
Moore, Alison
The Five Year Forward View could be a turning point in the battle to get mental health parity with physical health, address long waiting times and unmet need, and ensure people get care close to home.
Mental Illness and Juvenile Offenders
Underwood, Lee A.; Washington, Aryssa
Within the past decade, reliance on the juvenile justice system to meet the needs of juvenile offenders with mental health concerns has increased. Due to this tendency, research has been conducted on the effectiveness of various intervention and treatment programs/approaches with varied success. Recent literature suggests that because of interrelated problems involved for youth in the juvenile justice system with mental health issues, a dynamic system of care that extends beyond mere treatment within the juvenile justice system is the most promising. The authors provide a brief overview of the extent to which delinquency and mental illness co-occur; why treatment for these individuals requires a system of care; intervention models; and the juvenile justice systems role in providing mental health services to delinquent youth. Current and future advancements and implications for practitioners are provided. PMID:26901213
Mental Illness and Juvenile Offenders.
Underwood, Lee A; Washington, Aryssa
Within the past decade, reliance on the juvenile justice system to meet the needs of juvenile offenders with mental health concerns has increased. Due to this tendency, research has been conducted on the effectiveness of various intervention and treatment programs/approaches with varied success. Recent literature suggests that because of interrelated problems involved for youth in the juvenile justice system with mental health issues, a dynamic system of care that extends beyond mere treatment within the juvenile justice system is the most promising. The authors provide a brief overview of the extent to which delinquency and mental illness co-occur; why treatment for these individuals requires a system of care; intervention models; and the juvenile justice systems role in providing mental health services to delinquent youth. Current and future advancements and implications for practitioners are provided.
Child and Adolescent Mental Health
... Chats with Experts Clinical Trials Share Child and Adolescent Mental Health Overview Teen Depression Study: Understanding Depression ... Continue reading Recruitment Begins for Landmark Study of Adolescent Brain Development September 13, 2016 • Press Release The ...
The Autonomy of Mental Models.
ERIC Educational Resources Information Center
Fischbein, Efraim; And Others
Described is research which sought to prove the hypothesis that mental models tend to preserve their autonomy with regard to the originals they are meant to represent. The results of this investigation involving 200 Israeli students are presented. (CW)
Rehabilitation of mentally ill women
Chatterjee, Rajni; Hashim, Uzma
Women, the fair sex, are principal providers of care and support to families. But, they are considered to be the weaker sex and one of the most powerless and marginalized sections of our society. The provision of Rehabilitation for mentally ill women has been, and still is, one of the major challenges for mental health systems reform in the last decades, for various reasons. The present paper discusses the global and Indian scenario of rehabilitation of mentally ill women and goes on to detail the contribution of the state and voluntary agencies in this regard. It explores the need of recovery, multilayered strategy of Rehabilitation services and the availability of present services. The stigma attached and legal defects which interfere in good quality of life for the mentally ill women are reviewed. Strategies for changes in future are recommended. PMID:26330653
Adolescent offenders with mental disorders.
Grisso, Thomas
Thomas Grisso points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its consequences for the community. In this article, Grisso examines research and clinical evidence that may help in shaping a public policy that addresses that question. Clinical science, says Grisso, offers a perspective that explains why the symptoms of mental disorders in adolescence can increase the risk of impulsive and aggressive behaviors. Research on delinquent populations suggests that youth with mental disorders are, indeed, at increased risk for engaging in behaviors that bring them to the attention of the juvenile justice system. Nevertheless, evidence indicates that most youth arrested for delinquencies do not have serious mental disorders. Grisso explains that a number of social phenomena of the past decade, such as changes in juvenile law and deficiencies in the child mental health system, appear to have been responsible for bringing far more youth with mental disorders into the juvenile justice system. Research shows that almost two-thirds of youth in juvenile justice detention centers and correctional facilities today meet criteria for one or more mental disorders. Calls for a greater emphasis on mental health treatment services in juvenile justice, however, may not be the best answer. Increasing such services in juvenile justice could simply mean that youth would need to be arrested in order to get mental health services. Moreover, many of the most effective treatment methods work best when applied in the community, while youth are with their families rather than removed from them. A more promising approach, argues Grisso, could be to develop community systems of care that create a network of services cutting across public child
Angina and Mental Stress-Induced Myocardial Ischemia
Pimple, Pratik; Shah, Amit J.; Rooks, Cherie; Bremner, J. Douglas; Nye, Jonathon; Ibeanu, Ijeoma; Raggi, Paolo; Vaccarino, Viola
Objective Mental stress-induced myocardial ischemia is a common phenomenon in patients with coronary artery disease (CAD) and an emerging prognostic factor. Mental stress ischemia is correlated with ambulatory ischemia. However, whether it is related to angina symptoms during daily life has not been examined. Methods We assessed angina-frequency (past month) in 98 post-myocardial infarction (MI) subjects (age 18-60 years) using the Seattle Angina Questionnaire. Patients underwent [99mTc]sestamibi SPECT perfusion imaging at rest, after mental stress, and after exercise/pharmacological stress. Summed scores of perfusion abnormalities were obtained by observer-independent software. A summed-difference score (SDS), the difference between stress and rest scores, was used to quantify myocardial ischemia under both stress conditions. Results The mean age was 50 years, 50% were female and 60% were non-white. After adjustment for age, sex, smoking, CAD-severity, depressive, anger and anxiety symptoms, each 1-point increase in mental-stress SDS was associated with 1.73-unit increase in the angina-frequency score (95% CI: 0.09-3.37) and 17% higher odds of being in a higher angina-frequency category (OR: 1.17, 95% CI: 1.00-1.38). Depressive symptoms were associated with 12% higher odds of being in a higher angina-frequency category (OR: 1.12, 95% CI: 1.03-1.21). In contrast, exercise/pharmacological stress-induced SDS was not associated with angina-frequency. Conclusion Among young and middle-aged post-MI patients, myocardial ischemia induced by mental stress in the lab, but not by exercise/pharmacological stress, is associated with higher frequency of retrospectively reported angina during the day. Psychosocial stressors related to mental stress ischemia may be important contributory factor to daily angina. PMID:25727240
Combating the Stigma of Mental Illness. Revised.
ERIC Educational Resources Information Center
National Inst. of Mental Health (DHHS), Rockville, MD.
Many former mental patients see their biggest problem in resuming community life to be their inability to be accepted by other people. The National Institute of Mental Health has worked to remove the stigma associated with mental illness and research has unraveled many of the mysteries about the origins of mental illness. Deinstitutionalization,…
Mental health in Tamil cinema.
Mangala, R; Thara, R
Tamil cinema is a vibrant part of the lives of many in south India. A chequered history and a phenomenal growth have made this medium highly influential not only in Tamil Nadu politics, but also in the social lives of the viewers. This paper provides an overview of the growth of Tamil cinema, and discusses in detail the way mental health has been handled by Tamil films. Cinema can be used very effectively to improve awareness about mental health issues.
Making mental health a priority in Belize.
Killion, Cheryl; Cayetano, Claudina
Belize, Central America, the most sparsely populated country in Central America, has taken gigantic steps to improve the mental health of its citizens. This article profiles mental health in this country and explicates contextual factors circumscribing manifestations, treatment, and care of mental illness. An overview of mental health services is provided, with particular focus on the role of psychiatric nurse practitioners. Other innovative approaches in promoting mental health and providing care to the those who are mentally ill are highlighted. Current and future challenges for nursing care and mental health services are presented. Recommendations for future action are offered.
New Percepts via Mental Imagery?
Mast, Fred W.; Tartaglia, Elisa M.; Herzog, Michael H.
We are able to extract detailed information from mental images that we were not explicitly aware of during encoding. For example, we can discover a new figure when we rotate a previously seen image in our mind. However, such discoveries are not "really" new but just new "interpretations." In two recent publications, we have shown that mental imagery can lead to perceptual learning (Tartaglia et al., 2009, 2012). Observers imagined the central line of a bisection stimulus for thousands of trials. This training enabled observers to perceive bisection offsets that were invisible before training. Hence, it seems that perceptual learning via mental imagery leads to new percepts. We will argue, however, that these new percepts can occur only within "known" models. In this sense, perceptual learning via mental imagery exceeds new discoveries in mental images. Still, the effects of mental imagery on perceptual learning are limited. Only perception can lead to really new perceptual experience. PMID:23060830
Mental Retardation. Fact Sheet = El Retraso Mental. Hojas Informativas Sobre Discapacidades.
ERIC Educational Resources Information Center
National Information Center for Children and Youth with Disabilities, Washington, DC.
This fact sheet on mental retardation is written in both English and Spanish. It begins with a vignette of a 15-year-old boy with mental retardation. Mental retardation is briefly explained as are some causes of mental retardation. It notes that a diagnosis of mental retardation looks at two things: first, the ability of a person's brain to learn,…
The structural reform of mental health services.
Haver, Eitan; Baruch, Yehuda; Kotler, Moshe
During past decades many countries have initiated extensive mental health care system reforms, and the main goal of these reforms has been the transfer of treatment of the mentally ill from psychiatric hospitals to the community. For example, assessment of the results of these reforms in Italy and Austria demonstrates considerable reduction in the number of psychiatric beds, higher quality and more available community services, and increased total expenditure for mental health services. However, because sufficient data is not yet available, many questions regarding how these reforms impact improvement in patient clinical parameters remain unanswered. Some of the answers to these questions can be gleaned from the results of research carried out in the United States and Canada in the 1980s. This research evaluated transfer of psychiatric treatment from a hospital setting to a community service setting. The results demonstrated that community treatment models were more effective than a hospital treatment model in reducing the number of hospitalizations and shortening length of stay. Patient monitoring also demonstrated good integration into the community. However, alongside the research supporting these reforms, there is some research that demonstrates a number of possible disadvantages: an increase in the number of homeless and in the mortality rate among psychiatric patients, and an increase in rehospitalization rates of chronically ill patients," referred to as the "Revolving Door Syndrome." To avoid the disadvantages that could possibly accompany the reform, particular attention needs to be given to planning and funding, so that development of community services and reduction in psychiatric hospital system correspond. Care must be taken to ensure that the number and the geographic location of these services meets the need of the population at risk, and that staff is available and well trained. A monitoring system should be set in place to monitor the patients
Smoking cessation and reduction in people with chronic mental illness.
Tidey, Jennifer W; Miller, Mollie E
The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness.
Malaysia mental health country profile.
Parameshvara Deva, M
Malaysia is a tropical country in the heart of south east Asia with a population of 24 million people of diverse ethnic, cultural and religious backgrounds living in harmony in 330,000 km(2) of land on the Asian mainland and Borneo. Malaysia, which lies on the crossroads of trade between east and west Asia, has an ancient history as a centre of trading attracting commerce between Europe, west Asia, India and China. It has had influences from major powers that dominated the region throughout its history. Today the country, after independence in 1957, has embarked on an ambitious development project to make it a developed country by 2020. In this effort the economy has changed from one producing raw material to one manufacturing consumer goods and services and the colonial health system has been overhauled and social systems strengthened to provide better services for its people. The per capita income, which was under 1,000 US dollars at independence, has now passed 4,000 US dollars and continues to grow, with the economy largely based on strong exports that amount to over 100 billion US dollars. The mental health system that was based on institutional care in four mental hospitals at independence from British colonial rule in 1957 with no Malaysian psychiatrists is today largely based on over 30 general hospital psychiatric units spread throughout the country. With three local postgraduate training programmes in psychiatry and 12 undergraduate departments of psychiatry in the country--all started after independence--there is now a healthy development of mental health services. This is being supplemented by a newly established primary care mental health service that covers community mental health by integrating mental health into primary health care. Mental health care at the level of psychiatrists rests with about 140 psychiatrists most of whom had undertaken a four-year masters course in postgraduate psychiatry in Malaysia since 1973. However, there continues to be
Endocrine and musculoskeletal abnormalities in patients with Down syndrome.
Hawli, Yousra; Nasrallah, Mona; El-Hajj Fuleihan, Ghada
Down syndrome has a prevalence of one in 500 to one in 1,000 live births and is the most common cause of mental retardation. Most patients are treated in childhood and adolescence for mental or growth retardation. Studies that evaluate bone mass in Down syndrome are limited, and many are small case series in pediatric and adult populations who live either in the community or in residential institutions. Several environmental and hormonal factors contribute to low bone mineral density in such patients. Muscle hypotonia, low amounts of physical activity, poor calcium and vitamin D intakes, hypogonadism, growth retardation and thyroid dysfunction contribute to substantial impairments in skeletal maturation and bone-mass accrual that predispose these patients to fragility fractures. Here, we review indications and limitations of bone-mass measurements in children, summarize the endocrine and skeletal abnormalities in patients presenting with Down syndrome, and review studies that investigate therapeutic strategies for such patients.
Psychiatric Comorbidity in Patients from the Addictive Disorders Assistance Units of Galicia: The COPSIAD Study
Pereiro, César; Pino, Carlos; Flórez, Gerardo; Arrojo, Manuel; Becoña, Elisardo
The objective of this study is to assess the prevalence of psychiatric comorbidity in patients under treatment within the addictive disorders assistance units of Galicia (Spain). Material and Methods A total of 64 healthcare professionals performed clinical diagnosis of mental disorders (on DSM IV-TR criteria) in 2300 patients treated throughout March 2010 in 21 addictive disorders assistance units. Results 56.3% of patients with substance abuse/dependency also showed some other mental disorder, 42.2% of patients suffering from at least an Axis I condition and 20.2% from some Axis II condition. Mood and anxiety disorders and borderline and antisocial personality disorders were the most frequent disorders in both axes. Conclusions A high comorbidity was found between mental and substance use disorders (SUD) in patients seen at the addictive disorders assistance units of Galicia. PMID:23823135
Anxiety and depression in patients with advanced macular degeneration: current perspectives
Cimarolli, Verena R; Casten, Robin J; Rovner, Barry W; Heyl, Vera; Sörensen, Silvia; Horowitz, Amy
Age-related macular degeneration (AMD) – despite advances in prevention and medical treatment options – remains prevalent among older adults, often resulting in functional losses that negatively affect the mental health of older adults. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients. This article reviews the prevalence of anxiety and depression in patients with advanced AMD, discusses potential mechanisms accounting for the development of depression and anxiety in AMD patients, presents the state-of the-art of available interventions for addressing anxiety and depression in AMD patients, and delineates recommendations for eye care professionals regarding how to screen for these two prevalent mental health problems and how to facilitate appropriate treatment for patients with AMD. PMID:26766899
Autism and mental health: your guide to today's mental health issues.
Gould, Judith
Autism is not a mental health disorder, but it sometimes is misdiagnosed as one--and can bring its own mental health issues. Dr Judith Gould explains how a mental health problem may mask an undiagnosed autistic spectrum disorder.
Impact of Intimate Partner Violence on Pregnant Women's Mental Health: Mental Distress and Mental Strength
Rose, Linda; Alhusen, Jeanne; Bhandari, Shreya; Soeken, Karen; Marcantonio, Kristen; Bullock, Linda; Sharps, Phyllis
The mental health consequences of living with intimate partner violence (IPV) are substantial. Despite the growing awareness of the incidence of depression and PTSD in women experiencing IPV, few studies have examined prospectively the experience of IPV during pregnancy and the impact of the abuse on women's mental health. As a component of a larger clinical trial of an intervention for pregnant abused women, 27 women participated in a qualitative study of their responses to the abuse in the context of pregnancy and parenting. Results indicate that women's changing perceptions of self was related to mental distress, mental health, or both mental distress and mental health. PMID:20070224
Mental Illness And Brain Disease.
Bedrick, Jeffrey D
It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.
The Mental Health Status of California Veterans.
Tran, Linda Diem; Grant, David; Aydin, May
Data from the California Health Interview Survey (CHIS) from 2011--2013 showed approximately 90,000 veterans had mental health needs and 200,000 reported serious thoughts of suicide during the 12 months prior to participating in CHIS. Although the proportion of veterans reporting mental health need or serious psychological distress was no higher than the general population, California veterans were more likely to report lifetime suicide ideation. This policy brief uses CHIS data to examine the mental health status, needs, and barriers to care among veterans in California. Veterans were more likely to receive mental health or substance use treatment than nonveterans, yet three of four veterans with mental health needs received either inadequate or no mental health care. Integrating mental and physical health services, increasing access to care, retaining veterans who seek mental health treatment, and reducing stigma are among the strategies that might improve the mental health of California's veterans.
Linkages between community mental health centers and public mental hospitals.
Worley, N K; Lowery, B J
Directors of community mental health centers and superintendents of public mental health hospitals in one state were surveyed to gather data on interagency linkages. Implementation of affiliation agreements, exchange of staff training, and exchange of patient information were investigated. Affiliation agreements tended to be implemented with little difficulty and there was more interagency cooperation than that reported in earlier research. However, exchange of training and staff were still areas of minimal interaction. Geographic proximity was found to have a positive influence and competition a negative influence on cooperation. Further attempts at interagency linkages in the interest of continuity of patient care are recommended.
Balancing professional and team boundaries in mental health services: pursuing the holy grail in Somerset.
Gulliver, Pauline; Peck, Edward; Towell, David
The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge.
Schizotypy and mental time travel.
Winfield, Hannah; Kamboj, Sunjeev K
Mental time travel is the capacity to imagine the autobiographical past and future. Schizotypy is a dimensional measure of psychosis-like traits found to be associated with creativity and imagination. Here, we examine the phenomenological qualities of mental time travel in highly schizotypal individuals. After recollecting past episodes (autobiographical memory) and imagining future events (episodic future thinking), those scoring highly on positive schizotypy reported a greater sense of 'autonoetic awareness,' defined as a greater feeling of mental time travel and re-living/'pre-living' imagined events. Furthermore, in contrast to other sensory domains, imagery of the past and future episodes contained more olfactory detail in these high scorers. The results are discussed in relation to previous reports of anomalous olfactory experiences in schizotypy and heightened vividness of olfactory imagery in post-traumatic stress disorder, for which schizotypy is a risk factor.
'Chronic' identities in mental illness.
von Peter, Sebastian
The term 'chronicity' is still widely used in psychiatric discourse and practice. A category employed in political, administrative and therapeutic contexts, it guides practitioners' beliefs and actions. This paper attempts a review of the attitudes and procedures that result as a consequence of identifying 'chronically' disturbed identities in clinical practice. An essentially social, relational and materialist understanding of mental illness is used to highlight the kind of thinking underlying the notion of 'chronic' identities in day-to-day psychiatric routines. Problematising the notions of singularity and expressiveness, as well as mind/body- and self/other-distinctions, it claims the category itself is responsible for creating a 'chronic' kind of being. A spatial metaphor is presented in the conclusion, illustrating a mental strategy by which we can re-shape our thinking about 'chronic' identities. It attempts to describe how the shift from an epistemological to a praxeographic approach could build a more complete understanding of mental illness.
Adult Neurogenesis and Mental Illness
Schoenfeld, Timothy J; Cameron, Heather A
Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407
Integrating Mental Health In Care For Noncommunicable Diseases: An Imperative For Person-Centered Care.
Patel, Vikram; Chatterji, Somnath
Mental disorders such as depression and alcohol use disorders often co-occur with other common noncommunicable diseases such as diabetes and heart disease. Furthermore, noncommunicable diseases are frequently encountered in patients with severe mental disorders such as schizophrenia. The pathways underlying the comorbidity of mental disorders and noncommunicable diseases are complex. For example, mental and physical noncommunicable diseases may have common environmental risk factors such as unhealthy lifestyles, and treatments for one condition may have side effects that increase the risk of another condition. Building on the robust evidence base for effective treatments for a range of mental disorders, there is now a growing evidence base for how such treatments can be integrated into the care of people with noncommunicable diseases. The best-established delivery model is a team approach that features a nonspecialist case manager who coordinates care with primary care physicians and specialists. This approach maximizes efficiencies in person-centered care, which are essential for achieving universal health coverage for both noncommunicable diseases and mental disorders. A number of research gaps remain, but there is sufficient evidence for policy makers to immediately implement measures to integrate mental health and noncommunicable disease care in primary care platforms.
Mental Illness Disclosure Decision Making.
Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric
Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record
Predictors and effects of long-term dieting on mental well-being and weight loss in obese women.
Karlsson, J; Hallgren, P; Kral, J; Lindroos, A K; Sjöström, L; Sullivan, M
Sixty moderately obese women (mean BMI = 33, mean age = 43), randomized to a lactovegetarian or regular 1300-kcal weight-reducing diet were followed at 3, 8 and 24 months. Weight follow-up was 92%, while 47% complied with the program throughout with no differences between the two diets with respect to compliance rate, weight loss or behavioral test results. Over 24 months compliers lost a mean 3.9 kg compared to a gain of 1.8 kg in the non-compliers. Short-term improvements in mental well-being measured by the Mood Adjective Check List deteriorated after 2 years to lower levels than at entry. Self-assessed motivation to diet was inversely related to mental well-being at two years. Positive long-term changes of functional status (Sickness Impact Profile) were found. Though subjective prediction of success measured after 3 weeks on diet predicted short-term and maximum weight loss, it did not predict ultimate outcome. More difficulties in resisting emotional and social eating cues (high disinhibition score on the Three-Factor Eating Questionnaire) before and during the diet predicted weight gain. The more initial health-related dysfunction (SIP) the greater the weight regain. Psychological characteristics at baseline did not predict compliance or overall weight loss. The magnitude of weight loss after 24 months was related to amount and duration of maximum weight loss.
Serotonin syndrome in patients with peripheral neuropathy: a diagnostic challenge.
Prakash, Sanjay; Gosai, Falgun; Brahmbhatt, Jit; Shah, Chintan
According to the Hunter Serotonin Toxicity Criteria, the presence of either clonus or hyperreflexia is a must for making a diagnosis of serotonin syndrome (SS). We report five patients with SS who had areflexia because of associated polyneuropathy. None of the patients fulfilled the Hunter criteria for SS. However, all five patients had features suggestive of neuromuscular hyperactivity, autonomic hyperactivity and altered mental status and fulfilled the Sternbach criteria for SS. All patients responded to cyproheptadine within 5 days to 2 weeks duration. These cases highlight the limitations of the Hunter criteria for SS in patients with associated polyneuropathy.
Malayalam cinema and mental health.
Menon, Koravangattu Valsraj; Ranjith, Gopinath
There is a tradition of using films to teach various aspects of psychiatry and we feel that Malayalam cinema can also be used suitably to teach effectively. These films can be an invaluable resource in cultural competency training as they depict the effects of culture on psychopathology and cultural and regional influences on attitudes to mental illness and stigma. We also note that the portrayal is often far from reality but this is not a barrier for using the films as an effective alternative to traditional and didactic teaching methods. This method of teaching can stimulate interest and discussion and demystify the myths of novice students and others about mental health.
Medieval theories of mental representation.
Kemp, S
Throughout most of the Middle ages, it was generally held that stored mental representations of perceived objects or events preserved the forms or species of such objects. This belief was consistent with a metaphor used by Plato. It was also consistent with the medieval belief that a number of cognitive processes took place in the ventricles of the brain and with the phenomenology of afterimages and imagination itself. In the 14th century, William of Ockham challenged this belief by claiming that mental representations are not stored but instead constructed in the basis of past learned experiences.
Mental depression and kundalini yoga.
Devi, S K; Chansauria, J P; Udupa, K N
In cases of mental depression, the plasma serotonin, melatonin and glutamate levels are increased along with the lowering of urinary - 5 - hydroxyindole acetic acid, plasma monoamine oxidase and cortisol levels following three and six months Practice of Kundalini Yoga. The pulse rate and blood pressure in these patients are also lowered after Kundalini Yoga practice. Thus, the practice of Kundalini Yoga helps to maintain a perfect homeostasis by bringing an equilibrium between the sympathetic and parasympathetic activities and it can be used as a non - medical measure in treating patients with mental depression.
Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders
ERIC Educational Resources Information Center
Braun, Sharon A.; Cox, Jane A.
In this article, the authors provide an overview of the effectiveness of managed health care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…
Attitudes of Canadian psychiatry residents if mentally ill: awareness, barriers to disclosure, and help-seeking preferences
Hassan, Tariq; Tran, Tanya; Doan, Nam; Mazhar, Mir; Bajaj, Neeraj; Munshi, Tariq; Galbraith, Niall; Groll, Dianne
Background The medical culture is defined by mental illness stigma, non-disclosure, and avoidance of professional treatment. Little research has explored attitudes and help-seeking behaviors of psychiatry trainees if they were to become mentally ill. Method Psychiatry residents (n = 106) from training centres across Ontario, Canada completed a postal survey on their attitudes, barriers to disclosure, and help-seeking preferences in the context of hypothetically becoming mentally ill. Results Thirty-three percent of respondents reported personal history of mental illness and the frequency of mental illness by year of training did not significantly differ. The most popular first contact for disclosure of mental illness was family and friends (n = 61, 57.5%). Frequent barriers to disclosure included career implications (n = 39, 36.8%), stigma (n = 11, 10.4%), and professional standing (n = 15, 14.2%). Personal history of mental illness was the only factor associated with in-patient treatment choice, with those with history opting for more formal advice versus informal advice. Conclusions At the level of residency training, psychiatrists are reporting barriers to disclosure and help-seeking if they were to experience mental illness. A majority of psychiatry residents would only disclose to informal supports. Those with a history of mental illness would prefer formal treatment services over informal services. PMID:28344690
European comparisons between mental health services.
Wahlbeck, K
When developing accessible, affordable and effective mental health systems, exchange of data between countries is an important moving force towards better mental health care. Unfortunately, health information systems in most countries are weak in the field of mental health, and comparability of data is low. Special international data collection exercises, such as the World Health Organization (WHO) Atlas Project and the WHO Baseline Project have provided valuable insights in the state of mental health systems in countries, but such single-standing data collections are not sustainable solutions. Improvements in routine data collection are urgently needed. The European Commission has initiated major improvements to ensure harmonized and comprehensive health data collection, by introducing the European Community Health Indicators set and the European Health Interview Survey. However, both of these initiatives lack strength in the field of mental health. The neglect of the need for relevant and valid comparable data on mental health systems is in conflict with the importance of mental health for European countries and the objectives of the 'Europe 2020' strategy. The need for valid and comparable mental health services data is today addressed only by single initiatives, such as the Organisation for Economic Co-operation and Development work to establish quality indicators for mental health care. Real leadership in developing harmonized mental health data across Europe is lacking. A European Mental Health Observatory is urgently needed to lead development and implementation of monitoring of mental health and mental health service provision in Europe.
Effects of Mental Health Benefits Legislation
Sipe, Theresa Ann; Finnie, Ramona K.C.; Knopf, John A.; Qu, Shuli; Reynolds, Jeffrey A.; Thota, Anilkrishna B.; Hahn, Robert A.; Goetzel, Ron Z.; Hennessy, Kevin D.; McKnight-Eily, Lela R.; Chapman, Daniel P.; Anderson, Clinton W.; Azrin, Susan; Abraido-Lanza, Ana F.; Gelenberg, Alan J.; Vernon-Smiley, Mary E.; Nease, Donald E.
Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence is limited for other mental health outcomes. PMID:25998926
[Paradoxical situation in the organization of work: a threat for workers' mental health].
Therriault, Pierre-Yves; Streit, Ursula; Rhéaume, Jacques
For the past decades, in a world of high competition, firms struggle to regain an advantage over foreign competition. Thus, new management trends, usually based on price reduction, high quality products and speed production are now part of strategic reorganization plans of high impact on work organization particularly in terms of large demands put on workers, and take a heavy toll on workers. Thus the incidence of mental health problems in the work place has risen sharply in recent years and currently counts as one of the leading causes of work absenteeism. A study based on the psychodynamic of work was conducted among machine operators working in a high-technology company in the aviation sector. Important management and technological transformations were recently introduced in the factory. The content analysis of the study shows that the work organization places the operator in a double bind situation. They are caught between an injunction where the capacity of making a high quality product is directly opposed to that demanding speed production. Moreover, severe and arbitrary sanctions are applied when the operators do not comply with either injunction. The operators are put in a deadlock situation that creates fear and anxiety. They are obliged to turn to defensive psychological strategies such as individualism and cheating. Those defensive strategies have negative impacts on social relationships.
Mental health problems and satisfaction with amount of state compensation for intentional violent crime victimization in the Netherlands.
Kunst, M J J
The current study explored whether self-reported mental health problems among victims of violent crime (n = 151) affect their ratings of satisfaction with amount of financial compensation awarded by the Dutch state and vice versa. This topic is important to address, because satisfaction is often used as an indicator of quality of victim services. Relying on medical literature about satisfaction with compensation in patient populations, it was expected that satisfaction levels would be negatively associated with mental health problems. Mental health problems were assessed with the General Health Questionnaire. A threshold of 11/12 on this scale was used to differentiate between victims with and without probable mental health problems. In line with expectations, victims with probable mental health problems reported significantly lower levels of satisfaction than those without. Results remained unchanged after adjusting for potential confounding. Findings were discussed in light of study limitations and directions for future research.
Stigma and Mental Illness: Investigating Attitudes of Mental Health and Non-Mental-Health Professionals and Trainees
ERIC Educational Resources Information Center
Smith, Allison L.; Cashwell, Craig S.
The authors explored attitudes toward adults with mental illness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…
Stigma and mental disorder: phenomena and terminology.
Clausen, J A
My aim in this paper is to examine the application of the concept stigma to mental disorder and to the mentally ill. I believe that the loose use of this term serves to obscure the real issues that must be confronted in attempting to change public response to mental disorder. I shall examine recent, and in my opinion ill-advised, use of the concept stigma and then present some data that bear upon social responses to mentally ill patients and former patients in contemporary America. My data are derived from a long-term study of mental patients and their families, and I shall document that their feelings of stigmatization are not so much a consequence of the response of others to their having been hospitalized for mental illness or labeled mentally ill as of self-doubts or chronic manifestations of mental illness.
Plastic Surgeons Often Miss Patients' Mental Disorders
... page: https://medlineplus.gov/news/fullstory_163120.html Plastic Surgeons Often Miss Patients' Mental Disorders 10 percent ... News) -- Nearly one in 10 patients seeking facial plastic surgery suffers from a mental illness that distorts ...
Food insecurity and mental health: a pilot study of patients in a psychiatric emergency unit in Israel.
Grisaru, Nimrod; Kaufman, Roni; Mirsky, Julia; Witztum, Eliezer
The objective of this study was to examine food insecurity among psychiatric patients and as a concern for mental health practitioners. Food security and psychological distress were measured among 113 patients hospitalized in a psychiatric emergency unit. Of 113 respondents 67 (59.3%) enjoyed food security and 46 (40.7%) lacked food security. Food insecure respondents showed a higher level of psychological distress than food secure respondents. A large proportion of in-patients may be suffering food insecurity which is negatively associated with their psychological well being. Mental health practitioners need to be aware of the potential association of food insecurity and mental distress among psychiatric patients.
Genetic Counseling in Mental Retardation.
ERIC Educational Resources Information Center
Bowen, Peter
The task of the genetic counselor who identifies genetic causes of mental retardation and assists families to understand risk of recurrence is described. Considered are chromosomal genetic disorders such as Down's syndrome, inherited disorders such as Tay-Sachs disease, identification by testing the amniotic fluid cells (amniocentresis) in time…
Mental Computation and Conceptual Understanding.
ERIC Educational Resources Information Center
Blote, Anke W.; Klein, Anton S.; Beishuizen, Meindert
Assessed the strategic flexibility of students in mental arithmetic up to the number 100. Results from 60 Dutch second graders show that students' preference for certain mathematical procedures depend on the number characteristics of the problems, indicating that the students had a good conceptual understanding of numbers and procedures. Actual…
Adolescent Offenders with Mental Disorders
ERIC Educational Resources Information Center
Grisso, Thomas
In this paper, the author points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its…
Psychological Problems in Mental Deficiency.
ERIC Educational Resources Information Center
Sarason, Seymour B.; Doris, John
A statement of goals and the rationale for organization precede a historical discussion of mental deficiency and society. The problem of labels like IQ and brain injured and the consequences of the diagnostic process are illustrated by case histories; case studies are also used to examine the criteria used to decide who is retarded and to discuss…
Dichotic Stimulation and Mental Retardation.
ERIC Educational Resources Information Center
Mosley, James L.; Virbancic, Mirna I.
This paper reviews literature on the use of dichotic stimulation in individuals with mental retardation, and examines how noninvasive dichotic stimulation relates to hemisphere lateralization. Common findings are discussed concerning direction and magnitude of ear asymmetries, patterns of intrusion errors, and speech lateralization of Down…
ERIC Educational Resources Information Center
Detection of Malingered Mental Retardation
ERIC Educational Resources Information Center
Shandera, Anne L.; Berry, David T. R.; Clark, Jessica A.; Schipper, Lindsey J.; Graue, Lili O.; Harp, Jordan P.
In a cross-validation of results from L. O. Graue et al. (2007), standard psychological assessment instruments, as well as tests of neurocognitive and psychiatric feigning, were administered under standard instructions to 24 participants diagnosed with mild mental retardation (MR) and 10 demographically matched community volunteers (CVH). A 2nd…
Mental fatigue impairs emotion regulation.
Grillon, Christian; Quispe-Escudero, David; Mathur, Ambika; Ernst, Monique
Because healthy physical and mental functioning depends on the ability to regulate emotions, it is important to identify moderators of such regulations. Whether mental fatigue, subsequent to the depletion of cognitive resources, impairs explicit emotion regulation to negative stimuli is currently unknown. This study explored this possibility. In a within-subject design over 2 separate sessions, healthy individuals performed easy (control session) or difficult (depletion session) cognitive tasks. Subsequently, they were presented with neutral and negative pictures, with instructions to either maintain or regulate (i.e., reduce) the emotions evoked by the pictures. Emotional reactivity was probed with the startle reflex. The negative pictures evoked a similar aversive state in the control and depletion sessions as measured by startle potentiation. However, subjects were able to down-regulate their aversive state only in the control session, not in the depletion session. These results indicate that mental fatigue following performance of cognitive tasks impairs emotion regulation without affecting emotional reactivity. These findings suggest that mental fatigue needs to be incorporated into models of emotion regulation.
The Paradigmatic Mentality: A Diagnosis.
ERIC Educational Resources Information Center
Hammersley, Martyn
The major features of the paradigm argument are outlined and the disastrous effect that the paradigmatic mentality has had on the development of the new sociology of education is examined. The paradigm argument states that all knowledge is founded upon epistemological, theoretical, and political assumptions, and that, therefore, knowledge must be…
Books for Mentally Retarded Children.
ERIC Educational Resources Information Center
Cincinnati - Hamilton County Public Library, OH.
Presented is an annotated list of approximately 300 books for educable (EMR) and trainable mentally retarded (TMR) children and adolescents, 6 to 15 years of age. Books are arranged in the following groups for EMR students: Group I contains approximately 84 entries for students 6 to 9 years of age; Group II lists approximately 81 stories and books…
Trainable Mentally Handicapped: Protective Vocabulary.
ERIC Educational Resources Information Center
National Center on Educational Media and Materials for the Handicapped, Columbus, OH.
Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers 21 materials for teaching protective vocabulary to trainable mentally handicapped students. Entries are presented in order of NIMIS accession number and include…
[Are Mental Disorders Natural Kinds?].
Flórez Quintero, Daian Tatiana
A problem for both philosophers of Psychiatry and Psychiatrists within the domain of nosology is to determine which could be the more appropriate model to classify mental illnesses. Such an endeavor also requires questioning the very nature of mental illness. While trying to cope with the philosophical challenges of such a task, Peter Zachar purports to show that the nosological work in Psychiatry should not adhere to the model of natural kinds. He even considers that it is mistaken to treat mental disorders as natural kinds. Nonetheless, Zachar's view on the existence of natural kinds-even in domains where there is little room for doubting about their existence, like Chemistry-is very unstable. In 2001 he holds that there are no natural kinds, but in 2008 he argues that his objections to the model of natural kinds are more the manifestation of his skepticism against a tradition. Although the problem of the existence of natural kinds shall not be dealt with in this article, a brief description on how deflated is Zachar's view on this matter in 2008 is presented, with the central part of the article devoted to reconstruct and examine his rationale for the thesis that mental disorders are not natural kinds. In the critical section of this paper, it is suggested that, although Zachar's thesis may be right, the arguments he gives to support it are quite flawed.
Techniques of Assessing Mental Effort.
ERIC Educational Resources Information Center
Cennamo, Katherine S.
The search for techniques to increase the effort that learners invest in video-based instruction has been hindered by the limitations of the instruments used to assess the construct of mental effort. Several researchers have noted the confusion of terms in the field that refer to the cognitive resources devoted to processing the stimulus. In this…
Barometer. Mental health January 2005.
Mental health trust chief executives are increasingly confident about recruiting crisis resolution and early intervention teams, according to the new HSJ Barometer survey. However, very few expect to gain foundation status in the next two years. The survey also shows that bed occupancy rates are increasing, with about a fifth of trusts showing rates above 100 per cent.
Mental Health and the Economy.
ERIC Educational Resources Information Center
Ferman, Louis A., Ed.; Gordus, Jeanne P., Ed.
This volume offers a collection of papers which explores the relationships between major economic changes and individual and collective mental and physical well-being, including individual distress, deviant behavior, and other symptoms of underlying pathology. The contributors examine the processes leading from macroeconomic change to social and…
Transportation and the Mentally Retarded.
ERIC Educational Resources Information Center
President's Committee on Mental Retardation, Washington, DC.
Reported were the results of a contract that involved identification, description, and categorization of the nature of transportation problems for the mentally retarded by means of analysis of existing studies, two surveys, and an inventory of specialized programs and systems operating in the United States. One major problem was found to be…
Marriage, mental illness and law
Sharma, Indira; Reddy, Karri Rama; Kamath, Rabindra Mukund
The Special Marriage Act (SMA), 1954 and the Hindu Marriage Act (HMA), 1955 have put restrictions on the marriage of persons with mental illness, which are proving to be detrimental to patients and their families. There is an urgent need to address this problem. The deficiencies in the existing legislation have been projected and constructive suggestions have been put forward. PMID:26330652
Scouting for the Mentally Retarded.
ERIC Educational Resources Information Center
Boy Scouts of America, New Brunswick, NJ.
The handbook for leaders discusses ways in which scouting helps and how the unit serves the boys. Advancement, rank, and the boys are discussed; boy scout tests (tenderfoot and second class interpretation for mentally retarded boys), group activities, and a sample ceremony are detailed. Listings are given of membership provisions, helps for…
A Mental Disabilities Curriculum Framework.
ERIC Educational Resources Information Center
Gonwa, Jim; Clary, Joan Turner
The framework is intended to help staff develop curricula for mildly mentally retarded students in special and regular education and assist both educators and parents in evaluating the curricula. Distinctions between a curriculum and a framework are made. The proposed framework describes essential skills, competencies, and concepts necessary for…
Poverty and Women's Mental Health.
ERIC Educational Resources Information Center
Belle, Deborah
Discusses the prevalence and rise of poverty in the United States, which is found particularly among women, children, and those from minority groups. Discusses the positive association between poverty and mental health problems. Describes the impact of poverty on women, and the need for research to discover the psychological impact of poverty. (JS)
... degree in social work (M.S.W.); Licensed Clinical Social Workers (L.C.S.W.) have additional supervised training and clinical work experience. Licensed Professional Counselor: Master's degree in psychology, counseling or a related field. Mental Health Counselor: ...
Mental health care in Cambodia.
Somasundaram, D. J.; van de Put, W. A.
An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization. PMID:10212521
Mental Models in Social Interaction
ERIC Educational Resources Information Center
Fernandez-Berrocal, Pablo; Santamaria, Carlos
In this study, the authors introduce a new way to analyze cognitive change during social interactions, based on the mental model theory of reasoning. From this approach, cognitive performance can be improved for solving problems that require multiple models when participants in a social interaction group maintain qualitatively different models of…
ERIC Educational Resources Information Center
Weinstein, Henry C.
Briefly reviews historical development of mental health and the law as a multidisciplinary field and considers variety of information seekers addressing certain topics of special importance. Pertinent information sources and services are outlined. Fifteen references and a recommended core library for fellowship programs in forensic psychiatry are…
Vestibulosympathetic reflex during mental stress
NASA Technical Reports Server (NTRS)
Carter, Jason R.; Ray, Chester A.; Cooke, William H.
Increases in sympathetic neural activity occur independently with either vestibular or mental stimulation, but it is unknown whether sympathetic activation is additive or inhibitive when both stressors are combined. The purpose of the present study was to investigate the combined effects of vestibular and mental stimulation on sympathetic neural activation and arterial pressure in humans. Muscle sympathetic nerve activity (MSNA), arterial pressure, and heart rate were recorded in 10 healthy volunteers in the prone position during 1) head-down rotation (HDR), 2) mental stress (MS; using arithmetic), and 3) combined HDR and MS. HDR significantly (P < 0.05) increased MSNA (9 +/- 2 to 13 +/- 2 bursts/min). MS significantly increased MSNA (8 +/- 2 to 13 +/- 2 bursts/min) and mean arterial pressure (87 +/- 2 to 101 +/- 2 mmHg). Combined HDR and MS significantly increased MSNA (9 +/- 1 to 16 +/- 2 bursts/min) and mean arterial pressure (89 +/- 2 to 100 +/- 3 mmHg). Increases in MSNA (7 +/- 1 bursts/min) during the combination trial were not different from the algebraic sum of each trial performed alone (8 +/- 2 bursts/min). We conclude that the interaction for MSNA and arterial pressure is additive during combined vestibular and mental stimulation. Therefore, vestibular- and stress-mediated increases of MSNA appear to occur independently in humans.
Scholarly Productivity in Mental Retardation.
ERIC Educational Resources Information Center
Matson, Johnny L.; And Others
The most productive institutions in social, educational, and psychological research in mental retardation were identified by noting the affiliations of authors who have published recently (1978-84) in the field. Thirty of the 35 highest ranked institutions were state-assisted universities in the United States. (Author/DB)
Philosophy, biology and mental disorder.
Dawson, P J
The biological model has become the touchstone for our thinking on mental disorder. The success of this model has relegated opposing views to the sidelines. Philosophers have been considering the nature of mind for well over 2500 years, and their speculations may provide a useful antidote to the creeping reductionism and materialism inherent in simple biology. The emphasis in philosophical theories is on the nature of the mental and the structuring role of the mind in our construction of reality. This paper focuses on three philosophers, Kant, Heidegger and Husserl, and their contribution to our understanding of the nature of psychopathology. The biological theory is re-examined from the differing perspectives offered, and some of the assumptions on which it is based are subjected to criticism. The emphasis, found in the philosophical theories, on the mental as opposed to the physiological aspects of the mind, is considered to be more germane to the practical and therapeutic concerns of those who must deal with the dis-ease of mental disorder.
ERIC Educational Resources Information Center
Di Bono, Maria Grazia; Casarotti, Marco; Priftis, Konstantinos; Gava, Lucia; Umilta, Carlo; Zorzi, Marco
Growing experimental evidence suggests that temporal events are represented on a mental time line, spatially oriented from left to right. Support for the spatial representation of time comes mostly from studies that have used spatially organized responses. Moreover, many of these studies did not avoid possible confounds attributable to target…
Children's Mental Health. Beginnings Workshop.
ERIC Educational Resources Information Center
Plattner, Ilse Elisabeth; Haugen, Kirsten; Cohen, Alan; Levin, Diane E.
Presents four articles discussing mental health issues that pertain to early childhood education: "Granting Children Their Emotions" (Ilse Elisabeth Plattner); "Double Vision: Parent and Professional Perspectives on Our Family's Year in Crisis" (Kirsten Haugen); "Coping with Stress and Surviving Challenging Times" (Alan Cohen); and "When the World…
Mental Retardation: Diagnosis and Treatment.
ERIC Educational Resources Information Center
Poser, Charles M., Ed.
A collection of writings by 17 authors, the text includes the following discussions: general principles of diagnosis and management of mental retardation, neurologic evaluation of the infant and child, psychological evaluation, educational information, and treatment of pseudoretardation, communicative disorders, and metabolic and endocrine causes.…
Ethnic Lifestyles and Mental Health.
ERIC Educational Resources Information Center
Valencia-Weber, Gloria, Ed.
This document presents two overview essays (one on the ethnic history of the United States and one on multicultural society) and seven articles on various aspects of the relationship between ethnic values and mental health. Articles were originally presented as papers at a series of seminars convened to encourage humanists from four ethnic groups…
Mental Space Theory and Misunderstanding
ERIC Educational Resources Information Center
Liu, Hui; Gao, Yueqin
This essay attempts to conduct an explanatory research on MIS within the framework of mental space theory to demonstrate the cognitive operating process of MIS in people's social interaction and explore the deep causes lying behind the phenomenon. By text analysis, the author elaborates on the generating process of MIS, thus tracing cognitive…
Educable Mentally Retarded; Level II.
ERIC Educational Resources Information Center
Suo, Minnie A; Willemin, Helen
An introduction of the curriculum guide for educable retarded children with mental ages from 5.0 to 6.6 discusses the philosophy of educating the retarded, goals, the educable program, the readiness program, use of the guide, and a suggested daily schedule. Suggested units treat the following: citizenship and patriotism, family and school,…
Disaster mental health services: a personal perspective.
Weeks, S M
1. Services that may be provided by psychiatric-mental health nurses following a disaster include education, intervention, problem solving, advocacy, and referral. 2. Nurses providing disaster mental health services must be flexible and creative. Strong observational skills and teamwork are also essential characteristics in disaster settings. 3. Psychiatric-mental health nurses who wish to receive training for disaster mental health volunteer opportunities should contact their local chapter of the American Red Cross.
Arterial Stiffness in Patients Taking Second-generation Antipsychotics
Fındıklı, Ebru; Gökçe, Mustafa; Nacitarhan, Vedat; Camkurt, Mehmet Akif; Fındıklı, Hüseyin Avni; Kardaş, Selçuk; Şahin, Merve Coşgun; Karaaslan, Mehmet Fatih
Objective That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs. Methods Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded. Results Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (p=1), PWV was greater in patients in the antipsychotic group (p=0.048). Conclusion This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients. PMID:27776389
Counterfactual thinking in patients with amnesia.
Mullally, Sinéad L; Maguire, Eleanor A
We often engage in counterfactual (CF) thinking, which involves reflecting on "what might have been." Creating alternative versions of reality seems to have parallels with recollecting the past and imagining the future in requiring the simulation of internally generated models of complex events. Given that episodic memory and imagining the future are impaired in patients with hippocampal damage and amnesia, we wondered whether successful CF thinking also depends upon the integrity of the hippocampus. Here using two nonepisodic CF thinking tasks, we found that patients with bilateral hippocampal damage and amnesia performed comparably with matched controls. They could deconstruct reality, add in and recombine elements, change relations between temporal sequences of events, enabling them to determine plausible alternatives of complex episodes. A difference between the patients and control participants was evident, however, in the patients' subtle avoidance of CF simulations that required the construction of an internal spatial representation. Overall, our findings suggest that mental simulation in the form of nonepisodic CF thinking does not seem to depend upon the hippocampus unless there is the added requirement for construction of a coherent spatial scene within which to play out scenarios.
Viscosupplementation in patients with hemophilic arthropathy
Zelada, Flávio; de Almeida, Adriano Marques; Pailo, Alexandre Felicio; Bolliger, Raul; Okazaki, Erica; de Rezende, Márcia Uchôa
OBJECTIVE: To assess whether viscosupplementation with hyaluronic acid in patients with severe hemophilic arthropathy associated with triamcinolone after washing with saline improves joint pain, stiffness, function and quality of life. METHODS: Eleven patients with hemophilic arthritis of the knee with and without involvement of other joints (elbows and ankles) underwent joint lavage with saline and subsequent injection of Hylan and triamcinolone in all affected joints. The patients answered the algo-functional (Lequesne and WOMAC), visual analog scale for pain (VAS) and SF-36 (quality of life) questionnaires preoperatively, and at one and three months postoperatively. RESULTS: Pain (VAS and WOMAC pain) and stiffness (WOMAC stiffness) did not show significant improvement (p = 0.3, p = 0.2, p = 0.1, respectively). However function had significant improvement given by WOMAC total and function (averaging 11 points, p = 0.04 and p = 0.001). There was no significant variation in scores in Lequesne's questionnaire (p = 0.1), yet both mental and physical components of SF-36 presented clinically relevant and significant improvements (p = 0.002). CONCLUSION: Joint lavage with saline followed by injection of corticosteroids and Hylan is effective in the treatment of hemophilic arthropathy, especially in functional improvement and quality of life. Level of Evidence IV, Case series. PMID:24453636
Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings
ERIC Educational Resources Information Center
Dixon, Decia Nicole
Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…
Promoting and Protecting Mental Health as Flourishing: A Complementary Strategy for Improving National Mental Health
ERIC Educational Resources Information Center
Keyes, Corey L. M.
This article summarizes the conception and diagnosis of the mental health continuum, the findings supporting the two continua model of mental health and illness, and the benefits of flourishing to individuals and society. Completely mentally healthy adults--individuals free of a 12-month mental disorder and flourishing--reported the fewest missed…
States Pass Diverse Slate of Mental Health Legislation in 2013. Mental Health: 2013 Legislative Session
ERIC Educational Resources Information Center
Thomsen, Jennifer
Recent violence in schools and on college campuses has brought into sharp focus the need to address mental health issues in educational settings. Getting students with mental health problems the help they need, without stigmatizing mental illness, may help prevent future tragedies. Children with mental health problems face a host of challenges,…
The Role of Bilingual Workers without Professional Mental Health Training in Mental Health Services for Refugees.
ERIC Educational Resources Information Center
Egli, Eric
This paper discusses the use of bilingual workers who do not have formal mental health training as mediators and providers of mental health care for refugees. The introduction provides a background discussion of the need for refugee mental health services, the characteristics of bilingual mental health workers, and the work places and expectations…
Defendants with Intellectual Disabilities and Mental Health Diagnoses: Faring in a Mental Health Court
ERIC Educational Resources Information Center
Burke, M. M.; Griggs, M.; Dykens, E. M.; Hodapp, R. M.
Background: Begun in the late 1990s, mental health courts are specialty criminal courts developed to address the needs of persons with mental illness. Methods: As many persons with intellectual disabilities (IDs) may overlap in the mental health court system, we used mental health court records to examine the phenomenology and outcomes of 224…
Prejudice, Mental Health and Family Life.
ERIC Educational Resources Information Center
Ackerman, Nathan W.
This pamphlet explores the relationship among prejudice, mental health, and family life. Prejudice is learned behavior, initially within the family unit which sets the framework for good or bad mental health as well as for the development of positive or negative attitudes. The family also determines the degree and kind of mental health of each…
Quick Guide: Mental Health-Secondary Transition
ERIC Educational Resources Information Center
National Technical Assistance Center in Transition, 2016
Recently researchers have begun focusing on young adults with mental health disorders transitioning into adulthood. Research exploring the importance of mental health support in secondary transition have yielded positive outcomes. For example, strong collaboration between educational and mental health agencies ensuring academic, employment, and…
Mental Health Counseling: A Stakeholder's Manifesto.
ERIC Educational Resources Information Center
Beck, Edward S.
Discusses the original dreams of the founders of the American Mental Health Counselors Association; looks at history and comments on the state of mental health counseling as it has struggled to evolve as a profession. Urges those in the counseling profession to consider an acquisitions and mergers corporate mentality to ensure and enhance the…
Ethnic Issues in Adolescent Mental Health.
ERIC Educational Resources Information Center
Stiffman, Arlene Rubin, Ed.; Davis, Larry E., Ed.
The essays collected in this book examine the effects of ethnicity on the mental health of adolescents. A dual set of issues emerges throughout the volume: the importance of adolescent mental health in contributing to adult well-being, and the necessity of understanding ethnicity in studying and treating mental health problems. The book is divided…
Issues in Children's Mental Health. Special Report.
ERIC Educational Resources Information Center
Nimmo, Margaret L.
This Kids Count report examines issues related to children's mental health in Virginia. The report discusses the effects of children's mental illness, presents risk and protective factors, and describes the incidence of children's mental health problems. Information specific to Virginia is presented, including the prevalence of youth suicide,…
Handbook of Infant Mental Health. Second Edition.
ERIC Educational Resources Information Center
Zeanah, Charles H., Jr., Ed.
This revised edition offers an interdisciplinary analysis of the developmental, clinical, and social aspects of mental health from birth to age 3. Chapters are organized into five areas, covering the context of mental health, risk and protective factors, assessment, psychopathology, intervention, and applications of infant mental health. The…
Mental Health: An Interdisciplinary and International Perspective.
ERIC Educational Resources Information Center
Klineberg, Otto
The World Federation for Mental Health was founded as an international apolitical organization concerned with quality of life rather than merely the absence or prevention of mental illness. An examination of the manner and extent to which mental problems arise in different cultural settings can provide data needed to understand the relationship…
Mental Retardation: Prevention Strategies That Work.
ERIC Educational Resources Information Center
President's Committee on Mental Retardation, Washington, DC.
The report by the President's Committee on Mental Retardation reviews the current state of knowledge in the area of biological and environmental prevention of mental retardation and describes programs on the frontiers of research or service delivery. Section I examines programs that are effectively preventing mental retardation through biomedical…
Families, Managed Care, & Children's Mental Health.
ERIC Educational Resources Information Center
McManus, Marilyn C., Ed.
This theme issue of a bulletin on family support and children's mental health focuses on managed care and the impact on children who are in need of mental health services. Articles include: "Private Sector Managed Care and Children's Mental Health" (Ira S. Lourie and others); "Just What Is Managed Care?" (Chris Koyanagi); "Managed Behavioral…
Vision and Mental Function of the Elderly
ERIC Educational Resources Information Center
Snyder, Lorraine Hiatt; And Others
The relationship between vision and mental functioning was investigated in a study of 295 elderly residents from three levels of care. Visual acuity and mental status were assessed. Findings indicate that there was indeed a relationship between vision and mental status. (Author)
ERIC Educational Resources Information Center
Mental Health Issues in Rural Nursing.
ERIC Educational Resources Information Center
Babich, Karen S., Comp.
Five papers cover recent developments in rural mental health nursing. "Rural Mental Health Care: A Survey of the Research" (Karen Babich) chronicles recent interest in understanding the rural population's character and the nature of mental health services needed by and provided to rural America. Lauren Aaronson ("Using Health…
Innovations in Vocational Rehabilitation and Mental Retardation.
ERIC Educational Resources Information Center
Ayers, George E., Ed.
Conference proceedings of the Vocational Rehabilitation Subdivision Meetings held at the American Association on Mental Deficiency contain discussions of innovative aspects of vocational rehabilitation and mental retardation. In the area of training rehabilitation counselors, George Baroff describes the Mental Retardation Training Institute in…
Perceived Age Discrimination and Mental Health
ERIC Educational Resources Information Center
Yuan, Anastasia S. Vogt
Although perceived discrimination (especially due to race-ethnicity) decreases mental health, the influence of perceived discrimination due to other reasons on mental health needs to be explored. This study examines the relationship between perceived age discrimination and mental health and determines whether psychosocial resources explain or…
Young People's Experiences of Mental Health Care
ERIC Educational Resources Information Center
Cohen, Anjalee; Medlow, Sharon; Kelk, Norm; Hickie, Ian; Whitwell, Bradley
Fifteen in-depth interviews were conducted to explore young people's experiences of mental health care in Australia with the aim of informing the headspace National Youth Mental Health Foundation. The interviews revealed that significant numbers of respondents had been aware of their mental health problems for several years before seeking help and…
Student Mental Health Services in Higher Education.
ERIC Educational Resources Information Center
Blai, Boris, Jr.
Facts about mental and emotional illness and implications for student mental health services in higher education are reviewed. Psychoses, which are types of mental illness that are usually quite severe, are discussed in terms of symptoms, as are neuroses, which cause severe distress and impair coping with living conditions but are not as…
Client Outcome Evaluation in Mental Health Centers.
ERIC Educational Resources Information Center
Southern Regional Education Board, Atlanta, GA.
Outcome evaluation assesses the results or benefits of mental health services received by clients or communities by comparing descriptive data on the mental health status of clients at different points in time. It aids clinicians and managers in planning programs and managing clinical services. A mental health center should establish goal-oriented…
Hispanics and Culturally Sensitive Mental Health Services.
ERIC Educational Resources Information Center
Hispanic Research Center Research Bulletin, 1985
The objective of improving mental health care for Hispanics has been reviewed, most often, as dependent upon the provision of culturally sensitive mental health services. "Cultural sensitivity," however, is an imprecise term, especially when efforts are made to put it into operation when providing mental health services to Hispanic…
Mental Images towards the Concept of Drama
ERIC Educational Resources Information Center
Pekdogan, Serpil; Korkmaz, Halil Ibrahim
The aim of this study is to examine the mental images of preschool teacher candidates related to the concept of drama via metaphors. We questioned these questions; "What are the metaphors or mental images of teacher candidates?," "Under which conceptual categories are these metaphors or mental images can be collected?" and…
A review of psychosocial issues in patients with chronic hepatitis B.
Modabbernia, Amirhossein; Ashrafi, Mandana; Malekzadeh, Reza; Poustchi, Hossein
Psychosocial issues and health-related quality of life (HRQOL) are important components of care in patients diagnosed with chronic hepatitis B (CHBV). In this review, we searched Medline, ISI Web of Knowledge, Google Scholar and the American Association for the Study of Liver Diseases (AASLD) website (until January 2012) using relevant terms and we categorized the retrieved content into three areas: HRQOL, mental health, and psychosocial issues such as stigma and coping. Increasing severity of CHBV leads to a decline in HRQOL. Cirrhosis worsens HRQOL, whereas treatment and psycho-education improves it. Frequency of mood disorders seems to be increased in patients with CHBV, although not all studies have shown this trend. Some factors such as alcohol consumption and low social support negatively impact patients' mental health. Those with CHBV generally have better HRQOL and mental health than their hepatitis C (HCV) counterparts. Patients with psychiatric disorders, particularly those with prolonged institutionalization, have a generally higher risk of acquiring CHBV infection compared to the general population. Robust studies regarding the stigma in patients with CHBV are lacking, although some studies have suggested a higher degree of perceived stigma in these patients. HRQOL and mental health are significantly affected in CHBV patients, particularly in those with more severe forms of the disease. There are few studies that addressed the effects of intervention in CHBV patients with psychosocial problems. Other subjects necessitating additional research include stigma, coping mechanisms, and other less common, yet important psychosomatic disorders.
Northern Ireland Tier 4 Child and Adolescent Mental Health Services: A Survey of Admissions to the Child and Family Centre, January 2001-April 2004
ERIC Educational Resources Information Center
Fulton, Karen; Cassidy, Lisheen
In-patient care, provided at Tier 4 level, is a specialised field aimed at provision of high-quality care for young people with serious mental health problems. This survey investigates how the regional in-patient unit for children in Northern Ireland functioned. A retrospective investigation was performed of cases admitted under the care of the…
Text messaging interventions for individuals with mental health disorders including substance use: A systematic review.
Watson, Tyler; Simpson, Scot; Hughes, Christine
We completed a systematic review of the literature to characterize the impact of text messaging interventions on medication adherence or mental health related outcomes in people with mental health disorders including substance use. Four electronic databases were searched from January 1999 to October 2015. Seven studies met our inclusion criteria: three studies evaluated text messaging in patients with schizophrenia or schizoaffective disorder diagnosis, two studies evaluated text messaging in patients with chronic alcohol dependence, and two studies reviewed text messaging in patients with mood disorders. Six studies were randomized controlled trials and one was a prospective pilot study with pre-post intervention design. Text messaging frequency ranged from once weekly to twelve per day. The effect of text messaging on medication adherence was measured in five studies; one study reporting significant improvements in the text messaging intervention group. The effect of text messaging on mental health related outcomes was measured in all seven studies, with five studies showing significant improvements in a variety of psychiatric and social functioning assessments. Collectively, these studies suggest text messaging is a promising tool to support management of patients with mental illness. Further research examining theory-based text messaging interventions in larger samples of patients is required.
[Regaining quality of life despite rheumatoid arthritis].
A, Madame
A patient aged 32 who had been living with her partner for a few years, is diagnosed with rheumatoid arthritis. They both needed to understand and adapt. The caregivers had a frontline role in the multidisciplinary care but addressing the impact on the patient's sexual quality of life remains difficult. The patient describes her experience and how harmony and desire were re-established.
[Regaining quality of life despite rheumatoid arthritis].
A, Madame
A patient aged 32 who had been living with her partner for a few years, is diagnosed with rheumatoid arthritis. They both needed to understand and adapt. The caregivers had a frontline role in the multidisciplinary care but addressing the impact on the patient's sexual quality of life remains difficult. The patient describes her experience and how harmony and desire were re-established.
Regaining quantum incoherence for matter fields
Gonzalez-Driaaaz, P.F. )
The possible quantum state of wormholes or little baby universes should be described by a nonfactorizable density matrix given by the path integral over the class of asymptotically flat four-geometries and asymptotically vanishing matter-field configurations which suitably match the prescribed data on three-surfaces which do not divide the manifold on the inner boundary. An instanton is here obtained which can represent such a nonsimply connected wormhole manifold, and is used to evaluate the asymptotic effective interaction of the resulting correlated baby universes with ordinary quantum fields at low energies in the Fock representation. It is argued that the demand of locality on the interacting quantum field commutators is no longer valid for correlated baby universes, and it is therefore concluded that quantum coherence in the matter-field sector is lost as a consequence of the interaction with nonsimply connected wormholes. A proposal is advanced that wormholes may provide us with a complementary quantum state sector that would induce the collapse of the state vector in the quantum measurement of any observable for ordinary microscopic matter systems.
Conformal geometrodynamics regained: Gravity from duality
Gomes, Henrique
There exist several ways of constructing general relativity from 'first principles': Einstein's original derivation, Lovelock's results concerning the exceptional nature of the Einstein tensor from a mathematical perspective, and Hojman–Kuchař-Teitelboim's derivation of the Hamiltonian form of the theory from the symmetries of space–time, to name a few. Here I propose a different set of first principles to obtain general relativity in the canonical Hamiltonian framework without presupposing space–time in any way. I first require consistent propagation of scalar spatially covariant constraints (in the Dirac picture of constrained systems). I find that up to a certain order in derivatives (four spatial and two temporal), there are large families of such consistently propagated constraints. Then I look for pairs of such constraints that can gauge-fix each other and form a theory with two dynamical degrees of freedom per space point. This demand singles out the ADM Hamiltonian either in (i) CMC gauge, with arbitrary (finite, non-zero) speed of light, and an extra term linear in York time, or (ii) a gauge where the Hubble parameter is conformally harmonic.
An historical view of the pineal gland and mental disorders.
López-Muñoz, F; Molina, J D; Rubio, G; Alamo, C
Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine).
Mental Health Service Career Ladder
patients' conversation 48 1345 Conduct or participate in patient education classes 48 G296 Obtain and record pulse rates 48 1342 Conduct or participate...Conduct or participate in patient education classes 6.75 56 51 5.93 G285 Observe and report emotional status or needs of patients 6.50 63 63 5.04 L429...and record observations on patients' conversation 85 1345 Conduct or participate in patient education classes 85 F187 Perform handwashing techniques
Rural mental health: neither romanticism nor despair.
Wainer, J; Chesters, J
This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health. We then consider aspects of rural life and place that contribute to positive mental health or increase the likelihood of mental health problems. Issues identified include environment, place, gender identity, violence and dispossession and the influence of the effects of structural changes in rural communities. The paper concludes with a discussion of some of the determinants of resilience in rural places, including social connectedness, valuing diversity and economic participation.
Contemporary Perspectives on Spirituality and Mental Health
Sharma, Pulkit; Charak, Ruby; Sharma, Vibha
The paper strives to elucidate the complex yet intimate relation between spirituality and mental health from contemporary perspectives. The diverse and constantly evolving views that spiritualists and mental health professionals have held toward each other over last century are discussed with special accent on the transpersonal spiritual framework within psychology. The role of spirituality in promoting mental health and alleviating mental illness is highlighted. The paper is concluded with an increasing need to integrate spirituality within the mental health field albeit there are several impediments in achieving the same, which need to be worked through circumspectly. PMID:21938086
Mental illness: media perpetuation of stigma.
Williams, M; Taylor, J
Content analysis of 83 newspaper articles from February 1991 to January 1993 was the chosen method to determine the role of newspapers in the portrayal of the mentally ill. Two emergent themes arose: the closure of a mental health hospital was viewed negatively; and the stereotypical perception of the mentally ill as violent and unpredictable was reinforced. Over the two year period of the study the shift in focus from the ideology of de-institutionalisation, funding issues, crisis and chaos in the mental health hospital eventuated in an emphasis on the negativity associated with mental illness.
Platelet Aggregation and Mental Stress Induced Myocardial Ischemia: Results from the REMIT Study
Jiang, Wei; Boyle, Stephen H.; Ortel, Thomas L.; Samad, Zainab; Velazquez, Eric J.; Harrison, Robert W.; Wilson, Jennifer; Kuhn, Cynthia; Williams, Redford B.; O'Connor, Christopher M.; Becker, Richard C.
BACKGROUND Mental stress-induced myocardial ischemia (MSIMI) is common in patients with ischemic heart disease (IHD) and associated with a poorer cardiovascular prognosis. Platelet hyperactivity is an important factor in acute coronary syndrome. This study examined associations between MSIMI and resting and mental stress-induced platelet activity. METHODS Eligible patients with clinically stable IHD underwent a battery of 3 mental stress tests during the recruitment phase of REMIT (Responses of Myocardial Ischemia to Escitalopram Treatment) study. MSIMI was assessed by echocardiography and electrocardiography. Ex vivo platelet aggregation in response to ADP, epinephrine, collagen, serotonin, and combinations of serotonin plus ADP, epinephrine, and collagen were evaluated as was platelet serotonin transporter expression. RESULTS Of the 270 participants who completed mental stress testing, and had both resting and post-stress platelet aggregation evaluation, 43.33% (N=117) met criteria for MSIMI and 18.15% (N=49) had normal left ventricular response to stress (NLVR). The MSIMI group, relative to the NLVR groups, demonstrated heightened mental stress-induced aggregation responses, as measured by area under the curve, to collagen 10 μM (6.95[5.54] vs. −14.23[8.75].; p=0.045), epinephrine 10 μM (12.84[4.84] vs. −6.40[7.61].; p=0.037) and to serotonin 10 μM plus ADP 1 μM (6.64[5.29] vs. −27.34[8.34]; p < .001). The resting platelet aggregation and serotonin transporter expression, however, were not different between the two groups. CONCLUSIONS These findings suggest that the dynamic change of platelet aggregation caused by mental stress may underlie MSIMI. While the importance of these findings requires additional investigation, they raise concern given the recognized relationship between mental stress-induced platelet hyperactivity and cardiovascular events in patients with IHD. PMID:25819856
Mental health policy developments in Latin America.
Alarcón, R. D.; Aguilar-Gaxiola, S. A.
New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people's mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice. PMID:10885167
[Adolescent mental health promotion in school context].
Kaltiala-Heino, Riittakerttu; Ranta, Klaus; Fröjd, Sari
School performance, involvement in bullying and frequent absences from school are indicators of not only cognitive and social skills but also mental health. Mental disorders may interfere with learning and adjustment in many ways. Mental disorders may bring about problems in attention and motivation, and failure in schoolwork often makes an adolescent vulnerable to mental disorders. Early recognition of and prompt intervention in specific learning difficulties may prevent mental disorders. Adolescents involved in bullying present with increased risk of both internalising and externalising mental disorders, as do adolescents who are frequently absent from school, whether due to illness or due to truancy. Peer rejection is an important warning sign during adolescent development. These features can fairly easily be recognised at school, and school's psychosocial support systems should have plans for intervention. Mental health promotion in school should comprise approaches that make school safe and involving for all, and individual interventions for those at risk.
[Distant mental influence on living organisms].
Bonilla, Ernesto
This article reviews studies of distant mental influence on living organisms, including mental suggestions of sleeping and awakening, mental influence at long distances, mental interactions with remote biological systems, mental effects on physiological activity and the sense of being stared at. Significant effects of distant mental influence have been shown in several randomized controlled trials in humans, animals, plants, bacteria and cells in the laboratory. Although distant mental influence on living organisms appears to contradict our ordinary sense of reality and the laws defined by conventional science, several hypotheses have been proposed to explain the observed effects; they include skeptical, signal transfer, field, multidimensional space/time and quantum mechanics hypotheses. In conclusion, as the progress of physics continues to expand our comprehension of reality, a rational explanation for distant mind-matter interaction will emerge and, as history has shown repeatedly, the supernatural events will evolve into paranormal and then, into normal ones, as the scientific frontiers expand.
Mental Health Nursing Education: An Instructor's View.
Loveland, Lynnetta
If you knew no one with a mental illness, what would mold your perceptions of someone with a mental illness? A movie character, a television actor, a description from a friend? Each of these explanations has been given to me by nursing students beginning their mental health nursing clinical rotation. Reconsideration of the limited amount of mental health education in nursing school is urgent. As we become more engrossed as a society in television and movies, the result appears to be a deceptive idea of what true mental illness entails. This piece shares personal insight from a mental health nursing educator and the transformation she witnesses in her students after a mental health clinical rotation.
One hundred years of college mental health.
Kraft, David P
Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, "mental hygiene" was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.
Institutions, Politics, and Mental Health Parity
Hernandez, Elaine M.; Uggen, Christopher
Mental health parity laws require insurers to extend comparable benefits for mental and physical health care. Proponents argue that by placing mental health services alongside physical health services, such laws can help ensure needed treatment and destigmatize mental illness. Opponents counter that such mandates are costly or unnecessary. The authors offer a sociological account of the diffusion and spatial distribution of state mental health parity laws. An event history analysis identifies four factors as especially important: diffusion of law, political ideology, the stability of mental health advocacy organizations and the relative health of state economies. Mental health parity is least likely to be established during times of high state unemployment and under the leadership of conservative state legislatures. PMID:24353902
Media and mental illness: relevance to India.
Padhy, S K; Khatana, S; Sarkar, S
Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.
Hinduism, marriage and mental illness.
Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet
For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.
Promoting Teen Mothers' Mental Health.
Freed, Patricia; SmithBattle, Lee
In this second article in a two-part series, we call for the integration of strengths-based and trauma-informed care into services for teen mothers. Nurses working with teen mothers in health clinics, schools and home visiting programs can play a pivotal role in promoting their mental health. Many teen mothers have high levels of psychological distress and histories of adverse experiences that cannot be ignored, and cannot solely be addressed by referral to mental health services. Nurses must be prepared to assess for trauma and be open to listening to teen mothers' experiences. Principles of strengths-based and trauma-informed care are complementary and can be integrated in clinical services so that teen mothers' distress is addressed and their strengths and aspirations are supported. Potential screening tools, interviewing skills and basic strategies to alleviate teen mothers' distress are discussed.
Hinduism, marriage and mental illness
Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet
For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations. PMID:23858262
Causal reasoning with mental models
Khemlani, Sangeet S.; Barbey, Aron K.; Johnson-Laird, Philip N.
This paper outlines the model-based theory of causal reasoning. It postulates that the core meanings of causal assertions are deterministic and refer to temporally-ordered sets of possibilities: A causes B to occur means that given A, B occurs, whereas A enables B to occur means that given A, it is possible for B to occur. The paper shows how mental models represent such assertions, and how these models underlie deductive, inductive, and abductive reasoning yielding explanations. It reviews evidence both to corroborate the theory and to account for phenomena sometimes taken to be incompatible with it. Finally, it reviews neuroscience evidence indicating that mental models for causal inference are implemented within lateral prefrontal cortex. PMID:25389398
Causal reasoning with mental models.
Khemlani, Sangeet S; Barbey, Aron K; Johnson-Laird, Philip N
This paper outlines the model-based theory of causal reasoning. It postulates that the core meanings of causal assertions are deterministic and refer to temporally-ordered sets of possibilities: A causes B to occur means that given A, B occurs, whereas A enables B to occur means that given A, it is possible for B to occur. The paper shows how mental models represent such assertions, and how these models underlie deductive, inductive, and abductive reasoning yielding explanations. It reviews evidence both to corroborate the theory and to account for phenomena sometimes taken to be incompatible with it. Finally, it reviews neuroscience evidence indicating that mental models for causal inference are implemented within lateral prefrontal cortex.
Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings.
Ballbè, Montse; Gual, Antoni; Nieva, Gemma; Saltó, Esteve; Fernández, Esteve
Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.
Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care.
Kroenke, Kurt; Unutzer, Jurgen
Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety. Six key components of CC include a population-based approach, measurement-based care, treatment to target strategy, care management, supervision by a mental health professional (MHP), and brief psychological therapies. Multiple trials have also shown that CC for depression is equally or more cost-effective than many of the current treatments for medical disorders. Factors that may facilitate the implementation of CC include a more favorable alignment of medical and mental health services in accountable care organizations and patient-centered medical homes; greater use of telecare as well as automated outcome monitoring; identification of patients who might benefit most from CC; and systematic training of both PCPs and MHPs in integrated team-based care.
Nervous Facilitation in Cardiodynamic Response of Exercising Athletes to Superimposed Mental Tasks: Implications in Depressive Disorder
Tocco, Filippo; Crisafulli, Antonio; Milia, Raffaele; Marongiu, Elisabetta; Mura, Roberto; Roberto, Silvana; Todde, Francesco; Concu, Daniele; Melis, Salvatore; Velluzzi, Fernanda; Loviselli, Andrea; Concu, Alberto; Melis, Franco
Introduction : Motor commands to perform exercise tasks may also induce activation of cardiovascular centres to supply the energy needs of the contracting muscles. Mental stressors per se may also influence cardiovascular homeostasis. We investigated the cardiovascular response of trained runners simultaneously engaged in mental and physical tasks to establish if aerobically trained subjects could develop, differently from untrained ones, nervous facilitation in the brain cardiovascular centre. Methods : Cardiovascular responses of 8 male middle-distance runners (MDR), simultaneously engaged in mental (colour-word interference test) and physical (cycle ergometer exercise) tasks, were compared with those of 8 untrained subjects. Heart rate, cardiac (CI) and stroke indexes were assessed by impedance cardiography while arterial blood pressures were assessed with a brachial sphygmomanometer. Results : Only in MDR simultaneous engagement in mental and physical tasks induced a significant CI increase which was higher (p<0.05) than that obtained on summing CI values from each task separately performed. Conclusion : Aerobic training, when performed together with a mental effort, induced a CI oversupply which allowed a redundant oxygen delivery to satisfy a sudden fuel demand from exercising muscles by utilizing aerobic sources of ATP, thus shifting the anaerobic threshold towards a higher work load. From data of this study it may also be indirectly stated that, in patients with major depressive disorder, the promotion of regular low-intensity exercise together with mental engagement could ameliorate the perceived physical quality of life, thus reducing their heart risk associated with physical stress. PMID:26535050
Associations of Mental Health and Physical Function with Colonoscopy-related Pain
Yamada, Eiji; Watanabe, Seitaro; Nakajima, Atsushi
Objective To clarify the effects of mental health and physical function in association with colonoscopy-related pain. Methods The mental health and physical function were evaluated using the Japanese version of the SF-8 Health Survey questionnaire. Poor physical status was defined as a physical component summary (PCS) <40 and poor mental status as a mental component summary (MCS) <40. Pain was assessed using a visual analogue scale (VAS), with significant pain defined as VAS ≥70 mm and insignificant pain as VAS <70 mm. The background and colonoscopic findings were compared in patients with significant and insignificant pain. Patients This study evaluated consecutive Japanese patients who were positive on fecal occult blood tests and underwent total colonoscopy. Results Of the 100 patients, 23 had significant and 77 had insignificant colonoscopy-related pain. A multiple logistic regression analysis showed that MCS <40 [odds ratio (OR) 6.03; 95% confidence interval (CI) 1.41-25.9, p=0.0156], PCS <40 (OR 5.96; 95% CI 1.45-24.5, p=0.0133), and ≥300 seconds to reach the cecum (OR 4.13; 95% CI 1.16-14.7, p=0.0281) were independent risk factors for colonoscopy-related pain. Conclusion The mental health and physical function are important determinants of colonoscopy-related pain. Evaluating the mental health and physical function of patients prior to colonoscopy may effectively predict the degree of colonoscopy-related pain. PMID:28202858
The 2013 Canadian Forces Mental Health Survey
Bennett, Rachel E.; Boulos, David; Garber, Bryan G.; Jetly, Rakesh; Sareen, Jitender
Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings. Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system. The findings of recent population-based CAF mental health research are reviewed, with a focus on findings from the very similar mental health survey done in 2002. Finally, key aspects of the methods of the 2013 CFMHS are presented. Results: The findings of 20 peer-reviewed publications using the 2002 mental health survey data are reviewed, along with those of 25 publications from other major CAF mental health research projects executed over the past decade. Conclusions: More than a decade of population-based mental health research in the CAF has provided a detailed picture of its mental health and use of mental health services. This knowledge base and the homology of the 2013 survey with the 2002 CAF survey and general population surveys in 2002 and 2012 will provide an unusual opportunity to use the CFMHS to situate mental health in the CAF in a historical and societal perspective. PMID:27270738
Dental anomalies in mental patients.
Moraes, N; Moraes, E; Cunha Marques, H H
Fifty-three patients were examined for dental abnormalities at an institution specializing in care of the mentally deficient in Bauru, São Paulo State. The incidence of teeth with abnormal morphology, mainly second molars with an abnormal number of cusps, was extremely high. Enamel hypoplasia was frequently found in anterior teeth, and the percentage of fractured maxillary incisors was significantly higher than that observed in normal individuals.
Components of Mental Imagery Representation.
distance on scanning time have been replicated repeatedly (see 4 Beach, 1978; Kosslyn, 1973, 1978; Kosslyn, Ball, & Reiser, 1978; Pinker , 1980; Pinker ...neural tissue; see Kosslyn, Pinker , Smith & Shwartz, 1979). Other factors, such as the accuracy and efficacy of the FIND, PUT, and RESOLUTION...Submitted for publication. Pinker , S. Mental imagery and the third dimension. Journal of ExDerimental * Psycholo : General, 1980, M09l 354-371. Pinker
[Empathy in severe mental disorders].
Martin-Contero, M C; Secades-Villa, R; Aparicio-Migueza, A; Tirapu-Ustarroz, J
Introduccion. La empatia es un subproceso de la cognicion social que se define como la capacidad de comprender y compartir los pensamientos, deseos y sentimientos de otra persona, y es crucial en muchas formas de interaccion social adaptativa. Es un fenomeno contextual, flexible y multidimensional que se relaciona con diferentes procesos y redes neuronales. Objetivo. Evaluar la empatia en una muestra de sujetos con diagnosticos que se engloban dentro de la categoria de trastorno mental grave en tratamiento en un programa de rehabilitacion psicosocial. Sujetos y metodos. Participaron 22 personas con trastorno mental grave en tratamiento en programas de rehabilitacion psicosocial y 22 controles sanos. Se aplico a cada sujeto una bateria de pruebas: cociente de empatia, Reading the Mind in the Eyes Test (test de la mirada) e indice de reactividad interpersonal. Resultados. En el test de la mirada, el grupo experimental puntuo significativamente menos que el grupo control (t = 2,8; p < 0,05). En el resto de variables no se encontraron diferencias estadisticamente significativas. Conclusiones. Las personas con trastorno mental grave no muestran un deficit generalizado de la empatia; sin embargo, muestran dificultades a la hora de reconocer estados emocionales mediante la mirada, lo que indica un procesamiento de la informacion para las caras diferente a los sujetos de la poblacion normal.
Prism adaptation by mental practice.
Michel, Carine; Gaveau, Jérémie; Pozzo, Thierry; Papaxanthis, Charalambos
The prediction of our actions and their interaction with the external environment is critical for sensorimotor adaptation. For instance, during prism exposure, which deviates laterally our visual field, we progressively correct movement errors by combining sensory feedback with forward model sensory predictions. However, very often we project our actions to the external environment without physically interacting with it (e.g., mental actions). An intriguing question is whether adaptation will occur if we imagine, instead of executing, an arm movement while wearing prisms. Here, we investigated prism adaptation during mental actions. In the first experiment, participants (n = 54) performed arm pointing movements before and after exposure to the optical device. They were equally divided into six groups according to prism exposure: Prisms-Active, Prisms-Imagery, Prisms-Stationary, Prisms-Stationary-Attention, No Conflict-Prisms-Imagery, No Prisms-Imagery. Adaptation, measured by the difference in pointing errors between pre-test and post-test, occurred only in Prisms-Active and Prisms-Imagery conditions. The second experiment confirmed the results of the first experiment and further showed that sensorimotor adaptation was mainly due to proprioceptive realignment in both Prisms-Active (n = 10) and Prisms-Imagery (n = 10) groups. In both experiments adaptation was greater following actual than imagined pointing movements. The present results are the first demonstration of prism adaptation by mental practice under prism exposure and they are discussed in terms of internal forward models and sensorimotor plasticity.
[Orthodontics for mentally handicapped patients].
Remmelink, H J
The mentally handicapped exhibit a 3 times higher incidence of malocclusions and related functional problems than the general population. In contrast there is little available literature relating to the orthodontic treatment of handicapped patients. Based on published articles on orthodontic treatment of disabled patients the following recommendations can be given. First of all for each patient a 'problem list' should be drawn up, based on the diagnosis. In this list the orthodontic problems are formulated. Additionally, the list makes clear who is responsible for providing services related to orthodontic care, such as oral hygiene and transportation of the patient to the orthodontist. When deciding whether or not orthodontic treatment should be administered to a patient with a mental handicap the same functional and aesthetic considerations as with any other orthodontic case must be taken into account. Furthermore, the severity of the handicap and possible associated psychosocial and medical limitations as well as the extent to which it will be possible to treat the patient have to be considered. Contraindications are a severe mental handicap, inability to remain still in the dental chair, insufficient co-operation of parents/carers, open bite resulting from abnormal oral function, and a mild malocclusion. The orthodontic treatment should aim for an acceptable result, and not for orthodontic perfection.
Religion, Senescence, and Mental Health
Van Ness, Peter H.; Larson, David B.
The authors review epidemiological and survey research relevant to the relationships between religiousness/spirituality and mental health in people at the end of life, with the end of helping psychiatrists, psychologists, and other mental health professionals dealing with older Americans. They give special attention to well-being, religious coping, cognitive dysfunction, anxiety, depression, and suicide, and consider the extent to which hope is a mediator of the purported salutary effects of religiousness. Studies were selected from the comprehensive and systematic review of 20th-century scientific literature concerning religion and health. Authors also review current studies relevant to religion and end-of-life issues. Religious persons reported generally higher levels of well-being. The review also found fairly consistent inverse associations of religiousness with rates of depression and suicide. There was some negative association between religious participation and cognitive dysfunction, but the association with anxiety was inconsistent, with some studies showing a correlation between higher levels of religion and anxiety. Religion's effects on mental health are generally protective in direction but modest in strength. PMID:12095898
Mental Illness and Mental Health Defenses: Perceptions of the Criminal Bar.
Frierson, Richard L; Boyd, Mary S; Harper, Angela
As the number of state mental hospital beds declines, persons with persistent mental illness are increasingly encountered by those working in the legal system. Attorneys may have little experience in working with this population. This research involved a 32-item written survey of the 492 members of the criminal bar in South Carolina. Demographic variables were surveyed, and attorneys were asked to define two common terms describing mental illnesses (delusion and psychosis) and the legal criteria for verdicts of not guilty by reason of insanity and guilty but mentally ill. They were also asked to identify the most severe mental illness (schizophrenia). Attitudes about these verdicts and about working with defendants who are mentally ill were also surveyed. Results indicate that attorneys are fairly knowledgeable about mental illness, but not verdicts involving mental illness, particularly the verdict of guilty but mentally ill. Most attorneys prefer to work with clients who do not have mental illness. However, as they become more experienced interacting with defendants who are affected by mental illness, they become more knowledgeable and are more willing to defend them. A large majority believe that their law school education about mental illness was inadequate. When comparing attorney occupations, public defenders were the most knowledgeable about mental illness and mental health defenses, followed by prosecutors and private defense attorneys. Judges were the least knowledgeable group.
Creating a cultural analysis tool for the implementation of Ontario's civil mental health laws.
Dhand, Ruby
Ethno-racial people with mental health disabilities experience multiple inequities and differential outcomes when interacting with Ontario's civil mental health laws. Given the increasing multi-racial population in Ontario, there is a need to develop mechanisms to address these intersecting issues. Other countries that have created evaluative tools for mental health legislation include the United Kingdom and Australia. Australia's Rights Analysis Tool, the United Kingdom's Race Equality Impact Assessment, the Scottish Recovery Tool, and the World Health Organization's Mental Health and Human Rights checklist are examples of evaluative tools developed for mental health legislation. Such a tool does not exist in Canada, let alone in Ontario specifically. Thus, this study developed a Cultural Analysis Tool (CAT) consisting of specific and meaningful thematic questions that can be used by practitioners when addressing issues of culture and equity for ethno-racial people with mental health disabilities interacting with Ontario's civil mental health laws. It is hoped that the CAT, and the research underlying its development, will enable practitioners to critically question whether cultural and intersecting concerns are being appropriately addressed within an ethno-racial client's case and, furthermore, how equitable outcomes can be achieved. This article describes and analyzes the methodology, research and qualitative data used to develop the CAT. It then presents and examines the CAT itself. The qualitative data was drawn from thirty-five semi-structured interviews with seven members of each of the following groups: (1) ethno-racial people with mental health disabilities including in-patients and ex-patients, (2) lawyers who practice in the area of mental health law, (3) health care professionals including psychiatrists, nurses and social workers, (4) service providers such as front-line case workers at mental health agencies and (5) adjudicators, government advisors
Sharing mental simulations and stories: hippocampal contributions to discourse integration.
Race, Elizabeth; Keane, Margaret M; Verfaellie, Mieke
Accumulating evidence suggests that mental simulation of the future and past relies on common processes supported by the hippocampus. However, it is currently unknown whether the hippocampus also supports the ability to share these mental simulations with others. Recently, it has been proposed that language and language-related structures in the brain are particularly important for communicating information not tied to the immediate environment, and indeed specifically evolved so that humans could share their mental time travels into the future and the past with others. The current study investigated whether processes supported by the hippocampus are necessary for effectively communicating the contents of one's mental simulations by examining the discourse of amnesic patients with medial temporal lobe damage. In Experiment 1 we tested whether patients can produce integrated discourse about future and past events by measuring lower-level discourse cohesion and higher-level discourse coherence. Striking reductions in both measures were observed in amnesic patients' narratives about novel future events and experienced past events. To investigate whether these deficits simply reflected concurrent reductions in narrative content, in Experiment 2 we examined the status of discourse integration in patients' verbal narratives about pictures, which contained an equivalent amount of narrative content as controls'. Discourse cohesion and coherence deficits were also present when patients generated narratives based on pictures, and these deficits did not depend on the presence of neural damage outside the hippocampus. Together, these results reveal a pervasive linguistic integration deficit in amnesia that is not limited to discourse about the past or the future and is not simply secondary to reductions in narrative content. More broadly, this study demonstrates that the hippocampus supports the integration of individual narrative elements into coherent and cohesive discourse
Assessment of mental competency in community-dwelling elderly.
Schmand, B; Gouwenberg, B; Smit, J H; Jonker, C
over a physician's judgment, especially in patients with early dementia.
Mental disorders, functional impairment, and nerve growth factor
Salles, Fanny Helena Martins; Soares, Pedro San Martin; Wiener, Carolina David; Mondin, Thaise Campos; da Silva, Paula Moraes; Jansen, Karen; de Mattos Souza, Luciano Dias; da Silva, Ricardo Azevedo; Oses, Jean Pierre
Nerve growth factor (NGF) is an important member of the neurotrophin family and its alteration has been associated with psychiatric disorders. Functionality consists of the activities that an individual can perform, as well as their social participation, which is an important factor in analyzing the carrier living conditions of subjects with psychiatric suffering. Several studies have evaluated functionality in bipolar disorder; however, no studies have evaluated the functionality in other mental disorders. There are also few studies investigating the association between functionality and the biological bases of mental disorders. This study aimed to evaluate the serum NGF levels in psychiatric patients and to verify a possible association between the serum neurotrophic levels and functionality. This was a cross-sectional study with a convenient sample obtained from the Public Mental Health Service from the south of Brazil. The final sample was composed of 286 patients enrolled from July 2013 to October 2014. Data was collected using a sociodemographic questionnaire, and the diagnosis was confirmed using the Mini International Neuropsychiatric Interview (M.I.N.I) and a Functioning Assessment Short Test. The serum NGF levels were determined using the enzyme-linked immunosorbent assay method. Statistical analyses were performed using IBM SPSS Statistic 21.0 software. NGF serum levels were increased significantly in patients with obsessive–compulsive disorder compared with patients with no obsessive–compulsive disorder (P=0.015). An increase in serum NGF levels in generalized anxiety disorder patients was observed compared with patients with no generalized anxiety disorder (P=0.047). NGF was negatively associated with autonomy (P=0.024, r=−0.136), work (P=0.040, r=−0.124), and cognition (P=0.024, r=−0.137), thereby showing that changes in serum levels of NGF are associated with functionality in mental disorders. PMID:28053561
The Empirical Evidence for Telemedicine Interventions in Mental Disorders
Shannon, Gary W.; Bashshur, Noura; Yellowlees, Peter M.
Abstract Problem and Objective: This research derives from the confluence of several factors, namely, the prevalence of a complex array of mental health issues across age, social, ethnic, and economic groups, an increasingly critical shortage of mental health professionals and the associated disability and productivity loss in the population, and the potential of telemental health (TMH) to ameliorate these problems. Definitive information regarding the true merit of telemedicine applications and intervention is now of paramount importance among policymakers, providers of care, researchers, payers, program developers, and the public at large. This is necessary for rational policymaking, prudent resource allocation decisions, and informed strategic planning. This article is aimed at assessing the state of scientific knowledge regarding the merit of telemedicine interventions in the treatment of mental disorders (TMH) in terms of feasibility/acceptance, effects on medication compliance, health outcomes, and cost. Materials and Methods: We started by casting a wide net to identify the relevant studies and to examine in detail the content of studies that met the eligibility criteria for inclusion. Only studies that met rigorous methodological criteria were included. Necessary details include the specific nature and content of the intervention, the research methodology, clinical focus, technological configuration, and the modality of the intervention. Results: The published scientific literature on TMH reveals strong and consistent evidence of the feasibility of this modality of care and its acceptance by its intended users, as well as uniform indication of improvement in symptomology and quality of life among patients across a broad range of demographic and diagnostic groups. Similarly, positive trends are shown in terms of cost savings. Conclusion: There is substantial empirical evidence for supporting the use of telemedicine interventions in patients with mental
Mini-Mental State Examination as a Predictor of Mortality among Older People Referred to Secondary Mental Healthcare
Su, Yu-Ping; Chang, Chin-Kuo; Hayes, Richard D.; Perera, Gayan; Broadbent, Matthew; To, David; Hotopf, Matthew; Stewart, Robert
Background Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive. Methods and Findings Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE score<25), regardless of a dementia diagnosis. As a whole, the group with lower cognitive function had an adjusted hazard ratio (HR) of 1.42 (95% CI: 1.28, 1.58) regardless of diagnosis. An HR of 1.23 (95% CI: 1.18, 1.28) per quintile increment of MMSE was also estimated after confounding control. A linear trend of MMSE in quintiles was observed for the subgroups of dementia and other non-dementia diagnoses (both p-values<0.001). However, a threshold effect of MMSE score under 20 was found for the specific diagnosis subgroups of depression. Conclusion Current study identified an association between cognitive impairment and increased mortality in older people using secondary mental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation. PMID:25184819
[Changing Forensic Mental Health in France: A Review].
Nakatani, Yoji; Hasuzawa, Suguru
This article describes the background and recent changes in French forensic mental health. The literature suggests that three law reforms have been crucial to changes in the mental health system. First, the Penal Code of 1992 redefined the provisions of criminal responsibility and introduced the category of diminished responsibility. Second, a controversial law for preventive detention (rétention de sûretê) was enacted in 2008, according to which criminals with severe personality disorders are subject to incarceration even after the completion of their prison sentences if they are still considered to pose a danger to the public. Third, the revision of mental health laws in 2011 altered the forms of involuntary psychiatric treatments, stipulating a judge's authority to decide treatment. In parallel with these legal reforms, the psychiatric treatment system for offenders with mental disorders has been reconstructed. The number of difficult patient units (unités pour malades difficiles) has increased from four to ten across the nation in order to meet the needs of patients transferred from general psychiatric institutions for the reason of being unmanageable. In the penitentiary system, new facilities have been established to cope with the growing number of inmates with mental disorders. As background to these changes, it is pointed out that the current psychiatric system has undergone deinstitutionalization and become less tolerant of aggressive behavior in patients. In the broader context, public sensitivity towards severe crime, as shown by the sensation triggered by serious crimes conducted by pedophiles, seems to urge tough policies. In the 2000 s, several homicides committed by psychiatric patients had a great impact on the public, which led President Sarkozy to issue a statement calling for stronger security in psychiatric institutions. The harsh attitude of courts towards psychiatric practices is illustrated by a 2012 ruling; after a patient escaped from
Mental health literacy among caregivers of persons with mental illness: A descriptive survey
Poreddi, Vijayalakshmi; BIrudu, Raju; Thimmaiah, Rohini; Math, Suresh Bada
Background: Despite of growing evidence of mental disorders in developing countries, research on mental health literacy is limited from India. Aim: To examine mental health literacy among caregivers of persons with mental illness Materials and Methods: A cross-sectional descriptive survey was carried out among 161 randomly selected caregivers of persons with mental illness at outpatient department of a tertiary care centre. Data was collected through face to face interview using a structured questionnaire. Results: Regarding the causes of mental illness, a majority agreed that genetic inheritance (69%), substance abuse (64%) and brain disease (59.6%) are main factors for developing mental illness. Although more than two-thirds agreed that anyone could suffer from mental illness, 61.5% also agreed that people with mental health problems are largely to blame for their condition. The majority of the participants also agreed that mentally ill are not able to maintain friendships (45.9%), are dangerous (54%), and not capable to work (59.1%). Just over half (55.9%) of the participants would not want people to know if they had a mental illness and nearly half of them also expressed that they would feel ashamed if a family member had a mental illness. Conclusion: Based on the findings of the present study researchers suggest that there is an urgent need to educate and change the attitudes of caregivers through mental health literacy programs specifically designed for them. PMID:26167019
[Family models and mental anorexia. Part I. Patterns in patient's family origin].
Józefik, B
The paper presents family models which associate the development of anorexia nervosa with the specific functioning of the patient's family of origin. The described conceptions are based on systems theory which assumes circular conception of family relations. This allows for avoiding one-sidedness of approach, i.e. perceiving a patient as a victim of the family system. In fact, these models emphasize the patient's part in the specific "game" taking place within the family. The conceptions indicate a number of characteristic patterns of relations between the patient's parents as a married couple as well as between the patient and her parents, which, in the period of adolescence become the source of a crisis that assumes the form of anorexia nervosa. The presented approach, focussed on an analysis of family relations, does not question the importance of other aetiological factors. It only points out that the dynamics of mutual relations within a family is an important mechanism influencing the development of the patient's identification and her psychosexual role as well as the course of the separation/individuation process. These aspects seem pivotal for understanding and treatment of anorexia nervosa.
Mental Representations of Illness in Patients with Gestational Trophoblastic Disease: How Do Patients Perceive Their Condition?
Di Mattei, Valentina E.; Carnelli, Letizia; Mazzetti, Martina; Bernardi, Martina; Di Pierro, Rossella; Bergamini, Alice; Mangili, Giorgia; Candiani, Massimo; Sarno, Lucio
Background Gestational Trophoblastic Disease comprises a group of benign and malignant disorders that derive from the placenta. Using Leventhal's Common-Sense Model as a theoretical framework, this paper examines illness perception in women who have been diagnosed with this disease. Methods Thirty-one women diagnosed with Gestational Trophoblastic Disease in a hospital in Italy were asked to complete the Illness Perception Questionnaire-Revised to measure the following: illness Identity, illness opinions and causes of Gestational Trophoblastic Disease. Results High mean scores were observed in the Emotional representations and Treatment control subscales. A significant difference emerged between hydatidiform mole patients and those with gestational trophoblastic neoplasia on the Identity subscale. A significant correlation emerged between "time since diagnosis" and the Treatment control subscale. Discussion This study is the first to investigate illness perception in Gestational Trophoblastic Disease. From a clinical perspective the results highlight the need for multidisciplinary support programs to promote a more realistic illness perception. PMID:27101144
Deficits in language-mediated mental operations in patients with schizophrenia.
Wexler, Bruce E; Donegan, Nelson; Stevens, Alexander A; Jacob, Sharif A
We found previously that a subgroup of schizophrenic patients who passed screening tests of attentional competence showed memory deficits on word memory tasks, but were comparable with controls on tone memory tasks. To better understand the nature of language-specific memory deficits in this subgroup of patients, the present experiment was designed to bypass early perceptual processing of verbal material and determine if patients continue to show impaired performance on verbal memory tasks. Patients who passed the screening tests ('discriminator' patients; DSz) received four serial position tasks. In two, familiar sounds or line drawings were presented and subjects were required to remember the word associated with each stimulus item. In the other two, subjects received hard-to-label auditory and visual stimuli (birdsongs or snowflakes).DSz patients showed large memory deficits compared with controls when required to remember words associated with the familiar sounds or drawings, providing clear evidence of deficits in verbal memory processes independent of sensory processing of verbal stimuli. The interaction between diagnosis and labeling was highly significant, confirming that these patients have particular difficulty with verbal as opposed to non-verbal memory. This was particularly striking on the auditory tests where two patients out-performed all controls on the birdsong test, but were below all controls on the easy-to-label sounds test. The verbal memory tests were easier than the non-verbal memory tests for controls, thus deconfounding task difficulty and deficit specificity.
Cognitive Control of a Simple Mental Image in Patients with Obsessive-Compulsive Disorder
ERIC Educational Resources Information Center
Kocak, Orhan Murat; Ozpolat, Aysegul Yilmaz; Atbasoglu, Cem; Cicek, Metehan
The nature of obsessions has led researchers to try to determine if the main problem in obsessive-compulsive disorder (OCD) is impaired inhibitory control. Previous studies report that the effort to suppress is one of the factors that increase the frequency of obsessive thoughts. Based on these results and those of the present study that suggest…
Optimism, Social Support, and Mental Health Outcomes in Patients with Advanced Cancer
Applebaum, Allison J.; Stein, Emma M.; Lord-Bessen, Jennifer; Pessin, Hayley; Rosenfeld, Barry; Breitbart, William
Objective Optimism and social support serve as protective factors against distress in medically ill patients. Very few studies have specifically explored the ways in which these variables interact to impact quality of life (QOL), particularly among patients with advanced cancer. The present study examined the role of optimism as a moderator of the relationship between social support and anxiety, depression, hopelessness, and QOL among patients with advanced cancer. Methods Participants (N = 168) completed self-report assessments of psychosocial, spiritual, and physical well-being, including social support, optimism, hopelessness, depressive and anxious symptoms, and QOL. Hierarchical multiple regression analyses were conducted to determine the extent to which social support and optimism were associated with depressive and anxious symptomatology, hopelessness and QOL, and the potential role of optimism as a moderator of the relationship between social support and these variables. Results Higher levels of optimism were significantly associated with fewer anxious and depressive symptoms, less hopelessness and better QOL. Higher levels of perceived social support were also significantly associated with better QOL. Additionally, optimism moderated the relationship between social support and anxiety, such that there was a strong negative association between social support and anxiety for participants with low optimism. Conclusions This study highlights the importance of optimism and social support in the QOL of patients with advanced cancer. As such, interventions that attend to patients' expectations for positive experiences and the expansion of social support should be the focus of future clinical and research endeavors. PMID:24123339
[Disorders of mental function in patients with circulatory encephalopathy due to hypertension and atherosclerosis].
Voloshin, P V; Kryzhenko, T V; Mishchenko, T S; Shestopalova, L F
The authors described the dynamics of disorders of memory, attention and thinking in the course of treatment of patients with circulatory encephalopathy. It was shown that treatment resulted a prevailing regression of neurodynamic disorders of the higher psychic functions that was more productive at early stages of cerebrovascular insufficiency.
Mental health measures of anxiety and depression in patients with retinal detachment.
Mozaffarieh, Maneli; Sacu, Stefan; Benesch, Thomas; Wedrich, Andreas
In this study, the researchers examined anxious and depressive symptoms of patients with rhegmatogenous retinal detachment (RRD) prior to and up to year after retinal detachment surgery. One hundred and thirteen (113) patients with RRD took part in this prospective longitudinal study. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). Visual acuity (VA) results and HADS scores of all participants were recorded prior to and 3, 6 and 12 months after retinal detachment surgery. Pearson correlation analysis showed a significant association between the patients' VA and HADS psychological scores both prior to and three months after surgery, regardless of the type of surgery performed. Psychological distress is a significant problem associated with retinal detachments that requires more attention.
Psychiatric In-Patients Away from Home: Accounts by People with Intellectual Disabilities in Specialist Hospitals outside Their Home Localities
ERIC Educational Resources Information Center
Chinn, Deborah; Hall, Ian; Ali, Afia; Hassell, Holly; Patkas, Iannis
Background: This study reflects a growing concern with the placement of people with intellectual disabilities and complex mental health problems in out of area placements at a distance from their families and communities. Materials and methods: We interviewed service users (n = 17) living in out of area in-patient psychiatric units using a…
Pilot mental health: expert working group recommendations.
Following a March 27, 2012, incident in which a pilot of a major commercial airline experienced a serious disturbance in his mental health, the Aerospace Medical Association formed an Ad Hoc Working Group on Pilot Mental Health. The working group met several times and analyzed current medical standards for evaluating pilot mental health. The result of the working group was a letter sent to the FAA and other organizations worldwide interested in medical standards. The Committee found that it is neither productive nor cost effective to perform extensive psychiatric evaluations as part of the routine pilot aeromedical assessment. However it did recommend greater attention be given to mental health issues by aeromedical examiners, especially to the more common and detectable mental health conditions and life stressors that can affect pilots and flight performance. They encouraged this through increased education and global recognition of the importance of mental health in aviation safety.
Violence against women and mental health.
Oram, Sian; Khalifeh, Hind; Howard, Louise M
Violence against women is widely recognised as a violation of human rights and a public health problem. In this Series paper, we argue that violence against women is also a prominent public mental health problem, and that mental health professionals should be identifying, preventing, and responding to violence against women more effectively. The most common forms of violence against women are domestic abuse and sexual violence, and victimisation is associated with an increased risk of mental disorder. Despite clinical guidance on the role of mental health professionals in identifying violence against women and responding appropriately, poor identification persists and can lead to non-engagement with services and poor response to treatment. We highlight that little research has been done on how to improve identification and treatment of victims and perpetrators in contact with mental health services, but that mental health services could play a major role in primary and secondary prevention of violence against women.
Mental Imagery: Functional Mechanisms and Clinical Applications.
Pearson, Joel; Naselaris, Thomas; Holmes, Emily A; Kosslyn, Stephen M
Mental imagery research has weathered both disbelief of the phenomenon and inherent methodological limitations. Here we review recent behavioral, brain imaging, and clinical research that has reshaped our understanding of mental imagery. Research supports the claim that visual mental imagery is a depictive internal representation that functions like a weak form of perception. Brain imaging work has demonstrated that neural representations of mental and perceptual images resemble one another as early as the primary visual cortex (V1). Activity patterns in V1 encode mental images and perceptual images via a common set of low-level depictive visual features. Recent translational and clinical research reveals the pivotal role that imagery plays in many mental disorders and suggests how clinicians can utilize imagery in treatment.
Mental Imagery: Functional Mechanisms and Clinical Applications
Pearson, Joel; Naselaris, Thomas; Holmes, Emily A.; Kosslyn, Stephen M.
Mental imagery research has weathered both disbelief of the phenomenon and inherent methodological limitations. Here we review recent behavioral, brain imaging, and clinical research that has reshaped our understanding of mental imagery. Research supports the claim that visual mental imagery is a depictive internal representation that functions like a weak form of perception. Brain imaging work has demonstrated that neural representations of mental and perceptual images resemble one another as early as the primary visual cortex (V1). Activity patterns in V1 encode mental images and perceptual images via a common set of low-level depictive visual features. Recent translational and clinical research reveals the pivotal role that imagery plays in many mental disorders and suggests how clinicians can utilize imagery in treatment. PMID:26412097
Getting it right: appropriate therapeutic recreation programs for community based consumers of mental health services.
Pegg, S; Moxham, L
Over the last two decades in Australia, the deinstitutionalization process, which began with the intent of moving consumers of mental health services from in-patient facilities and then seeking to integrate these same individuals into the community, has served to highlight a wide range of consumer needs that have remained largely unfulfilled throughout the process. One such need has been the provision of appropriate therapeutic recreation programs for the community based consumers of the various state co-ordinated mental health services. This paper argues a case for a change in the approach which professional staff provide and lead therapeutic recreation based programs to enable participants to be empowered, rather than disempowered, through their involvement. Further, this paper contends that there is a need for health care staff, more generally, to accept the concept of such programs for the community based consumers of various mental health services as a valued one.
Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications.
Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel
Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service.
How culture shapes social cognition deficits in mental disorders: A review.
Koelkebeck, Katja; Uwatoko, Teruhisa; Tanaka, Jiro; Kret, Mariska Esther
Social cognitive skills are indispensable for successful communication with others. Substantial research has determined deficits in these abilities in patients with mental disorders. In neurobiological development and continuing into adulthood, cross-cultural differences in social cognition have been demonstrated. Moreover, symptomatic patterns in mental disorders may vary according to the cultural background of an individual. Cross-cultural studies can thus help in understanding underlying (biological) mechanisms and factors that influence behavior in health and disease. In addition, studies that apply novel paradigms assessing the impact of culture on cognition may benefit and advance neuroscience research. In this review, the authors give an overview of cross-cultural research in the field of social cognition in health and in mental disorders and provide an outlook on future research directions, taking a neuroscience perspective.
Plasticity of the human visual system after retinal gene therapy in patients with Leber's congenital amaurosis.
Ashtari, Manzar; Zhang, Hui; Cook, Philip A; Cyckowski, Laura L; Shindler, Kenneth S; Marshall, Kathleen A; Aravand, Puya; Vossough, Arastoo; Gee, James C; Maguire, Albert M; Baker, Chris I; Bennett, Jean
Much of our knowledge of the mechanisms underlying plasticity in the visual cortex in response to visual impairment, vision restoration, and environmental interactions comes from animal studies. We evaluated human brain plasticity in a group of patients with Leber's congenital amaurosis (LCA), who regained vision through gene therapy. Using non-invasive multimodal neuroimaging methods, we demonstrated that reversing blindness with gene therapy promoted long-term structural plasticity in the visual pathways emanating from the treated retina of LCA patients. The data revealed improvements and normalization along the visual fibers corresponding to the site of retinal injection of the gene therapy vector carrying the therapeutic gene in the treated eye compared to the visual pathway for the untreated eye of LCA patients. After gene therapy, the primary visual pathways (for example, geniculostriate fibers) in the treated retina were similar to those of sighted control subjects, whereas the primary visual pathways of the untreated retina continued to deteriorate. Our results suggest that visual experience, enhanced by gene therapy, may be responsible for the reorganization and maturation of synaptic connectivity in the visual pathways of the treated eye in LCA patients. The interactions between the eye and the brain enabled improved and sustained long-term visual function in patients with LCA after gene therapy.
Optimization of anti-TNF therapy in patients with Inflammatory Bowel Disease.
Strik, A S; Bots, S J A; D'Haens, G; Löwenberg, M
After the introduction of anti-tumor necrosis factor (anti-TNF) agents, the clinical outcome of patients with Inflammatory Bowel Disease (IBD) has improved significantly. However, use of anti-TNF therapy is complicated by loss of response. In order to maintain remission, adequate serum levels are required. Hence, therapeutic drug monitoring (TDM) is important in order to optimize serum drug levels, especially in patients with loss of response to these agents. Optimization of anti-TNF therapy by applying TDM enables clinicians to regain response to TNF blockers in a significant proportion of patients. It is important to use anti-TNF agents in their most optimal way, since these therapeutic agents are expensive and the medical options after failing anti-TNF therapy are limited. Here, we will discuss how to optimize treatment with anti-TNF agents in IBD patients in order to improve treatment efficacy, prevent anti-drug antibody formation, reduce side effects, discontinue unnecessary treatment and manage costs.
[Mental health care for immigrants in Germany].
Schouler-Ocak, M
Immigrants represent a very heterogeneous population, with various stress factors for mental disorders. These individuals are confronted with numerous access barriers within the health care system, which are reflected in limited utilization of the mental health system and psychotherapy services. A particularly large gap in health service provision exists among refugees and asylum-seekers. There is an urgent need for action in terms of opening up of the mental health system, improving and simplifying routes of access, and facilitating treatment options.