European Psychiatry
0924-9338
Cơ quản chủ quản: CAMBRIDGE UNIV PRESS , Cambridge University Press
Lĩnh vực:
Psychiatry and Mental Health
Phân tích ảnh hưởng
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Provision of perinatal mental health services in a community setting Introduction Psychiatric illness and suicide in particular have been a leading overall cause of maternal mortality in the United Kingdom. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer leading causes, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children's subsequent development. Aims To identify the current practice for management and prevention of perinatal mental illness within a community mental health setting. To identify the extent to which policy recommendations from NICE “Antenatal and postnatal mental health” been implemented Methods The audit included all women who are pregnant, breastfeeding or who are planning to become pregnant and referred to the CMHT between November 2008 to April 2010 20 Cases identified by asking all team members to recall relevant clients. Results 65% of those referred were in the antenatal period and 25% were in the post natal period. 40% of those referred had a pre existing mental illness and 60% were new onset during antenatal & postnatal period. The main diagnosis was depression and anxiety disorders. 55% of those referred to the CMHT were on Psychotropic medications. However following the assessment and follow up by CMHT, only 25% of those referred needed to be on the psychotropics. Good compliance was achieved in the documentation of past psychiatric history and family history, provision of appropriate psychosocial interventions and specific considerations for the use of antidepressant medication during pregnancy and the postnatal period.
Tập 26 - Trang 1096 - 2011
P01-361 - Melas - How Much Do We Know and Should We Know More? Introduction Mitochodrial Encephalopathy, Lactic Acidosis and Stroke like episodes, better known as MELAS continues to be rare and psychiatric literature on this disorder remains sparse. This maternally transmitted genetic disorder is progressive and fatal. Aims and objectives The neurological and neurophysiological symptoms of the disorder can be made out from the name MELAS which does not convey the plethora of psychiatric manifestations it can have. The psychiatric presentations can range from anxiety disorders, attention deficit, eating disorders, personality disorders and psychoses of the paranoid or affective types. Psychopathology can precede or appear during the course of neurological symptomatology leading to dementia. More knowledge about the possible psychiatric presentations is required to help detection and develop management guidelines. Methods Awareness of MELAS can result only from cohort studies. In the background of nearly fifteen years' follow up of a cohort with heavy genetic loading, the role of psychiatry in managing ongoing symptomatology with scope for futuristic interventions is discussed. Results The fatality or the rarity of the disorder should not be a deterrant in charting out treatment guidelines for MELAS. Psychotropics, multidisciplinary care package and primary support net work maintain quality of life against progress of the disorder. Conclusion Understanding MELAS would help in maintaining and improving the quality of life of this patient group. MELAS requires further, in depth multidisciplinary studies. Comprehensive neuro-psychiatric, psychosocial and palliative models of management protocols need to be developed.
Tập 25 - Trang 574 - 2010
Neurotrophic factors and the pathophysiology of schizophrenic psychoses Abstract The aim of this review is to summarize the present state of findings on altered neurotrophic factor levels in schizophrenic psychoses, on variations in genes coding for neurotrophic factors, and on the effect of antipsychotic drugs on the expression level of neurotrophic factors. This is a conceptual paper that aims to establish the link between the neuromaldevelopment theory of schizophrenia and neurotrophic factors. An extensive literature review has been done using the Pub Med database, a service of the National Library of Medicine, which includes over 14 million citations for biomedical articles back to the 1950s. The majority of studies discussed in this review support the notion of alterations of neurotrophic factors at the protein and gene level, respectively, and support the hypothesis that these alterations could, at least partially, explain some of the morphological, cytoarchitectural and neurobiochemical abnormalities found in the brain of schizophrenic patients. However, the results are not always conclusive and the clinical significance of these alterations is not fully understood. It is, thus, important to further neurotrophic factor research in order to better understand the etiopathogenesis of schizophrenic psychoses and, thus, potentially develop new treatment strategies urgently needed for patients suffering from these devastating disorders.
Tập 19 - Trang 326-337 - 2004
Abnormal brain oscillations persist after recovery from bipolar depression Abstract When directly perturbed in healthy subjects, premotor cortical areas generate electrical oscillations in the beta range (20–40 Hz). In schizophrenia, major depressive disorder and bipolar disorder (BD), these oscillations are markedly reduced, in terms of amplitude and frequency. However, it still remains unclear whether these abnormalities can be modulated over time, or if they can be still observed after treatment. Here, we employed transcranial magnetic stimulation (TMS) combined with EEG to assess the frontal oscillatory activity in eighteen BD patients before/after antidepressant treatments (sleep deprivation and light therapy), relative to nine healthy controls. In order to detect dominant frequencies, event related spectral perturbations (ERSP) were computed for each TMS/EEG session in all participants, using wavelet decomposition. The natural frequency at which the cortical circuit oscillates was calculated as the frequency value with the largest power across 300 ms post-stimulus time interval. Severity of depression markedly decreased after treatment with 12 patients achieving response and nine patients achieving remission. TMS/EEG resulted in a significant activation of the beta/gamma band response (21–50 Hz) in healthy controls. In patients, the main frequencies of premotor EEG responses to TMS did not significantly change before/after treatment and were always significantly lower than those of controls (11–27 Hz) and comparable in patients achieving remission and in those not responding to treatment. These results suggest that the reduction of natural frequencies is a trait marker of BD, independent from the clinical status of the patients. The present findings shed light on the neurobiological underpinning of severe psychiatric disorders and demonstrate that TMS/EEG represents a unique tool to develop biomarkers in psychiatry.
Tập 41 - Trang 10-15 - 2017
EPA-1686 – Schizophrenia vs. complex trauma: challenging millon MCMI-III inventory results with Lacter & Lehmann (2008) differential diagnosis guidelines
Tập 29 - Trang 1 - 2014
Neurofunctional Effects of Cannabis on Response Inhibition Background: This study examined the effect of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on brain activation during a motor inhibition task. Methods: Functional magnetic resonance imaging and behavioural measures were recorded while 15 healthy volunteers performed a Go/No-Go task following administration of either THC or CBD or placebo in a double-blind, pseudo-randomized, placebo-controlled repeated measures within-subject design. Results: Relative to placebo, THC attenuated activation in the right inferior frontal and the anterior cingulate gyrus. In contrast, CBD deactivated the left temporal cortex and insula. These effects were not related to changes in anxiety, intoxication, sedation, and psychotic symptoms. Conclusions: These data suggest that THC attenuates the engagement of brain regions that mediate response inhibition. CBD modulated function in regions not usually implicated in response inhibition.
Tập 24 - Trang S208 - 2009