scholarly journals First Do No Harm: An Analysis of the Risk Aspects and Side Effects of Clinical Holistic Medicine Compared With Standard Psychiatric Biomedical Treatment

2007 ◽  
Vol 7 ◽  
pp. 1810-1820 ◽  
Author(s):  
Søren Ventegodt ◽  
Isack Kandel ◽  
Joav Merrick
Keyword(s):  
Side Effects ◽  
Psychiatric Treatment ◽  
Treatment Method ◽  
Mental Illnesses ◽  
Holistic Medicine ◽  
Treatment As Usual ◽  
Philosophy Of Life ◽  
Do No Harm ◽  
Comparative Review ◽  
Patients At Risk

Clinical holistic medicine (CHM) is short-term psychodynamic psychotherapy (STPP) complemented with bodywork and philosophical exercises, to be more efficient in treating patients with severe mental and physical illness. STPP has already been found superior to psychiatric treatment as usual (TAU) and thus able to compete with psychiatric standard treatment as the treatment of choice for all non-organic mental illnesses; we have found the addition of bodywork and philosophy of life to STPP to accelerate the process of existential healing and recovery (salutogenesis). In this paper we compare the side effects, suicidal risk, problems from implanted memory and implanted philosophy of CHM with psychopharmacological treatment. Method: Qualitative and quantitative comparative review. Results: In all aspects of risks, harmfulness, and side effects, we have been considering, CHM was superior to the standard psychiatric treatment. The old principle of “first do no harm“ is well respected by CHM, but not always by standard psychiatry. CHM seems to be able to heal the patient, while psychopharmacological drugs can turn the patient into a chronic, mentally ill patient for life. Based on the available data CHM seems another alternative to patients with mental illness. There seem to be no documentation at all for CHM being dangerous, harmful, having side effects of putting patients at risk for suicide. As CHM uses spontaneous regression there is no danger for the patient developing psychosis as, according to some experts, has been seen with earlier intensive psychodynamic methods. CHM is an efficient, safe and affordable cure for a broad range of mental illnesses.

Do no harm in due process – a historical analysis of social determinates of institutionalization in the USA

2021 ◽  
pp. 0957154X2110346
Author(s):  
Tyler Durns
Keyword(s):  
Mentally Ill ◽  
Due Process ◽  
Psychiatric Treatment ◽  
Historical Analysis ◽  
Involuntary Hospitalization ◽  
Fundamental Function ◽  
Cultural Paradigms ◽  
Do No Harm ◽  
The Usa ◽  
Legislative Amendments

Involuntary hospitalization has been a fundamental function of psychiatric care for mentally ill persons in the USA for centuries. Procedural and judicial practices of inpatient psychiatric treatment and civil commitment in the USA have served as a by-product of socio-political pressures that demanded constant reform throughout history. The origin of modern commitment laws can best be understood through the lens of cultural paradigms that led to their creation and these suggest caution for future legislative amendments.

scholarly journals Toxic Animal-Based Medicinal Materials Can Be Effective in Treating Endometriosis: A Scoping Review

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 145
Author(s):  
Su-In Hwang ◽  
Young-Jin Yoon ◽  
Soo-Hyun Sung ◽  
Ki-Tae Ha ◽  
Jang-Kyung Park
Keyword(s):  
Side Effects ◽  
Clinical Studies ◽  
Malignant Tumors ◽  
Experimental Studies ◽  
Herbal Medicines ◽  
Treatment Method ◽  
Reproductive Age ◽  
Dependent Growth ◽  
Gynecological Disorder ◽  
Preclinical And Clinical Studies

Animal toxins and venoms have recently been developed as cancer treatments possessing tumor cell growth-inhibitory, antiangiogenesis, and proapoptotic effects. Endometriosis is a common benign gynecological disorder in reproductive-age women, and no definite treatment for this disorder is without severe side effects. As endometriosis and malignant tumors share similar characteristics (progressive, invasive, estrogen-dependent growth, and recurrence), animal toxins and venoms are thought to be effective against endometriosis. The objective of this study was to outline studies using toxic animal-based medicinal materials (TMM) as endometriosis treatment and to explore its clinical applicability. Preclinical and clinical studies using TMM were searched for in four databases from inception to October 2020. A total of 20 studies of TMM on endometriosis were included. In eight clinical studies, herbal medicines containing TMM were effective in relieving symptoms of endometriosis, with no side effects. In twelve experimental studies, the main therapeutic mechanisms of TMM against endometriosis were proapoptotic, antiangiogenesis, estrogen level-reducing, and possible anti-inflammatory effects. TMM are thus considered promising sources for the development of an effective treatment method for endometriosis. Further studies are needed to clarify the therapeutic mechanism of TMM against endometriosis and to provide sufficient grounds for clinical application.

scholarly journals Methodology for Development of a Community Level Intervention Module for Physical Illness in Persons with Mental Illness (CLIPMI)

2020 ◽  
Vol 42 (6_suppl) ◽  
pp. S94-S98
Author(s):  
Ramanujam Govindan ◽  
Thara Rangaswamy ◽  
Sujit John ◽  
Sunitha Kandasamy
Keyword(s):  
Mental Health ◽  
Intervention Program ◽  
Intervention Group ◽  
Mental Health Program ◽  
Mental Illnesses ◽  
Community Level ◽  
Treatment As Usual ◽  
Health Delivery ◽  
Expected Outcome ◽  
Health Delivery System

Background and Objectives: Medical illnesses seen in persons with psychiatric disorders are important but often ignored causes of increased morbidity and mortality. Hence, a community level intervention program addressing the issue is proposed. Materials and Methods: Patients with severe mental illnesses will be identified by a door-to-door survey and assessed for comorbid physical illnesses like anemia, hypertension, diabetes, and so on. They will then be randomized into two groups. The treatment as usual (TAU) group will not receive intervention from the trained community level workers, while the Intervention group will receive it. Results: The two groups will be compared for the prevalence and severity of comorbid physical illnesses. The expected outcome is compared to the TAU group, the intervention group will have a greater reduction in the morbidity due to physical illnesses and improved mental health. Conclusion: If successful, the module can be incorporated into the community level mental health delivery system of the District Mental Health Program (DMHP).

scholarly journals Advances in psychiatric treatment in primary care

2001 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Christopher Dowrick
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
Health Professionals ◽  
Depressive Disorders ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Mental Illnesses ◽  
Breaking Work

Following ground-breaking work by Shepherd et al (1966) and, more recently, Goldberg & Huxley (1992), primary care is now recognised as the arena in which most contact occurs between the National Health Service (NHS) and people with mental health problems. General practitioners (GPs) remain the first, and in many cases the only, health professionals involved in the management of a whole range of conditions, from common anxiety and depressive disorders to severe and enduring mental illnesses.

scholarly journals Group cognitive-behavioural therapy for schizophrenia

2006 ◽  
Vol 189 (6) ◽  
pp. 527-532 ◽  
Author(s):  
Christine Barrowclough ◽  
Gillian Haddock ◽  
Fiona Lobban ◽  
Steve Jones ◽  
Ron Siddle ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Method ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Positive Symptom ◽  
Secondary Outcome ◽  
Symptom Improvement ◽  
Treatment As Usual ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural

BackgroundThe efficacy of cognitive–behavioural therapy for schizophrenia is established, but there is less evidence for a group format.AimsTo evaluate the effectiveness of group cognitive – behavioural therapy for schizophrenia.MethodIn all, 113 people with persistent positive symptoms of schizophrenia were assigned to receive group cognitive – behavioural therapy or treatment as usual. The primary outcome was positive symptom improvement on the Positive and Negative Syndrome Scales. Secondary outcome measures included symptoms, functioning, relapses, hopelessness and self-esteem.ResultsThere were no significant differences between the cognitive-behavioural therapy and treatment as usual on measures of symptoms or functioning or relapse, but group cognitive – behavioural therapy treatment resulted in reductions in feelings of hopelessness and in low self-esteem.ConclusionsAlthough group cognitive – behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.

scholarly journals Metabolic side effects of clozapine in patients at south ceredigion community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S345-S345
Author(s):  
Harish Reddy
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Side Effects ◽  
Nutritional Intervention ◽  
Serum Glucose ◽  
Lifestyle Changes ◽  
Glucose Levels ◽  
Fasting Level ◽  
Waist Size ◽  
Patients At Risk

AimsThe aim of the audit was to identify patients at risk of developing Metabolic Syndrome who are on Clozapine in the community. Anyone who has three of following attributes has Metabolic Syndrome. A large waist size (greater than 40 inches in men or 35 inches in women) ,high blood pressure (130/85 mm Hg or higher) ,high triglycerides — a form of fat in the blood (150 mg/dL or higher) ,high blood sugar (a fasting level of 100 mg/dL or higher).Patients receiving should be regularly monitored under clinical review particularly in relation to side effects of the drug and maintain minimum standards of review both physically and clinical investigations once a year .BackgroundTo measure the screening of central obesity, Blood Pressure, serum glucose levels and lipid profile in last one year.MethodData were collected from Blood results and electronic entries of patients who are on Clozapine in South Ceredigion Community Mental Team. There were 31 patients of which 20 were male and 11 were female patients. The age range was 31–66 years and average was 46 years.Result52% of the patients had obesity,34 % with Hypertension,50 %Dyslipidaemia and 43 % had Increased glucose tolerance. 80 % were only on clozapine,3% were on combined Amisulpride, 10% on combined on Ariprazole, 3 % on combined Quetiapine.ConclusionTreatment of causes like making changing lifestyle changes, weigh reduction using health diet and to include regular physical activity. Reduce Abdominal Obesity and in possible provide nutritional intervention.

Therapeutics and Medical Emergencies

2019 ◽  
Author(s):  
Nicholas Longridge ◽  
Pete Clarke ◽  
Raheel Aftab ◽  
Tariq Ali
Keyword(s):  
Side Effects ◽  
Life Support ◽  
The Body ◽  
Practice Setting ◽  
Oral Side ◽  
Do No Harm ◽  
Medical Emergencies ◽  
The Will ◽  
Key Topics ◽  
Basic Level

Firstly, do no harm. This is held as the first law of clinical practice when considering any intervention to improve the health of our patients. This may at times be a difficult proposition, especially when the approach to treating a condition is fraught with risks and can carry the danger of adverse and unwanted side effects. Prescribing therapeutics is the time perhaps when this maxim should be most at the forefront of a clinician’s mind, as therapeutic interven­tions may not cause any immediately discernible danger or harm in the same way as operative interventions. It is therefore important for the prescriber to understand the relevant pharmacodynamics (the effects of the agent on the body) and pharmacokinetics (the effects of the body on the agent). To add a further layer of complexity, the reader should understand that pharmacological sciences are possibly the fastest evolving part of medicine. It would be a fair bet to say that, within the course of the reader’s undergraduate education, entire new classes of therapeutics will have emerged and established perceptions of other agents would have significantly changed. Practically speaking, this does not mean that it is necessary to mem­orize the nuances of all therapeutic agents (although you should have a good grasp of those you prescribe regularly); rather it is more important that a clinician understands how to recognize potential dangers and then be resourceful enough to mitigate against them, given the best know­ledge available at the time. Access to an up- to-date formulary and the will to use it are the surest way to navigate any prescribing pitfalls. ‘We don’t rise to the occasion, we fall to the most basic level of our training’. Thankfully, medical emergencies occur infrequently in the general practice setting. It is the rarity of such events that often leads to anxieties when dealing with them. This reaction is amplified by the caregiver’s nat­ural instinct to do something immediately, but often not knowing exactly what to do because the diagnosis is not immediately clear. The ABCDE approach, as advocated by the Resuscitation Council, is a safe and methodical way to approach any emergency. ABCDE is not only a hierarchy of importance for systems critical to life, but it also acts as an aide- memoire to undertake examinations and interventions when necessary. Most importantly, it buys time whilst the diagnosis is found or declares itself, without adversely affecting the outcome by inaction. Key topics include: ● Common drugs for common medical conditions ● Drug interactions ● Oral side effects of medications ● Basic life support ● Medical emergencies in dentistry (including the Resuscitation Council UK guidelines) ● ABCDE approach.

Mental Health Treatment over Time

2018 ◽  
pp. 149-160
Author(s):  
Mary C. Zanarini
Keyword(s):  
Outpatient Treatment ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Psychotropic Medications ◽  
Evidence Based ◽  
Outpatient Psychotherapy ◽  
Health Treatment ◽  
Treatment As Usual ◽  
Borderline Patients ◽  
Over Time

At baseline, borderline patients reported using high rates of outpatient treatment and more restrictive forms of treatment, such as inpatient psychiatric treatment. Over time, these rates have declined, particularly for more restrictive and costly forms of treatment. However, high rates of borderline patients remain in outpatient psychotherapy and continue taking standing medications in all major classes of psychotropic medications. Perhaps most concerning is that a substantial percentage of borderline patients have been treated with aggressive polypharmacy (three or more standing medications) despite the health consequences, such as obesity, and despite there being no empirical evidence for this common practice. Evidence-based psychosocial treatments are reviewed, and suggestions are made for treatment as usual.

scholarly journals MON-252 Pituitary Tumor Apoplexy Presenting with Acute Psychosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Maria Mercedes Pineyro ◽  
Patrica Agüero ◽  
Florencia Irazusta ◽  
Claudia Brun ◽  
Paula Duarte ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Pituitary Tumor ◽  
Psychiatric Treatment ◽  
Psychiatric Symptoms ◽  
Mental Illnesses ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Sellar Mass ◽  
History Of ◽  
Pituitary Tumor Apoplexy

Abstract Background: Pituitary tumors (PT) can present with neuropsychiatric symptoms. It has been associated with hormonal changes, as well as extension of the tumor to the diencephalon. Psychopathology has been reported in up to 83% in Cushing Disease (CD) and 35% in acromegaly (ACR). Psychiatric disorders (depression, anxiety and psychosis) have been reported up to 77% in CD and 63% in ACR. We present a rare case of a patient presenting with acute psychosis and a PT apoplexy. Case: A 27 year-old Caucasian female with a PMH of primary hypothyroidism presented with a 15-day history of delusions. She had delusional ideas on the subject of harm and prejudice, persecutory and mystical-religious. The mechanism was mainly intuitive and interpretive with false acknowledgments. She also had sleep disturbance, death ideation and subacute alteration of consciousness. There was no history of substance abuse or psychiatric disorders. She did not report headaches, visual disturbances, symptoms of hormone hypersecretion or hypopituitarism. She had regular menses on BCP. She had no family history of mental illnesses. Physical exam revealed reluctance, latency in responses and bradypsychia. She did not have acromegalic or cushingoid features. She was diagnosed with acute psychosis with atypical features so a brain CT was performed, which showed a sellar mass. Pituitary MRI revealed a sellar mass measuring 15x12x13 mm, with suprasellar extension, optic chiasm compression, hyperintense on T1- and hypointense on T2-weighted imaging compatible with subacute hemorrhage. She was treated with neuroleptics and benzodiazepines. Lab work revealed high prolactin (PRL) (114ng/dl), and normal 8 AM cortisol, FT4, LH, FSH and IGF-1 levels. Repeated PRL was 31,6 ng/dl after changing psychiatric treatment to aripiprazole. Her psychiatric symptoms improved. We postulate a diagnosis of PT apoplexy that presented with acute psychosis. In relation to the nature of the PT we postulate a non functioning pituitary adenoma (NFA) or a partial resolution of a prolactinoma after apoplexy. A follow up MRI is pending. Discussion: Infrequently, psychiatric symptoms may be the primary manifestation of brain tumors. Patients with PT have been reported to have altered quality of life, reduced coping strategies, increased prevalence of psychopathological alterations and maladaptive personality disorders. In addition, they can present with psychotic symptoms, mostly reported with hormone excess (GH and cortisol). Psychiatric symptoms such as anxiety and neurosis have been reported in NFA and prolactinomas. However, it is not clear a higher prevalence of psychiatric illnesses in these tumors. To our knowledge this is the first case of a pituitary tumor apoplexy presenting with acute psychosis. Conclusion: Psychiatric symptoms can be the first manifestation of PT, so atypical presentations should warrant further workup with brain imaging.

scholarly journals From the Origins of Pharmacogenetics to First Applications in Psychiatry

2019 ◽  
Vol 53 (04) ◽  
pp. 155-161 ◽  
Author(s):  
Daniel J. Müller ◽  
Zoe Rizhanovsky
Keyword(s):  
Side Effects ◽  
Clinical Outcome ◽  
Conceptual Framework ◽  
Drug Targets ◽  
Genetic Factors ◽  
Psychiatric Treatment ◽  
Clinical Pharmacologist ◽  
Genetic Traits ◽  
Future Studies ◽  
Practical Implications

AbstractPharmacogenetics is the division of science addressing how genetic factors contribute to the metabolism, response, and side effects of a given medication. What was once regarded as a subdivision of genetics and pharmacology is now recognized as its own field and has its own unique story of origin. While the term “pharmacogenetics” was coined by Friedrich Vogel in 1959, the relevance of inherited genetic traits in affecting the clinical outcome to xenobiotics has been observed long before. In fact, there is much hope that pharmacogenetics can help unravel the “mysteries” as to why different people may display variable responses to the same medication as well as identify new drug targets. This article will highlight the conceptual framework for pharmacogenetics advanced by pioneer scientists Arno Motulsky and Friedrich Vogel (both human geneticists), as well as Werner Kalow (clinical pharmacologist), leading up to the creation of modern pharmacogenetics. Finally, the practical implications and first steps toward implementation for current psychiatric treatment are reviewed followed by an outlook on future studies.

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