Psychiatric Illness in Patients with Persistent Somatisation

1995 ◽  
Vol 166 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Per Fink
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Personality Disorder ◽  
Broad Spectrum ◽  
Psychiatric Illness ◽  
Psychiatric Services ◽  
Psychiatric Diagnoses ◽  
Mental Health Care System ◽  
Icd 10

BackgroundThis study explores the incidence and nature of mental illness among persistent somatisers, and analyses their use of mental health services.MethodIndividuals with at least ten admissions to non-psychiatric departments during an 8-year period were studied. Persistent somatisers (n = 56) were compared with other frequent users (n = 57) of non-psychiatric services.ResultsOf the persistent somatisers, 82% had been examined by a psychiatrist at least once (median, 3 times). Sixteen per cent were mentally retarded, 48% were dependent on alcohol or drugs, and 48% had DSM–III–R personality disorder. The most prevalent ICD–10 diagnoses were anxiety states (54%), depressions (30%), phobias (18%) and psychoses (20%).ConclusionsPersistent somatisation is associated with severe mental illness and a broad spectrum of heterogeneous psychiatric diagnoses and syndromes. Persistent somatisers impose a serious burden on the mental health care system.

Mental health services for single homeless people

2020 ◽  
pp. 1-11
Author(s):  
Philip Timms ◽  
Jenny Drife
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Personality Disorder ◽  
Health Services ◽  
Substance Misuse ◽  
Homeless People ◽  
Psychiatric Services ◽  
Background Information ◽  
The Past ◽  
The Uk

SUMMARY Homelessness has long been associated with high rates of psychosis, alcohol and substance misuse, and personality disorder. However, psychiatric services in the UK have only recently engaged actively with homeless people. This article provides some background information about homelessness and mental illness and describes the elements of inclusion health and some of the models of service for homeless people that have been established over the past 30 years.

Learning disability, autism and the Criminal Procedure (Scotland) Act

2020 ◽  
Vol 14 (5) ◽  
pp. 149-167
Author(s):  
Fionnuala Williams ◽  
Mike Warwick ◽  
Colin McKay ◽  
Callum Macleod ◽  
Moira Connolly
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Personality Disorder ◽  
Learning Disability ◽  
Design Methodology ◽  
Medication Use ◽  
Criminal Procedure ◽  
Content Type ◽  
Scottish Government

Purpose This paper aims to investigate the use of Part VI of the Criminal Procedure (Scotland) Act 1995 (CPSA) for people with Learning Disability (LD) and/or Autism. This is in the context of a recent review commissioned by the Scottish Government into whether the provisions in the Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA) meet the needs of these groups which would also affect associated legislation such as CPSA. Design/methodology/approach All CPSA orders active on the 3 January 2018 were identified and analysed for a number of variables including diagnoses, detention length, level of hospital security and medication use. Findings Of the 580 people on CPSA orders, 69 (11.9%) had LD and 27 (4.7%) had possible/definite Autism. Most people with LD (56.5%) did not have a mental illness or personality disorder. Most (81.2%) had mild LD. There were two patients whose only diagnosis was Autism. Mean duration of detention was longer for those with LD than for those without. Most patients with LD alone were prescribed medication (61.5%) and, if in hospital, were managed in low secure units (59%). Originality/value The results indicate that people with LD or Autism are differently affected by the application of the CPSA from other people with mental disorders, and that this is potentially discriminatory, if it is not objectively justified . It supports the stance from the recent review that to reduce the potential for discrimination, substantial changes to MHA and CPSA should be considered in the wider review of the MHA in Scotland.

Management of personality disorder

2012 ◽  
pp. 901-910
Author(s):  
Giles Newton-Howes ◽  
Kate Davidson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Personality Disorder ◽  
Psychiatric Services ◽  
Optimal Conditions ◽  
Mental Health Practice ◽  
Equivalent Position ◽  
Personality Dysfunction ◽  
Explanatory Trials ◽  
The Cost

Some years ago that most sceptical of academic psychiatrists, Michael Shepherd, in referring to the contents of a book entitled Recent Advances in Psychiatry commented that the content was more accurately defined as ‘recent activities’, as ‘advances’ was too generous a word. Whilst not going quite as far as this in regard to advances in the treatment of personality disorder it is fair to add that the promise of effective therapies across the spectrum of personality dysfunction remains a long way off and we must be very careful not to oversell the evidence. The complexity of personality disorders often requires complex intervention, however, until we are confident that single treatments are effective the arguments for evaluating them in combination have to be very strong on theoretical grounds to justify the cost. We are still at the stage in which explanatory trials (ones demonstrating efficacy under optimal conditions) are at least as necessary as pragmatic ones (demonstrating benefit in conditions of ordinary practice). These need to be carried out with adequate numbers of patients (at least 50 in each treatment arm rather than an artificially derived sample size to justify a small number) and with good independent assessments carried out by research workers who are masked as much as possible from disclosure of treatment. These requirements are exacting but can be achieved. We also need better pragmatic trials of patients seen in ordinary mental health practice whose treatment and characteristics are both representative and from whom it is possible to generalize findings with confidence. Currently there are very few studies that satisfy this requirement; one recent study combining an educational intervention with problem-solving is an exception. Despite the caution of these statements these are exciting times in the management of personality disorder. We are no longer listening to the once powerful lobby that claimed that patients with these conditions should not be treated by psychiatric services, or to the pessimists that still regard these conditions as untreatable. We are in the equivalent position as those in the early 1950s who suddenly became aware of the possibility that powerful treatments for severe mental illness were ready and waiting to be used. They do indeed appear to be within reach, but we must use them wisely.

scholarly journals Current Issues within the Perinatal Mental Health Care System in Aichi Prefecture, Japan: A Cross-Sectional Questionnaire Survey

2021 ◽  
Vol 18 (17) ◽  
pp. 9122
Author(s):  
Kei Fujita ◽  
Tomomi Kotani ◽  
Yoshinori Moriyama ◽  
Takafumi Ushida ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Drug Use ◽  
Mental Health Care ◽  
Health Care System ◽  
Psychotropic Drug ◽  
Maternity Care ◽  
Cross Sectional ◽  
Mental Health Care System

Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 were mailed to the head physicians of 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. A total of 82 (52.6 per 100,000 births) women were admitted to mental health care units during the perinatal period, and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs. Approximately 40% of patients were hospitalized in psychiatric hospitals without maternity care units. Eighty-four (71.1%) and 76 (64.4%) maternity care units did not have psychiatrists or social workers, respectively. Moreover, 20–35% of the head physicians in private clinics, general hospitals, and ART units endorsed the discontinuation of psychotropic drug use during pregnancy. However, the corresponding figures were only 5% among those in maternal-fetal centers. Resources for perinatal mental illness might be limited. Perspectives on psychotropic drug use differed based on the type of facilities where the doctors were working.

Stephen Weiner, Patient in the Mental Health System

2015 ◽  
Author(s):  
Stephen Weiner ◽  
Susanne Petermann
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Palliative Care ◽  
Emotional Disturbance ◽  
Scientific Basis ◽  
Not Given ◽  
Know How ◽  
Mental Health Care System ◽  
System P

Excerpts from an interview with Stephen Weiner, who recounts his experience in the mental health care system from being told he had an emotional disturbance as a child (1957–1958) to his work with a psychiatrist on strengthening his more rational self. As a child, he was not given a diagnosis, making it difficult to know how “objectively” to evaluate his condition. Probably little was known about the phenomenology of derealization and solipsism then. After college he decided to seek treatment for his growing depression and alcohol abuse under a method known as Rolfing. He describes his skepticism toward psychiatrists and allied professionals unwilling to explain the scientific basis of their treatment. He suggests that the switch to the biological model of mental illness, while mostly good, brought about new difficulties for patients. After seeing three different doctors, Weiner settled with a psychiatrist who offered relief and palliative care.

scholarly journals Keeping pace with current issues in reporting suicide and mental illness

2007 ◽  
Vol 4 (2) ◽  
pp. 51-64
Author(s):  
J. Skehan ◽  
◽  
L. S. Burns ◽  
T. Hazell ◽  
◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Health Care System ◽  
Voluntary Euthanasia ◽  
Mental Health Care System ◽  
National Media ◽  
Multi Media ◽  
Deaths In Custody

The Response Ability Project, funded under the Mindframe National Media Initiative in Australia, seeks to influence tertiary curricula so that graduates in journalism will be aware of and able to respond appropriately to issues relating to suicide and mental illness. Whilst the initial multi-media resources developed to support journalism educators have been received well, engagement with media organisations and individual journalists under other Mindframe projects have revealed further complexities associated with the reporting of suicide and mental illness. In particular, journalists have indicated that the issues become more problematic when they are required to report suicides in other contexts, such as murder-suicides, deaths in custody and voluntary euthanasia. Similarly, the reporting of mental illness was more complex in the context of crime and in the reporting of the mental health care system. This paper will highlight some of these new complexities of reporting and discuss how the Response Ability project has responded through the development of supplementary resources to allow educators to raise such issues with students.

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