scholarly journals Management of self-harm in adults: which way now?

2005 ◽  
Vol 187 (6) ◽  
pp. 497-499 ◽  
Author(s):  
Navneet Kapur
Keyword(s):  
Staff Training ◽  
Service Provision ◽  
Good Practice ◽  
Public Health Problem ◽  
Evidence Based ◽  
Current Management ◽  
Important Public Health Problem ◽  
Psychological Treatments ◽  
Low Intensity ◽  
Self Harm

SummarySelf-harm remains an important public health problem and two sets of clinical guidelines have been published recently. While these include elements of accepted good practice they are not evidence-based. Further research might concentrate on either very large trials of low-intensity interventions or smaller trials of longer-term psychological treatments. The current management of self-harm may be improved by shifting professionals' views, involving users in staff training, and changing service provision – perhaps moving from risk assessment to needs assessment.

Pattern of acute adult poisoning at Tikur Anbessa specialized teaching hospital, a retrospective study, Ethiopia

2010 ◽  
Vol 30 (7) ◽  
pp. 523-527 ◽  
Author(s):  
Mekonnen Desalew ◽  
Azaje Aklilu ◽  
Amare Amanuel ◽  
Melkie Addisu ◽  
Tesfaye Ethiopia
Keyword(s):  
Medical Records ◽  
Epigastric Pain ◽  
Case Fatality ◽  
Public Health Problem ◽  
Acute Poisoning ◽  
University Hospital ◽  
Important Public Health Problem ◽  
Self Harm ◽  
The Common ◽  
Suicidal Patients

Acute poisoning continues to be an important public health problem. Medical records of 116 adult patients presented to Tikur Anbessa Specialized University Hospital from January 2007 to December 2008 were reviewed retrospectively. Females outnumbered males. Mean age was 21 years. Most (96.5%) were intentional self-harm poisonings. Household cleansing agents were the leading causes of poisoning (43.1%) followed by organophosphate (21.6%) and phenobarbitone (10.3%). Loss of consciousness, vomiting and epigastric pain were the common presenting features accounting 46.2%, 23.8% and 22.5%, respectively. A total of 13(11.2%) patients had already known mental illness and 12 of them poisoned by using their own medications. Among 65 patients who reported their reason of poisoning, temporary quarrel (57%) and emotional disturbance (26%) were frequently cited. The case fatality rate was 8.6%. Death was most occurred by organophosphate (5/25) and phenobarbitone poisoning (3/12). Awareness on proper handling of chemicals and prescribed agents should be forwarded to users of these agents. Majority of patients poisoned for intentional self-harm purposes so that linkage of suicidal patients to appropriate mental health service is recommended. The availability of psychiatry consultation in the hospital is also recommended.

scholarly journals Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

2002 ◽  
Vol 25 (4) ◽  
pp. 178 ◽  
Author(s):  
Stewart L Einfeld ◽  
John Beard ◽  
Margaret Tobin ◽  
Richard Buss ◽  
Michael Dudley ◽  
...  
Keyword(s):  
Young People ◽  
Service Provision ◽  
Policy Development ◽  
Best Practice ◽  
Service Management ◽  
Evidence Based Practice ◽  
Successful Implementation ◽  
Evidence Based ◽  
Self Harm ◽  
Attitudinal Changes

In 1998-1999, two Area Health Services in NSW conducted a project to implement evidence-based service enhancements for the clinical management of young people who present with Deliberate Self Harm (DSH) behaviour. The present study examined what structures and procedures were required to implement and sustain evidence-based practice in different health care settings for patients with DSH behaviour. Service provision was assessed at three points during the initial project to assess the degree of change that occurred, and 9 months after the completion of the project to allow an assessment of sustainability of the service provision. We examined staff perceptions of the importance of education, management directives, policy and procedure changes, and cultural/ attitudinal changes, in implementing clinical best practice. Results indicated that support from both service management and clinical staff is necessary for successful implementation of service enhancements. High levels of staff education and policy development were also associated with high levels of service performance. The best sustained enhancements were those that were developed by the services themselves.

scholarly journals VEIKSMINGI PSICHOLOGINĖS PAGALBOS BŪDAI PSICHOTRAUMATOLOGIJOJE

Psichologija ◽  
2013 ◽  
Vol 47 ◽  
pp. 102-115 ◽  
Author(s):  
E. Kazlauskas
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Good Practice ◽  
Psychological Trauma ◽  
Psychosocial Treatment ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Psychological Treatments ◽  
Evidence Based Treatments

Straipsnyje analizuojamas psichologinės pagalbos būdų suaugusiems asmenims psichotraumatolo­gijoje veiksmingumas. Įsigilinus į 1998–2012 m. paskelbtas metaanalizes, sistemines apžvalgas, geros praktikos vadovus, daromos išvados, kad daugelis tyrimų patvirtina trumpalaikės į traumą orientuotos kognityviosios elgesio terapijos bei nujautrinimo akių judesiais ir perdirbimo (EMDR) terapijos veiksmin­gumą potrauminio streso sutrikimų turintiems asmenims. Tyrimų rezultatai rodo, kad asmenims iš kar­to po trauminio įvykio nerekomenduojama taikyti formalias psichosocialinės intervencijos procedūras, kaip antai psichologinis susirinkimas (angl. debriefing). Yra mokslinių įrodymų, kad trumpalaikė eklekti­nė terapija (BEPP), internetu teikiamos pagalbos ar virtualios realybės taikymo metodai gali veiksmingai padėti asmenims, kurie turi potrauminio streso sutrikimą. Straipsnyje aptariamos tyrimais paremtų psi­chologinės pagalbos metodų diegimo psichotraumatologijos praktikoje problemos. Pagrindiniai žodžiai: psichologinė trauma, potrauminio streso sutrikimas, pagalbos veiksmingumas.   EFFECTIVE PSYCHOLOGICAL TREATMENTS IN PSYCHOTRAUMATOLOGYEvaldas Kazlauskas SummaryThe present article gives an overview of the psycho­logical treatments of psychological trauma. The article is oriented towards practitioners who want to update their knowledge of the recent developments in psychotraumatology. The research findings, based on meta-analyses and good practice guidelines, are presented and the issues related to the implementation of evidence-based treatments are discussed.The study has shown that the critical stress incident debriefing developed by J. T. Mitchell in 1983 (or psychological debriefing) is not recommended imme­diately after trauma. Metaanalysis (Rose et al., 2003; van Emmeric et al., 2002) revealed no positive long-term effects of debriefing immediately after trauma, with indications of negative outcomes in some studies. Practical guidelines of the International Society of Traumatic Stress Studies, as well as other guidelines do not recommend debriefing as a regular procedure for all survivors. Practical, social or legal assistance provided in an empathic way is recommended during the first month after the trauma. Meta-analytical studies published since 1998 concerning the effectiveness of posttraumatic stress disorder treatments demonstrated the efficacy of trauma-focused cognitive-behavioral therapies (TF-CBT) and eye movement reprocessing and desen­sitization therapy (EMDR). Evidence from studies on the effects of a brief eclectic psychotherapy for posttraumatic stress disorder (BEPP), developed by B. Gersons, internet-based treatments, and virtual reality are promising, and these treatments in the future are possible effective alternatives for TF-CBT and EMDR in evidence-based practice. Psychological treatments should be the first option for the treatment of PTSD, with medication used only when the appro­priate psychological treatments are unavailable or the client prefers medication over psychosocial treatment. While a number of RCT studies have shown the efficacy of TF-CBT and EMDR treatment for PTSD, there is still a gap between research and everyday clinical practice. From the practitioner’s point of view, transfer of manual-based methods from RCT efficacy studies to daily practice is not easy. Clinicians are facing complicated cases, and comorbid disorders are widely prevalent with PTSD. We must also be aware that with the new treatments developed, training of these methods and particularly the availability of sys­tematic supervisions are not always easily accessible; this slows down the dissemination and implementation of evidence-based treatments. Clinicians have to take their own responsibility for selecting what is best for a particular client; however, practitioners also need to make decisions based on what science shows to be the most effective treatment.Key words: psychological trauma, posttraumatic stress disorder, effectiveness of treatment.   o:OfficeDocumentSettings> Veiksmingi psichologinės pagalbos būdai psichotraumatologijoje 

scholarly journals Deliberate self-harm: service development in Kettering

1995 ◽  
Vol 19 (8) ◽  
pp. 475-477 ◽  
Author(s):  
Catherine Gordon ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Service Provision ◽  
Public Health Problem ◽  
District General Hospital ◽  
Service Development ◽  
Paracetamol Poisoning ◽  
Deliberate Self Harm ◽  
Threefold Increase ◽  
Self Harm ◽  
Recent Trends

Services for deliberate self-harm patients in the general hospital are unsatisfactory in many respects. A survey of activity and quality in a district general hospital confirmed recent trends observed elsewhere and highlights areas in which service provision can be improved.High rates of deliberate self-harm (DSH) are a public health problem. A study in Oxford showed rising rates among young women during the late 1980s, and a threefold increase in the proportion due to paracetamol poisoning between 1976 and 1990 (Hawton & Fagg, 1992). A multicentre European study found a trend of increasing peak age, a declining female to male ratio, and unexplained differences between regions (Platt, 1992). In the year following DSH, 9% repeat (Hawton & Fagg, 1992); and suicide rates reach 1.1 to 1.3% of patients in the three years following an episode of DSH (Owens et al. 1991).

scholarly journals The effects of psychological treatment of perinatal depression: an overview

2021 ◽  
Author(s):  
Pim Cuijpers ◽  
Eirini Karyotaki
Keyword(s):  
Parental Stress ◽  
Perinatal Depression ◽  
Psychological Treatment ◽  
Public Health Problem ◽  
Psychological Interventions ◽  
Important Public Health Problem ◽  
Psychological Treatments ◽  
Treatment Of Depression ◽  
Moderate Effect Size ◽  
Meta Analyses

Abstract Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.

The Factors Related with Behaviors and Approaches of Mothers in Avoiding Children from Gastroenteritis

2019 ◽  
Vol 14 (04) ◽  
pp. 186-193
Author(s):  
Yasemin Durduran ◽  
Bahar Kandemir ◽  
Sevgi Pekcan ◽  
Reyhan Evci
Keyword(s):  
Low Socioeconomic Status ◽  
Outpatient Clinic ◽  
Good Practice ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Hand Washing ◽  
P Value ◽  
Chi Square ◽  
Important Public Health Problem ◽  
Cross Sectional

Gastrointestinal infection is an important public health problem in children and is frequently seen in developing countries due to low socioeconomic status and education levels, not obeying hygiene rules, and lack of environmental sanitation. Prevention of diarrheal diseases and raising the awareness of the mothers about diarrhea/gastroenteritis is a very important subject. The aim of this study was to evaluate the knowledge and attitude of the mothers, who attended a pediatric outpatient clinic for any reason, about the management and prevention of gastroenteritis in children.This cross-sectional study was performed in Konya, Turkey. The study was carried out with mothers who attended the pediatric outpatient clinic of a faculty of medicine and who had a baby between 0 and 2 years of age. Surveys prepared according to the literature, were used for collecting data. Descriptive statistics, chi-square test, and independent t-test were used for data analysis. A p-value of < 0.05 was considered to be significant.The mean age of mothers was 31.7 ± 7.2 years. Of all the mothers, 97.2% had short nails, 76.3% regularly cleaned their nails once a week, and 92.2% used soap for hand washing every time. A mean score of 8.7 ± 2.8 for a question giving 12 situations where hand washing was necessary was obtained. Of the mother's babies, 40.3% had had diarrhea at least once. In terms of giving baby water and changing feeding behavior during diarrhea/gastroenteritis, significant differences were found between mothers whose babies had diarrhea/gastroenteritis previously and those whose babies had not experienced diarrhea/gastroenteritis. 83.6% of mothers had never heard about vaccination against rotavirus.Washing hands correctly and mothers' knowledge about proper water and food hygiene are important points in protecting children against diarrheal and gastroenteritis diseases. However, there is lack of knowledge and good practice, both in protecting children from, and managing children with, diarrhea. Thus, we believe that it would be beneficial to inform and educate mothers with little children, regularly about these issues.

Suicide on the Indian Subcontinent

Crisis ◽  
2002 ◽  
Vol 23 (3) ◽  
pp. 104-107 ◽  
Author(s):  
Murad M. Khan
Keyword(s):  
Sri Lanka ◽  
Mental Health Professionals ◽  
Indian Subcontinent ◽  
Interpersonal Relationship ◽  
Public Health Problem ◽  
Elderly Subjects ◽  
Important Public Health Problem ◽  
Policy Makers ◽  
Formidable Challenge ◽  
Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.

Study of the efficacy of Pathadi Ghanavati with Lajamanda in the management of Aamatisara

2019 ◽  
Vol 4 (03) ◽  
Author(s):  
Madhura Jadhav ◽  
P. D. Londhe
Keyword(s):  
Acute Diarrhoea ◽  
Public Health Problem ◽  
World Health ◽  
Important Public Health Problem ◽  
Loose Motion ◽  
Economic Class ◽  
Watery Stool ◽  
Health Organization ◽  
Effective Remedy ◽  
Trial Drug

Acute Diarrhoea is an important public health problem worldwide. The World Health Organization estimates that there are more than 1000 million cases of Acute Diarrhoea. Loose motion less than 2 weeks that labelled as Acute Diarrhoea. Diarrhoea is described in Ayurvedic classics with the name of ‘Atisara’. It means passing of excessive flow of watery stool through anus. Most important factor in the pathogenesis of Aamatisara is Mandagni. In present study 50 patients of Aamatisara were selected from OPD and IPD of Kayachikitsa department. For the clinical study Pathadi Ghanavati and Lajamanda was selected as the trial drug which was given for the duration of 7 days in the dose of 1gm twice a day. It was observed that 32% patients were from the age group 51-60 years, 70% were females, 62% were from lower-middle socio economic class. Sama Jivha was found in all the patients. Among results loose motion showed 98.75% relief, 97.82% showed improvement in Udarashoola, 97.43% improvement in Agnimandya and Daurbalya each, 100% relief was seen in Aruchi. All the symptoms showed highly significant results. Hence it can be concluded that Pathadi Ghanavati and Lajamanda is very effective remedy in the patients of Aamatisara.

Disorders of Impulse Control and Self-Harm

2010 ◽  
pp. 504-530 ◽  
Author(s):  
Matthew K. Nock ◽  
Christine B. Cha ◽  
Halina J. Dour
Keyword(s):  
Environmental Factors ◽  
Psychological Factors ◽  
Impulse Control ◽  
Clinical Presentation ◽  
Evidence Based ◽  
Comprehensive Review ◽  
Assessment And Treatment ◽  
Self Harm ◽  
Clinical Problems ◽  
Control Spectrum

Disorders of impulse-control and self-harm are dangerous clinical problems that often present significant challenges for scientists and clinicians. In this chapter, we provide a comprehensive review of each disorder on the impulse-control spectrum. We begin by describing the clinical presentation and epidemiology of each disorder. Next, we discuss what is currently known about the etiology of these disorders, summarizing recent research on genetic/neurobiological factors, environmental factors, and psychological factors that appear to influence these disorders. The assessment and treatment of disorders of impulse-control and self-harm is complicated by the relatively low base-rate of these disorders, as well as by their dangerous and sensitive nature. Nevertheless, several evidence-based approaches to assessment and treatment have been developed and also are reviewed here. We conclude with recommendations for future scientific and clinical efforts aimed at better understanding, predicting, and preventing disorders of impulse-control and self-harm.

Sign in / Sign up

Export Citation Format

Share Document