scholarly journals Anticonvulsant monitoring in psychiatric practice

2001 ◽  
Vol 25 (9) ◽  
pp. 356-358 ◽  
Author(s):  
Debbie Nelson ◽  
Douglas Gray
Keyword(s):  
Psychiatric Illness ◽  
Best Practice ◽  
Literature Search ◽  
Serum Levels ◽  
Psychiatric Practice ◽  
Clinical Implications

Aims and MethodA Medline literature search revealed a large number of articles on anticonvulsant monitoring. More relevant articles were selected with the aim of summarising current best practice in this area.ResultsMost articles were written to address monitoring in epilepsy and not psychiatric illness. Serum ranges should only be regarded as guidelines. Some patients may show toxic signs at therapeutic serum levels while others may show tolerance and require higher levels.Clinical ImplicationsAppropriate monitoring of serum levels improves efficacy and enhances safety. Clinician ignorance may lead to inappropriate or inaccurate sampling with resultant adverse consequences for the patient.

scholarly journals Brain fag syndrome: a culture-bound syndrome that may be approaching extinction

2015 ◽  
Vol 39 (4) ◽  
pp. 156-161
Author(s):  
Oyedeji A. Ayonrinde ◽  
Chiedu Obuaya ◽  
Solomon Olusola Adeyemi
Keyword(s):  
Strong Evidence ◽  
Current Knowledge ◽  
Explanatory Models ◽  
West African ◽  
Psychiatric Practice ◽  
Clinical Implications ◽  
Place Of Birth ◽  
Somatic Disorders ◽  
Structured Questionnaire

Aims and methodTo explore the current salience of ‘brain fag’ as a nosological, diagnostic and clinical construct in modern West African psychiatry. A semi-structured questionnaire and vignette based on classical symptoms of brain fag syndrome were used to explore current knowledge, explanatory models and practice among Nigerian psychiatrists.ResultsOf 102 psychiatrists who responded, 98% recognised the term ‘brain fag syndrome’ and most recognised the scenario presented. However, only 22% made a diagnosis of brain fag syndrome in their practice preferring diagnoses of anxiety, affective and somatic disorders.Clinical implicationsA decreasing number of Nigerian psychiatrists are making a diagnosis of ‘brain fag syndrome’. We found strong evidence of nosological and diagnostic decline in the syndrome in its place of birth. This may signal the early extinction of this disorder or nosological metamorphosis from a ‘culture-bound’ syndrome in West African psychiatric practice.

scholarly journals Substance use disorders and psychological trauma

2009 ◽  
Vol 33 (7) ◽  
pp. 257-260
Author(s):  
Shaheen Shora ◽  
Elizabeth Stone ◽  
Keron Fletcher
Keyword(s):  
Substance Use ◽  
Alcohol Dependence ◽  
Life Events ◽  
Substance Use Disorders ◽  
Best Practice ◽  
Clinical Course ◽  
Traumatic Events ◽  
Psychological Trauma ◽  
Clinical Implications ◽  
The Impact

Aims and MethodThe Impact of Events Scale was administered to 104 in-patients detoxing from alcohol or opiates to determine the prevalence of psychological trauma, the severity of its symptoms and the types of trauma responsible for symptoms.ResultsOut of the 104 in-patients undergoing detoxification, 75 had symptoms of psychological trauma; in 60 patients the symptoms were in the treatable range. Patients with alcohol-dependence were more severely affected. ‘Life events’ traumatised a higher proportion of individuals than ‘traumatic events’.Clinical ImplicationsPsychological trauma requiring treatment is commonly found in substance misusers. This is rarely addressed despite the cormorbid disorder running a complicated clinical course. There are conflicting opinions about best practice, but consideration should be given to providing patients with accessible treatments for psychological trauma.

Increased Serum Levels of Soluble CD30 in Patients with Common Variable Immunodeficiency and Its Clinical Implications

2007 ◽  
Vol 28 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Nima Rezaei ◽  
Mostafa Haji-Molla-Hoseini ◽  
Asghar Aghamohammadi ◽  
Ali Akbar Pourfathollah ◽  
Mina Moghtadaie ◽  
...  
Keyword(s):  
Common Variable Immunodeficiency ◽  
Serum Levels ◽  
Clinical Implications ◽  
Soluble Cd30 ◽  
Common Variable

scholarly journals Service innovations: second opinions in child and adolescent psychiatry

2003 ◽  
Vol 27 (1) ◽  
pp. 22-24
Author(s):  
Greg Richardson ◽  
David Cottrell
Keyword(s):  
Mental Health ◽  
Young People ◽  
Adolescent Psychiatry ◽  
Best Practice ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Clinical Implications ◽  
Academic Unit ◽  
Diagnosis And Management

AIMS AND METHODSTo devise a protocol, reflecting best practice, for obtaining second opinions in child and adolescent psychiatry through discussion with consultants in child and adolescent psychiatry within the Yorkshire region at their quarterly meetings.ResultsThe major pressure for second opinions falls upon the Academic Unit of Child and Adolescent Mental Health and on the in-patient units. Other consultants who are considered to have specialist expertise in certain areas may also receive referrals for second opinions. Both consultants requesting and offering second opinions considered a protocol for obtaining them would be helpful to their practice.Clinical ImplicationsAn agreed protocol between consultants in child and adolescent psychiatry within a region ensures that young people with complex problems have access to second opinions on their diagnosis and management by consultants who can be recommended to referrers by other consultants. The network of consultants ensures such opinions are not requested excessively and that ‘rogue’ opinions without therapeutic follow-up are avoided.

Serum Levels of NTx and TRACP5b in Giant Cell Tumor of Bone and its Clinical Implications

2015 ◽  
Vol 61 (08/2015) ◽  
Author(s):  
Jiangtao Chen ◽  
Aikebaier Younusi ◽  
Li Cao ◽  
Leilei Xu ◽  
Yijun Zhou ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Serum Levels ◽  
Cell Tumor ◽  
Clinical Implications

Psychiatric Morbidity in HIV Patients

1998 ◽  
Vol 43 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Hani Raoul Khouzam ◽  
Nancy J Donnelly ◽  
Nabil F Ibrahim
Keyword(s):  
Quality Of Life ◽  
Psychiatric Illness ◽  
Literature Search ◽  
Psychiatric Morbidity ◽  
Clinical Information ◽  
Hiv And Aids ◽  
Psychiatric Evaluation ◽  
Diagnostic Code ◽  
Dsm Iv

Objective: To provide an accessible source of clinical information related to the diagnosis and treatment of psychiatric morbidity associated with HIV infection. Method: A selective MEDLINE literature search was used to identify 225 relevant articles, 67 of which were selected for inclusion based upon the presence of psychiatric morbidity. Psychiatric morbidity was defined by the presence of a DSM-IV diagnostic code reflecting psychiatric illness. Results: HIV-infected patients have high rates of psychiatric morbidity. Conclusion: The psychiatric evaluation and treatment of psychiatric morbidity improve the quality of life of HIV and AIDS patients.

scholarly journals Body mass index and blood glucose in psychiatric and general practice populations

2016 ◽  
Vol 40 (3) ◽  
pp. 127-131 ◽  
Author(s):  
Sarah McAvoy ◽  
Matthew Cordiner ◽  
Jackie Kelly ◽  
Laura Chiwanda ◽  
Christine Jefferies ◽  
...  
Keyword(s):  
Body Mass Index ◽  
General Practice ◽  
Blood Glucose ◽  
Environmental Factors ◽  
Body Mass ◽  
Psychiatric Illness ◽  
Metabolic Parameters ◽  
Metabolic Effects ◽  
Clinical Implications ◽  
Practice Population

Aims and methodUsing a retrospective observational approach, we aimed to discern whether there was a difference in metabolic parameters between psychiatric and general practice populations in the same locality. Second, we aimed to establish differences in metabolic parameters of patients taking olanzapine, clozapine or aripiprazole.ResultsPatients with psychiatric illness had a body mass index (BMI) comparable to that of the general practice population (28.7 v. 29.7 kg/m2), but blood glucose was significantly lower in the general practice population (4.8 v. 6.1 mmol/L). Olanzapine was associated with the lowest BMI (26.1 kg/m2) and aripiprazole the highest (32.2 kg/m2), with no difference in blood glucose between antipsychotics.Clinical implicationsAwareness of environmental factors and how they affect individuals is important and medications are not the only cause of metabolic effects. There may be a channelling bias present, meaning practitioners are cognisant of potential metabolic effects prior to prescribing. Overall monitoring of physical health is important regardless of potential cause.

scholarly journals Capacity, compliance and electroconvulsive therapy (ECT): the practice of ECT among consultant psychiatrists

2006 ◽  
Vol 30 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Richard Law-Min ◽  
John Patrick Stephens
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Best Practice ◽  
Response Rate ◽  
Common Law ◽  
Good Practice ◽  
Legal Framework ◽  
Clinical Implications ◽  
Clinical Vignettes

Aims and MethodThe aim of this study was to seek the views of consultant psychiatrists on the legal framework they would use when considering treatment with electroconvulsive therapy (ECT). A questionnaire, consisting of three clinical vignettes, was sent to 70 consultants in the Wessex rotation (East Dorset/Hampshire region).ResultsA total of 56 questionnaires were returned; a response rate of 80%. Most consultant psychiatrists agree when giving ECT to capacitated and non-consenting patients. However, there was a lack of consensus when dealing with seemingly incapacitated but compliant patients.Clinical ImplicationsMore clarification in this area is needed. Trusts can assist clinicians by devising their own policies based on nationally agreed standards of best practice. The treatment of mentally incapacitated but compliant patients is an area of practice where uncertainty exists. If proceeding under common law in such cases, it is good practice to discuss with relatives/carers and obtain a second opinion from a consultant colleague. The most recent Bournewood judgement and the new Mental Health Bill will have further implications for clinical practice.

scholarly journals Taking the temperature: attitudes of patients on an all-female psychiatric ward to staff gender

2009 ◽  
Vol 33 (12) ◽  
pp. 457-460
Author(s):  
Lisa Conlan ◽  
Helen Read ◽  
Elizabeth Picton
Keyword(s):  
Best Practice ◽  
Large Majority ◽  
Psychiatric Ward ◽  
Clinical Implications ◽  
Single Gender ◽  
Weekly Basis ◽  
Staff Members ◽  
Anonymous Questionnaire ◽  
Predominantly Female ◽  
Mixed Gender

Aims and MethodTo survey the attitudes of in-patients on an all-female ward to staff gender. All patients were invited to complete an anonymous questionnaire which was then repeated on a four-weekly basis for 4 months. Staff members were surveyed once within this period.ResultsOnly 15% of patients (n = 52) wanted all staff members to be female, whereas 87% reported feeling comfortable with male staff; 51% would prefer a predominantly female, mixed-gender staff. All staff (n = 11) were in favour of mixed-gender staffing.Clinical ImplicationsCurrent best practice for staffing single-gender acute in-patient units is unclear. This survey is in line with findings from other studies in that a large majority of female in-patients prefer to be in a unit with mixed staff.

scholarly journals Clozapine prescribing in adolescent psychiatry: survey of prescribing practice in in-patient units

2005 ◽  
Vol 29 (10) ◽  
pp. 377-380 ◽  
Author(s):  
Giovanni Cirulli
Keyword(s):  
Young People ◽  
Adolescent Psychiatry ◽  
Best Practice ◽  
Child And Adolescent Psychiatry ◽  
Effective Drug ◽  
Clinical Implications ◽  
Treatment Resistant ◽  
Practice Recommendations ◽  
Prescribing Practice ◽  
The Uk

Aims and MethodClozapine is an effective drug in treatment-resistant schizophrenia, but it seems to be prescribed for few patients under the age of 18 years. This study reports a survey of consultant psychiatrists working in adolescent units in the UK, looking at their use of clozapine and experience with it.ResultsOut of 83 clinicians, 59 responded (71%). More than 40% of respondents do not use clozapine, and those who do may not always be following best practice recommendations. Reasons for not using clozapine, beliefs about its effectiveness and problems encountered in its use are described.Clinical ImplicationsClozapine may not always be made available to young people with treatment-resistant schizophrenia. There is a need for more education, guidance and debate on clozapine use in child and adolescent psychiatry.

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