Pharmacotherapy with psychotropic drugs

1982 ◽  
Vol 63 (1) ◽  
pp. 19-23
Author(s):  
I. E. Zimakova ◽  
A. M. Karpov ◽  
S. V. Kirshin

From 6 to 12% of the population of economically developed countries suffer from various mental disorders, more than 80% of which are borderline forms of neuropsychic pathology [2]. These include those psychopathological conditions that are manifested by symptoms of anxiety and fear, increased fatigue and exhaustion, increased irritability, anxious suspiciousness, low mood, obsessions, senestopathies, hypochondria, insomnia, autonomic disorders. These mental disorders are observed both in mental illnesses - neuroses, psychopathies, sluggish schizophrenia, and in neurosis-like and psychopathic conditions arising from somatic diseases [12]. The pathogenesis of borderline states has not been fully studied, but the fundamental idea that psychogenic (sociogenic) and biological (constitutional, genetic, 'exogenous) factors are combined in their origin in a dialectical unity has been established in Russian literature. It is generally accepted that the treatment of patients with borderline conditions should be comprehensive - to combine psycho- and pharmacotherapy [2, 3]. Psychotherapy addresses the psychogenic links of pathogenesis, pharmacotherapy - to biological ones.

2021 ◽  
Vol 8 (1) ◽  
pp. 5-11
Author(s):  
Paulina Pisaniak ◽  
Joanna Żołądź ◽  
Aleksander Tarczoń ◽  
Dorota Ozga

Aim: Stigmatization is about making a division – people are grouped into better and worse, people with mental disorders are very often perceived as different, which is why they are largely stigmatized. Mental illnesses are a growing problem among the society of developed countries, therefore, the problem of stigmatization of these people has also become noticeable, which may adversely affect their mental condition and the convalescence process. The aim of the study is to assess the degree of stigmatization of mentally ill people by paramedics. Material and methods: An original questionnaire was used to collect the data, distributed from February 15, 2020 to April 7, 2020. among paramedics working in various medical rescue units and in units cooperating with the National Medical Rescue system. We collected 91 respondents replied. The research was a pilot study. Results: Paramedics are a professional group that does not show any particular signs of stigmatization in relation to the mentally ill, but single responses were obtained, which may indicate a given respondent’s lack of understanding for the mentally ill. Conclusions: In order to prevent stigmatization of the mentally ill, it is very important to educate not only paramedics, but also representatives of other medical professions who have contact with people suffering from mental disorders.


2020 ◽  
Author(s):  
Louise Mewton ◽  
Briana Lees ◽  
Lindsay Squeglia ◽  
Miriam K. Forbes ◽  
Matthew Sunderland ◽  
...  

Categorical mental disorders are being recognized as suboptimal targets in clinical neuroscience due to poor reliability as well as high rates of heterogeneity within, and comorbidity between, mental disorders. As an alternative to the case-control approach, recent studies have focused on the relationship between neurobiology and latent dimensions of psychopathology. The current study aimed to investigate the relationship between brain structure and psychopathology in the critical preadolescent period when psychopathology is emerging. This study included baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study® (n = 11,721; age range = 9-10 years; male = 52.2%). General psychopathology, externalizing, internalizing, and thought disorder dimensions were based on a higher-order model of psychopathology and estimated using Bayesian plausible values. Outcome variables included global and regional cortical volume, thickness, and surface area. Higher levels of psychopathology across all dimensions were associated with lower volume and surface area globally, as well as widespread and pervasive alterations across the majority of cortical and subcortical regions studied, after adjusting for sex, race/ethnicity, and parental education. The relationships between general psychopathology and brain structure were attenuated when adjusting for cognitive functioning. There was evidence of a relationship between externalizing psychopathology and frontal regions of the cortex that was independent of general psychopathology. The current study identified lower cortical volume and surface area as transdiagnostic biomarkers for general psychopathology in preadolescence. The widespread and pervasive relationships between general psychopathology and brain structure may reflect cognitive dysfunction that is a feature across a range of mental illnesses.


Author(s):  
I. Kukhtevich

Functional autonomic disorders occupy a significant part in the practice of neurologists and professionals of other specialties as well. However, there is no generally accepted classification of such disorders. In this paper the authors tried to show that functional autonomic pathology corresponds to the concept of somatoform disorders combining syndromes manifested by visceral, borderline psychopathological, neurological symptoms that do not have an organic basis. The relevance of the problem of somatoform disorders is that on the one hand many health professionals are not familiar enough with manifestations of borderline neuropsychiatric disorders, often forming functional autonomic disorders, and on the other hand they overestimate somatoform symptoms that are similar to somatic diseases.


2013 ◽  
Vol 7 ◽  
pp. SART.S8108 ◽  
Author(s):  
Kristin V. Carson ◽  
Malcolm P. Brinn ◽  
Thomas A. Robertson ◽  
Rachada To-A-Nan ◽  
Adrian J. Esterman ◽  
...  

Tobacco smoking remains the single most preventable cause of morbidity and mortality in developed countries and poses a significant threat across developing countries where tobacco use prevalence is increasing. Nicotine dependence is a chronic disease often requiring multiple attempts to quit; repeated interventions with pharmacotherapeutic aids have become more popular as part of cessation therapies. First-line medications of known efficacy in the general population include varenicline tartrate, bupropion hydrochloride, nicotine replacement therapy products, or a combination thereof. However, less is known about the use of these products in marginalized groups such as the indigenous, those with mental illnesses, youth, and pregnant or breastfeeding women. Despite the efficacy and safety of these first line pharmacotherapies, many smokers continue to relapse and alternative pharmacotherapies and cessation options are required. Thus, the aim of this review is to summarize the existing and developing pharmacotherapeutic and other options for smoking cessation, to identify gaps in current clinical practice, and to provide recommendations for future evaluations and research.


2020 ◽  
Vol 2 (3-4) ◽  
pp. 273-276
Author(s):  
Prakash B. Behere ◽  
Aniruddh P. Behere ◽  
Debolina Chowdhury ◽  
Amit B. Nagdive ◽  
Richa Yadav

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.


2015 ◽  
Vol 17 (1) ◽  
pp. 79-87 ◽  

The Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health (NIMH) in early 2009 as the implementation of Goal 1.4 of its just-issued strategic plan. In keeping with the NIMH mission, to "transform the understanding and treatment of mental illnesses through basic and clinical research," RDoC was explicitly conceived as a research-related initiative. The statement of the relevant goal in the strategic plan reads: "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." Due to the novel approach that RDoC takes to conceptualizing and studying mental disorders, it has received widespread attention, well beyond the borders of the immediate research community. This review discusses the rationale for the experimental framework that RDoC has adopted, and its implications for the nosology of mental disorders in the future.


Author(s):  
Vijay Kumar Chattu ◽  
Paula Mahon

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.


Author(s):  
Elsebeth Stenager ◽  
Egon Stenager ◽  
Annette Erlangsen

The association between somatic disorders and suicidal behaviour has been examined in many studies. Despite large variation in quality and study design, recent studies have improved our knowledge substantially, not only regarding the extent of risk but also factors influencing the risk. Most studies have been conducted in European countries, the US, Australia, Japan, and South Korea. A series of studies have examined suicide risk in relation to somatic disorders of older persons, while others addressed somatic disorders and attempted suicide in children and youth. Physical conditions may play an important role in medical settings, regardless of whether mental disorders are present or not, though especially when mental disorders are present. This chapter presents a review of present knowledge on suicide and suicidal behaviour in selected somatic disorders and pain syndromes, with a focus on studies from different parts of the world.


2018 ◽  
Vol 66 (2) ◽  
pp. 228-242
Author(s):  
Andreas Heinz

Abstract Mental disorders have been suggested to differ from somatic diseases because they lack an organic correlate. We show that this argument is both empirically wrong and theoretically irrelevant, because diseases are defined by functional impairments and not biological variation. Due to human diversity, a multitude of functions can be defined, and any selection of medically relevant functional impairments is necessarily value-based. We suggest that such values include individual survival and living in a shared world with others, and that their definition requires public debate and a critical reflection by Philosophical Anthropology. However, the presence of functional impairments that are generally relevant for human life and survival only fulfils the so-called disease criterion, which is necessary but not sufficient to diagnose a clinically relevant malady. This would only be justified if such functional impairments cause individual harm, either because they are accompanied by suffering (the illness criterion) or because they interfere with basic activities of daily living such as personal hygiene and food intake (the sickness criterion of a clinically relevant malady). We apply this theory to mental disorders, conclude that only a fraction of such “disorders” currently listed in international classifications of diseases are clinically relevant mental maladies, suggest focusing on the needs of persons with such maladies and recommend avoiding “pathologization” of human diversity.


2018 ◽  
Vol 7 (2) ◽  
pp. 46-50
Author(s):  
D.K. Thapa ◽  
N. Lamichhane ◽  
S. Subedi

Introduction: Mental illnesses are commonly linked with a higher disability and burden of disease than many physical illnesses. But despite that fact, it is a general observation that a majority of patients with mental disorder never seek professional help. To elaborate further, the widely prevalent magico-religious beliefs associated with mental illness and lower literacy, poses significant social obstacles in seeking appropriate health care for psychiatric patients. In general, mental illness is seen as related to life stresses, social or family conflicts and evil spirits and the concept of biological causes of mental illness is rare even among the educated. The idea that illness and death are due to malevolent spirits is common notion that is shared practically by all level of society from the so-called primitive to modern industrialized societies, thus indicating the strong influences of cultural background. When there is a magico- religious concepts of disease causation, there is tendency to consult indigenous healers. Therefore, the patients with mental illness often either visit or are taken to faith healers by their relatives. The objective of the study was to determine the various psychiatric cases that were referred by the traditional faith healers to the authors. Material and Method: This is a cross- sectional, hospital- based descriptive study, conducted at the Psychiatric outpatient department of Pokhara Om Hospital, Pokhara, Kaski, Nepal for the period of one year, from June 2016 to May 2017. The total of 35 cases, referred by the traditional faith healers was included in the study. Subjects of any age, any gender, any literacy level, any caste, from any locality and religious background were included in the study after their consent. Subjects who refused to consent were not included in the study. The psychiatric diagnosis was based on the complete history and examination and ICD- 10 DRC criteria. Results: Though the sample size is small, it is interesting to note that patients with various kinds of mental disorders were referred by traditional faith healers. There were patients suffering from neurotic disorders, psychotic disorders, mood disorders, seizure, substance use disorder, intellectual disability etc seeking the treatment from traditional faith healers. Among the cases referred, predominantly were female and neurotic cases. Most patients were educated. Conclusion: The study shows that patients with various mental disorders visit traditional faith healer. This area surely requires further in-depth look as traditional faith healers can be an important source of referral of psychiatric patients.


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