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Archive for January, 2011

 

Article Date: 14 Oct 2010 – 4:00 PDT

New guidelines published by the Royal College of Psychiatrists (RCPsych) and the Royal College of Physicians (RCP) hope to reduce the number of avoidable deaths of patients with severe anorexia nervosa on general medical units.

The guidelines are aimed at all medical, nursing and dietetic staff working in hospitals to which a patient with severe anorexia nervosa could be admitted. They provide advice on the physical assessment of patients, required members of the in-patient medical team, the use of mental health legislation, and advice for commissioners on required services for this group of very ill patients.

The guidelines have been produced by the MARSIPAN working group, which stands for the MAnagement of Really SIck Patients with Anorexia Nervosa. The group was established in 2008 because of serious concerns over the number of deaths of young people with severe anorexia on general medical wards. Some died from medical complications such as pneumonia. Others died from, re-feeding syndrome (RFS) when food intake is increased too rapidly after weeks of starvation, or from “underfeeding syndrome” when nutrition intake is increased too slowly.

Most people with severe anorexia nervosa should be treated on specialist eating disorder units (SEDU). However, they may be admitted to a medical ward if a SEDU bed is not available, or if they need treatments that are not available on a psychiatric ward such as intravenous infusions or artificial ventilation. Anorexia nervosa has one of the highest mortalities of any psychiatric condition, and some deaths are inevitable. But patients admitted to medical wards are often at high risk and may not be seen by staff with specialist knowledge.

The guidelines make 9 key recommendations including:

– Physical risk assessment in these patients should include body mass index (BMI), physical examination, including muscle power, blood tests and electrocardiography (ECG).  

Read in Full:  http://www.medicalnewstoday.com/articles/204570.php



Out of The Darkness
Article Date: 13 Oct 2010 – 10:00 PDT
 
As people all over the world await with bated breath for the successful conclusion of the nail-biting dramatic rescue of the 33 Chilean miners trapped underground, attention now turns to the fact that for the miners themselves, another journey begins, one that could prove as challenging to mind and body as the entombment itself: the road to recovery and normality.

The rescue operation at the San José copper and gold mine in Copiapó, in the heart of the Atacama Desert in Northern Chile, began just after midnight local time on Wednesday, as the first miner, 31-year old Florencio Avalos, wearing special sunglasses to protect his eyes, was brought to the surface among jubilations from the waiting crowd of rescue workers, families, reporters and the Chilean President Sebastián Piñera and his wife.

Video footage of the rescue operation underground was captured by the miners themselves, reported El Mercurio. It shows how Manuel González a rescue technician, who went down to the miners first, prepares each man to enter the torpedo-shaped rescue capsule, less than 28 inches in diameter (71 cm).

 
The 33 Chilean Miners
The 33 Chilean Miners
 
The men, aged from 19 to 63, have survived underground for 69 days since the mine collapsed on 5 August. For 17 days there was no news of them, until a drill searching for air pockets punched a hole through to the underground room they men were in. Until then they were cut off, with no light.

American astronaut Jerry Linenger, who spent five months isolated and confined in space aboard the Russian space station Mir, told CNN that until that point, the miners were in “survival mode”, which is “tough psychologically because you are in a life and death situation”.

All the reports so far say that the miners appear to be in very good physical shape. But the Chilean health authorities are taking no chances, and preparations to receive the men as they emerge from their underground prison have been extensive.

 
As this is the longest time that miners have spent underground before being rescued, nobody really knows what to expect, the chief medical officer of the rescue team, Dr. Jean Romagnoli, told the Los Angeles Times.

Experts from NASA, with experience of treating astronauts, have been advising the Chilean health team as they prepare to receive the miners. They suggest the main areas of concern will be the effects of confinement, sleep disruption and deprivation, lack of sanitation, and other problems like lack of sunlight, and nutrition.

There may also be other effects, such as due to the poor air quality thought to exist in the mine.

Dr Neil Schachter, a specialist in respiratory care in New York, told ABC News that he expects some of the men will have respiratory infections.

 
One billion people have watched on television the exit of the first miner.

As well as the physical effects, there will be concerns about the miners’ mental health.

 
It has been suggested that some may experience post-traumatic stress, with panic attacks, nightmares, and being overly startled by sounds, smells, or even images similar to what they may have experienced underground such as the sounds of drilling or rocks falling.

There will also be new stresses to cope with, even as a result of joyous occasions such as reunions with family and friends, and rejoining society.

And of course, the miners are now celebrities; their lives have changed dramatically, and demands on their time and attention from the press and media will be intense, as will the pressure to decide how to respond to them.

The deputy chief medical officer at Johnson Space Center, Dr Michael Duncan, told CNN news that:

“The work is just beginning when the miners get out of the mine.”

 
Bolivian Miner
23 year old Bolivian Miner
Chile’s Health Minister, Jaime Manalich, said things were going well so far. The miners’ health is “pretty good”, he said, and the first two miners have already been seen by eye doctors, skin doctors and had chest X-rays at Copiapó Hospital.

The miners are first spending time with their families in a special meeting room before being taken to hospital.

Although they were strongly recommended to go to hospital for evaluation and checks, the miners did have the option not to do so. But Manalich said they all said they would go.

 
 
 
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Article Date: 14 Oct 2010 – 3:00 PDT

According to a new survey sponsored by Janssen®, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc, 94 percent of psychiatric nurses feel very or extremely involved in providing care for people with mental illness. Although some psychiatric nurses believe that their specialty is as difficult as or more difficult than oncology nursing, or emergency nursing, one-third would prefer to be more involved in patient care than they are now. The survey also revealed that psychiatric nurses believe their work affects patient care, with more than 90 percent of psychiatric nurses viewing the time they spend with patients as very important to patient satisfaction with their overall healthcare experience. A majority of the nurses strongly agree that their involvement helps to achieve better outcomes for patients living with mental illness.

Results of the survey revealed that more than three-fourths of psychiatric nurses feel they are very responsible for educating patients about aspects of mental health and more than two-thirds feel a great deal of responsibility in the care of psychological problems and managing patients’ overall well-being. Additional survey findings include:

  • More than one-half of psychiatric nursing professionals would like greater participation in the treatment team and 44 percent desire more involvement in helping patients adhere to their treatment.
  • More than 90 percent feel they help to bridge any communication gap between patients and physicians.
  • Almost one-half of psychiatric nurses feel they do not have enough time to be more involved in providing healthcare for psychiatric patients.

The survey results are being presented and discussed for the first time at the American Psychiatric Nurses Association Annual Meeting in Louisville, KY, October 13-16, 2010. Several psychiatric nursing experts will present and discuss the results in front of an audience of their peers during a roundtable discussion sponsored by Janssen®. The discussion is being moderated by Dorothy E. Hill, RN, former president of APNA (2001) and a now retired psychiatric nurse after committing 40 years to the care of people with mental illness.

Read in Full:  http://www.medicalnewstoday.com/articles/204592.php



 

By Selena Chavis
Reviewed by John M. Grohol, Psy.D. on October 12, 2010 

People who use cannabis are twice as likely to have mental health issues as those who do not.

These are the findings of a recent study published by Statistics Netherlands—known in Dutch as the Centraal Bureau voor de Statistiek (CBS). CBS is the Dutch governmental institution that gathers statistical information about the Netherlands.

Carried out between 2007 and 2009, researchers studied 18,500 people and found that more than four percent of 15- to 65-year-olds had smoked cannabis during the previous month. More than a quarter of this group reported smoking cannabis on a daily or almost-daily basis.

Cannabis—also known as marijuana—is a recreational drug used worldwide. It is only exceeded in popularity by alcohol, caffeine and tobacco. Estimates of those who have tried the drug in the United States alone exceed 100 million.

There has also been notable interest in the use of cannabis for medical conditions including neurogenic pain, movement disorders, glaucoma and asthma.

This recent study found that nearly 20 percent of male cannabis users indicated they had psychological problems versus nearly 10 percent of nonusers. Similarly, the findings indicated that more than 28 percent of female users had psychological problems versus more than 14 percent of nonusers, according to CBS.

The most common complaints associated with mental health were nervousness, depression, unhappiness or restlessness.

“People who reported to have smoked cannabis in the past 30 days in the period 2007-2009, feel less healthy mentally or psychologically than non-cannabis users,” CBS wrote in a statement.

Read in Full:  http://psychcentral.com/news/2010/10/08/cannabis-use-increases-risk-for-mental-health-issues-2/19425.html



 

Article Date: 14 Oct 2010 – 0:00 PDT

Despite modest economic gains, gloomy unemployment numbers and low workplace morale still loom large within corporate America. Whether or not companies can capitalize on the momentum of this fragile financial revitalization is dependent on more than enhancing consumer confidence or introducing new products to the marketplace – it falls largely on employees working for organizations and their level of commitment to corporate success. Researchers from the Kellogg School of Management at Northwestern University and the Haas School of Business at the University of California, Berkeley have discovered that building a more committed workforce can be as simple as asking employees to reflect on their company’s history.

“Institutions that can communicate a compelling historical narrative often inspire a special kind of commitment among employees. It is this dedication that directly affects a company’s success and is critical to creating a strong corporate legacy,” said author Adam Galinsky, Morris and Alice Kaplan professor of ethics and decision in management.

Read in Full:  http://www.medicalnewstoday.com/articles/204440.php



 

Article Date: 14 Oct 2010 – 0:00 PDT

Research led by a Michigan State University psychologist is playing a key role in the effort to change the way mental health clinicians classify personality disorders.

The study by Christopher Hopwood and colleagues calls for a more scientific and practical method of categorizing personality disorders – a proposal that ultimately could improve treatment, Hopwood said.

“We’re proposing a different way of thinking about personality and personality disorders,” said Hopwood, MSU assistant professor of psychology and an experienced clinician. “There’s widespread agreement among personality disorder researchers that the current way to conceptualize personality disorders is not working.”

The study is being cited by the team of experts that currently is developing criteria for the manual used to diagnose personality disorders – the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, slated to come out in 2013.

The study is being considered for inclusion in the DSM-5. The DSM, published by the American Psychiatric Association, is considered the bible of the U.S. mental health industry and is used by insurance companies as the basis for treatment approval and payment. The study also will appear in an upcoming issue of the Journal of Personality Disorders.

The current method of classifying personality disorders, as spelled out in the fourth edition of the DSM, or DSM-IV, breaks personality disorders into 10 categories, Hopwood said. That system is flawed, he said, because it does not take into account severity of personality disorders in an efficient manner and often leads to overlapping diagnoses.

“It’s just not true that there are 10 types of personalities disorders, and that they’re all categorical – that you either have this personality disorder or you don’t,” Hopwood said. “Scientifically, it’s just not true.”

Read in Full:  http://www.medicalnewstoday.com/articles/204445.php



 

ScienceDaily (Oct. 13, 2010) — Parents of children with undiagnosed learning disorders, developmental deficits, and congenital abnormalities face a host of psychological and social challenges, which are explored in detail in a reflective article in Genetic Testing and Molecular Biomarkers, a peer-reviewed journal.

An interview-based study of parents of children with undiagnosed disorders describes the parental experience as a “journey” comprised of an inner, emotional journey and an outer-world, sociological experience. Celine Lewis, from Genetic Alliance UK (London) and Heather Skirton and Ray Jones, from the University of Plymouth (UK), identify the primary components of this multifaceted journey in the article entitled “Living Without a Diagnosis: The Parental Experience.” A commonly expressed theme among the study participants was the sense of frustration that is present throughout their experiences.

Many of the experiences described during the interviews are similar to those expressed by parents of children with known disabilities. These include the initial recognition and acceptance of the disorder and the process of pursuing a diagnosis, which are components of the inner journey. Additionally, shared social or outer-world experiences might include the interaction with members of the child’s healthcare team and dealing with issues such as education and housing. The questioning and uncertainty associated with undiagnosed disorders in children adds another layer of complexity to the challenges these parents face, conclude the authors of the study.

Read in Full:  http://www.sciencedaily.com/releases/2010/10/101013124328.htm



 

ScienceDaily (Oct. 13, 2010) — Mental disorders in children are often difficult to identify due to the myriad of changes that occur during the normal course of maturation. For the first time, researchers at the National Institute of Mental Health have reported on the prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents, which show that approximately one in five children in the U.S. meet the criteria for a mental disorder severe enough to disrupt their daily lives.

The prevalence of the mental health disorders as well as the notable link between parental mental health issues and their teen’s disorders are the subject of the article by Merikangas and colleagues in the October 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

In the article titled “Lifetime Prevalence of Mental Disorders in U.S. Adolescents : Results from the National Comorbidity Study-Adolescent Supplement (NCS-A).,” Dr. Merikangas and colleagues examined the lifetime prevalence, severity, and comorbidity of DSM-IV mental health disorders across broad classes of disorders. The NCS-A is a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States.2 Diagnostic assessment of DSM-IV mental disorders were measured using a modified version of the World Health Organization (WHO) Composite International Diagnostic Interview.

The researchers found that anxiety disorders were the most common condition (31.9%),followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder.

Strikingly, the overall prevalence of disorders with severe impairment and/or distress, marked by interference with daily life was over one in five children, or 22.2%.

Read in Full:  http://www.sciencedaily.com/releases/2010/10/101013121606.htm



 

ScienceDaily (Oct. 12, 2010) — Children who spend longer than two hours in front of a computer or television screen are more likely to suffer psychological difficulties, regardless of how physically active they are.

The PEACH project, a study of over a 1,000 children aged between ten and 11, measured the time children spent in front of a screen as well as their psychological well being. In addition, an activity monitor recorded both children’s sedentary time and moderate physical activity. The results showed that more than two hours per day of both television viewing and recreational computer use were related to higher psychological difficulty scores, regardless of how much time the children spent on physical activity.

The authors of the report, published in the November edition of the journal Pediatrics, conclude that limiting children’s screen time may be important for ensuring children’s future health and wellbeing.

According to the activity monitor, the children in the study who spent more time sedentary had better psychological scores overall. Those children who did more moderate physical activity fared better in certain psychological areas, including emotional and peer problems, but fared worse in some areas related to behaviour, including hyperactivity.

Read in Full:  http://www.sciencedaily.com/releases/2010/10/101011085958.htm



 

Article Date: 13 Oct 2010 – 3:00 PDT

Education is the key to reducing depression in older Australians according to a study from The Australian National University.

The research, by Professor Helen Christensen and Dr Janine Walker from the ANU Centre for Mental Health Research (CMHR) contributes to the Beyond Ageing Project. The large randomised controlled trial examined the effectiveness of psychological and lifestyle approaches in preventing depression in older adults at risk. The study is being released in conjunction with Mental Health Week.

Conducted over two years with 900 participants, the study looked at the effectiveness of three non-drug based approaches; encouraging physical activity, folate and vitamin B12 supplements and reading about mental health and depression.

The results, published in the July 2010 British Journal of Psychiatry, indicated that the group who received the literature regarding depression had a reduction in depressive symptoms compared to the control group. The literature included information about what depression is, what works for treating depression, and where to go for help.

“The study suggests that mental health literacy interventions may have a role in lowering the risk for depression”, said Dr Walker.

Read in Full:  http://www.medicalnewstoday.com/articles/204396.php