Much information is available through the print and other forms of media about pregnancy, parenthood, and the birth process, but significantly less information exists about postnatal depression or about how to cope with the often-painful realities of childbirth and parenting. Even less information exists about the effectiveness of caregiver intervention, especially from the point of view of womens' remembered experience. This study helps to fill the information gap identified in the literature. This is a hermeneutic phenomenological study guided by the ideas of van Manen (1990). I interviewed women who had experienced postnatal depression and health professional intervention, and asked them about their experiences. Some of the questions were, "What are the types and quality of health professional interventions provided for you by health professionals treating your postnatal depression?" "Which interventions did they use that were helpful for you, and which interventions were unhelpful?" The interviews were open-ended and tape-recorded, took one hour each, and the data was allowed to unfold naturally. The data were transcribed and analysed, then interpreted using the philosophical underpinning of phenomenology to guide my interpretation. The search for meaning in the text, and my attempts to make sense of the findings resulted in the development of two major themes, the first being Dual Reality and the second being Interventions, each theme had three sub-themes. Within the theme of Dual Reality were the sub themes of Behind the Mask, the Stresses involved in Being a New Mother, and The Depression Experience. Within the theme of Interventions were the three sub themes of Getting Help (the helpful interventions), Lack of Support, (the unhelpful interventions), and the Need for Education and More Services for Postnatal Depression (the missing interventions). The helpful and unhelpful health professional interventions were examined, some were positive and helped the women to heal from postnatal depression, and others were unhelpful (or simply absent), and the women were not assisted in their recovery. A number of recommendations are made and also suggestions for further research are included as a result of the findings of this study. / Thesis (Ph.D.)--Department of Clinical Nursing, 2005.

Class of 2015 Abstract / Objectives: Pharmacists’ level of training and experience in psychiatric pharmacy were compared for: 1) self-perceived preparedness to provide pharmacotherapy services; and 2) perceived barriers to providing services to individuals with psychiatric disorders. Methods: This study used data from an internet-based questionnaire. Respondents were divided into 2 groups: 1) completed the Arizona Pharmacy Association’s Psychiatric Certificate Program, and/or Board Certified in Psychiatric Pharmacy, and/or College of Psychiatric and Neurologic Pharmacists member, and/or completed a PGY2 psychiatric pharmacy residency; and 2) no specialized training/experience in psychiatric pharmacy. A Mann-Whitney U analysis was used to compare the scaled responses for each group. A Bonferroni alpha correction was use in the case of multiple tests. Results: Compared to pharmacists without training/experience in psychiatry (N = 235), respondents with specialized training/experience in psychiatry pharmacy (N = 38) reported more frequent interactions with psychiatric patients and provided more counseling/drug information, monitoring for adverse drug reactions, recommending non-pharmacological treatments, screening for treatment issues, and making therapeutic recommendations (p < 0.05). Trained pharmacists in psychiatry reported being more prepared to provide all pharmacotherapy services (p = 0.003), except in addressing non-adherence, utilizing online resources, and providing pharmacotherapy services to patients with attention deficit-hyperactivity disorder. They reported fewer barriers (α = 0.005) except for time to provide services, having a private consultation area, and reimbursement for patient care activities. Conclusions: This study found that responding pharmacists without psychiatric training/experience may need additional education/training post-graduation and that they perceive more barriers in providing services to this population.

Class of 2005 Abstract / Objectives: The purpose of this study was to determine the demographics of co-morbid disorders and drug abuse characteristics of patients admitted to an inpatient facility for detoxification and treatment of chemical dependency to characterize the treatment programs including the psychiatric medication usage and prescribing patterns and to identify differences between men and women. Methods: Criteria inclusion for admittance included a diagnosis of chemical dependence at Sierra Tucson Behavioral Health Hospital during the time of January through June 2004. Patients were admitted to that were diagnosed with a chemical dependency, identified using a past hospital census. Charts of previously discharged patients were obtained from the medical records department of the institution. Specific variables from each chart were extracted for further analysis utilizing a data form. Results: 285 (170 women and 115) men chemically dependent patients that were admitted during the six-month study period. In this patient population there was a high incidence, 76.84%, of co-morbid psychiatric conditions. The most frequently abused drugs in men were alcohol, nicotine, and cocaine. The most frequently abused drugs in women were alcohol, nicotine, and opiates. Men and women were most frequently placed on a librium based alcohol detoxification program, and secondly a buprenorphine based opiate detoxification program. There was statistical significant improvement in the of Beck Depression Inventory scale (BDI), Beck Hopelessness scale (BHS), and Global Assessment Function (GAF) scores at admit and discharge and a downward trend in Clinical Institute Withdrawal Assessment (CIWA) and Clinical Opiate Withdrawal (COW) scores. Implications: There was a high incidence of co-morbid psychiatric conditions such as depression and anxiety that were present in both genders. In men, Attention Deficit and Hyperactivity Disorder/ Attention Deficit Disorder (ADHD/ADD) was an additional common condition observed, while in women eating disorders were observed. The treatments provided led to an overall improvement in GAF, BDI, BHS, CIWA and COW scores indicating effectiveness of the treatment program.

Long non-coding RNAs (lncRNAs) are non-protein coding transcripts longer than 200 nucleotides. Many of these lncRNAs have regulatory functions and have recently emerged as major players in governing fundamental biological processes. Here, we review the definition, distribution, identification, databases, analysis, classification, and functions of lncRNAs. We also discuss the potential roles of lncRNAs in the etiological processes of psychiatric disorders and the implications for clinical diagnosis and treatment. Psychiatr Genet 26:109-116 .

Background. A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial. Methods. Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed. Results. HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders. Conclusion. Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.

No description available.

No description available.

Hyperacusis is a type of decreased sound tolerance where the individual has decreased loudness discomfort levels (LDL), normal hearing thresholds and is sensitive to ordinary environmental sounds. Persons with hyperacusis frequently seek help at audiological departments as they are often affected by other audiological problems. Regrettably, there is neither a consensus-based diagnostic procedure nor an evidence-based treatment for hyperacusis. The principal aim of this thesis was to gain knowledge about the clinical condition hyperacusis. The specific aim of Paper I was to compare hyperacusis measurement tools in order to determine the most valid measures for assessing hyperacusis. Items from a constructed clinical interview were compared with the LDL test, the Hyperacusis Questionnaire (HQ) and the Hospital Anxiety and Depression Scale (HADS). LDLs were significantly correlated with the anxiety subscale of the HADS. A third of the 62 investigated patients scored below the previously recommended cut-off for the HQ. The results suggest that HQ and HADS in combination with a clinical interview are useful as part of the assessment procedure in patients with hyperacusis. The aim of Paper II was to further investigate the patient group with respect to individual characteristics, psychiatric morbidity and personality traits. It was shown that anxiety disorders and anxiety-related personality traits were over-represented, which suggests common or cooperating mechanisms. Avoidance behaviour proved to be very common in the patient group, as was being unable to work due to hyperacusis. In Paper III it was investigated in a randomized controlled trial whether Cognitive Behaviour Therapy (CBT) could be helpful for patients with hyperacusis. The effect of CBT for hyperacusis was assessed with measures of LDLs, symptoms of hyperacusis and of anxiety and depression, fear of (re)injury due to exposure to sounds, and quality of life, compared to a waiting list control group. There were significant group effects for a majority of the measures with moderate and strong effect sizes within- and between groups. After assessment the waiting list group was also given CBT, and was then reassessed with similar effects. The results were maintained for 12 months, concluding CBT to be potentially helpful for these patients.

O uso problemático de álcool tem sido apontado como problema de saúde pública. A prevalência de dependência de álcool é maior em pessoas com transtornos psiquiátricos. Esta comorbidade pode trazer sérias implicações para a identificação, tratamento e reabilitação do indivíduo doente. O presente estudo teve como objetivo identificar o uso problemático de álcool em pacientes com transtornos psiquiátricos, a partir da realidade clínica assistencial terciária de um serviço universitário. Foi realizado um estudo transversal, com uma amostra clínica ambulatorial composta por 127 indivíduos em tratamento por um dos seguintes diagnósticos: esquizofrenia, transtorno afetivo bipolar, depressão e transtornos de ansiedade. Os dados foram colhidos através de entrevista com o paciente e também através do prontuário. As informações coletadas foram: dados sócio-demográficos, história psiquiátrica, problemas de saúde, características familiares e registros do prontuário relacionados ao diagnóstico do paciente e ao consumo de álcool. Foi aplicado o instrumento de rastreamento CAGE e realizada a entrevista estruturada em conformidade com os diagnósticos da CID-10 para uso nocivo e dependência de álcool. A fim de aumentar a sensibilidade do CAGE,trabalhou-se com o ponto de corte ¡Ý1. Da amostra total, 6,3% fazem uso nocivo de álcool e 3,9% são dependentes, de acordo com os critérios da CID-10. Quarenta e três pessoas (33,9%) pontuaram positivo no CAGE, o que indica a possibilidade de uso problemático de álcool em algum momento de suas vidas. Os fatores sócio-demográficos que mostraram relação com o uso problemático de álcool foram: ser homem, ter menos de 40 anos de idade, não ter companheiro(a) e não ser praticante de religião. Ao se comparar médias de escore no CAGE, entre os quatro grupos diagnósticos estudados, encontrou-se que a maior média foi a do grupo de esquizofrenia, seguida pelo de transtornos ansiosos, transtorno afetivo bipolar e, por último, depressão. Foi encontrada uma relação entre pontuação no CAGE e idade de início da enfermidade. Entre os pacientes que pontuaram positivo no CAGE, 60,5% não tinham registros, em seus prontuários, de uso de álcool. Sugere-se a disseminação de informações a respeito da comorbidade entre transtornos psiquiátricos e uso problemático de álcool na formação de profissionais de saúde, assim como treinamento para uso de instrumentos de rastreamento do uso problemático de álcool. / The problematic use of alcohol is becoming recognised as a serious public health problem. The prevalence of alcohol dependence is higher in persons with a psychiatric disorder. This comorbidity has serious implications for the identification, treatment and rehabilitation of the person. The aim of this research is to identify the problematic use of alcohol among individuals with psychiatric disorders by evaluating patients attending a psychiatric outpatient clinic at a university hospital. A transversal study was carried out, with a clinical sample composed of 127 individuals in treatment for one of the following disorders: schizophrenia, bipolar disorder, depression and anxiety disorders. The data was gathered from the patient’s records and through interview. The information collected was: sociodemographic data, psychiatric history, health problems, family characteristics and information from the records concerning the patient’s diagnosis and their previous alcohol use. The screening instrument CAGE was applied along with a structured interview based on the ICD-10 criteria for harmful use and alcohol dependence. In order to increase the sensitivity of CAGE the cut off point ¡Ý1 was used. It was found that 6.3% of patients met the criteria for harmful alcohol use and 3.9% for dependence (ICD-10). Forty-three persons (33,9%) scored positive with CAGE, indicating the possibility of problematic use of alcohol at a point in their lives. The sociodemographic factors that showed an association with problematic use of alcohol were: to be male, to be less than 40 years of age, to be without a partner and not to be practicing a religion. When the mean averages of CAGE scores for the four studied diagnostic groups were compared, the schizophrenia group scored higher, followed by the anxiety disorder group, bipolar disorder group and the depression group. A relationship was found between CAGE scores and patient age at the onset of the disorder. Among patients that scored positive with CAGE, 60,5% did not have any history, in their records, of alcohol use. It is suggested that information regarding comorbidity between psychiatric disorders and problematic use of alcohol be disseminated among health professionals, in conjunction with training in the use of screening instruments for problematic use of alcohol.

A proposição deste estudo se configura em dois momentos, a princípio, descrever a experiência de familiares de portadores de esquizofrenia no primeiro episódio psicótico e, em um segundo instante, compreender como é o cotidiano destes familiares. Com o intuito de salientar e analisar a realidade social de uma determinada população, sendo esta permeada por uma infinidade de significações, optamos pela utilização dos pressupostos do método qualitativo. Para tanto, nos baseamos no estudo de caso, que fornece de forma aprofundada, o conhecimento de uma instância singular.Os colaboradores do presente estudo foram quatro famílias que possuíam um de seus membros vinculados a um serviço aberto do interior paulista, CAPS-II e, estes últimos, consistiam em portadores de esquizofrenia por um período de no máximo cinco anos. Para a coleta de dados foram realizadas entrevistas semi-estruturadas, sendo estas gravadas e posteriormente, transcritas pelo próprio pesquisador. Após a construção de um conjunto de categorias descritivas, a análise dos dados permitiu a identificação de cinco temáticas relacionadas ao convívio de familiares durante o primeiro episódio psicótico, sendo elas: a família frente ao primeiro episódio psicótico, trajetória percorrida durante o adoecimento; razões e dificuldades em aceitar o “adoecer psíquico"; preocupação com o trabalho e a ociosidade e o cotidiano dos portadores de esquizofrenia e familiares. Foi possível constatar no decorrer deste estudo que familiares nesta situação atravessam momentos difíceis, dolorosos, conflitantes mas mesmo assim, seus depoimentos ainda são permeados por forte esperança na remissão dos sintomas clássicos da esquizofrenia e que suas vidas “retornarão" à normalidade. Entretanto, para amenizar as dificuldades relatadas por estes núcleos familiares faz-se necessário maior investimento na equipe multiprofissional que compõem os serviços de saúde tidos como “portas de entrada", como é o caso do hospital geral, por este constituir no primeiro local de acesso, como também, a criação de novas estratégias no atendimento desta população nos serviços abertos. / The purpose of this study configures at two moments, at first, describe the experience of familiar of carriers of schizophrenia in first psychotic episode and, in a second instant, understand the daily of these families. With intention to point out and to analyze the social reality of one determined population, being this an infinity of significances, we opt to the use of the estimated ones of the qualitative method. For in such a way, on we base them on the case study that it supplies of deepened form, the collaborating singular. The knowledge of an instance of the present study they had been four families whom one of its entailed members to an open service of the São Paulo, Caps II, these last ones, consisted of carriers of schizophrenia for a period of in the maximum five years. For the collection of data recorded and later, transcribing ones for the proper researcher had been carried through half-structuralized interviews, being these. After the construction of a set of descriptive categories, the analysis of the related data allowed the identification of five thematic ones to the conviviality of familiar during the first psychotic episode, being they: the family front to the first psychotic episode, trajectory covered during the disturbance; reasons and difficulties in accepting “the psychic disorder" concern with the work and the idleness and the daily one of the familiar carriers of schizophrenia and. It was possible to evidence in elapsing of this study that the family in this situation crosses difficult moments, painful, conflicting but exactly thus, its depositions still are strong hope in the remission of the classic symptoms of the schizophrenia and that its lives "will return" to normality. However, to brighten up the difficulties told for these familiar nuclei one becomes necessary greaters investments in the professionals of general hospitals, because its to constitute in the first place of access, as also, the creation of new strategies in the attendance of this population in the open services.