bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stratification of a medium secure forensic care pathway according to risk and need: A study from dundrum hospital
Authors: Basrak N. , Khogali Y. , Twomey R. , O’Leary C. , Prashant D. , Elamin M. Elhassan , Kennedy H. , Davoren M. 
Published: February 2022

IntroductionSecure forensic mental health services have a dual role, to treat mental illness and reduce violent recidivism. Those admitted to secure forensic services have a significant history of violence and treatment needs in multiple domains including psychiatric illness, violence and other areas such as substance misuse and physical health.ObjectivesThe aim of this study was to ascertain if the units in a medium secure forensic hospital are stratified according to individual risks and needs. We also aimed to clarify if there were differences in the symptom level, risks and needs of those with and without community leave and to clarify the risks and needs of the female patients and ID patients.MethodsThis is a cross sectional study a cohort of patients (n=138) in a secure forensic hospital.ResultsThere was a total of 138 patients, the majority of whom were male (n=123, 89.1%). The most common diagnosis was schizophrenia (n=99, 71.7%). Placements in the care pathway of the medium secure forensic hospital were associated with level of symptomatology (PANSS positive), dynamic violence risk (F=26.880,P<0.001), DUNDRUM-3 therapeutic programme completion (F=44.067,P<0.001), and DUNDRUM 4 recovery (F=59.629,P<0.001). Patients with community leave had better scores than those without leave on violence risk (F=77.099, P<0.001), therapeutic programme completion (F=116.072, P<0.001) and recovery (F=172.211, P<0.001).ConclusionsStratifying secure forensic psychiatric hospitals according to individual risks and needs provides in-patient care in the least restrictive setting appropriate for individuals, however niche groups such as female forensic patients and ID patients may need special consideration.
Baclofen approval in france: A balance between two conceptions of medicine
Authors: Rolland B. 
Published: February 2022

In October 2018, France became the first country to officially approve baclofen for alcohol use disorder (AUD), even if the French Drug Agency (ANSM) officially stated that the efficacy of baclofen in AUD could be not established at this stage, in the light of the available evidence. The decision of the ANSM comprised obvious political aspects, as baclofen approval followed a decade-long practice of off-label prescription, where doses used could reach 300 mg per day or more. This situation led to a prolonged and ferocious debate between those who questioned such a widespread and unevidenced practice, and those who defended the place of an “common sense” empirical medicine. The French story of baclofen echoes other similar controversial off-label prescribing practices in the country, from the pioneer use buprenorphine for opioid use disorder in the 1990s, to the more recent off-label use of hydroxychloroquine during the COVID-19 outbreak. In each case, similar “pros” and “cons” arguments were opposed, highlighting the difficult interpenetration between evidence-based medicine on the one hand, and on-the-ground practice on the other hand.DisclosureBenjamin Rolland declare having received fees for lectures and expertise from Ethypharm. He was the principal investigator of a phase-1 study funded by Ethypharm
Dangerousness assessment in psychiatric inpatients suffering from psychotic disorders
Authors: Khouadja S. , Melki R. , Taleb C. Ben , Zarrouk L. 
Published: February 2022

IntroductionDangerousness is a state in which a person is likely to commit violent acts.ObjectivesDescribe the socio-demographic and clinical characteristics of psychiatric inpatients hospitalized in the locked unit and suffering from schizophrenia or other psychotic disorders and to assess their dangerousness.MethodsThis is a cross-sectional study carried out in the locked unit of psychiatric department of the University Hospital of Mahdia during one year. We have collected data of patients diagnosed with schizophrenia or other psychotic disorders according to DSM 5. Psychometric assessment was done using the BPRS, the PANSS, the VRAG and the HCR-20 scales.ResultsWe have included 173 patients. The average age was 36 years with a sex ratio of 9. The majority of our patients were unmarried and of a low economic level. Alcohol and cannabis consumption was found in 7.6% and in 5.7% of cases respectively. A history of incarceration was found in 79% of cases. Homicide was the infraction the most committed in 8% of cases. 71.2% of patients had an anterior hospitalization in the locked unit. Aggressiveness and instability were the main indication for hospitalization. The diagnosis was schizophrenia in 84% of cases. Patients were treated with classic antipsychotic drugs in 55.8% of cases. Non-adherence to treatment was reported in 33% of cases. The average score of psychometric scales were BPRS = 21.4; VRAG = - 4.87 and HCR-20 = 17± 0.87.ConclusionsOur study showed comparable assessments for dangerousness with the literature. Evaluating dangerousness should represent the first step of the therapeutic process.
Elderly criminal patients in Razi psychiatric hospital of tunis
Authors: Jemli H. , Jomli R. , Rym H. , Bouslama I. , Ahmed A. Ben Cheikh , Nacef F. 
Published: February 2022

IntroductionCriminality has become of increasing concern in the practice of psychiatry. However, violence among elderly psychiatric patients is an underestimated and understudied phenomenon.ObjectivesThe aim of the study is to identify differences in the socio-demographic, clinical and criminological profiles between elderly criminals under treatment for psychiatric disorders and those not known to have mental disorders prior to the criminal offense in Tunisia.MethodsWe present a retrospective study on twenty male criminal mental patients, aged sixty years or older, who were hospitalized in the Forensic Psychiatry Department of Razi Hospital during 18 years, following a dismissal for insanity under Article 38 of the Penal Code and Article 29 of Law 92/83 on Mental Health.ResultsPrevalence was higher among elderly criminals without a known psychiatric history (2.42% versus 1.98%). The average age was roughly the same, around 73 years old.Neurological and cardiovascular histories were the most common in both groups. The criminal act was indicative of dementia in 8 cases. Criminal history was more frequent in elderly patients with a personal psychiatric history (55.5% versus 18.2%). Patients whose act was revelatory of their mental disorder committed more violent crimes (63.7% versus 44.4%) using blunt objects (71.4% versus 0%).The victim most often belonged to the aggressor’s family, particularly the spouse (87.5%).ConclusionsScreening for criminal risk factors in the elderly, early diagnosis of mental disorders and a comprehensive therapeutic project are necessary to prevent the risk of violent behaviour.
Cognitive styles and specific learning disorders in children and adolescents
Authors: Galletta D. , D’Amaro M. , Celentano S. , Santoriello C. , Passerini R. 
Published: February 2022

IntroductionLearning Difficulties relates to significant and unusual difficulties in the acquisition and use of one or more of the following areas: listening, speaking, reading, writing and mathematical skills. In the last twenty years, following the research conducted by cognitive psychology, from neuropsychology, from pedagogy and from the confrontation between educators and psychologists, the attention was focused on the cognitive modalities of the subjects engaged in learning tasks.ObjectivesThanks to the study of cognitive styles and Learning Styles thelearning subject was placed at the center of the educational project, stimulating from on the one hand there is also reflection on teaching styles and the most appropriate ones methodologies, teaching methods and methods of approaching the individual disciplines and, on the other hand, prompting clinicians to research around the intellectual peculiarities of each subject and a outline a descriptive criterion of his / her cognitive functioning profile.MethodsThe intellectual scale (WISC IV) of 32 children (aged between 7 and 15 years) with specific learning disabilities was analyzed, in order to highlight the underlying intellectual functioning and any cognitive styles.ResultsAccording to the international scientific literature, the results show a greater fall in the area of working memory, followed by the cognitive domain concerning processing speed.ConclusionsIn detail, by analyzing the individual subtests, greater difficulties are noted, at all ages, in the processes of abstraction and conceptualization, in short-term auditory memory, in the speed of processing and visual-praxic motor coordination.
An outpatient clinic for integrative mental health: Patient and treatment characteristics and health outcomes based on patient reported routine outcome monitoring data
Authors: Hoenders R. , Bartels A. , Castelein S. , Visser E. , Booij S. 
Published: February 2022

IntroductionThere is an increasing interest in integrative (mental) health care and a growth in centers offering such services, but a paucity of research on patient characteristics, diagnosis, treatments offered, the effects of those treatments and patient satisfaction.ObjectivesTo examine the course of mental health outcomes in the context of the nature and quality of care of outpatients at a center for integrative psychiatry in the Netherlands, as well as relevant sociodemographic, clinical, and treatment-related moderators of this course.MethodsBaseline patient demographics, clinical and treatment characteristics of 537 patients with a completed care episode between 2012 and 2019 were assessed. Satisfaction and mental health treatment outcomes were examined using routine outcome monitoring and analyzed with multilevel intention-to-treat models.ResultsTwo thirds of patients were woman (median age 41 years), predominantly with a primary diagnosis of mood or anxiety disorder. Mean number of treatment sessions was 49 (SD=94) and total clinical time was 54 hours (SD=109). Mean treatment duration was 460 days (SD=407). Ninety percent of the sample filled out one or more assessment(s). Of the individuals with a baseline assessment, 50% completed a follow-up. Significant improvements in symptomatology, social functioning, interpersonal functioning, wellbeing, resilience and quality of life were found. Clinical and scientific interpretation, moderator analyses and patient satisfaction will be presented at the conference.ConclusionsAlthough no definite conclusions can be drawn due to the naturalistic design and missing data, especially at follow-up, patients seem to improve on all measured domains, including psychopathology, functioning and wellbeing.
Scope: A new service supporting family doctors dealing with psychiatric patients in the community: Current utilization and quality improvement implementation protocol in the covid era
Authors: Hytman L. , Bolea-Alamañac B. 
Published: February 2022

IntroductionSeamless Care-Optimizing Patients Experience-Mental Health (SCOPE-MH) is a hub-based integrative case management and psychiatric care program supporting family physicians (FPs). SCOPE-MH provides patient resource navigation, social support, counselling, psychiatric consults, and short-term follow-up. Due to COVID-19, SCOPE-MH pivoted to serve patients completely online.ObjectivesTo assess current utilization and evaluate patients’ and FPs’ experiences using SCOPE-MH as an online service before and during COVID-19.MethodsThis evaluation was developed under the RE-AIM framework (Reach, Adoption, Implementation and Maintenance). Two surveys, one for Patient Reported Experience Measures (PREMS), and one seeking FPs perspective on the service, will complement the evaluation.ResultsPast data showed that 66.4% of referrals to SCOPE-MH were women (ages 14-97), and 33.6% were men (ages 14-91). The most common diagnoses were anxiety and depression, followed by adjustment reaction and PTSD. 72% of referred patients had more than one psychiatric diagnosis. 35.4% of the referrals were resource navigation and brief coordination of care. 39.2% required long term involvement. The main recommendations provided were counselling resources in the community and referral to local community mental health teams. Data on patient and FP experiences using SCOPE-MH, and perspectives on unique needs for psychiatric care in COVID-19, is still being collected. Surveys will be sent within 6 months.ConclusionsSCOPE-MH is an effective model to support FP’s addressing patients’ psychiatric needs. The information obtained from the evaluation will be used to modify the online service to address unmet needs during COVID-19 and optimize current resources to serve more patients.
Ranzcp efforts to improve access to funded treatments
Authors: Allan J. 
Published: February 2022

IntroductionAustralia has a universal health insurance scheme covering part costs for private mental health care and which supports the public system. The Medical Benefits Schedule (MBS) schedule provides a recommended fee for each service, the amount the Australian Government thinks the service should cost. Many patients still pay a gap fee for the service. Similarly a system for medications, the Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicines for most medical conditions. As new evidence emerges in the treatment of psychiatric conditions, it is important that the MBS and PBS are updated so patients receive subsidised best practice treatment.ObjectivesTo provide an overview of RANZCP efforts to expand treatment availability through evidence and advocacy to government.MethodsThe RANZCP made submissions to the independent Medical Services Advisory Committee (MSAC) requesting an MBS listing for repetitive transcranial magnetic stimulation (rTMS) for treatment of antidepressant medication-resistant major depressive disorder. Submissions were made to the independent Pharmaceutical Benefits Advisory Committee (PBAC) to request ability to prescribe quetiapine in 25mg ranges for maintenance therapy.ResultsFollowing RANZCP submissions, the MSAC supported public funding for initial treatment with rTMS for adults with major depression who have tried antidepressant medicine or psychological therapy and remain unwell. The PBAC has recommended changes allowing prescription of 25mg quetiapine tablets for maintenance therapy for acute mania, bipolar 1 disorder and in the treatment of schizophrenia following RANZCP submission.ConclusionsThe RANZCP has achieved access to treatments to provide optimal symptom relief for people living with mental illness.
The impact of COVID-19 on clinical practice and well-being of global mental health professionals
Authors: Rebello T. , Reed G. 
Published: February 2022

Some of the most direct and brutal effects of the COVID-19 pandemic are experienced by health care professionals who are working in demanding environments while having to deal with their own fears of infection and mortality. To assess the impact of COVID-19 on the practice and well-being of global mental health professionals, we designed a three-part, longitudinal, internet-based study. Here we present data from part 1, implemented in June-July 2020 in six languages to members of WHO’s Global Clinical Practice Network composed of 15,500 mental health practitioners. The study assessed COVID-19’s impact on: work circumstances; occupational well-being; use and transition to telehealth; and expectations, needs and recommendations. 2,505 mental health professionals from 126 countries responded to the study (47% psychiatrists). 93.7% of respondents were currently practicing and 70.9% continued to see patients in person. The impact on clinical workload varied in terms of direction and extent depending on type of service provided and country of practice. Most participants had started or increased their use of telehealth services, and we identified a need for training to support telehealth use. Overall, clinicians scored high on well-being indices. However, a subset scored above the cutoff for low well-being and reported a significant number of post-traumatic symptoms. Five factors affected work-related stress: fear of infection, severe COVID-related events, life disruption, lack of adequate protection and role disruption. Data from this study will provide information relevant for the design, development, and integration of mental health services in the continuing pandemic, and in similar future scenarios.DisclosureNo significant relationships.
Profile of tunisian students consulting in psychopedagogy unit
Authors: Messedi N. , Abdelkafi N. , Bouattour O. , Chamseddine A. , Ghorbel A. 
Published: February 2022

IntroductionA signifiant proportion of adolescents and young adults suffer from mental disorders that interfere with their development and influence their academic and professional succes.ObjectivesTo describe the soscio-demographic and clinical profile of tunisian students who have consulted in the psycho-pedagogy unit.MethodsA retrospective descriptive study, data were collected from the files of 359 pupils and students having consulted in the psycho-pedagogy unit of the psychiatry (B) department of the Hedi Chaker university hospital of Sfax in Tunisia, from 2014 to 2018.ResultsThe average age of students was 20.38 ±2.38 years old. The Sex ratio = 0.95 (175 M / 184 W). Students were undergraduates in 55.4 of the cases. THey are smokers in 19% and consume alcohol in 7% of case. A family psychiatric history was present in 34% of students and personal history in 25%. A difficult childhood was found in77.5% of patients and their academic results were low (< 10/20) in 54%. Adjustement disorders were the most frequent disorders in psycho-educationel counseling (47% of case). The most prescribed psychotropic drugs were antidepressants (31.8%) followed by anxiolytics (23.7%) and the withdrawel syndrome was found in 18% of patients.ConclusionsA students with a difficult childhood, low academic results and adjustement disorders such is the profile most frequently encountered among patients consulting the psychopedagogy unit. In this way,the promotion and protection of adolescent’s health particulary pupils and students benefits not only for their own health, but also for the economic and the society.
Perceived stress among nurses: A hospital-based study
Authors: Hrairi A. , Kchaou A. , Masmoudi R. , Abbes A. , Hammami K. Jmal , Masmoudi M.L. , Masmoudi J. , Hajjeji M. 
Published: February 2022

IntroductionStress can be described as a dynamic and reciprocal relationship between the person and the environment. Nursing is considered as an occupation with a constellation of circumstances leading to stress.ObjectivesThis study aims to assess perceived stress among staff nurses in Hedi Chaker and Habib bourguiba Hospital from Sfax city, TunisiaMethodsNurses from Hedi Chaker and Habib bourguiba University hospitals in Sfax- Tunisia were invited to complete a structured self-report questionnaire. The questionnaire consists of the following parts: Perceived Stress Scale (10-item form), personal data and information relevant to types of work shifts and years of experience.ResultsA total of 146 (males = 49; females = 97) nurses participated in this study. The mean age was 37 years. Nearly 82 % of the participants considered themselves in very good health. Rotating shifts work was noted in 72.50% of cases. The average length of working experience was 7.96 years. The stress in most of nurses was in severe level (74.65%), followed by mild (23.28%) and moderate (2.05%) levels. High level of perceived stress was significantly associated with general health problems (P= 0.032). No significant association was found between level of perceived stress, types of work shifts and years of experience.ConclusionsThe results show a significantly high level of stress among staff nurses. Hence, nurses need support and subsequent interventions to cope with stress. Actions in this direction may contribute to the improvement of health, well-being and quality of life of the professionals.Conflict of interestNo significant relationships.
Mental health impact of covid on athletes
Authors: Shah K. , Jain S. , Glick I. 
Published: February 2022

IntroductionThe coronavirus pandemic continues to impact all aspects of the daily life of the public worldwide. With decreased economic activity, the sports industry faces significant challenges of maintaining athletes’ mental health while seeking the best strategies for eventual return to sports competition.ObjectivesWe aim to evaluate COVID-19 related factors impacting on the mental health of athletes and provide appropriate management steps.MethodsWe examined MeSH terms “Athletes,” “Sports,” “COVID-19,” in the context of “Mental Health,” “Mental Disorders,” “Behavioral Medicine,” “Risk Factors.” We identified seven studies for the qualitative synthesis per the PRISMA guidelines, searching Medline, PubMed, PubMed Central, and PsychInfo databases until July 2020.ResultsThe pandemic has negatively impacted athletes’ mental wellbeing due to decreased physical activities, limited resources, fears, and delays or cancellations of the sporting event. The negative psychological impact on athletes is due to self-isolation measures leading to worries of less preparedness for the lockdown, reduced physical activity, loss of competitive advantages, fear of being infected, social isolation, and loneliness. During this period, athletes struggled to maintain baseline routine and engaged in excessive calorie intake, eating low-quality food, substance use, and sleep disruption. It has caused anxiety, depression, PTSD, and mood disorder at varying degrees of severity in athletes.ConclusionsLimited resources during a pandemic have caused adverse mental impact on athletes. We recommend improving physical activity through confined or virtual training programs with colleagues. A collaborative approach is required by clinicians, psychologists, coaches, sports organizations, government bodies to limit the pandemic’s mental health impact.
Dying child and nurses’ mourning
Authors: Zartaloudi A. , Lekas C. , Koutelekos I. , Evangelou E. , Kyritsi E. 
Published: February 2022

IntroductionOne of the most complex and emotional aspects of nursing is the interaction between the nurse and the dying child. The attitudes of nurses towards death, affect the quality of care.ObjectivesTo investigate pediatric nurses’ attitudes towards death.MethodsMethodology: 170 nurses, working in pediatric hospital departments completed a questionnaire which included sociodemographic characteristics and information related to their previous training and clinical experience regarding death issues in general and dying children’s care in particular.Results68.6% reported that the death of a child affects them very much, while 44.7% of the participants didn’t feel well prepared to manage death issues. Pediatric nurses were greatly affected by children’s death, expressing mainly feelings of sadness (44%), compassion (22%), guilt (22%) and anger (22%). 73% of the sample wished the hospitalized child, died when they were not present. 53.5% had been trained regarding the care of dying patients and the management of death and mourning as part of their curriculum and 21.2% had attended a relative seminar / lecture. The importance of proper and adequate education becomes particularly apparent considering that the majority of our sample either did not feel sufficiently prepared in order to deal with death and mourning, even though more than 70% of our participants had been relatively educated.ConclusionsThe incorporation of the notions of death and care at end of life in the theoretical and practical fields of nursing will improve the quality of services offered at the end of life for patients and their families.