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Psychiatric Intervention (psychiatric + intervention)
Selected AbstractsMental health in patients with systemic sclerosis: a controlled investigationJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2008A Mozzetta Abstract Background Despite the undeniable impact of systemic sclerosis (SS) on quality of life, only a few studies so far have focused on its psychiatric or psychological aspects. We aimed at assessing psychiatric symptoms and self-image in inpatients with SS and comparing them with patients with either a very mild skin condition or a serious skin condition. Methods Three groups were recruited: (i) 38 consecutive female inpatients with SS; (ii) 38 age-matched female outpatients with melanocytic naevi; (iii) 35 age-matched female inpatients with melanoma. All participants completed the Zung Anxiety Scale, the Zung Depression Scale and a self-report questionnaire measuring self-perceived personal qualities. Patients with SS were also clinically interviewed by a psychologist. Results The clinical interview revealed the presence of a psychiatric disorder in most (81%) patients with SS. The Zung scales corroborated the presence of mild to moderate anxiety and depression among patients with SS, who scored significantly higher than patients with either naevi or melanoma on both scales. Scores on the questionnaire assessing self-perceived personal qualities were very similar in the three groups and indicated a fairly high level of self-esteem. Conclusions This study suggested that psychosocial issues are quite relevant in patients with SS and underscored the need for a biopsychosocial approach to the clinical management of these patients. Timely detection of psychosocial difficulties and appropriate psychological or psychiatric intervention may represent important steps toward better adherence to medical treatment and improved psychological well-being and quality of life. [source] Mental health issues of peacekeeping workersPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2002JUN SHIGEMURA Abstract The end of the Cold War has brought a dramatic change to the international political situation and the role of the United Nations peacekeeping operations (PKO) has drawn increased attention. While many reports on PKO have focused on political or sociologic considerations, the mental health of the peacekeepers themselves has received little attention and psychiatric problems that can have a negative impact on mission success have been largely ignored. Participation in PKO creates a number of stressors and serious psychiatric and/or physical disorders may result. Yet, there is little research on this topic, either domestically or globally, and the methodology for clinical intervention remains in an early stage of development. We have reviewed previous reports to determine how various stressors before, during and after deployment affect the participants. Research in associated fields (e.g. crisis workers and military personnel) are also reviewed and their application to peacekeeping psychiatry is discussed. It must be admitted that the significance of PKO is arguable and each PKO is unique in terms of the nature of its mission and the local situation. Yet, the relationship between the psychiatric status of the personnel and the characteristics of an individual mission has never been studied. At present, no clear consensus regarding a framework for psychiatric intervention exists. Studies that enhance the recognition and significance of peacekeeping psychiatry are likely to improve the efficacy of PKO. [source] Randomization in psychiatric intervention research in the general practice settingINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000CM Van Der Feltz-Cornelis Faculty of Medicine Abstract Most studies of psychiatric interventions in general practice settings conform only in part to the requirements of randomization, placebo control and blinding as formulated by the Cochrane Collaboration. It is possible, nonetheless, to develop experimental research designs that are sufficiently near to this standard. These must deal with certain methodological issues specific to psychiatric research. This article discusses scientific standards of psychiatric research with special consideration of interventions in general practice settings. These issues are accompanied by concrete examples and suggestions on how to confront the problems. In psychiatric intervention research, equivalence studies with single-blind outcome assessment, a tested and ethically justified method, are generally used in place of placebo-controlled studies. The article also examines randomization procedures in greater depth. Randomization can be applied across trial subjects or across doctors' practices. Practical consequences of randomizing across subjects, and specific implementations of it such as crossover and pre-post designs in general practice settings, are clarified. Overall, a research design using randomization across doctors' practices is judged preferable to one that randomizes across trial subjects. One potential problem is that the control group may become too small, especially when considerable effects are expected from the intervention being studied. One might consider making the control condition smaller in the first place, or, if indicated on ethical grounds, performing an intermediate analysis and then breaking off the study as soon as a statistically significant effect has been demonstrated. Multilevel statistical techniques offer new opportunities for analysis within such designs. Copyright © 2000 Whurr Publishers Ltd. [source] Development and validation of the psychosomatic scale for atopic dermatitis in adultsTHE JOURNAL OF DERMATOLOGY, Issue 7 2006Tetsuya ANDO ABSTRACT Psychosocial factors play an important role in the course of adult atopic dermatitis (AD). Nevertheless, AD patients are rarely treated for their psychosomatic concerns. The purpose of the present study was to develop and validate a brief self-rating scale for adult AD in order to aid dermatologists in evaluating psychosocial factors during the course of AD. A preliminary scale assessing stress-induced exacerbation, the secondary psychosocial burden, and attitude toward treatment was developed and administered to 187 AD patients (82 male, 105 female, aged 28.4 ± 7.8, 13,61). Severity of skin lesions and improvement with standard dermatological treatment were assessed by both the dermatologist and the participant. Measures of anxiety and depression were also determined. In addition, psychosomatic evaluations were made according to the Psychosomatic Diagnostic Criteria for AD. Factor analysis resulted in the development of a 12-item scale (The Psychosomatic Scale for Atopic Dermatitis; PSS-AD) consisting of three factors: (i) exacerbation triggered by stress; (ii) disturbances due to AD; and (iii) ineffective control. Internal consistency indicated by Cronbach's alpha coefficient was 0.86 for the entire measure, 0.82 for (i), 0.81 for (ii), and 0.77 for (iii), verifying the acceptable reliability of PSS-AD. Patients with psychosomatic problems had higher PSS-AD scores than those without. PSS-AD scores were positively associated with the severity of the skin lesions, anxiety and depression. The scores were negatively associated with improvement during dermatological treatments. In conclusion, PSS-AD is a simple and reliable measure of the psychosomatic pathology of adult AD patients. It may be useful in dermatological practice for screening patients who would benefit from psychological or psychiatric interventions. [source] | |||||||||||||||||||