Schizophrenic patients who were never treated – a study in an Indian urban community

1998 ◽  
Vol 28 (5) ◽  
pp. 1113-1117 ◽  
Author(s):  
R. PADMAVATHI ◽  
S. RAJKUMAR ◽  
T. N. SRINIVASAN
Keyword(s):  
Health Services ◽  
Psychiatric Disorders ◽  
Epidemiological Study ◽  
Schizophrenic Patient ◽  
Urban Population ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Number Of Patients ◽  
Schizophrenic Patients ◽  
Standardized Screening

Background. A significant number of patients with severe psychiatric disorders remain untreated in the community although health services are available. The factors related to non-treatment are not well understood.Method. A door-to-door survey was conducted on an Indian urban population of 100 000 using standardized screening and clinical instruments as a part of a larger epidemiological study. Treatment status was determined from multiple sources of information.Results. Nearly one-third of 261 schizophrenia patients were found never to have received treatment. They were older in age and ill for a longer duration than those who had been treated and were more symptomatic and severely disabled. They were more often uneducated and divorced and lived with larger extended/joint families. This last factor was considered as being the important factor in determining whether the patient received treatment.Conclusion. The larger extended/joint family, which was able to compensate and cope with the dysfunctional member, seemed to be the crucial factor related to non-treatment of the schizophrenic patient.

Basis for Decisions on Emerging Health Technology: A Danish Feasibility Study

1998 ◽  
Vol 14 (4) ◽  
pp. 624-635 ◽  
Author(s):  
Torben Jørgensen ◽  
Lars Grupe Larsen
Keyword(s):  
Health Services ◽  
Feasibility Study ◽  
Early Identification ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Decision Makers ◽  
Sources Of Information ◽  
Early Assessment ◽  
Danish Health ◽  
Number Of Patients

AbstractThe objectives of the feasibility study were to evaluate sources of information for an eventual Danish system for early identification and assessment of emerging health technology, to identify potential users of the system, and to clarify their specific need for information concerning emerging health technology. The methods used were questionnaires to informants within and outside the health services and to decision makers on different levels in the health services, and follow-up telephone interviews. Our study reveals a strong, and to some extent unsatisfied, need among policy makers, planners, and managers in the Danish health services for information concerning emerging health technology. The requested information should in particular concern indication for use, number of patients affected, clinical effectiveness and side effects, running cost, and investments. The time horizon most relevant to the decision makers seems to be only zero to 2 years. Furthermore, we found that numerous sources are available that frequently display information on emerging technology important to the health services. The challenges seem to be to select information of sufficient importance and quality, and to combine information, since very few, if any, single primary sources cover all the requested information. In conclusion, we recommend the establishment of a Danish national system for early identification and assessment of emerging health technology, consisting of a small secretariat that collaborates nationally and internationally, the latter in particular on identification of technology and on development of methods for early assessment.

Carbamazepine in the Treatment of Aggressive Behavior in Schizophrenic Patients: A Case Report

1983 ◽  
Vol 28 (7) ◽  
pp. 566-568 ◽  
Author(s):  
R. Yassa ◽  
D. Dupont
Keyword(s):  
Case Report ◽  
Temporal Lobe Epilepsy ◽  
Aggressive Behavior ◽  
Psychiatric Disorders ◽  
Schizophrenic Patient ◽  
Behavioral Problems ◽  
Violent Behavior ◽  
Eeg Abnormalities ◽  
Schizophrenic Patients ◽  
Maintenance Ect

Carbamazepine has been used in the treatment of temporal lobe epilepsy since 1963. It has also been found effective in the treatment of psychiatric disorders accompanying epilepsy. Patients with nonspecific EEG abnormalities without overt epilepsy but with behavioral problems, including gross psychopathology and violent behavior, improve on carbamazepine. These findings prompted us to use it in the treatment of aggressive behavior in a schizophrenic patient. Due to the frequency and severity of aggressive behavior in this patient, maintenance ECT was given. However, when carbamazepine was instituted, ECT was discontinued and the patient has been virtually free from aggressive behavior since this medication has been instituted. The authors conclude that carbamazepine may be used in the treatment of aggressive behavior in schizophrenic patients.

Analisis Pengalaman Keluarga Merawat Pasien Skizofrenia dengan Masalah Halusinasi Pendengaran Pasca Hospitalisasi

2019 ◽  
Vol 4 (2) ◽  
pp. 282
Author(s):  
Isti Harkomah
Keyword(s):  
Health Services ◽  
Family Support ◽  
Depth Information ◽  
Continuous Family ◽  
Family Experience ◽  
Schizophrenic Patients ◽  
Heavy Burden ◽  
Document Review ◽  
Depth Interviews

<p><em>Clients with hallucinations really need continuous family support both internal and external families. Reduced external family support will cause a heavy burden on the internal family in caring for hallucinatory clients. The reason families bring to the hospital is the inability to treat patient hallucinations at home after hospitalization because hallucinations pose a burden on the family. The purpose of this study was to find out in-depth information about family experience in treating schizophrenic patients who experience auditory hallucinations after hospitalization. This research is qualitative research, the phenomenology approach uses the method of collecting data by in-depth interviews and document review. Data were obtained by in-depth interviews with six participants. The results of the study are two main themes, namely family understanding of recognizing hallucinatory problems after hospitalization and family experience in treating schizophrenic patients with hallucinatory problems.It is hoped that health services will further improve the quality of health services in providing health education to families about how to properly care for hallucinatory patients and families are expected to be able to treat hallucinogenic patients well.</em></p><p><em><br /></em></p><p><em><em>Klien dengan halusinasi sangat membutuhkan dukungan dari keluarga secara terus menerus baik keluarga internal maupun eksternal. Berkurangnya dukungan keluarga eksternal akan menimbulkan beban yang berat bagi keluarga internal dalam merawat klien halusinasi. Alasan keluarga membawa ke RSJ adalah ketidakmampuan merawat halusinasi pasien dirumah pasca rawat inap karena halusinasi menimbulkan beban bagi keluarga. Tujuan penelitian ini adalah untuk mengetahui informasi mendalam tentang pengalaman keluarga dalam merawat pasien skizofrenia yang mengalami masalah halusinasi pendengaran pasca hospitalisasi. Penelitian ini merupahkan penelitian kualitatif, pendekatan fenomenologi menggunakan metode pengumpulan data dengan wawancara mendalam dan telaah dokumen. Data didapatkan dengan wawancara mendalam terhadap enam partisipan. Hasil wawancara dianalisis dengan menggunakan metode Collaizi. Hasil penelitian yaitu terdapat 2 utama tema yaitu pemahaman keluarga tentang mengenal masalah halusinasi pasca hospitalisasi dan pengalaman keluarga dalam merawat pasien skizofrenia dengan masalah halusinasi.Diharapkan bagi pelayanan kesehatan agar lebih meningkatkan mutu pelayanan kesehatan dalam memberikan pendidikan kesehatan kepada keluarga tentang cara merawat pasien halusinasi yang benar dan keluarga diharapkan dapat merawat pasien halusinasi dengan baik.</em></em></p>

Supporting the Development of Clinical Reasoning of Preprofessional Novices in Dysphagia Management

2019 ◽  
Vol 40 (03) ◽  
pp. 151-161 ◽  
Author(s):  
Sebastian Doeltgen ◽  
Stacie Attrill ◽  
Joanne Murray
Keyword(s):  
Clinical Reasoning ◽  
Clinical Decision Making ◽  
Management Practice ◽  
Clinical Decision ◽  
Assessment Process ◽  
Evidence Based ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Implicit Processing ◽  
Reasoning Skills

AbstractProficient clinical reasoning is a critical skill in high-quality, evidence-based management of swallowing impairment (dysphagia). Clinical reasoning in this area of practice is a cognitively complex process, as it requires synthesis of multiple sources of information that are generated during a thorough, evidence-based assessment process and which are moderated by the patient's individual situations, including their social and demographic circumstances, comorbidities, or other health concerns. A growing body of health and medical literature demonstrates that clinical reasoning skills develop with increasing exposure to clinical cases and that the approaches to clinical reasoning differ between novices and experts. It appears that it is not the amount of knowledge held, but the way it is used, that distinguishes a novice from an experienced clinician. In this article, we review the roles of explicit and implicit processing as well as illness scripts in clinical decision making across the continuum of medical expertise and discuss how they relate to the clinical management of swallowing impairment. We also reflect on how this literature may inform educational curricula that support SLP students in developing preclinical reasoning skills that facilitate their transition to early clinical practice. Specifically, we discuss the role of case-based curricula to assist students to develop a meta-cognitive awareness of the different approaches to clinical reasoning, their own capabilities and preferences, and how and when to apply these in dysphagia management practice.

scholarly journals The use of computerised tomography in mental handicap patients

1992 ◽  
Vol 16 (10) ◽  
pp. 616-618
Author(s):  
S. K. Lekh ◽  
B. K. Puri ◽  
I. Singh
Keyword(s):  
Psychiatric Disorders ◽  
Research Tool ◽  
Clinical Neurology ◽  
Computerised Tomography ◽  
Chronic Schizophrenic ◽  
Mental Handicap ◽  
Schizophrenic Patients

Since its inception (Hounsfield, 1973), computerised tomography (CT) has become an invaluable diagnostic and research tool, particularly in clinical neurology and neurosurgery. Clinically, CT has proved useful in differentiating between ‘functional’ and ‘organic’ psychiatric disorders where it is particularly helpful in the diagnosis of potentially treatable organic disorders. For example, Owens et al (1980) found clinically unsuspected intracranial pathology in 12 of 136 chronic schizophrenic patients examined by CT and Roberts & Lishman (1984) found diagnosis, management, and/or prognosis were influenced in approximately 12% of cases referred by psychiatrists for CT imagining.

scholarly journals Mobility Trends before and after the Pandemic Outbreak: Analyzing the Metropolitan Area of Barcelona through the Lens of Equality and Sustainability

2021 ◽  
Vol 13 (14) ◽  
pp. 7908
Author(s):  
Lucía Mejía-Dorantes ◽  
Lídia Montero ◽  
Jaume Barceló
Keyword(s):  
Metropolitan Area ◽  
Spatial Arrangement ◽  
Individual Characteristics ◽  
Sources Of Information ◽  
Mobility Patterns ◽  
Multiple Sources ◽  
Temporal Dimension ◽  
Population Groups ◽  
Highly Educated ◽  
Before And After

The spatial arrangement of a metropolis is of utmost importance to carry out daily activities, which are constrained by space and time. Accessibility is not only shaped by the spatial and temporal dimension, but it is also defined by individual characteristics, such as gender, impairments, or socioeconomic characteristics of the citizens living or commuting in this area. This study analyzes mobility trends and patterns in the metropolitan area of Barcelona before and after the COVID-19 pandemic outbreak, with special emphasis on gender and equality. The study draws on multiple sources of information; however, two main datasets are analyzed: two traditional travel surveys from the transport metropolitan area of Barcelona and two coming from smartphone data. The results show that gender plays a relevant role when analyzing mobility patterns, as already highlighted in other studies, but, after the pandemic outbreak, some population groups were more likely to change their mobility patterns, for example, highly educated population groups and those with higher income. This study also highlights that e-activities may shape new mobility patterns and living conditions for some population segments, but some activities cannot be replaced by IT technologies. For all these reasons, city and transport planning should foster sustainable development policies, which will provide the maximum benefit for society.

A case of rare allele T 126, 30,32 base pairs in a schizophrenic patient: A study case

2016 ◽  
Vol 33 (S1) ◽  
pp. S585-S586
Author(s):  
A.I. Sabau ◽  
P. Cristina ◽  
B. Valerica ◽  
P. Delia Marina
Keyword(s):  
Schizophrenic Patient ◽  
Complex Disease ◽  
Susceptibility Gene ◽  
Rflp Analysis ◽  
Rare Allele ◽  
Base Pairs ◽  
Gene Coding ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionSchizophrenia is a severe and complex disease clinically characterized by disturbed thought processes, delusions, hallucinations and reduced social skills. Gene coding for neregulin 1 (NRG 1) located in 8 p21chromosomeand single nucleotide polymorphism (SNPs) have been identified strongly supporting NRG1 gene as a susceptibility gene for schizophrenia.ObjectiveThe present preliminary study, determines the relationship between polymorphism nucleotide sites (SNPs2) of NRG1 gene and schizophrenia.AimsIdentifying rare allele T of neregulin 1 genein schizophrenic patients.MethodWe analyzed the polymorphism (SNPs2) of NRG1 gene in 20 patients recruited from Psychiatry Department of Emergency Clinical Hospital of Arad diagnosed with schizophrenia according to DSM-5-TM and ICD-10 criteria and 10 healthy controls. From all subjects, we obtained 2 mL of peripheral blood samples. Genomic DNA was extracted using the phenol-chloroform method. Genotyping was performed byPCR-based RFLP analysis for all subjects. The obtained PCR product mixture was completely digested with restriction enzyme, separated on SNP1 and SNP2 agarose gel. We present the case of a 31 years old, male, schizophrenic patient with the SNPs2 polymorphism and rare allele T 126.ResultsIn both groups, common allele G 127 and 60 base pairs was identified but only 2 schizophrenic patients presented rare allele T 126 and 30,32 base pairs.ConclusionsThe polymorphism SNPs2 of NRG1 gene with rare allele T 126 and 30,32 base pairs, may play a role in predisposing an individual to schizophrenia. Further and extended replicating studies with multiple sequencing of NRG1 gene are necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An epidemiological study of concomitant use of herbal medicine and antipsychotics in schizophrenic patients: implication for herb-drug interaction

2011 ◽  
Vol 26 (S2) ◽  
pp. 1536-1536
Author(s):  
Z.-J. Zhang
Keyword(s):  
Herbal Medicine ◽  
Clinical Outcomes ◽  
Epidemiological Study ◽  
Urban Areas ◽  
Psychiatric Hospitals ◽  
Adverse Outcomes ◽  
Antipsychotic Treatment ◽  
Clinical Effects ◽  
Association Analyses ◽  
Number Of Patients

Herb-drug interactions are an important issue in drug safety and clinical practice. The aim of this epidemiological study was to characterize associations of clinical outcomes with concomitant herbal and antipsychotic use in patients with schizophrenia. A total of 1795 patients with schizophrenia who were randomly selected from 17 psychiatric hospitals in China were interviewed face-to-face using a structured questionnaire. Association analyses were conducted to examine correlates between Chinese medicine (CM) use and demographic, clinical variables, antipsychotic medication mode, and clinical outcomes. The prevalence of concomitant CM and antipsychotic treatment was 36.4% [95% confidence interval (95% CI) 34.2%–38.6%]. Patients using concomitant CM had a significantly greater chance of improved outcomes than non-CM use (61.1% vs. 34.3%, OR = 3.44, 95% CI 2.80–4.24). However, a small but significant number of patients treated concomitantly with CM had a greater risk of developing worse outcomes (7.2% vs. 4.4%, OR = 2.06, 95% CI 2.06–4.83). Significant predictors for concomitant CM treatment-associated outcomes were residence in urban areas, paranoid psychosis, and exceeding 3 months of CM use. Herbal medicine regimens containing Radix Bupleuri, Fructus Gardenia, Fructus Schisandrae, Radix Rehmanniae, Akebia Caulis, and Semen Plantaginis in concomitant use with quetiapine, clozapine, and olanzepine were associated with nearly 60% of the risk of adverse outcomes. Our study suggests that concomitant herbal and antipsychotic treatment could produce either beneficial or adverse clinical effects in schizophrenic population. Potential herb-drug pharmacokinetic interactions need to be further evaluated.

scholarly journals Altered Glutathione Redox State in Schizophrenia

2006 ◽  
Vol 22 (1-2) ◽  
pp. 83-93 ◽  
Author(s):  
Jeffrey K. Yao ◽  
Sherry Leonard ◽  
Ravinder Reddy
Keyword(s):  
Psychiatric Disorders ◽  
Antioxidant Status ◽  
Dynamic State ◽  
Radical Scavenger ◽  
Enzymatic Reactions ◽  
Control Subjects ◽  
Age Related ◽  
Schizophrenic Patients ◽  
Schizophrenic Group ◽  
Positive Correlations

Altered antioxidant status has been reported in schizophrenia. The glutathione (GSH) redox system is important for reducing oxidative stress. GSH, a radical scavenger, is converted to oxidized glutathione (GSSG) through glutathione peroxidase (GPx), and converted back to GSH by glutathione reductase (GR). Measurements of GSH, GSSG and its related enzymatic reactions are thus important for evaluating the redox and antioxidant status. In the present study, levels of GSH, GSSG, GPx and GR were assessed in the caudate region of postmortem brains from schizophrenic patients and control subjects (with and without other psychiatric disorders). Significantly lower levels of GSH, GPx, and GR were found in schizophrenic group than in control groups without any psychiatric disorders. Concomitantly, a decreased GSH:GSSG ratio was also found in schizophrenic group. Moreover, both GSSG and GR levels were significantly and inversely correlated to age of schizophrenic patients, but not control subjects. No significant differences were found in any GSH redox measures between control subjects and individuals with other types of psychiatric disorders. There were, however, positive correlations between GSH and GPx, GSH and GR, as well as GPx and GR levels in control subjects without psychiatric disorders. These positive correlations suggest a dynamic state is kept in check during the redox coupling under normal conditions. By contrast, lack of such correlations in schizophrenia point to a disturbance of redox coupling mechanisms in the antioxidant defense system, possibly resulting from a decreased level of GSH as well as age-related decreases of GSSG and GR activities.

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