Purpose: Venous thromboembolism (VTE) poses a significant threat to individuals' health, yet its correlation with mental disorders remains underappreciated. Here, we conducted a retrospective ...analysis to explore the characteristics of psychiatric patients presenting with VTE. Methods: We retrospectively analyzed psychiatric inpatients with elevated plasma D-dimer levels at the Mental Health Center, First Affiliated Hospital, Zhejiang University School of Medicine, from January 2014 to January 2022. The inclusion criteria comprised comprehensive demographic and clinical profiles, including laboratory and imaging findings. Results: A cohort of 33 eligible patients was included, with plasma D-dimer levels ranging from 880 to 10,700 microg/L FEU. Significantly higher D-dimer levels were observed in patients diagnosed with severe mental disorders (SMD), such as schizophrenia and bipolar disorder, compared to those with mild mental disorders (MMD), including depression and anxiety disorders (p = 0.007). Furthermore, individuals receiving antipsychotic medications for less than one year exhibited elevated D-dimer levels compared to those on treatment for over one year (p = 0.005). However, normalization of D-dimer levels did not demonstrate a significant association with psychiatric diagnosis or treatment duration (p > 0.05). Conclusion: Our findings suggest that patients diagnosed with SMD or those undergoing antipsychotic treatment for less than one year may have elevated D-dimer levels, indicating a potential predisposition to VTE severity. This underscores the importance of recognizing VTE risk in individuals with severe mental disorders and warrants further investigation into the impact of antipsychotic treatment duration on thrombotic risk. Keywords: asymptomatic thromboembolism, D-dimer, psychiatric disorder, risk factors
The paper contributes to the literature on legal consciousness in medical settings by focusing on psychiatric patients' understanding of rights during hospitalization in Israeli psychiatric wards. It ...asks whether hospital personnel act as agents who promote patients' legal consciousness and whether patients are aware of their legal and social rights during hospitalization.
The data for this study were derived from the Patient Experience Survey of Psychiatric Public Hospitals, a comprehensive survey conducted by the Israel Ministry of Health in 2017. The survey included two variables that were used to measure patients' legal consciousness: legal consciousness with hospitalization rights and legal consciousness with social rights. To predict legal consciousness and patient satisfaction, a logistic regression model was employed.
The analysis reveals low rates of patients' awareness of hospitalization and social rights, varying between 55 and 66%, respectively. Variations in awareness are not strongly associated with patients' socioeconomic and demographic attributes or with hospital characteristics but are somewhat associated with hospitalization conditions. The data also reveal that awareness of legal rights (whether hospitalization rights or social rights) is likely to increase satisfaction with the hospitalization experience.
The analysis underscores a significant finding. Patients' awareness of their legal rights during hospitalization is limited. Interestingly, this awareness is more influenced by the conditions of hospitalization than by the patients' socio-demographic attributes. This research also provides insights into the potential role of legal awareness in shaping patients' attitudes toward treatment and enhancing their satisfaction during hospitalization.
•The paper contributes to the literature on legal consciousness.•The analysis reveals low rates of patients' legal awareness.•Legal consciousness of hospitalization and social rights vary between 55 and 66%.•Legal awareness is somewhat associated with hospitalization conditions.•Legal consciousness is likely to increase satisfaction with hospitalization.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To ascertain factors associated with worsening of psychiatric conditions during the coronavirus disease 2019 (COVID-19) pandemic.
This study anonymously examined 2,734 psychiatric patients worldwide ...for worsening of their preexisting psychiatric conditions during the COVID-19 pandemic. An independent clinical investigation of 318 psychiatric patients from United States was used for verification.
Valid responses mainly from 12 featured countries indicated self-reported worsening of psychiatric conditions in two-thirds of the patients assessed that was through their significantly higher scores on scales for general psychological disturbance, posttraumatic stress disorder, and depression. Female gender, feeling no control of the situation, reporting dissatisfaction with the response of the state during the COVID-19 pandemic, and reduced interaction with family and friends increased the worsening of preexisting psychiatric conditions, whereas optimism, ability to share concerns with family and friends, and using social media like usual were associated with less worsening. An independent clinical investigation from the United States confirmed worsening of psychiatric conditions during the COVID-19 pandemic based on identification of new symptoms that necessitated clinical interventions such as dose adjustment or starting new medications in more than half of the patients.
More than half of the patients are experiencing worsening of their psychiatric conditions during the COVID-19 pandemic.
Functional connectivity between different regions of the brain in the resting state has been a recent topic of interest in neurophysiological research. EEG coherence happened to be an useful tool for ...measuring changes in neuro-psycho-physiological functioning which are not detectable by simply measuring amplitude or power spectra.
The aim of our study was to investigate the changes in the EEG coherence in groups of different mental disorders such as: depression, general anxiety disorder, ADHD, Asperger syndrome and headaches, compared to control group. All measures were made in two conditions: eye opened (EO) and eyes closed (EC).
The obtained results show that in EO condition there is a significantly lower coherence for delta waves between analyzed groups. For theta coherence only for Asperger syndrome we found lower coherence compared to control group, ADHD and headaches in parietal region (P3-P4). Obtained results for intrahemispheric coherence have shown that there was significantly lower coherence in both conditions for delta and theta bands in almost all sites for Asperger’s syndrome, and opposite increased intrahemispheric coherence for patients with headaches (for delta band in the anterior regions and for theta band in the posterior regions). ADHD patients expressed lower delta inter-hemispheric coherence in frontal regions, and increased coherence of theta in central regions but increased delta coherence in posterior regions only in EO condition. For depressive and anxiety patients we found decreased intrahemispheric coherence for EO condition for delta brain waves all over the cortex. Concerning the coherence in anxiety patients in our current study we have obtained hypo coherence in centro-parieto-occipital region only for delta in inter-hemispheric coherence and also lower delta coherence through the cortex for intrahemispheric coherence.
Our findings for interhemispheric hyper coherence in subjects with depression specifically for alpha and beta bands were confirmed in other studies.
We suggest that EEG coherence analysis could be a sensitive parameter in the detection of electrophysiological abnormalities in patients with anxiety, depression, ADHD, Asperger syndrome and headaches. These results can confirm the development of QEEG state and trait biomarkers for psychiatric disorders.
Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic ...review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen's d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care.
PROSPERO ID: CRD42019131959.
•Social network enhancement should be encouraged during mental health treatment.•Small additive effects of social network interventions emerged on social network outcomes and mental health outcomes.•No additive effects of social network interventions were found for psychiatric and psychological symptom reduction.•Female patients seemed more susceptible to positive effects of social network interventions on psychiatric symptoms.•Future research is warranted to explore the most optimal social network interventions and enhance the personalised care for psychiatric patients.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The relationship between coping and defense mechanisms warrants attention. These constructs have historically been conflated and difficult to distinguish, and have gained renewed research interest in ...recent years. Defense mechanisms are commonly seen as temporally stable, unconscious, and related to personality functioning while coping mechanisms are often seen as flexible, conscious, and stressor dependent. We conducted a scoping review of the empirical literature on the relationship between coping and defense mechanisms. A total of 35 empirical studies were identified, consisting of 23 cross-sectional and 12 longitudinal studies in psychiatric, medical, and community samples. The cross-sectional studies reported consistent relationships between maladaptive coping and immature defense mechanisms, as well as between adaptive coping mechanisms and mature defense mechanisms. The temporality and stability of adaptive functioning have produced inconsistent results and require further research. Although studies suggest that defense mechanisms can improve with therapeutic intervention, change in the use of coping mechanisms in therapy is less clear. We suggest future hypotheses and highlight the importance of novel developments in observer-rated measures of assessment that may be applied longitudinally over time.
Public Health Significance Statement
This systematic review explores the empirical relationship between coping and defense mechanisms, reflecting issues of taxonomy, adaptiveness, and temporality. The identified studies show strong relationships between coping and defense mechanisms in cross-sectional research but reveal inconsistent relationships in longitudinal research.
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BFBNIB, CEKLJ, FFLJ, FZAB, GIS, IJS, KILJ, NUK, ODKLJ, OILJ, PEFLJ, SBCE, SBMB, UPUK
Introduction
The confinement did begot a recrudescence in the rate of stress within populations. Meanwhile, research targeting the mental health of the psychiatric patients’ accompanyings are scarce.
...Objectives
Detect and evaluate anxiety levels of patients’ entourage during confinement.
Methods
It is a retrospective, descriptive and analytical study based on a random sample of People accompanying psychiatric patients from externals consultations service in the only Psychiatric Hospital in Tunisia. Data were been collected during the month of June 2020 via a 20 items questionnaire and a score HAD issued in Arabic.
Results
One hundred thirty five accompanyings were surveyed. The age group was predominantly between 51 and 60 with a sex ratio of 0.31. Near half was the parents. eighty seven were unemployed, 38 stopped working due to confinement and 10 have been worked normally. A pathological anxiety HAD score (>7) was found in 36 accompanyings (26, 67 %). Amongst them, 19 had manifested symptoms. Anxiety levels are significantly much higher in accompanyings of patients with personality disorders (p=0.053). Otherwise, 52, 6% of accompanyings who stopped working felt more under pressure than before lockdown. In contrary to those who did not worked before at all (29.9 %) and those who continued working (10%).
Conclusions
It seems that the entourage of mentally ill patients experience a continuous psychological distress, which was uncovered and marked in confinement period. Thus, it is necessary to establish screening programs, psychological education and early care to ensure their well-being.
Disclosure
No significant relationships.
The article describes a conceptual model proposing that aggression in psychiatric facilities may be reduced by designing the physical environment with ten evidence-grounded stress-reducing features. ...The model was tested in a newer hospital in Sweden having wards with nine of the ten features. Data on two clinical markers of aggressive behavior, compulsory injections and physical restraints, were compared with data from an older facility (replaced by the newer hospital) that had only one stress-reducing feature. Another hospital with one feature, which did not change during the study period, served as a control. The proportion of patients requiring injections declined (p<0.0027) in the new hospital compared to the old facility but did not change in the control hospital. Among patients who received injections, the average number of injections declined marginally in the new hospital compared to the old facility, but increased in the control hospital by 19%. The average number of physical restraints (among patients who received at least one) decreased 50% in the new hospital compared to the old. These findings suggest that designing better psychiatric buildings using reasoned theory and the best available evidence can reduce the major patient and staff safety threat posed by aggressive behavior.
•A conceptual model for designing psychiatric wards to reduce stress and aggression is described.•The model identifies ten ward design features that may help reduce aggression.•We hypothesized that aggression would be lower in hospitals with several compared to few design features.•Injections for aggression were reduced in a new hospital with nine features compared to hospitals with one.•Restraint use declined 50% in the new hospital compared to an older facility it replaced.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The treatment of mental disorders has shifted from inpatient wards to community-based settings in recent years, but some patients may still have to be admitted to inpatient wards, sometimes ...involuntarily. It is important to maintain the length of hospital stay (LoS) as short as possible while still providing adequate care. The present study aimed to explore the factors associated with the LoS in involuntarily admitted psychiatric patients.
A ten-year retrospective chart review of 332 patients admitted involuntarily to the inpatient psychiatric ward of the General University Hospital of Ioannina, Northwestern Greece, between 2008 and 2017 was conducted.
The mean LoS was 23.8 (SD = 33.7) days and was relatively stable over the years. Longer-stay hospitalization was associated with schizophrenia-spectrum disorder diagnosis, previous hospitalizations and the use of mechanical restraint, whereas patients in residential care experienced significantly longer LoS (52.6 days) than those living with a caregiver (23.5 days) or alone (19.4 days). Older age at disease onset was associated with shorter LoS, whereas no statistically significant differences were observed with regard to gender.
While some of our findings were in line with recent findings from other countries, others could not be replicated. It seems that multiple factors influence LoS and the identification of these factors could help clinicians and policy makers to design more targeted and cost-effective interventions. The optimization of LoS in involuntary admissions could improve patients' outcomes and lead to more efficient use of resources.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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