The Psychiatric clinics of North America
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Primary sleep disorders include those not attributable to another medical or psychiatric condition: insomnia disorder, hypersomnolence disorder, narcolepsy, obstructive sleep apnea hypopnea syndrome, central sleep apnea syndrome, and the parasomnias. They are commonly encountered and are comorbid with many psychiatric disorders. It is important to recognize these disorders and be comfortable treating them or to know when to refer to a sleep disorders center and sleep specialist. Treatment of a comorbid sleep disorder can improve the overall quality of life, symptoms in mood disorders, and symptoms of excessive daytime sleepiness, and decrease cardiovascular morbidity and mortality.
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Burn injuries pose complex biopsychosocial challenges to recovery and improved comprehensive care. The physical and emotional sequelae of burns differ, depending on burn severity, individual resilience, and stage of development when they occur. ⋯ Psychiatric recovery is affected by pain, mental disorders, substance abuse, and burn stigmatization. Individual resilience, social supports, and educational or occupational achievements affect outcomes.
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Psychiatr. Clin. North Am. · Mar 2015
ReviewCognitive functioning, mental health, and quality of life in ICU survivors: an overview.
Critical illness can and often does lead to significant cognitive impairment and to the development of psychological disorders. These conditions are persistent and, although they improve with time, often fail to completely abate. ⋯ Potential contributors may include the potentially toxic effects of sedatives and narcotics, delirium, hypoxia, glucose dysregulation, metabolic derangements, and inflammation. Patients with preexisting vulnerabilities, including predisposing genetic factors, and frail elderly populations may be at particular risk for emergence of acceleration of conditions such as mild cognitive impairment.
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Humor has not been taken as seriously as it should be. Humor has many positive effects in the daily lives of patients and clinicians need to take advantage of these. ⋯ Freudian, rational emotive therapy, and kleinian views are presented, as well as examples of how to use playful therapy. In addition, advice on how to develop humor is given.
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Neuromodulation techniques in obsessive-compulsive disorder (OCD) involve electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). This article reviews the available literature on the efficacy and applicability of these techniques in OCD. ECT is used for the treatment of comorbid depression or psychosis. ⋯ Low-frequency TMS provides significant but mostly transient improvement of obsessive-compulsive symptoms. DBS shows a response rate of 60% in open and sham-controlled studies. In OCD, it can be concluded that DBS, although more invasive, is the most efficacious technique.