International journal of psychiatry in medicine
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Int J Psychiatry Med · Jan 2013
Improving the doctor-patient relationship in China: the role of balint groups.
Doctor-patient relationships in China have been deteriorating for the past 10 years. Many Chinese doctors are involved in tense and conflictual doctor-patient relationships. Most patients do not trust doctors or other medical staff and physical attacks on these professionals have become a common event. The Balint group offers a better understanding of the doctor-patient relationship in a safe environment and relieves the doctors from the daily stress. ⋯ Perhaps Balint work in China is a contribution to the integration of traditional Chinese virtues: benevolence, tolerance, magnanimity, and prudence with modern medicine. Balint work could be an alternative to the outcome-oriented pressure to perform and to the machine paradigm of biomedicine.
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Int J Psychiatry Med · Jan 2013
Randomized Controlled Trial Multicenter StudyAssociation of anxiety and depression with pulmonary-specific symptoms in chronic obstructive pulmonary disease.
To examine the association of anxiety and depression with pulmonary-specific symptoms of Chronic Obstructive Pulmonary Disease (COPD), and to determine the extent to which disease severity and functional capacity modify this association. ⋯ Anxiety and depression were associated with higher levels of fatigue, shortness of breath, and frequency of COPD symptoms. It is important for clinicians to be aware of the presence of anxiety and depression in COPD patients, which appears to correlate with pulmonary-specific COPD symptoms, especially in patients with lower functional capacity. Prospective design studies are needed to elucidate the causal relationships between anxiety and depression and pulmonary-specific symptoms in COPD patients.
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Int J Psychiatry Med · Jan 2013
Review Case ReportsSuicide prevention as a prerequisite for recovery from severe mental illness.
For a significant number of people suffering from severe mental illness (SMI) prevention of suicide is a prerequisite for their recovery. This review summarises and interprets risk/protective factors for suicide in the context of schizophrenia and bipolar disorder, thereby enabling evidence-based suicide risk assessment and management. A history of self-harm greatly increases suicide risk among people with schizophrenia or bipolar disorder. ⋯ Research suggests that suicide risk associated with SMI should be reduced by early intervention, restricting access to lethal means, improvement of treatment adherence, treating more patients with clozapine and lithium, assertive outreach, treating psychiatric comorbidity (depression, alcohol/drug misuse, etc.), 24-hour crisis care, timely (compulsory) hospitalization (sufficient bed provision imperative), improving psychiatric inpatient ward safety, lowering the risk of absconding from wards, appropriate use of electroconvulsive therapy, intensive follow-up postdischarge, and improving access to psychological/psychosocial interventions, notably cognitive behavioural therapy. The clinical interview is the optimum method of suicide risk assessment and locally developed risk assessment tools should not be used. Evidence-based suicide risk assessment/management within primary care and secondary mental health services warrants recurrent, mandatory training.
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Int J Psychiatry Med · Jan 2013
Comparative StudyGreater frequency of depression associated with chronic primary headaches than chronic post-traumatic headaches.
To compare the prevalence of co-morbid depression between patients with chronic primary headache syndromes and chronic posttraumatic headaches. ⋯ Co-morbid depression occurs less frequently among patients with chronic post-traumatic headaches and TBI without headaches than among those with chronic primary headaches.
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Int J Psychiatry Med · Jan 2013
Comparative StudyComparison of consecutive periods of 1-, 2-, and 3-year mortality of geriatric inpatients with delirium, dementia, and depression in a consultation-liaison service.
Dementia, depression, and delirium are the most prevalent psychiatric disorders in elderly medical inpatients and are all associated with higher mortality. The purpose of this study was to assess and compare consecutive periods of 1-, 2-, and 3-year mortality among elderly patients with dementia, depression, and delirium seen by a psychiatry consultation-liaison service in a general hospital. ⋯ Clinical physicians should give special attention to delirious patients within the first year after referral. Patients at risk for mortality should be closely followed and early intervention provided in an effort to decrease or delay mortality.