Encephale
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This study assesses the impact of major mental and personality disorders on the quality of life perceived by a Belgian adult male population in a forensic hospital. METHOD.- ⋯ The results of this study encourage us to further consider personality disorders associated or not with major mental disorders. This study reinforces the idea that to apprehend the quality of life of the forensic population is a fundamental element of their treatment.
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Treatment of severe mental illness in the community is gaining interest under ethical, clinical and economical pressure, which has led to mental health reform and deinstitutionalisation. However, this can lead to conflicts between all the parties involved in the community. Several countries have initiated extensive efforts to coordinate health services to enhance quality of care without increasing costs. According to Gray [Hum Relat 38 (1985) 911-936.], the first conditions facilitating interorganizational collaboration are the identification of common problems, recognition of partners (legitimacy and expertise) and interest in collaborating gains to be made from such collaboration [int J Health Plann Manage 17(4) (2002) 315-32.]. ⋯ Deinstitutionalisation and more respect of patients' rights were considered as positive changes for most patients, but as a risk for the most vulnerable ones. Clearer mental health policy targets were requested for suicidal, difficult to engage and dual diagnosis patients. Collaborative efforts must focus on teaching primary care professionals for suicide and dual diagnosis patients, on direct help to welfare services for difficult to engage patients and on psychiatric services for high users. Intensive home care and liaison with primary care are viewed as key components. Identifying common targets in the network may enhance collaboration. Pathways to care need to be studied, including people involved outside a "classical" health network, such as police, welfare services and patients or carers associations.
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Comparative Study
[Association between the intensity of childbirth pain and the intensity of postpartum blues].
The aim of this study was to highlight a link between childbirth pain and mood disorders in the immediate postpartum. ⋯ According to the results of this study, our hypothesis assuming a link between the intensity of labor pain and mood disorders in early postpartum appears to be confirmed. The intensity of postpartum blues is the best predictor of postnatal depression. Hence, knowledge of the risk factors, such as pain, could help to improve the efficiency of detection, and let professionals focus on the psychological impact of labor and especially on post-traumatic stress disorders.
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While traumatic brain injury is a major public health issue, schizophrenia-like psychosis following traumatic brain injury is relatively rare and poorly studied. Yet the risk of developing schizophrenia-like psychosis after traumatic brain injury is 3 times more important than in the general population. ⋯ Further systematic studies are needed to confirm this hypothesis.