Psychiat Danub
-
the mental Health Assessment Unit (MHAU) is a unit set up in 2009 as a gateway between community services and in-patient services. The aim of the MHAU is to provide an acute setting in which to assess patients within 72 hours, with the view to reducing in-patient hospital admissions. ⋯ we recommend further study into patients' experiences with care coordinators particularly at times of need. We also plan to re-audit for a longer time frame with the view to compare data to in-patient admissions and bed occupancy.
-
Deinstitutionalization has made possible the development of modern community psychiatric services, however radical decrease in the number of hospital beds may result in a reduction in the overall standard of psychiatric care and disruptions in service delivery. The authors present an example of deinstitutionalisation in Hungary, which led to serious difficulties in the provision of healthcare in the field of psychiatry, contrasted with a case from Germany serving as an example of an alternative solution.
-
Research data from studies of functional neuroanatomy and neurochemistry indicate various dysfunctions in certain areas of the brain in individuals who suffer from chronic Posttraumatic Stress Disorder. These abnormalities are involved in the evolution of symptoms of PTSD, deterioration of cognitive functions and decreased quality of life of the survivors. The intensity of these symptoms is in direct correlation with the degree of dysfunction in the central nervous system. The aim of our study, was to evaluate the subjective perception of the Quality of life in subjects suffering from chronic PTSD and to compare prior to treatment results to results three and six months after receiving therapy, as well as to analyze whether perception of the Quality of life change related to treatment. The study was conducted at the Psychiatric Clinic of the Sarajevo University Clinical Center. ⋯ The results of our study indicate that subjects who are suffering from chronic PTSD have a lower subjective perception of their quality of life. Combined psychopharmacological and psychotherapeutic treatment over a period of six months lead to improvement in the perception of quality of life. This may indicate the need for longer treatment of individuals suffering from chronic PTSD. A significant increase has been noted in the number of contacts with close friends between the first, second and third test, reflecting positive treatment effects on everyday life functioning and coping skills.
-
The concept of personalized drug therapy on the basis of genetic investigations has become a major issue in psychopharmacology. Pharmacogenetic studies have focused on polymorphisms in liver cytochrome P450 isoenzymes that metabolize many antidepressant and antipsychotic medications. The most significant results are the association between drug metabolic polymorphisms of cytochrome P450 with variations in drug metabolic rates and side effects. ⋯ Genetic tests for the pretreatment prediction of antipsychotic response have obvious implications for the selection of most appropriate drug and dose and contribute for the optimization of antipsychotic treatment. The pretreatment determination of individual's drug metabolic rates by CYP genotyping is the leading field. This review summarizes the present knowledge of associations between cytochrome P450 isoenzymes and the efficacy and side effects of antipsychotics.
-
Violence is an important social problem. Violence in the community has important social relevance for the political, criminal justice, and health care systems. Studies of homicide offenders have suggested a high prevalence of neurologic dysfunction due to organic brain damage such as traumatic brain injury, epilepsy and dementia have been observed to exhibit excessive violence. ⋯ A correlation between the potential for impulsive aggression mediated by limbic brain structures, and the control of the aggression by frontotemporal brain regions has been shown. The individuals with such brain dysfunction have an increased risk of violent behavior and scored high on the Webster's and Hare's violence risk assessment scale. This article reviews the relationship between psychiatric comorbidity, violence risk assessment and neuroimaging in forensic psychiatry and showing the useful directions for future research, screening and prevention of violent behavior among mentally ill criminal offenders.