Psychiatr Pol
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SARS-CoV-2 poses a particular risk to the elderly and people with many comorbidities. In the case of people with dementia, the compliance with sanitary recommendations and the necessary physical isolation can have far-reaching negative consequences in terms of limiting the continuation of tailored care, support and treatment. The recommendations related to the SARS-CoV-2 pandemic must take into account not only the medical consequences of lack of access to medical care, but also their long-term effects and the disease progression in accordance with the concept of social health. ⋯ Prepared under the auspices of the Polish Psychiatric Association, the recommendations for people living alone, with their family and in long-term care facilities are intended to draw attention to key epidemiological issues that can be planned by medical staff within the organization of patient care. However, mental and social needs of patients, whose fulfilment is particularly significant in times of restrictions related to everyday activities, are of equal importance. Further monitoring of the epidemiological situation and scientific reports related to the SARS-CoV-2 pandemic are necessary to verify and update the guidelines.
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In June 2018, WHO published the 11th edition of the International Classification of Diseases (ICD). The new edition introduced numerous changes. One of the most important was to rebuild the coding system and adapt ICD to digital use. ⋯ Taking into account the modern epidemiology and knowledge about the etiology of mental disorders, some categories have been removed from ICD. Moreover, several nonexistent categories have been added. The article summarizes and discusses the most important changes in ICD with the introduction of ICD-11, both in the coding system and in individual subchapters covering mental health issues.
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Twenty years after publication of the previous version, the new and completely revised version of the US diagnostic system of psychiatric disorders, the Diagnostic and Statistical Manual of Mental Disorders - DSM-5, was introduced in 2013. Over the course of its preparation, which took many years, current knowledge was summarized and the respective consequences for the classification and diagnosis of psychiatric disorders were discussed in groups of high-ranking experts. In many regards, DSM-5 does not fulfil the original plans and expectations; however, for the most part it can be seen as an acceptable summary of current knowledge on mental disorders. ⋯ However, ICD-11, despite the original plan for it to be very similar to DSM-5, will find many of its own solutions. This paper presents some important issues on DSM-5 that will be of interest to clinicians working in the field of mental disorders. In addition, it uses some examples to illustrate how DSM-5 operationally defines some disorders and how it differs from ICD-10 and DSM-IV.
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Electroconvulsive therapy (ECT) is the treatment method widely used in psychiatric disorders such as depression, bipolar disorder, schizophrenia and schizoaffective disorder. The advantage of ECT is therapeutic response that occurs significantly earlier than during pharmacotherapy. Initially ECTwas used without anesthesia. ⋯ The results of this review are inconclusive when it comes to the effect of intravenous anesthetics on the quality of the ECT treatment and side effects relating to respiratory and cardiovascular system. On this basis it is impossible to determine which of intravenous anesthetics is most advantageous from the point of view of the patient. To develop the optimum scheme of anesthesia for ECT, it is necessary to conduct further, methodologically correct studies.
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The 11th edition of the International Classification of Diseases (ICD-11) is scheduled for approval by the World Health Assembly in May 2018. The chapter on mental disorders is currently under development. ⋯ For all the other sections of the chapter on mental disorders, a brief general definition and sometimes a description of some of the included disorders can be found on the ICD-11 beta platform. In the present article, we summarize the content of the various sections of the classification on the basis of the available documents, with the warning that some of the elements of these sections may still be subject to revision.