Tijdschrift voor psychiatrie
-
Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics. ⋯ The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry.
-
In general psychiatry the risk of violence has to be assessed regularly, for instance in cases where civil commitment is under consideration. ⋯ In general psychiatric practice a potential risk of violence should be assessed systematically in a structured manner. If there are risks of violence these can best be studied and assessed in specialised clinics or by specialized teams. Dynamic risk factors and protective factors should be evaluated systematically in cooperation with the various organizations concerned.
-
Major depressive disorder (mdd) can be elicited by various kinds of stress, such as negative life events, chronic stress and experiences of abuse early in life. These stressors interact with personality traits and with a genetic predisposition to depression, thereby bringing about mdd. Therefore, the neurobiology of depression cannot be separated from the neurobiology of stress system. ⋯ On the other hand, genetic variations can play a role in the hpa axis dysfunction and in vulnerability to depression. Evidence is emerging that certain genes are directly involved in the functioning of the hpa axis. Other genetic factors, not directly related to the hpa axis, are probably relevant as well, the best known example being the serotonin transporter gene.
-
Review Meta Analysis
[Serotonin-noradrenalin reuptake inhibitors in the treatment of non-malignant pain syndromes; a systematic review].
Chronic pain and depressive symptoms are often comorbid. Antidepressants seem to influence not only the symptoms of depression but also the perception of pain. ⋯ The results revealed that SNRIs are effective in reducing pain particularly in the treatment of diabetic neuropathy. Results with regard to the other medical conditions are less clear. More research is needed to find out in which medical conditions SNRIs have a significant pain reducing effect and why this effect does not hold in the case of other medical conditions.
-
The consequences of mild traumatic brain injury have been well described and are considered to be benign symptoms. So far, little is known about the chronicity of the symptoms (post-concussion syndrome) and about the treatment of the symptoms. ⋯ Scientific research into post-concussion syndrome has given considerable attention to diagnostic issues, but has given much less attention to the development of treatment. Future research into the treatment of the post-concussion syndrome should result from the integration of current viewpoints and a description of the syndrome in terms of a disease process.