Psychiatrikē = Psychiatriki
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The use of physical and mechanical restraints in mental health services in Greece arise many ethical and practical issues. The justification of the use of such procedures is rather controversial and subjective to scientific debate. The practice of restraint puts both patients and staff at risk for injury and death. ⋯ Further to the clear public, medical and operational concerns for the restraints, these procedures are expensive for the mental health services. In our study we estimated the costs of the procedures per patient, excluding the medication costs. According to our data each mechanical restraint costs at least € 57.28 and each seclusion € 47.16 respectively for up to 2 hours of duration and increase according to the prolongation of the restraint procedures.
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Historical Article
The "Biopsychosocial Model": 40 years of application in Psychiatry.
In 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "TheIn 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "Theneed for a new medical model: A challenge for biomedicine", introducing the term Biopsychosocial Model. This model basedon the results of Engel's studies in ulcerative colitis, depression and psychogenic pain, constituted a challenge for biomedicineand the biomedical model. The basic principles of the model included the biological, psychological and social dimensions of the person's life and theperception that the person suffers as a whole and not as isolated organs. ⋯ Psychiatry in everyday practice presents particularities versus other medical disciplines due to the complexity and polymorphismPsychiatry in everyday practice presents particularities versus other medical disciplines due to the complexity and polymorphismof the expression of mental disorders, their close relation to psychosocial factors, the lack of explicit pathognomonicelements and the stigmatization of mental illness. For these reasons, the biopsychosocial model is particularly applicable inpsychiatric disorders, but it should not be over looked also in somatic illnesses. The biopsychosocial model, despite the criticism it was subjected to, continues to offer valuable clinical, educational andresearch services, as well as to provide an important contribution to the formation of health policies, not only for psychiatry, butfor the whole of medicine as well.
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Telepsychiatry was introduced in the early 1950's for the provision of mental health services from a distance. In 1990 the progress made in telecommunications technologies caused a significant expansion in telepsychiatry services. It can refer to store and forward technologies, interactive technologies, remote monitoring technologies and it is applied to contribute to the lift of restrictions placed on providing mental health services. ⋯ This need is served by the electronic medical record that facilitates access to patient records, improves the quality of care, reduces the probability of making wrong decisions and contributes to the promotion of research and service evaluation. KLIMAKA's electronic medical record contains more than ten thousand cases of which 4544 are related to individuals served by the Mobile Mental Health Unit during the years 2003-2010. This article presents the basic functions and parameters of the electronic medical record, the applications of telepsychiatry in the whole range of services provided by the scientific staff and provides information on how human and technology resources are distributed to the branches of the Mobile Mental Health Unit of SE Cyclades.
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During the last decade a number of studies have been conducted in order to examine if virtual reality exposure therapy can be an alternative form of therapy for the treatment of mental disorders and particularly for the treatment of anxiety disorders. Imaginal exposure therapy, which is one of the components of Cognitive Behavioral Therapy, cannot be easily applied to all patients and in cases like those virtual reality can be used as an alternative or a supportive psychotherapeutic technique. Most studies using virtual reality have focused on anxiety disorders, mainly in specific phobias, but some extend to other disorders such as eating disorders, drug dependence, pain control and palliative care and rehabilitation. ⋯ Virtual reality can be proven particularly useful in some specific psychological states. For instance, patients with post-traumatic stress disorder (PTSD) who prone to avoid the reminders of the traumatic events. Exposure in virtual reality can solve this problem providing to the patient a large number of stimuli that activate the senses causing the necessary physiological and psychological anxiety reactions, regardless of his willingness or ability to recall in his imagination the traumatic event.
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The recovery movement differentiated clinical, which is related to disorder's symptoms, from personal recovery, which is outlined by a subjectively defined wellness state, characterised by hope and self-management. Schizophrenia research has long focused on risk factors and symptoms. The recovery movement triggered a focus shift from psychopathology towards better adjustment and growth despite living with schizophrenia. ⋯ Lately, positive psychotherapy was adapted for schizophrenia patients and was proven a feasible intervention that might contribute to improvement in functioning.12 Conclusively, sustained improvement in social and occupational functioning remains the most important indicator of recovery from schizophrenia. Still, such an improvement may not be accomplished in all patients by currently available pharmacological treatment alone. Studies that implement resilience and other positive psychology concepts reinforce schizophrenia research shift from risk to protective factors, reverse the question "which factors associate with relapse and chronicity" to "which factors promote recovery" and are promising for the development of additional therapeutic approaches.