Psychiatrists

精神科医生
  • 文章类型: Journal Article
    背景:研究“精神治疗传播和教育指南(EGIUDE)的有效性”项目是否会影响催眠药物的处方率和精神病医生处方的催眠药物类型,在日本,精神分裂症和重度抑郁症。
    方法:EGUIDE项目是一项针对日本精神分裂症和重度抑郁症的循证临床指南的全国性前瞻性研究。从2016年到2021年,从参加EGUIDE项目的医院出院的患者的临床和处方数据被用于检查催眠药的处方率和每种类型的催眠药的处方率(苯二氮卓受体激动剂,非苯并二氮杂受体激动剂,褪黑素受体激动剂,和食欲素受体拮抗剂)在参加EGUIDE项目的精神科医生开处方的患者和未参加的精神科医生开处方的患者之间进行了比较。进行了多因素logistic回归分析,以检查EGUIDE项目对催眠药物处方的影响。
    结果:共纳入12,161例精神分裂症患者和6,167例重度抑郁症患者。参与EGUIDE项目的精神科医生显着降低了精神分裂症(P<0.001)和重度抑郁症(P<0.001)患者的催眠药和苯二氮卓受体激动剂的处方率。
    结论:这是第一项调查精神病治疗指南对精神科医生在给患者开催眠药方面的教育效果的研究。EGUIDE项目可能在降低催眠药物处方率方面发挥重要作用,特别是关于苯二氮卓受体激动剂。结果表明,EGUIDE项目可能会改善治疗行为。
    BACKGROUND: To examine whether the \"Effectiveness of Guideline for Dissemination and Education in psychiatric treatment (EGIUDE)\" project affects the rate of prescriptions of hypnotic medication and the type of hypnotic medications prescribed among psychiatrists, for schizophrenia and major depressive disorder in Japan.
    METHODS: The EGUIDE project is a nationwide prospective study of evidence-based clinical guidelines for schizophrenia and major depressive disorder in Japan. From 2016 to 2021, clinical and prescribing data from patients discharged from hospitals participating in the EGUIDE project were used to examine hypnotic medication prescriptions The prescribing rate of hypnotics and the prescribing rate of each type of hypnotic (benzodiazepine receptor agonist, nonbenzodiazepine receptor agonist, melatonin receptor agonist, and orexin receptor antagonist) were compared among patients who had been prescribed medication by psychiatrists participating in the EGUIDE project and patients who had been prescribed medication by nonparticipating psychiatrists. Multivariate logistic regression analysis was performed to examine the effect of the EGUIDE project on the prescription of hypnotic medications.
    RESULTS: A total of 12,161 patients with schizophrenia and 6,167 patients with major depressive disorder were included. Psychiatrists participating in the EGUIDE project significantly reduced the rate of prescribing hypnotic medication and benzodiazepine receptor agonists for both schizophrenia (P < 0.001) and major depressive disorder (P < 0.001) patients.
    CONCLUSIONS: This is the first study to investigate the educational effects of guidelines for the treatment of psychiatric disorders on psychiatrists in terms of prescribing hypnotic medications to patients. The EGUIDE project may play an important role in reducing hypnotic medication prescription rates, particularly with respect to benzodiazepine receptor agonists. The results suggest that the EGUIDE project may result in improved therapeutic behavior.
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  • 文章类型: Journal Article
    为重复经颅磁刺激的最佳给药提供指导,以科学证据为基础,辅以专家临床共识。
    文章和信息来自现有指南和已出版文献。然后,作者将研究结果制定为基于共识的建议和指导。该指南在RANZCP内部进行了严格的连续咨询,涉及ECT和神经刺激(SEN)委员会的部门,更广泛的成员和专家委员会。
    rTMS管理的RANZCP专业实践指南(PPG)提供了有关rTMS在临床实践中使用的最新建议。该指南旨在供从事rTMS管理的精神科医生和非精神科医生使用,以促进最佳实践,以优化患者的预后。该指南力求在促进最佳循证实践与承认rTMS使用证据之间找到适当的平衡。
    该指南为精神科医生和非精神科医生提供了最新的建议,以促进rTMS实践的最佳标准。
    UNASSIGNED: To provide guidance for the optimal administration of repetitive transcranial magnetic stimulation, based on scientific evidence and supplemented by expert clinical consensus.
    UNASSIGNED: Articles and information were sourced from existing guidelines and published literature. The findings were then formulated into consensus-based recommendations and guidance by the authors. The guidelines were subjected to rigorous successive consultation within the RANZCP, involving the Section of ECT and Neurostimulation (SEN) Committee, its broader membership and expert committees.
    UNASSIGNED: The RANZCP professional practice guidelines (PPG) for the administration of rTMS provide up-to-date advice regarding the use of rTMS in clinical practice. The guidelines are intended for use by psychiatrists and non-psychiatrists engaged in the administration of rTMS to facilitate best practice to optimise outcomes for patients. The guidelines strive to find the appropriate balance between promoting best evidence-based practice and acknowledging that evidence for rTMS use is a continually evolving.
    UNASSIGNED: The guidelines provide up-to-date advice for psychiatrists and non-psychiatrists to promote optimal standards of rTMS practice.
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  • 文章类型: Journal Article
    根据联合国残疾人权利公约,印度政府用变革性的“印度心理健康法案”取代了1987年的“心理健康法案”,2017\“(IMHCA2017),于2017年4月7日获得总统批准。虽然新法案符合CRPD准则,强调晋升,保护和实现完整和公平的人权,法律行为能力,精神病患者的平等和尊严,它面临着各种利益相关者的不同批评,尤其是精神科医生。本研究使用现有的已发表资源系统地探讨了精神科医生对IMHCA2017的批评和担忧,并在CRPD指南的背景下评估了这些批评。
    我们对文献进行了范围审查,使用PubMed和Scopus等两个搜索引擎。该评论涵盖了学术出版物,来自国家和国际来源的报告和文件,由精神病学家和精神病学组织撰写,与IMHCA2017有关。主要搜索词“IMHCA2017”的使用没有时间限制。最终分析包括印度和世界各地的心理健康专业人员撰写的出版物。通过定性分析,确定了反映精神科医生观点的关键主题。这些主题,以大量批评为标志,然后根据CRPD的指导原则进行评估,包括其任择议定书和一般性意见。
    该研究分析了33份手稿,讨论了对IMHCA2017的批评和担忧。手稿类型包括意见文件(60.6%),原创研究文章(21.21%),评论文章(9.09%),社论(6.06%)和评论(3.03%)。除了一篇文章外,所有文章都是由精神病学家撰写的,其中5名由非印度作家撰写,其余由印度精神病学家撰写。大多数文章发表在印度精神病学杂志上(75.76%),一些在其他期刊上。大约54.55%的人严格审查了法案规定,45.45%强调积极方面。分析确定了七个突出的批评主题:临床忧虑,缺乏清晰度和全面性,可行性挑战,忽视照顾者,对精神病医生的不信任,综合医院精神科的危机和意识形态保留。
    每个主题都在CRPD指南的背景下进行了严格评估,并提出了相应的建议。
    UNASSIGNED: Informed by the UN Convention on the Rights of Persons with Disabilities, the Indian government replaced the 1987 Mental Health Act with the transformative \"Indian Mental Healthcare Act, 2017\" (IMHCA 2017), which gained presidential approval on April 7, 2017. While the new act aligns with CRPD guidelines, emphasizing the promotion, protection and realization of complete and equitable human rights, legal capacity, equality and dignity for persons with mental illness, it has faced diverse criticism from various stakeholders, particularly psychiatrists. This study systematically explores the critiques and apprehensions expressed by psychiatrists regarding the IMHCA 2017 using available published resources and assesses these criticisms within the context of CRPD guidelines.
    UNASSIGNED: We conducted a scoping review of the literature, using two search engines like PubMed and Scopus. The review covered academic publications, reports and documents from both national and international sources, authored by psychiatrists and psychiatric organizations, related to the IMHCA 2017. The primary search term \"IMHCA 2017\" was used without temporal restrictions. Publications authored by mental health professionals from India and around the world were included in the final analysis. Through qualitative analysis, key themes reflecting psychiatrists\' viewpoints were identified. These themes, marked by substantial criticism, were then assessed in accordance with the guiding principles of the CRPD, including its optional protocol and general comments.
    UNASSIGNED: The study analyzed 33 manuscripts discussing criticisms and concerns about IMHCA 2017. Manuscript types included opinion papers (60.6%), original research articles (21.21%), review articles (9.09%), editorials (6.06%) and comments (3.03%). All but one article were authored by psychiatrists, with five by non-Indian authors and the rest by Indian psychiatrists. Most articles were published in the Indian Journal of Psychiatry (75.76%), with some in other journals. About 54.55% critically scrutinized act provisions, while 45.45% highlighted positive aspects. The analysis identified seven prominent criticism themes: clinical apprehensions, lack of clarity and comprehensiveness, feasibility challenges, neglect of caregivers, mistrust toward psychiatrists, crises in general hospital psychiatry units and ideological reservations.
    UNASSIGNED: Each theme was critically assessed in the context of CRPD guidelines, and corresponding recommendations were formulated.
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  • 文章类型: Journal Article
    运动精神病学是一个年轻的医学和精神病学领域,专注于运动员的心理健康,以及精神病学和精神障碍中的运动和锻炼。然而,体育精神病学的发展及其活动领域因地区而异,还不统一。运动精神病学和运动精神病学家的作用也已经在运动和运动医学领域进行了讨论,在竞技体育和精英体育的医疗队中。运动精神病学的统一定义,它的活动领域,运动精神病医生,和基本知识,技能,和能力(加上态度,运动精神病学家的eKSAA)是国际运动精神病学学会(ISSP)峰会的一部分,以及关于运动精神病学的第一个国际共识声明。在体育精神病学中可以区分三个活动领域:(i)心理健康和竞技体育和精英体育中的障碍,(ii)预防和治疗精神障碍的运动和锻炼,和(iii)休闲运动中的心理健康和特定于运动的精神障碍。每个字段都有自己的eKSA+A。运动精神病学和运动精神病学家的定义,以及eKSA+A在不同领域的运动精神病学家的活动框架将有助于统一和规范运动精神病学的未来发展,在体育精神病学和邻近学科中建立服务标准,并且应该包括在电流中,以及未来的体育精神病学教育和培训。
    Sports psychiatry is a young field of medicine and psychiatry that focuses on mental health among athletes, and sports and exercise within psychiatry and mental disorders. However, the development of sports psychiatry and its fields of activity vary from region to region and are not uniform yet. Sports psychiatry and the role of sports psychiatrists have also already been discussed in the field of sports and exercise medicine, and within medical teams in competitive and elite sports. A uniform definition on sports psychiatry, its fields of activity, sports psychiatrist, and the essential knowledge, skills, and abilities (plus attitudes, eKSA+A) of the sports psychiatrist were developed as part of an International Society for Sports Psychiatry (ISSP) Summit, as well as First International Consensus Statement on Sports Psychiatry. Three fields of activity can be distinguished within sports psychiatry: (i) mental health and disorders in competitive and elite sports, (ii) sports and exercise in prevention of and treatment for mental disorders, and (iii) mental health and sport-specific mental disorders in recreational sports. Each of these fields have its own eKSA+A. The definitions on sports psychiatry and sports psychiatrists, as well as the framework of eKSA+A in the different fields of activity of sports psychiatrists will help to unify and standardize the future development of sports psychiatry, establish a standard of service within sports psychiatry and together with the neighboring disciplines, and should be included into current, and future sports psychiatry education and training.
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  • 文章类型: Review
    •在诊断手册中解释诊断精神障碍所需的步骤。•确定分类和报告长期悲伤障碍的当前程序。
    2018年《国际疾病分类》第11版和《精神障碍诊断和统计手册》第5版在其2022年文本修订版中增加了长期悲伤障碍(PGD)。因此,根据既定指南报告和分类PGD已成为科学研究和临床实践的基础。然而,PGD评估工具和标准仍在开发和辩论中。本文的目的是研究当前对PGD进行分类和报告的程序的充分性,并为将来的调查和知识传播提供指导。我们概述了诊断和评估精神障碍所需的标准步骤(特别是,临床访谈的管理)。为了说明在最近的科学文章中关于PGD的存在/流行的报告,我们对Scopus进行了搜索,确定了2019年至2023年之间发表的22篇相关文章。我们对文献的回顾表明,(尚未)遵循标准分类程序。PGD的患病率基于自我报告的症状学,根据丧亲者在问卷上达到一定截止分数的百分比得出的比率,没有临床访谈。这可能会导致对患病率的系统高估。然而,PGD患病率的实际确定通常在标题中说明,摘要,和文章的结果部分。Further,仅在讨论部分的局限性中经常提到需要对诊断分类进行结构化临床访谈,但并未强调.最后,我们为研究和报告自我报告的长期悲伤症状以及PGD的存在/患病率提供了指导。
    UNASSIGNED: • Explain the steps required for diagnosis of mental disorders in diagnostic handbooks.• Identify current procedures for classifying and reporting prolonged grief disorder.
    UNASSIGNED: Prolonged grief disorder (PGD) was added to the 11th edition of the International Classification of Diseases in 2018 and to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders in its 2022 text revision. Thus, reporting and classifying PGD according to established guidelines has become fundamental for scientific research and clinical practice. Yet, PGD assessment instruments and criteria are still being developed and debated. The purpose of this article is to examine the adequacy of current procedures for classifying and reporting PGD in research and to suggest guidelines for future investigation and dissemination of knowledge. We outline the standard steps required for diagnosis and assessment of a mental disorder (notably, the administration of clinical interviews). In order to illustrate reporting about the presence/prevalence of PGD in recent scientific articles, we conducted a search of Scopus that identified 22 relevant articles published between 2019 and 2023. Our review of the literature shows that standard classification procedures are not (yet) followed. Prevalences of PGD are based on self-reported symptomatology, with rates derived from percentages of bereaved persons reaching a certain cutoff score on a questionnaire, without clinical interviewing. This likely results in systematic overestimation of prevalences. Nevertheless, the actual establishment of PGD prevalence was often stated in titles, abstracts, and results sections of articles. Further, the need for structured clinical interviews for diagnostic classification was frequently mentioned only among limitations in discussion sections-but was not highlighted. We conclude by providing guidelines for researching and reporting self-reported prolonged grief symptoms and the presence/prevalence of PGD.
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  • 文章类型: Journal Article
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