BACKGROUND: It is widely acknowledged that personal therapy positively contributes to the continued personal well-being and ongoing professional development of mental health professionals, including psychiatrists. As a result, most training bodies continue to recommend personal therapy to their trainees. Given its reported value and benefits, one might hypothesize that a high proportion of psychiatrists avail of personal therapy. This systematic review seeks to investigate whether this is the case.
OBJECTIVE: To identify and evaluate the findings derived from all available survey-based studies reporting quantitative data regarding psychiatrists\' and psychiatry trainees\' engagement in personal therapy.
METHODS: A systematic search for survey-based studies about the use of personal therapy by psychiatric practitioners was conducted in four databases and platforms (PubMed, Scopus, Embase and EbscoHost) from inception to May 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality using the quality assessment checklist for survey studies in psychology (Q-SSP) and findings summarized using narrative synthesis.
RESULTS: The proportion of trainees who engaged in personal therapy ranged from a low of 13.4% in a recent UK based study to a high of 65.3% among Israeli residents. The proportion of fully qualified psychiatrists who engaged in personal therapy varied from 32.1% in South Korea to 89% in New Zealand.
CONCLUSIONS: This review represents the first known attempt to collect and synthesize data aimed at providing insights into the past and current trends in psychiatrists\' use of personal therapy across different geographic regions and career stages.

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.

Grief after suicide or patient-perpetrated homicide can be complex for those involved in the patient\'s care. Mental health practitioners with patients who die unexpectedly may be called to assist in the formal investigation processes that follow. The aim of this study was to examine the experience of mental health practitioners called to attend a coroner\'s inquest or other forms of formal inquiry. A protocol for a systematic review was prospectively registered on PROSPERO (CRD42023400310). A thematic synthesis of existing literature was conducted. We identified six articles for inclusion and constructed three themes from our analysis: Blame and enduring hostility, In the dark, and Limited learning. We found mental health practitioners may construct narratives of self-blame. These can be reinforced by the investigatory processes that follow. Feedback from inquiries is often delivered haphazardly and may not reflect the realities of clinical work. The support given to assist practitioners through inquiry processes varied-both in amount and how helpful it was. The research conducted on this topic is limited. More qualitative research should be conducted to understand the factors that make this experience more or less difficult as well as well as what support is needed for whom.

BACKGROUND: The evolution of psychiatric care for patients with cancer has played out over the last century. The first collaboration of psychiatry, oncology surgery, and radiation-oncology occurred in the mid-1950s and represented the early seeds of psycho-oncology. The role of a psychiatrist specializing in treating patients with cancer, a psychosocial oncologist or psycho-oncologist, spans the care continuum from prevention to end of life. The specific needs of patients with gastrointestinal (GI) malignancies range from management of anxiety and depression to focused management for adjustment to an ostomy to sexual dysfunction to treatment in the face of a neuroendocrine tumor (NET).
METHODS: This is a scoping review; we compiled and summarized psychiatric illnesses commonly encountered in care of patients with cancer in addition to unique GI oncology-related issues. We conducted an electronic PubMed search between 1990-2022. We are presenting the data and providing our insight into psychosocial oncology care for this special population.
RESULTS: The field of psycho-oncology is relatively new. We failed to identify any randomized prospective studies, the majority of the studies were retrospective or longitudinal. The majority of the publications were in the form of review. We reviewed the GI literature to identify the psychological impact of ostomies, sexual impairment and metabolically active NETs. We provide suggested treatment interventions targeting the biological, psychological, and social aspects of patient and family lives.
CONCLUSIONS: The role of a psychosocial oncologist as part of the collaborative multidisciplinary treatment team provides nuanced care with attention to unique cancer-related issues that arise during the disease course. The psycho-oncologist brings expertise in combining targeted therapeutic strategies with pharmacologic interventions to address the multi-dimensional symptomatology patients experience. Using a layered approach, patients with mild symptoms can be supported by the general team, while those with moderate to severe symptoms require specialty psychiatric consultation.

暂无摘要。

Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as \"second victims\" of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988-2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513-26.
Coraz powszechniejsze wśród pracowników ochrony zdrowia oskarżenia o niedopełnienie obowiązków zawodowych stanowią silne źródło stresu, który może prowadzić do rozwoju zespołu stresu związanego z błędem medycznym (medical malpractice stress syndrome – MMSS). Jest on często porównywany do zespołu stresu pourazowego (post-traumatic stress disorder – PTSD), a lekarze są określani jako drugie ofiary (second victims) błędów medycznych. Celem publikacji jest zwrócenie uwagi na MMSS, jego objawy, podobieństwo do PTSD i konsekwencje oraz metody zapobiegania mu i radzenia sobie z nim. Ponadto w celu zobrazowania skali zjawiska zwrócono uwagę na liczbę pozwów o błąd medyczny wśród specjalizacji lekarskich, których ten problem dotyczy najczęściej. Praca ma charakter przeglądu narracyjnego. Poddano analizie informacje zawarte w medycznych bazach artykułów i czasopism naukowych (PubMed, ResearchGate, Biblioteka Nauk), wydawnictwie termedia oraz serwisie Jurnals.viamedica z lat 1988–2023. Psychiczne objawy MMSS obejmują gniew, frustrację, lęk, poczucie winy, problemy ze snem, utratę wiary w siebie i nastrój depresyjny. Następnie pojawiają się także objawy somatyczne, w tym sercowo-naczyniowe. Zespół ten może prowadzić do zlecania pacjentom zbędnych badań, odwlekania decyzji terapeutycznych lub przedwczesnego odejścia z zawodu. W ostatnich latach pacjenci są bardziej świadomi przysługujących im praw, przez co liczba pozwów sądowych o błąd medyczny rośnie, szczególnie w takich specjalizacjach jak ginekologia i położnictwo, neurochirurgia i radiologia. Obawy przed prawnymi skutkami błędów medycznych wpływają na wybór specjalizacji przez absolwentów uczelni medycznych, którzy często unikają specjalizacji związanych z wysokim ryzykiem popełnienia błędu. W radzeniu sobie z MMSS konieczne jest wsparcie społeczne oraz współpraca obarczonego błędem medycznym lekarza z prawnikami i nierzadko psychiatrami, a profilaktyka MMSS obejmuje znajomość reakcji na stres oraz postępowanie, które zmniejszy ryzyko popełnienia błędu medycznego i jego sądowych konsekwencji. Rozpowszechnienie MMSS wśród lekarzy i wpływ ryzyka pozwu o błąd lekarski na wybór specjalizacji medycznej w Polsce wymagają dalszej oceny. Med Pr Work Health Saf. 2023;74(6):513–26.

BACKGROUND: Consultation-liaison psychiatrists frequently address dyspnea in intensive care unit (ICU) patients. Dyspnea is common in this patient population, but is frequently misunderstood and underappreciated in noncommunicative ICU patients.
OBJECTIVE: This paper provides an updated review on dyspnea specifically in the ICU population, including its pathophysiology and management, pharmacological and nonpharmacological, aimed at consultation-liaison psychiatrists consulting in ICU.
METHODS: A literature review was conducted with PubMed, querying published articles for topics associated with dyspnea and dyspnea-associated anxiety in ICU patient populations. When literature in ICU populations was limited, information was deduced from dyspnea and anxiety management from non-ICU populations. Articles discussing the definition of dyspnea, mechanistic pathways, screening tools, and pharmacologic and nonpharmacologic management were included.
RESULTS: A reference guide was created to help consultation-liaison psychiatrists and intensivists in the screening and treatment of dyspnea and dyspnea-associated anxiety in critically ill patients.
CONCLUSIONS: Dyspnea is frequently associated with anxiety, prolonged days on mechanical ventilation, and worse quality of life after discharge. It can also increase the risk of posttraumatic stress disorder post-ICU discharge. However, it is not routinely screened for, identified, or addressed in the ICU. This manuscript provides an updated review on dyspnea and dyspnea-associated anxietyin the ICU population, including its pathophysiology and management, and offers a useful reference for consultation-liaison psychiatrists to provide treatment recommendations.

Electroconvulsive therapy (ECT) is a complex medical procedure, the delivery of which requires specialist knowledge and skills. We reviewed the standards required for ECT credentialing in different jurisdictions in Australia. We reviewed the Chief Psychiatrist guidelines and statewide policy standards on ECT and focused on standards required for initial credentialing and ongoing privileging in ECT. We compared the credentialing requirements within these documents with the standards specified in the Royal Australian and New Zealand College of Psychiatrists professional practice guideline for ECT. Most of the jurisdictions had specific standards for initial credentialing and maintenance of this credentialing; however, there was significant variance in the credentialing process and standards required. It would be useful to have a minimum standard for credentialing for ECT psychiatrists and prescribers. This standard would be relevant for practice of ECT internationally. States and territories would have the responsibility for implementation of these standards. Appropriate training and establishing good clinical governance processes are essential to the provision of high quality ECT.

Psychiatrists require frequent contact with and treatment of patients with mental illnesses. Due to the influence of associative stigma, psychiatrists may also be targets of stigma. Occupational stigma warrants special consideration because it significantly affects psychiatrists\' career advancement, well-being, and their patients\' health. Given that there is no complete summary of this issue, this study reviewed the existing literature on psychiatrists\' occupational stigma to clearly synthesize its concepts, measurement tools, and intervention strategies. Herein, we emphasize that psychiatrists\' occupational stigma is a multifaceted concept that simultaneously encompasses physically, socially, and morally tainted aspects. Currently, standardized methods to specifically measure psychiatrists\' occupational stigma are lacking. Interventions for psychiatrists\' occupational stigma may consider the use of protest, contact, education, comprehensive and systematic methods, as well as the use of psychotherapeutic approaches. This review provides a theoretical basis for the development of relevant measurement tools and intervention practices. Overall, this review seeks to raise public awareness of psychiatrists\' occupational stigma, thereby promoting psychiatric professionalism and reducing its stigma.

Burnout is a consequence of chronic occupational stress exposure. Psychiatrists are prone to burnout due to specific work-related factors. This study examined the burnout prevalence among psychiatrists.
The study protocol was registered in PROSPERO (CRD42020204615). We searched MEDLINE, EMBASE, CENTRAL, PsycINFO, Web of Science, ClinicalTrials.gov, and OpenGrey for relevant publications. Random-effect meta-analysis was performed. We used subgroup analysis and meta-regression to reveal any association of geographical region, survey year, participants\' age, gender, and response rate with burnout.
Thirty-six studies involving 5481 participants were included. The prevalence of overall burnout was 25.9% [11.1%-40.7%] as measured by a Maslach Burnout Inventory (MBI) and 50.3% [30.9%-69.8%] as measured by a Copenhagen Burnout Inventory (CBI). The pooled prevalence was 43.5% [27.9%-59%] for high emotional exhaustion (EE), 28.2% [17.5%-38.9%] for high depersonalization (DP), and 32.4% [3.4%-61.3%] for low personal accomplishment (PA). The mean scores of 22-item MBI subscales were 21.51 [18.64%-24.38%] for EE, 6.57 [5.53%-7.62%] for DP, and 31.83 [25.73%-37.94%] for PA. European psychiatrists revealed (p = 0.045) lower EE score (20.82; 95% CI 7.24-24.41) measured by 22-item MBI compared to their non-European colleagues (24.99; 95% CI 23.05-26.94). Other results include mean scores for 16-item MBI-General Survey, burnout rates, and scores in CBI subscales.
The main limitation was high heterogeneity in terms of statistics, screening methods, burnout definitions, and cut-off points utilized in included studies.
Burnout is highly prevalent among psychiatrists. Future research should focus on finding consensus on burnout screening, longitudinal evaluation of psychiatrists\' burnout predictors, and development of effective intervention strategies.