Search results for ‘Subject term:"mental health problems"’ Sort:
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Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials
- Authors:
- LIEB Klaus, et al
- Journal article citation:
- British Journal of Psychiatry, 196(1), January 2010, pp.4-9.
- Publisher:
- Cambridge University Press
This review aimed to evaluate the evidence of effectiveness of pharmacotherapy in treating different facets of the psychopathology of borderline personality disorder. A Cochrane Collaboration systematic review and meta-analysis of randomised comparisons of drug v. placebo, drug v. drug, or single drug v. combined drug treatment in adult patients with borderline personality disorder was conducted. Primary outcomes were overall disorder severity as well as specific core symptoms. Secondary outcomes comprised associated psychiatric pathology and drug tolerability. Twenty-seven trials were included in which first- and second-generation antipsychotics, mood stabilisers, antidepressants and omega-3 fatty acids were tested. Most beneficial effects were found for the mood stabilisers topiramate, lamotrigine and valproate semisodium, and the second-generation antipsychotics aripiprazole and olanzapine. However, the robustness of findings is low, since they are based mostly on single, small studies. Selective serotonin reuptake inhibitors so far lack high-level evidence of effectiveness. The current evidence from randomised controlled trials suggests that drug treatment, especially with mood stabilisers and second-generation antipsychotics, may be effective for treating a number of core symptoms and associated psychopathology, but the evidence does not currently support effectiveness for overall severity of borderline personality disorder. Pharmacotherapy should therefore be targeted at specific symptoms.
Altering perceptions
- Author:
- SHRUBBS Richard
- Journal article citation:
- Mental Health Today, March 2012, pp.8-9.
- Publisher:
- Pavilion
- Place of publication:
- Hove
In the 1950s and 60s, a raft of research was carried out into psychedelic drugs, such as lysergic acid diethylamide (LSD), psilocybin (a compound found in magic mushrooms), MDMA (ecstasy) and mescaline, which alter cognition and perception, and their potential benefit to people with mental health problems. But at the same time as this research was being carried out, recreational use of psychedelic drugs led to the political view of these drugs being dangerous. As a result, the US banned all uses of psychedelics in 1968, even for research. However, after decades of being seen purely as illegal, the potential for psychedelic drugs to be used as a treatment for mental health problems is being considered once again. A number of studies are taking place that are once again investigating whether psychedelic drugs could have a therapeutic benefit if administered properly. Initial research has shown that MDMA has positive effects on post-traumatic stress disorder and that psilocybins may be able to treat personality disorders. In addition, the fear that psychedelics cause schizophrenia appears to be largely unfounded.
Behavioural and pharmacological treatment of Trichotillomania
- Authors:
- STEMBERGER Ruth M. T., STEIN Dan J., MANSUETO Charles S.
- Journal article citation:
- Brief Treatment and Crisis Intervention, 3(3), 2003, pp.339-352.
- Publisher:
- Oxford University Press
Hair pulling, known as trichotillomania (TTM), has become increasingly recognized as an often chronic problem for a large number of individuals, most of whom are women. This paper discusses current conceptualizations of TTM with particular focus on the medical and behavioral approaches. The relationship of TTM to other disorders is discussed and issues in pharmacotherapy that are unique to TTM are reviewed. A comprehensive behavioral model (ComB) that explains the environmental, motoric, sensory, cognitive, and affective patterns involved in hair pulling is presented. This model is used to describe how a clinician can develop treatment plans tailored to individual patients, including specific strategies for hair pulling reduction. Potential pitfalls and complications that may occur during treatment are also discussed.
Prevalence of DSM—IV psychiatric disorder in the French elderly population
- Authors:
- RITCHIE K., et al
- Journal article citation:
- British Journal of Psychiatry, 184(2), February 2004, pp.147-152.
- Publisher:
- Cambridge University Press
France has high rates of psychotropic drug consumption and suicide in the elderly population, but it has not yet been possible to determine whether this is due to exceptionally high morbidity rates. The aim was to describe the first longitudinal population study of psychiatric disorder undertaken in France, and to estimate current and lifetime prevalences and age of onset of psychiatric disorder. A study group of 1873 non-institutionalised persons aged 65 years and over was randomly recruited from the Montpellier district electoral rolls. The Mini International Neuropsychiatric Interview was used to assess current and lifetime symptoms. Cases identified by the application of DSM — IV criteria were re-examined by a clinical panel. Forty-six per cent of the study population had experienced a mental disorder in their lifetime, and 3.7% had made a suicide attempt. Lifetime prevalence of major depression was 26.5% and 30% for anxiety disorders. Current prevalence rates were 14.2% for anxiety disorders, 10.7% for phobia, 3% for major depression and 1.7% for psychosis. Results show veryhigh rates of lifetime but not current major depression. Rates of currentphobia and suicidal ideation in the very elderly are also high compared with other studies. The rates reported are likely to be underestimates.
Mental disorders, medications and clinical social work
- Author:
- AUSTRIAN Sonia G
- Publisher:
- Columbia University Press
- Publication year:
- 1995
- Pagination:
- 317p.,bibliog.
- Place of publication:
- New York
Practical guide, aimed at social workers, to mental health problems. Includes chapters on: anxiety disorders; mood disorders; somatoform and factitious disorders; dissociative disorders; schizophrenia; disorders arising from substance abuse; eating disorders; personality disorders; dementia; psychological and neuropsychological assessment; and psychotropic medications.
Clozapine use in personality disorder and intellectual disabilities
- Authors:
- KIANI Reza, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.364-370.
- Publisher:
- Emerald
Purpose: Clozapine is a well-known antipsychotic medication licensed for treatment-resistant schizophrenia, but there is limited research available to suggest its efficacy in the context of personality disorder and intellectual disabilities presenting with high-risk behaviour with or without psychotic symptoms. The purpose of this paper is to raise awareness of the benefits of using clozapine in patients with intellectual disabilities and personality disorder that present with a complex picture of serious risk of harm to both their life and the lives of others. Design/methodology/approach: The authors present five patients with intellectual disabilities and serious life-threatening challenging behaviour whom were started on clozapine as part of their multidisciplinary treatment plan to manage their presentation. The authors completed baseline assessment of five main symptom domains and then repeated this assessment following treatment with clozapine. Findings: In all five cases use of clozapine was objectively associated with an improvement in symptomatology, quality of life and a safe transfer to the community. Originality/value: The findings suggest that judicious use of clozapine could be considered as one of the effective pharmacological strategies in the management of patients with intellectual disabilities and personality disorder who present with serious life-threatening challenging behaviours. (Publisher abstract)
Treatment of obsessive compulsive disorder and comorbid social phobia
- Author:
- SEIGEL Alan
- Journal article citation:
- Brief Treatment and Crisis Intervention, 3(1), Spring 2003, pp.55-81.
- Publisher:
- Oxford University Press
The purpose of this article is to help persons in the helping professions recognize the serious threats to self, family life, and work experienced by persons with obsessive compulsive disorder (OCD) and social phobia and help engage persons affected in focused, clinically responsible treatment. The articlel presents findings from epidemiological studies of the disorders presenting conjointly, illustrates comorbidity in clinical practice through case examples, and reviews clinically relevant information gleaned in the diagnostic assessment. Core triage decisions in initiating treatment are reviewed. Medication approaches and patient concerns regarding medication are overviewed. The article summarizes psycho-educational information regarding cognitive errors in OCD and social phobia that may be presented to the patient to help the patient limit anxiety evocative and depressive thought. The author provides illustrations of cognitive behavioural treatment in individual and group psychotherapy, transfer of training, treatment resistance, and adjunctive treatments, resources for consumers and practitioners, and emerging challenges in the field.
Personality disorder
- Author:
- GEORGE Mike
- Journal article citation:
- Care and Health Guide, 14.08.02, 2002, pp.31-33.
- Publisher:
- Care and Health
A lack of clarity extends across the whole range of personality disorders. Personality disorders, particularly anti-social personality disorders, are receiving increasing attention as a result of the government's proposed legislation to introduce compulsory treatment. The draft Mental Health Bill, which is out for consultation until September 16, 2002 explicitly enables compulsion to be used for people with personality disorders.
Drug treatment in psychiatry: a guide for the community mental health worker
- Authors:
- TYRER Peter, HARRISON-READ Phil, van HORN Elizabeth
- Publisher:
- Butterworth-Heinemann
- Publication year:
- 1997
- Pagination:
- 308p.,bibliog.
- Place of publication:
- Oxford
Contains chapters on: the justification for drug treatment in psychiatry; drugs and the brain; drug treatment in clinical practice; multidisciplinary teamwork; organic disorders; community treatment of schizophrenia; mood disorders; neurotic and stress related disorders; substance misuse; the place of drug treatment in personality disorders; and strategies for drug treatment in the community.