Showing papers in "International Journal of Psychiatry in Medicine in 2014"
TL;DR: A closer look at the field of “Spirituality, religion, and health,” showing that this field of research has been constantly growing and consolidating in the scientific community.
Abstract: Objective:Although several studies have examined the contribution of specific countries, journals, and authors in different scientific disciplines, little is known about the contribution of different world countries, journals, and authors to scientific research in the field of “Spirituality, religion, and health” (S/R). The present study aims to analyze the last 15 years of research in the field of spirituality and religiousness (S/R) through a bibliometric analysis.Methods:Using the Pubmed database, we retrieved all articles related to S/R field for the period 1999–2013. We then estimated the total number of publications, number of articles published per year, articles published per country, journals with most publications in S/R field, most productive authors, and most used keywords.Results:We found a growth of publications in the last years, most from the United States and the United Kingdom and published in the English language. Noteworthy, some developing countries such as India, Brazil, Israel, and ...
112 citations
TL;DR: The new DMM-5 diagnostic criteria, prevalence, and presentation of patients with PTSD in primary care, and key findings in terms of neurobiological underpinnings with implications for future treatment are discussed.
Abstract: Post-traumatic stress disorder (PTSD) is one of the few mental disorders in which the cause is readily identifiable. In this article, we review the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, prevalence, and presentation of patients with PTSD in primary care. The purpose of this article is to review current literature regarding theory, etiology, and treatment effectiveness. Key findings in terms of neurobiological underpinnings with implications for future treatment are discussed. Recommendations regarding effective psychotherapy and pharmacotherapy, emerging treatment, and management issues in primary care settings are offered.
79 citations
TL;DR: Survey results support the feasibility and safety of using webcams, secure/encrypted software and veteran-owned personal computers for the delivery of mental health services into the home and suggest fewer no-show appointments in home-based telemental health compared to clinic-based Telemental Health.
Abstract: Objectives:The first Home-Based Telemental pilot program (HBTMH) in the Department of Veterans Affairs addresses the significant challenge of access to mental health treatment for rural veterans. T...
45 citations
TL;DR: How procedures for the ongoing assessment and management of suicide risk in a clinical trial that compares in-office treatment to home-based treatment delivered via web-cam to U.S. military service members and veterans with depression is described.
Abstract: The effective assessment and management of suicidal patients is an essential component of telehealth-based care. With this article, we describe how we have implemented procedures for the ongoing assessment and management of suicide risk in a clinical trial that compares in-office treatment to home-based treatment delivered via web-cam to U.S. military service members and veterans with depression. We describe our safety protocol and how it was adapted from current recommended best practices, published guidelines, and local requirements for managing patient safety during home-based telepractice. We conclude with discussion of other key safety issues associated with telepractice. The topics discussed are relevant to all mental health practitioners who are interested in clinical telepractice services.
40 citations
TL;DR: The idea that the higher prevalence of oral diseases among patients with mental disorders may be attributed to the side effects of their medications mediated by complex interactions between different targeted receptors is supported.
Abstract: Patients with problems related to central nervous system dysfunctions are often treated with psychotropic drugs. These include antipsychotics, antidepressants, mood stabilizers, anticonvulsants, and drugs blocking specific receptors in the brain such as anticholinergics or beta-blockers. However, these medications have serious side effects affecting the oral health. In addition, many dental patients make use of psychoactive drugs, such as amphetamine, ecstasy, and cocaine. This article aims to review data on the psychotropic drugs being used in the last 30 years, their pharmacological profile, with special attention to the side effects related to the oral health. Oral diseases such as bruxism, orofacial dystonia, oromandibular dyskinesia, and rabbit syndrome are related to extrapyramidal effects of antipsychotic drugs because of their antagonist activity on the dopaminergic receptors. Drugs with anticholinergic and/or antiadrenergic effects such as tricyclic antidepressants may cause dry mouth and related complications such as candidiasis and other oral infections. Among mood stabilizers, lithium treatment induces a wide range of side effects on oral system including dry mouth, sialorrhea, infections, and ulceration of the oral cavity. Psychostimulants may instead provoke xerotomia, gingival enlargements, bruxism, dental erosion, mucosal ulceration, and oral/nasal lesions. This literature review supports the idea that the higher prevalence of oral diseases among patients with mental disorders may be attributed to the side effects of their medications mediated by complex interactions between different targeted receptors. Thus, dentists must be aware of the possible risks of these medications in order to take appropriate precautions in treating these patients.
38 citations
TL;DR: It is suggested that psychiatry clerkship training may improvemedical students' attitudes towards psychiatry and mental illness, but its influence on medical students' consideration to choose psychiatry as a future medical career is limited.
Abstract: Objective:The study was to examine the changes in attitudes towards psychiatry and mental illness among Chinese medical students during their psychiatry clerkship training.Methods:The Attitudes Towards Mental Illness (AMI) and the Attitudes Towards Psychiatry-30 (ATP-30) questionnaires were administered to 325 fourth-year Chinese medical students before and after they completed an 8-week psychiatry clerkship training.Results:After the clerkship training, there was a significant improvement in attitudes towards psychiatry and mental health as reflected by the total scores on ATP-30 (103.4 ± 8.6 versus 111.8 ± 9.6, p < 0.001) and AMI (58.9 ± 6.3 versus 64.1 ± 6.6, p < 0.001). The proportions of students who showed positive attitudes to psychiatry and mental illness were significantly increased on most of the items on ATP-30 and AMI after rotation (p's = 0.027). Although there was a significant change after training, the percentage of the students who would consider psychiatry as their future medical special...
38 citations
TL;DR: In this paper, the authors determined differences in reported barriers to treatment completion associated with telemedicine vs. in-person delivery of evidence-based treatment for PTSD in combat veterans.
Abstract: Objective:To determine differences in reported barriers to treatment completion associated with telemedicine vs. in-person delivery of evidence-based treatment for PTSD in combat veterans.Method:The present study was derived from two ongoing randomized controlled trials (RCTs) comparing in-person vs. telemedicine delivery of exposure therapy for PTSD. A onetime telephone assessment of participants who dropped out from the treatment phase of these two studies was conducted, with measures focusing on reported reasons for dropout, and perceived comfort and efficacy of the treatment modality. Dichotomous data were analyzed via chi-square and logistic regression; continuous data via ANOVA.Results:Forty-seven of 69 total dropouts participated. There was no difference in rate of dropout between modalities. A greater proportion of participants receiving in-person exposure therapy reported difficulties with logistical aspects of care (e.g., parking), whereas a greater proportion of participants receiving telemedic...
37 citations
TL;DR: Perceptions of telehealth are unrelated to outcomes for mental health treatment, so clinicians should be confident in using this approach with patients, regardless of their familiarity or comfort with the technology.
Abstract: Objective:Telehealth is a method to expand the reach of clinical care for PTSD treatment. However, those with limited prior exposure to telehealth or limited confidence using telehealth may have po...
37 citations
TL;DR: This article will explore ways in which Engel's biopsychosocial vision can be realized through building the capacities of clinicians to become more self-aware and resilient, and engage in compassionate action.
Abstract: George Engel's biopsychosocial vision was simultaneously scientific and humanistic. He passionately presented an approach to clinical care to correct the progressive distancing of clinical care and research from the lived experience of the patient. Yet, while science provides ever greater evidence for the linkages between subjectively-reported experience and health outcomes, trainees and practicing clinicians struggle to realize a biopsychosocial vision in a pragmatic way. These challenges are magnified by the mandate for greater patient autonomy and participation in care, increased access to information, and overlaps and omissions as multiple professionals try to address the whole person. Importantly, trainees and clinicians get stuck implementing the biopsychosocial model partly because they have not developed the capacity for resilience, self-awareness, and self-monitoring. These capacities must accompany efforts to help clinicians engage more deeply with their patients; otherwise, they risk emotional distress, empathic failure, premature closure, and withdrawal from effective connections with patients. This article will explore ways in which Engel's biopsychosocial vision can be realized through building the capacities of clinicians to become more self-aware and resilient, and engage in compassionate action.
31 citations
TL;DR: While there are different stereotypes for different mental illnesses, the perceived risks of aggressive behaviors determine the public's acceptance, and future interventions among Chinese should aim to reduce the public’s exaggeration of the aggressive image of psychotic patients.
Abstract: OBJECTIVE: There is a lack of in-depth studies on the stigmatization of mental health patients in China. This study aimed to investigate the stigmatizing opinions of Chinese toward different types of mental illnesses by a qualitative approach. METHOD: Nine focus group interviews with 5 to 12 participants each were conducted in areas of different social classes in Hong Kong. Opinions on different types of mental illnesses, including anxiety, depression, schizophrenia, dementia, mania, bipolar disorder, and alcohol/drug abuse, were discussed by the focus group participants. RESULTS: The participants tended to share very negative examples about the potential violent and annoying behaviors of patients with psychosis, including schizophrenia, mania, and bipolar disorders. However, the stigmatizing opinions did not generalize across different mental illnesses. Patients with anxiety or dementia were much better accepted than those with psychosis. The views on depression were diverse, depending on whether the patients had violent behaviors. Alcohol and drug abuse were seldom related to mental illnesses by the participants. CONCLUSIONS: While there are different stereotypes for different mental illnesses, the perceived risks of aggressive behaviors determine the public's acceptance. Future interventions among Chinese should aim to reduce the public's exaggeration of the aggressive image of psychotic patients. Language: en
28 citations
TL;DR: Olfactory loss in chronic sinonasal diseases was found to be associated with anxiety and depression symptoms and anxiety was correlated with depression.
Abstract: Objectives:To explore mental health of patients with olfactory loss due to chronic sinonasal diseases and investigate the effects of age-, gender-, and socio-economic variables on anxiety and depression symptoms.Methodology:One hundred and eight patients (62 males; mean age: 39.78 ± 16.11 years), suffering from olfactory impairment due to chronic rhinosinusitis and allergic rhinitis and 30 healthy subjects (16 males; mean age, 37.03 ± 13.09 years) were studied. Olfactory function was evaluated using “Sniffin‘ Sticks” test. All patients completed four validated questionnaires specific for assessing anxiety and depression (Zung Anxiety Scale, State-Trait Anxiety Inventory-STAI, Zung Depression Scale, and Beck Depression Inventory-BDI).Results:We found significantly more severe anxiety and depression symptoms in anosmic (all p < 0.001) and hyposmic patients compared to healthy controls. No significant differences were observed between normosmic patients and controls. Scores in all psychological measures were...
TL;DR: Brief, web-based approaches may offer a promising alternative to address access barriers for adolescents with depressed mood, and preliminary data from the large ongoing randomized controlled trial have indicated moderate levels of access.
Abstract: OBJECTIVE: Adolescent depression is a major public health concern. Efficacious interventions exist, but are underutilized. Novel approaches to improving access are therefore a top priority. Web-based approaches offer a viable treatment delivery solution; this approach may reach adolescents who might not otherwise receive formal treatment. Behavioral activation (BA) approaches have had success in treatment of depressive symptoms in youth. The purpose of this article is to: (1) describe the development process of a web-based, behavioral activation intervention for adolescents; (2) summarize the preliminary feasibility data; and (3) discuss the benefits and challenges associated with development and evaluation of adolescent self-help resources. METHODS: The current study is part of a larger NIMH funded study focusing on the development and evaluation of Bounce Back Now (BBN), an evidence-informed, web resource for disaster-affected adolescents and their families. This study is specifically on the development of the BA component of the mood module of BBN, which was evaluated more extensively than other components. We present data from a formal usability evaluation conducted with 24 adolescents, and preliminary usage data collected from 2,000 disaster affected adolescents recruited from the tornado-affected coordinates in Alabama and Joplin, MO. RESULTS: Preliminary data supported the feasibility of this approach: qualitative data with the clinic-based sample revealed favorable reactions to the intervention, and preliminary data from the large ongoing randomized controlled trial have indicated moderate levels of access. CONCLUSIONS: Brief, web-based approaches may offer a promising alternative to address access barriers for adolescents with depressed mood. Language: en
TL;DR: It is proposed that the unique pharmacodynamics of this drug served to stabilize dysregulated neural circuits, neurotransmitters, and neuropeptides, allowing the mitigation of pain, assuaging opioid cravings, easing depression, and resolving suicidal ideation.
Abstract: The very strong relationship between suicide, depressive disorders, and substance use disorders is well recognized. Certain pain syndromes are significantly associated with suicide, irrespective of co-occurring medical or psychiatric diagnosis. Chronic pain, depression, substance use disorders, and suicide appear to involve overlapping neural pathways and brain regions that function in the processing of emotional and physical pain, as well as maintaining reward and anti-reward circuitry. In this article, we employ a clinical case to illustrate how various stressors disrupted the balance between pain and opioid-facilitated analgesia. This disruption resulted in excessive use of short-acting opioids to treat pain with ensuing allostatic overload and culmination in chronic suicidal ideation with a suicide attempt. Sublingual buprenorphine was selected to treat the opioid use disorder. We propose that the unique pharmacodynamics of this drug served to stabilize dysregulated neural circuits, neurotransmitters, and neuropeptides, allowing the mitigation of pain, assuaging opioid cravings, easing depression, and resolving suicidal ideation. To our knowledge, this is the first case report to describe the possible anti-suicidal effect of sublingual buprenorphine.
TL;DR: Clinical significant anxiety is common among weight loss surgery (WLS) candidates and Cognitive-emotional clustering of anxiety symptoms was more common than hypothesized, lending support for the utility of psychotherapeutic approaches tailored to address maladaptive thoughts to address anxiety and potentially improve WLS outcomes.
Abstract: Objective:Depression among weight loss surgery (WLS) candidates is common. Anxiety in this population is less studied. Untreated anxiety persists post-surgery and is associated with poor surgical o...
TL;DR: It could be concluded that both disorders involved a high risk for developing psychiatric disorders; additionally, adolescents with PNES have higher rates of stressors and lower levels of self-esteem.
Abstract: Objective: Children and adolescents with psychogenic non-epileptic seizures (PNES) and epilepsy are known to have psychosocial problems. The aim of the present study was to compare the psychosocial difficulties, history of stressful life events/abuse, psychiatric diagnosis, and self-esteem of adolescents with PNES to the ones with epilepsy and healthy controls at a tertiary care center in Turkey. Method: Thirty-four adolescents with PNES diagnosed by video-EEG were compared with 23 adolescents that have epilepsy and 35 healthy volunteers. Comorbid psychiatric diagnoses of participants were examined by semi-structured interviews using Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version (KSADS-PL). Self-esteem of adolescents was evaluated by Rosenberg Self Esteem Scale (RSES). Results: No differences in sociodemographic features were observed between the groups. The PNES group showed significantly higher rates of parental conflicts, difficulties in relationship with siblings/peers, school under-achievement, and history of
TL;DR: The impact of gender and marital status seem to be emerging determinants in defining sense of coherence among inhabitants of rural Crete.
Abstract: OBJECTIVES/AIM: This article reports the results of an observation study, aimed at exploring an association between spirituality, religiousness, and sense of coherence in a population group residing in a rural area of Crete, Greece.
STUDY DESIGN AND METHODS: The study was conducted during the period 2007-2009. Subjects aged 65 years and older (n = 118) living in two remote and rural villages in the Heraklion county (Crete) were eligible. Eighty-nine people (51 women and 38 men) participated. Demographic data were obtained, and all participants were asked to complete the Greek version of the self-reported Royal Free Interview for Spiritual and Religious Beliefs, and the Sense of Coherence Scale.
RESULTS: Most participants reported strong religious beliefs and this was found to be related with increased age. Widowed participants expressed greater religiousness and spirituality (p = 0.029). The total score for Sense of Coherence was negatively correlated with gender (women have lower scores, p < 0.05), marital status (widows presented lower scores, p < 0.001), and increased age. A strong positive correlation of the Sense of Coherence score with the Spiritual Scale as measured by three questions of the Royal Free Interview was also identified (p = 0.039).
CONCLUSIONS: The impact of gender and marital status seem to be emerging determinants in defining sense of coherence among inhabitants of rural Crete. The positive association between religious/spiritual beliefs and sense of coherence deserves further attention to promote a multidimensional approach in its study.
TL;DR: MiRNA137 may not be a significant susceptibility gene for schizophrenia, but in patients, rs66642155 allelic variant of miRNA137 appears to influence age at onset and the severity of positive symptoms.
Abstract: Objectives:MicroRNA137 (miRNA137) regulates several gene expressions involved in brain development, and a recent large genome wide association study (GWAS) revealed a possible association between miRNA137 and schizophrenia.Methods:The allelic variants of rs66642155, a variable number tandem repeat polymorphism, and the single nucleotide polymorphism rs1625579 A/C in the miRNA137 host gene fragment were compared between 300 schizophrenic patients and 300 healthy controls from the Han Chinese population. The association of these polymorphisms with clinical characteristics of schizophrenia was also tested.Results:Genotype and allele frequencies of these polymorphisms were not significantly different between patient and control populations. In patients, however, age at onset was much later in wild type rs66642155 carriers than in mutation carriers. Total positive score on the Positive and Negative Symptom Scale (PANSS), total five-factor model positive score, and the delusions symptom score were all significa...
TL;DR: Plasma galanin levels may be an important biomarker for depression severity, especially in female patients, and there was a significant positive correlation between plasma galanIn levels and depression severity in women MDD patients.
Abstract: Objective:This study investigated the association between plasma galanin level and depression severity.Methods:The severity of depression symptoms of 79 patients with major depressive disorder (MDD...
TL;DR: Targeted interventions to mitigate the adverse effects of SPD are needed, independent of programs to address depression, above and beyond the effects of depression.
Abstract: Objective:To examine the association between serious psychological distress (SPD) and the Physical and Mental Health components of Quality of Life (QOL) while controlling for depression in a national sample of adults with diabetes.Methods:SPD was assessed in 1,659 adults with diabetes who participated in the 2007 Medical Care Expenditure Survey (MEPS). SPD was measured by the 6-item Kessler scale. Depression was assessed with the PHQ-2 screen. Quality of life was measured with the physical (PCS) and mental (MCS) components of the SF-12. We used multiple linear regression to assess the relationship between SPD and quality of life while controlling for relevant covariates and depression screen results to assess the independent effect of SPD on QOL above and beyond the effect of depression.Results:Among US adults with diabetes, 9% had SPD and 15.4% screened positive for depression. Among those with SPD, 85.8% had depression and among those with depression, 50.5% had SPD. In the adjusted model for sociodemogr...
TL;DR: In this article, a mixed methods study involved analysis of quantitative data collected from older adults with serious mental illness (SMI) and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives to explore family involvement in medical care.
Abstract: Objective:Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI.Methods:This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care.Results:Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medi...
TL;DR: Findings suggest that coping mediates the association between attachment anxiety and attachment avoidance on the one hand and mental health and physical functioning in patients with morbid obesity on the other hand.
Abstract: Objective: The presence of mental health problems and limitations in physical functioning is high in patients suffering from morbid obesity. The purpose of the current study was to examine the mediating role of coping style in the relationship between attachment representations and mental health and physical functioning in a morbidly obese population. Method: A total of 299 morbidly obese patients who were referred to the Slotervaart bariatric surgery unit in Amsterdam, the Netherlands, completed self-report questionnaires assessing adult attachment style (Experiences in Close Relationship–Revised Questionnaire), coping style (Utrecht Coping List), and patients physical
TL;DR: Rural T2DM patients reported high rates of repeated depressive symptoms without corresponding rates of depression treatment, and may benefit from close monitoring and ongoing adjustment of their treatment for depression and diabetes by primary care providers.
Abstract: ObjectiveDespite high rates of diabetes and depression in rural areas, limited data exists to document patterns and predictors of depressive symptoms in rural patients with type 2 diabetes (T2DM). ...
TL;DR: Depression is common among HIV-infected persons in Nigeria and is associated with low CD4 cell counts, and the screening and treatment of mental health problems such as depression should be considered an integral component of HIV care and support.
Abstract: ObjectiveDepression is common in people living with HIV/AIDS and there is some evidence that depressive symptoms may have adverse effects on immune functioning. The purpose of this study was to det...
TL;DR: A curriculum to improve family medicine residents' skills in the treatment of patients with chronic pain and is targeted towards resident physicians is developed.
Abstract: Chronic pain is a challenging condition, both for the patient, who is coping with constant pain and limitations in functionality, and for the treating physician. Narcotic medications, often used for the treatment of chronic pain, can be addictive and rates of overdose deaths associated with their use have increased significantly in the last 10 years [1]. Behavioral and physician faculty at the Lincoln Family Medicine Center developed a curriculum to improve family medicine residents' skills in the treatment of patients with chronic pain. The experience includes education in pain physiology and assessment, administration of medications, adjunctive treatments, and interactions with difficult patients. Two cohorts of residents have participated in the curriculum with positive results. The curriculum may be helpful for primary care providers with privileges to prescribe narcotic medications and is targeted towards resident physicians.
TL;DR: The results suggest that extremity fractures are associated with ADHD symptoms in adults and may provide an insight into better understanding the lifelong negative impact of ADHD on the physical health of its sufferer.
Abstract: Objective: Recent studies showed that attention deficit hyperactivity disorder (ADHD) is a lifelong disorder which may be seen in adults as well as children. However, information about the relationship between ADHD and general medical conditions in adulthood is limited. This case-control study aims to determine whether ADHD symptoms are associated with extremity fractures and their clinical characteristics. Methods: Forty patients (25 male and 15 female; aged 18-50 years) who were seen due to extremity fractures and 40 control subjects were enrolled. Childhood and present ADHD symptoms of the participants were assessed using Wender Utah Rating Scale (WURS) and Adult ADHD Self-Report Scale (ASRS), respectively. Trauma type, reason of the trauma, fracture localization, hospitalization requirement, treatment type, and history of previous fracture(s) of the patients were recorded. Results: Total score and all subscale scores of WURS were higher in the fracture groups compared with controls. Patients also had higher ASRS total score and ASRS hyperactivity-impulsivity subscore than the controls did. WURS irritability, inattentiveness, and behavioral problems/impulsiveness subscore and total score were positively correlated with the history of previous fracture. The patients in whom the reason for the fracture was
TL;DR: It is suggested that ramelteon was a safe and useful alternative to melatonin for the treatment of delirium in elderly patients and Randomized, controlled studies are necessary to confirm the therapeutic benefits of ramelTeon.
Abstract: Objective:Melatonin is effective in the prevention and treatment of delirium. Ramelteon has few adverse effects and higher affinity for MT1 and MT2 receptors than melatonin. The aim of the present ...
TL;DR: The characteristics of the suicidal behaviors and the process for preventing a suicide reattempt associated with an adolescent with ASD who attempted suicide are presented.
Abstract: Although the suicide risk of autism spectrum disorder (ASD) has been suggested to be higher than previously recognized, there are few case reports focusing on the process for preventing suicide reattempts. We reported that a 17-year-old male who had attempted suicide by jumping was admitted to our emergency department and hospitalized for lumbar spine fracture. In addition to the diagnosis of adjustment disorder, he was diagnosed as ASD according to his life history. This article presents the characteristics of the suicidal behaviors and the process for preventing a suicide reattempt associated with an adolescent with ASD who attempted suicide.
TL;DR: This bimodal protocol of intervention resulted in better symptom control, improved communication with the team and family, reduction of psychological distress, promotion of autonomy, dignity, and self-esteem in a patient in advanced stages of ALS.
Abstract: This case describes a psychotherapy intervention in a patient in advanced stages of ALS. The inability for verbal communication at these stages necessitated the inclusion of a computational system to favor augmentative and alternative communication (AAC) to provide psychological care. The association of this device and software with ongoing psychotherapy acted in a synergistic manner. AAC devices made it possible to maintain patient-therapist communication and provided material support for psychotherapy despite severe speech limitations. This bimodal protocol of intervention resulted in better symptom control, improved communication with the team and family, reduction of psychological distress, promotion of autonomy, dignity, and self-esteem. The novelty of this communication is to report how the regular psychological care could be adapted to the patient circumstances using a computer device. Clinical trials will be required to evaluate the effectiveness of this mode of psychotherapy for the general population of ALS patients.
TL;DR: The belief that problem drinkers are unwilling to change was not supported by this study, and treatment for problem drinking should involve a collaborative evaluation of options with an emphasis on patient preference and treatment within the primary care setting.
Abstract: Objective:Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are “in denial,” or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.Method:Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and (3) a list of treatment modalities to be rated based on level of interest.Results:Within a random sample of 402 patients, 40.2% reported high risk drinking and 16.3% reported problem drinking. Among the latter group, 89.3% were either considering change, or had begun to take steps to make changes in their drinking behaviors. When asked about treatment pre...
TL;DR: A possible role of e-cigarettes that has not yet been explored is in the primary prevention of conventional cigarette use among young adults that are smoking-naïve.
Abstract: The controversy regarding the use of electronic cigarettes as a possible modality for smoking cessation has grown in recent years. Epidemiologic surveys indicate that usage rates in both adults and adolescents have increased substantially as the popularity of these devices continues to rise. At present, there is a small but growing body of evidence studying the possible role that these “e-cigarettes” may have as a nicotine replacement tool. Much of the existing data are from observational studies and surveys which track the epidemiologic and demographic trends of e-cigarette users. More recentlypublished articles have begun to utilize randomized, experimental designs to directly compare the efficacy of e-cigarettes to active and passive controls in outcome measures such as conventional cigarette quit rates and time to relapse. Barriers to widespread adoption of e-cigarette use as a smoking cessation modality include a lack of long-term safety and toxicology data, a lack of standardization of devices, and a debate regarding whether devices can be marketed for both social nicotine use, as well as nicotine replacement. A possible role of e-cigarettes that has not yet been explored is in the primary prevention of conventional cigarette use among young adults that are smoking-naive. (Int’l. J. Psychiatry in Medicine 2014;48:325-332)