- MeSH
- agorafobie diagnóza etiologie komplikace MeSH
- anxiolytika aplikace a dávkování klasifikace škodlivé účinky MeSH
- diferenciální diagnóza MeSH
- fobie diagnóza MeSH
- lidé MeSH
- obsedantně kompulzivní porucha diagnóza etiologie komplikace MeSH
- panická porucha diagnóza etiologie MeSH
- sociálně-úzkostná porucha diagnóza etiologie MeSH
- úzkostné poruchy * diagnóza etiologie farmakoterapie klasifikace komplikace terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- nedobrovolné psychiatrické léčení * metody statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
In the field of psychiatry the decline of recruitment and brain-drain are currently one of the most discussed topics among stakeholders on national and European level. Even though comprehensive data on psychiatric training in Europe have been already reported, no data are available on even the approximate number of early career psychiatrists (ECPs). With this objective in mind, the Early Career Psychiatrists Committee of the European Psychiatric Association (EPAECPC) and the European Federation of Psychiatric Trainees (EFPT) have undertaken a survey. Based on the methodology used, the total number of ECPs in all European countries was 46 144 with the average number of ECPs being 5.5/100 000 country inhabitants. The actual numbers in this respect varied greatly among countries from 0.4 and 0.6 ECPs/100 000 in Azerbaijan resp. Russia; to 20.4 and 28.4 ECPs/100 000 in Norway resp. Switzerland. An obvious East-West gradient with increasing numbers of ECPs when moving from East to West, and from South to North were found, mirroring the economic strength of European countries. This is the first study to specifically explore the number of ECPs across Europe which might have key implications for planning and establishing recruitment activities and for developing strategies for prevention of brain-drain, such as improvement of educational system and enlargement of professional opportunities.
- MeSH
- lidé MeSH
- psychiatrie výchova pracovní síly statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Despite the recent increase of research interest in involuntary treatment and the use of coercive measures, gender differences among coerced schizophrenia patients still remain understudied. It is well recognized that there are gender differences both in biological correlates and clinical presentations in schizophrenia, which is one of the most common diagnoses among patients who are treated against their will. The extent to which these differences may result in a difference in the use of coercive measures for men and women during the acute phase of the disease has not been studied. METHODS: 291 male and 231 female coerced patients with schizophrenia were included in this study, which utilized data gathered by the EUNOMIA project (European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice) and was carried out as a multi-centre prospective cohort study at 13 centers in 12 European countries. Sociodemographic and clinical characteristics, social functioning and aggressive behavior in patients who received any form of coercive measure (seclusion and/or forced medication and/or physical restraint) during their hospital stay were assessed. RESULTS: When compared to the non-coerced inpatient population, there was no difference in sociodemographic or clinical characteristics across either gender. However coerced female patients did show a worse social functioning than their coerced male counterparts, a finding which contrasts with the non-coerced inpatient population. Moreover, patterns of aggressive behavior were different between men and women, such that women exhibited aggressive behavior more frequently, but men committed severe aggressive acts more frequently. Staff used forced medication in women more frequently and physical restraint and seclusion more frequently with men. CONCLUSIONS: Results of this study point towards a higher threshold of aggressive behavior the treatment of women with coercive measures. This may be because less serious aggressive actions trigger the application of coercive measures in men. Moreover coerced women showed diminished social functioning, and more importantly more severe symptoms from the "excitement/hostile" cluster in contrast to coerced men. National and international recommendation on coercive treatment practices should include appropriate consideration of the evidence of gender differences in clinical presentation and aggressive behaviors found in inpatient populations.
- MeSH
- agrese psychologie MeSH
- dospělí MeSH
- hospitalizovaní pacienti psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- pohlavní dimorfismus * MeSH
- prospektivní studie MeSH
- schizofrenie (psychologie) * MeSH
- schizofrenie terapie MeSH
- stupeň závažnosti nemoci MeSH
- ústavy pro duševně nemocné MeSH
- zodpovědnost duševně nemocného * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: A content analysis was used to describe the association between psychiatric disorders and aggression in the printed media in the Czech Republic and Slovakia. METHODS: Articles were chosen from the most widely read daily newspapers and magazines in both countries during five one-week periods in 2007. A coding manual was developed and a content analysis was performed. Aggressive behavior was assessed by two separate categories - the role of the mentally ill person in the violent act (perpetrator/victim) and the type of aggressive act (homicide, suicide). RESULTS: A total of 375 articles were analyzed. Main findings: 1) The proportion of articles depicting psychiatric disorders together with either self- or other-directed aggressive behavior is 31.2%; 2) Homicide was most frequently mentioned in the context of psychotic disorders and schizophrenia, while affective disorders were most frequently associated with both completed suicides and homicides; 3) Eating disorders and anxiety disorders were seldom associated with any kind of aggressive behavior, including self-harm; 4) The vast majority of articles presented mentally ill people as perpetrators, and these articles were more often coded as stigmatizing. 5) Articles with aggressive behavior mentioned on the cover are roughly as frequent as those with aggressive behavior in the later sections of the media (36.7% vs. 30.7%). CONCLUSIONS: The results are similar to the findings in countries with longer histories of consistent advocacy for improved depiction of mental illness in the media. However, we have shown that persons with mental illness are still over-portrayed as perpetrators of violent crimes, especially homicides.
- MeSH
- agrese psychologie MeSH
- duševní poruchy psychologie MeSH
- lidé MeSH
- násilí psychologie MeSH
- noviny jako téma MeSH
- oběti zločinu psychologie MeSH
- periodika jako téma MeSH
- sebevražda psychologie MeSH
- vražda psychologie MeSH
- zločinci psychologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
Farmakologická léčba má v algoritmu zvládání akutně neklidného pacienta své nezpochybnitelné místo, ale měla by být zahájená pouze v případě, když selžou deeskalační techniky a další nefarmakologické postupy. Ideální neklidová medikace by měla být neinvazivní, snadno aplikovatelná, s rychlým nástupem účinku, efektivně tlumící neklid bez nadměrné sedace pacienta, dobře tolerovaná a pozitivně ovlivňující příznaky základního onemocnění. I přes pestrou paletu momentálně dostupných preparátů ani jeden z nich nesplňuje všechny podmínky. V přehledovém článku jsou diskutovány aktuální možnosti léčebných strategií u neklidného pacienta s primárně psychiatrickou příčinou agitovanosti. I přes řadu existujících doporučení „expertů“ a výsledků randomizovaných studií, velkou roli v užití neklidové medikace hraje dlouhodobá klinická zkušenost a otázky ekonomické.
Pharmacological treatment has in the algorithm of the management of an acutely agitated patient its indisputable place and should be initiated only if previous de-escalation techniques and other non-pharmacological methods had fail. Ideal drug for such purpose should be non-invasive; easy to apply; with rapid onset of action; effectively decreasing agitation without excessive sedation; well-tolerated and should positively affect the underlying psychiatric condition. Despite the wide variety of currently available drugs nor one meets all the criteria. The review article discusses the current treatment options for agitated patients with primary psychiatric causes of agitation. Despite many existing „expert recommendations“ and the results of randomized controlled trials, a longlasting clinical experience together with economical factors plays signifiant role in the use of forced medication.
- Klíčová slova
- agitovanost, omezovací opatření,
- MeSH
- agrese účinky léků MeSH
- antipsychotika klasifikace škodlivé účinky terapeutické užití MeSH
- benzodiazepiny škodlivé účinky terapeutické užití MeSH
- bipolární porucha farmakoterapie komplikace MeSH
- diazepam škodlivé účinky MeSH
- farmakoterapie metody MeSH
- fyzické omezení MeSH
- lékové interakce MeSH
- lidé MeSH
- lorazepam terapeutické užití zásobování a distribuce MeSH
- násilí prevence a kontrola psychologie MeSH
- psychomotorický neklid diagnóza etiologie farmakoterapie MeSH
- psychotické poruchy farmakoterapie komplikace MeSH
- vztahy mezi lékařem a pacientem MeSH
- způsoby aplikace léků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
