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[PMID]:28462636
[Au] Autor:Ditton-Phare P; Loughland C; Duvivier R; Kelly B
[Ad] Endereço:1 Hunter New England Mental Health, Newcastle, NSW, Australia.
[Ti] Título:Communication skills in the training of psychiatrists: A systematic review of current approaches.
[So] Source:Aust N Z J Psychiatry;51(7):675-692, 2017 Jul.
[Is] ISSN:1440-1614
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. METHODS: The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. RESULTS: Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. CONCLUSION: The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.
[Mh] Termos MeSH primário: Comunicação
Educação de Pós-Graduação em Medicina
Psiquiatria/educação
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1177/0004867417707820


  2 / 29539 MEDLINE  
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[PMID]:28448697
[Au] Autor:Maust DT; Blow FC; Wiechers IR; Kales HC; Marcus SC
[Ad] Endereço:Department of Psychiatry, University of Michigan, NCRC 016-222W, 2800 Plymouth Rd, Ann Arbor, MI 48109. maustd@umich.edu.
[Ti] Título:National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care.
[So] Source:J Clin Psychiatry;78(4):e363-e371, 2017 Apr.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time among visits to primary care providers and psychiatrists. METHODS: Data were from the National Ambulatory Medical Care Survey (years 2003-2005 and 2010-2012), a nationally representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n = 14,282) and psychiatrists (n = 1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals. Odds of medication use were calculated for each stratum, adjusting for demographic and clinical characteristics. RESULTS: The visit rate by older adults to primary care providers where any of the medications were prescribed rose from 16.4% to 21.8% (adjusted odds ratio [AOR] = 1.43, P < .001) while remaining steady among psychiatrists (75.4% vs 68.5%; AOR = 0.69, P = .11). Primary care visits rose for antidepressants (9.9% to 12.3%; AOR = 1.28, P = .01) and other anxiolytic/sedative-hypnotics (3.4% to 4.7%; AOR = 1.39, P = .01), but the largest growth was among benzodiazepines (5.6% to 8.7%; AOR = 1.62, P < .001). Among patients in primary care, increases primarily occurred among men, non-Hispanic white patients, and those with pain diagnoses as well as those with no mental health or pain diagnoses. CONCLUSIONS: From 2003 to 2012, use of the most common psychotropic medications among older adults seen in primary care increased, with concentration among patients with no mental health or pain diagnosis. As the population of older adults grows and receives mental health treatment in primary care, it is critical to examine the appropriateness of psychotropic use.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Benzodiazepinas/uso terapêutico
Hipnóticos e Sedativos/uso terapêutico
Médicos de Atenção Primária/estatística & dados numéricos
Atenção Primária à Saúde/estatística & dados numéricos
Psiquiatria/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Médicos de Atenção Primária/tendências
Atenção Primária à Saúde/tendências
Psiquiatria/tendências
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Hypnotics and Sedatives); 12794-10-4 (Benzodiazepines)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.4088/JCP.16m10713


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[PMID]:29292925
[Au] Autor:Köhler P; Krona H; Josefsson J
[Ad] Endereço:n/a - Vuxenpsykiatrin Malmö Malmö, Sweden n/a - Vuxenpsykiatrin Malmö Malmö, Sweden.
[Ti] Título:Psykisk ohälsa, radikalisering och terrorism - Inget säkert samband har kunnat påvisas..
[So] Source:Lakartidningen;114, 2017 Nov 09.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:Mental illness and terrorism There is little evidence supporting the concept of mental illness as a part of, or reason behind radicalization towards violent extremism and terrorism. There is weak evidence that lone gunmen, particularly those involved in school shootings, may suffer from mental illness to a larger degree than the general population, whereas organized terrorist groups such as jihadists and right-wing extremists seem to avoid mentally unstable individuals. Clinical use of the instruments developed for screening and risk assessment of individuals suspected of radicalization towards violent extremism will compromise the trust placed in the Swedish health care system by the citizens it is there to serve. The usage of empirically grounded risk assessment instruments should be restricted to forensic psychiatric clinics. Individuals at risk of radicalization towards violent extremism who present signs and symptoms of mental illness should be offered psychiatric treatment.
[Mh] Termos MeSH primário: Transtornos Mentais/diagnóstico
Terrorismo/psicologia
Violência/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Psiquiatria/organização & administração
Medição de Risco
Suécia
Terrorismo/prevenção & controle
Violência/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29292960
[Au] Autor:Johansson PM; Fahlke C
[Ti] Título:Blivande psykiatrer behöver utbildning i integrativ kunskapssyn..
[So] Source:Lakartidningen;114, 2017 12 04.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Mh] Termos MeSH primário: Educação de Pós-Graduação em Medicina/organização & administração
Psiquiatria/educação
Psicoterapia
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Seres Humanos
Psicoterapia/educação
Psicoterapia/métodos
Inquéritos e Questionários
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29281801
[Au] Autor:Pouncey C
[Ad] Endereço:From Eudaimonia Associates, Philadelphia.
[Ti] Título:President Trump's Mental Health - Is It Morally Permissible for Psychiatrists to Comment?
[So] Source:N Engl J Med;378(5):405-407, 2018 Feb 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Responsabilidade pela Informação/ética
Ética Médica
Pessoas Famosas
Empregados do Governo/psicologia
Saúde Mental
Psiquiatria/ética
[Mh] Termos MeSH secundário: Códigos de Ética/história
Ética Médica/história
História do Século XX
Seres Humanos
Masculino
Sociedades Médicas/história
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Trump D
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1714828


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[PMID]:28465390
[Au] Autor:Ackling E
[Ad] Endereço:Edward Ackling, fourth-year medical student, Cardiff University. Email: acklinge@cardiff.ac.uk.
[Ti] Título:The red corner: in support of formal risk prediction in psychiatry.
[So] Source:Br J Psychiatry;210(5):369, 2017 05.
[Is] ISSN:1472-1465
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Psiquiatria
[Mh] Termos MeSH secundário: Seres Humanos
Risco
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1192/bjp.210.5.369a


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[PMID]:28465384
[Au] Autor:Haigh R
[Ad] Endereço:Rex Haigh, MA, BM, BCh, MRCGP, FRCPsych, MembInstGA, Berkshire Healthcare NHS Foundation Trust, ASSiST Office, Upton Hospital, Slough SL1 2BJ, UK. Email: rexhaigh@nhs.net.
[Ti] Título:Therapeutic communities enter the world of evidence-based practice.
[So] Source:Br J Psychiatry;210(5):313-314, 2017 05.
[Is] ISSN:1472-1465
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This editorial provides the modern-day context for a long-established psychiatric treatment, democratic therapeutic communities. As this treatment is now such a small field in psychiatry, readers may not have enough background to be able to place the research in a suitable context. This includes the previous gap in experimental research, the difference between the modern model and the one used in the 20th century and the general field of personality disorder evidence.
[Mh] Termos MeSH primário: Prática Clínica Baseada em Evidências/normas
Psiquiatria/normas
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos da Personalidade/terapia
Prática Profissional
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1192/bjp.bp.116.193326


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[PMID]:28465383
[Au] Autor:Newton-Howes G; Ryan CJ
[Ad] Endereço:Giles Newton-Howes, MBChB, MRCPsych, FRANZCP, Department of Psychological Medicine, University of Otago, Wellington, New Zealand; Christopher James Ryan, MBBS, MHL, FRANZCP, Discipline of Psychiatry and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia giles.newton-howes@otago.ac.nz.
[Ti] Título:The use of community treatment orders in competent patients is not justified.
[So] Source:Br J Psychiatry;210(5):311-312, 2017 05.
[Is] ISSN:1472-1465
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Empirical evidence for the effectiveness of community treatment orders (CTOs) is at best mixed. We examine CTOs through the prism of human rights and discrimination, bearing the evidence in mind, and argue that a necessary condition for their use is that a person lacks decision-making capacity.
[Mh] Termos MeSH primário: Internação Compulsória de Doente Mental/legislação & jurisprudência
Serviços Comunitários de Saúde Mental/legislação & jurisprudência
Competência Mental/legislação & jurisprudência
Transtornos Mentais/terapia
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Violações dos Direitos Humanos/legislação & jurisprudência
Seres Humanos
Direitos do Paciente/legislação & jurisprudência
Psiquiatria
Reino Unido
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1192/bjp.bp.116.193920


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[PMID]:29328560
[Au] Autor:Samardzic RM; Zivic B; Krstic D; Jokovic D; Dolic M; Stojanovic Z; Eror A; Dokic M; Milojevic S; Mandic-Gajic G
[Ti] Título:Re-evaluating disability assessment in war veterans with posttraumatic stress disorder.
[So] Source:Vojnosanit Pregl;73(10):945-9, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Sametimes war veterans may resort to such strategies as preducing exaggerated symptoms and malingerating in order to obtain material compensation rights. The aim of this study was to assess the accuracy of the diagnosis of posttraumatic stress disorder (PTSD) on the basis of which war veterans were entitled to a financial compensation due to their disability. Methods: The diagnoses of 259 war veterans were re-evaluated. Veterans were previously diagnosed by a psychiatrist on local level, while regional state medical commission determined the degree of disability and the right to a financial compensation. A team of experts, consisting of psychiatrists with research experience in the field of traumatic stress and who were trained to use a structured interview for PTSD, conducted the evaluation of medical data from veterans' military records. The diagnostic process was conducted using the standardized diagnostic interview (Clinician-Administered PTSD Scale ­ CAPS), after which the diagnosis was reaffirmed or reviewed. This influenced disability status and consequential financial compensation. Results: There was a remarkable difference between the first diagnostic assessment of PTSD, conducted by the psychiatrists on local level, and the second evaluation conducted by the team of experts. In more than half of 259 veterans (52.1%) diagnosed with PTSD in the first assessment the diagnosis was not confirmed. The diagnosis was confirmed in 31.7% of veterans. Those veterans who were diagnosed with lifetime PTSD (7.3%) should also be treated as accuratelly diagnosed. This means that a total of 39% of the diagnoses were accurate. The rest (8.9%) were diagnosed with other diagnoses, but not PTSD, as was the case in the initial assessment. Conclusion: The possibility for war veterans to obtain the right to disability and financial compensation due to a diagnosis of PTSD might interfere with the proper diagnostic assessment and thus the treatment outcome. During the procedures for the obtention of these rights, exaggeration or simulation of symptoms are common. The quality of the diagnostic assessment of PTSD can be improved by applying evidence based standardized procedures.
[Mh] Termos MeSH primário: Avaliação da Deficiência
Transtornos de Estresse Pós-Traumáticos/diagnóstico
Saúde dos Veteranos
Veteranos/psicologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Seguro por Invalidez
Masculino
Meia-Idade
Variações Dependentes do Observador
Equipe de Assistência ao Paciente
Valor Preditivo dos Testes
Prognóstico
Psiquiatria
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
Transtornos de Estresse Pós-Traumáticos/economia
Transtornos de Estresse Pós-Traumáticos/psicologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150124090S


  10 / 29539 MEDLINE  
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[PMID]:29191040
[Au] Autor:Reda OA
[Ad] Endereço:From the Department of Psychiatry, Providence Health & Services, Portland, Ore.
[Ti] Título:The War on Terror: Is There Ever Room for Compassion?
[So] Source:Am J Psychiatry;174(12):1144-1145, 2017 Dec 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Empatia
Psiquiatria/ética
Terrorismo
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.17091058



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