Mental health nurse education supports institutional psychiatric practice in an insufficiently questioning way. Its formal curricula in universities are often undermined by the informal curricula of practice environments. As an institution, mental health nursing pays insufficient attention to both these issues because it is an arguably un-reflexive and rule-following discipline.
Neuroscientist and psychologist Marc Lewis, author of “The Biology of Desire: Why Addiction Is Not A Disease,” suggests in the Guardian that treating addiction as if it is a learned pattern of thinking, rather than a medical illness, gives addicts the chance to stay clean. “As a neuroscientist, I recognise that the brain changes with addiction, but I see those changes as an expression of ongoing plasticity in an organ designed to change with strong emotions and repeated experiences. Similar changes have been recorded when people fall in love, become obese, gamble compulsively, or overindulge on the internet,” Lewis writes. “And as a developmental psychologist (my other hat), I see addiction as an attitude or self-concept that grows and crystallises with experience, often initiated by difficulties in childhood or adolescence.”
Long-term treatment with antipsychotic drugs is currently considered the standard treatment for patients diagnosed with ‘schizophrenia.’ A new study challenges this practice, however. The results, published this month in Psychological Medicine, reveal that patients who were not taking antipsychotic drugs had significantly higher levels of functioning than medicated patients.
A new study suggests that most people diagnosed with depressive, anxiety, and substance abuse disorders recover without treatment within a year of diagnosis. “This study further supports the argument that meeting diagnostic criteria for a mental disorder does not necessarily indicate a need for mental health treatment,” the researchers, led by Jitender Sareen from the University of Manitoba, write.
Earlier this year, the US Preventative Services Task Force (USPSTF) came out with the controversial recommendation that all adolescent and adult patients undergo depression screening in primary care. A new study, published in the Canadian Journal of Psychiatry, calls this recommendation into question. Researchers led by Brett Thombs from McGill University reviewed the accuracy of the existing screening instruments used for the detection of depression in children and adolescents and found insufficient evidence for their use.
For The Lancet, Jules Morgan reviews a new book, “The Brain’s Way of Healing,” by psychiatrist and psychoanalyst Norman Doidge. Doidge challenges current understandings of how the brain works and presents neuroplasticity as a means by which cognitive and motor functions can be regained once damaged. “If neuroplasticity is now accepted in neuroscience,” he writes, “why are these clinical approaches that make use of it not more widely available and mainstream?”
Psychiatrists and psychologists have traditionally taken distinct approaches toward mental health and, according to a new study, these differences may be here to stay. Researchers in the UK surveyed psychiatrists and psychologists in training about their perspectives on the causes of mental health issues and found that, despite attempts to integrate the field, the two disciplines “continue to sit at opposite ends of a biological/psychological spectrum.”
A new study investigating fifteen years of patient records at a Midwestern hospital found that psychiatrists almost always responded to patient complaints about their relationships by prescribing antidepressants, despite the fact that these complaints had little to do with the DSM criteria for depression. The study’s lead author, Jonathan Metzl, a professor of Sociology and Medicine, Health and Society at Vanderbilt, suggests that after the decision in 1974 to remove homosexuality from the DSM, psychiatry continued to enforce forms of socially accepted relationships through the prescription of antidepressants.
For The Times, Labour MP Luciana Berger writes about her concerns with the increased use of antidepressants. “Antidepressants should never be prescribed as a first response to mild depression,” she writes. “Psychological therapies are what the National Institute for Health and Care Excellence (NICE) recommends. Unlike fluoxetine, citalopram and the rest, talking therapies are non-addictive and can be matched to a patient’s needs.”
Recently, the Supreme Court of Canada ruled that adults with a “grievous and irremediable” condition have a right to medically assisted suicide. In an effort to legislate this right, a parliamentary committee was formed that suggested extending this definition to nonterminal medical conditions, including psychiatric disorders. In response, the Canadian Medical Association Journal printed an editorial by bioethics and public health experts Scott Kim and Tudo Lemmens. Kim and Lemmens argue that extending assisted dying laws to include patients diagnosed with psychiatric disorders “will put many vulnerable and stigmatized people at risk.”
Every one of the Fageda Cooperative’s 300 workers – from milking shed to packing plant – will tell you that this cooperative makes the finest yogurt in all Spain, if not in the world. Last year, they made 1.4 million yogurts every week. In Catalonia, only Nestle and Danone sell more. But Fageda isn’t in business to make yogurt. For over 30 years, its sole mission has been to provide fully-paid, flexible employment to anyone from the region diagnosed with a mental health problem but who still wants to work.
In the Washington Post psychiatrist, Samantha Boardman argues that counselors should focus on a patient’s strengths instead of what they perceive as being wrong. “The researchers found that deliberately capitalizing on an individual’s strengths outperforms a treatment that compensates for an individual’s weaknesses,” she writes. “This challenges the assumption held by many health professionals that we need to fix the problem before focusing on anything else.”
Richard Smith, the former editor of The BMJ, reports back from a meeting in the Netherlands last week featuring former DSM-IV chair, Allen Frances, and Peter Gøtzsche, a Danish physician, researcher, and leader of the Nordic Cochrane Center. “Dutch psychiatrists, it was explained to me, are feeling vulnerable because there are too many of them. They have two treatments to offer–drugs and psychotherapy. But the Netherlands has many clinical psychologists, and they have taken over the psychotherapy,” Smith writes. “Psychiatrists are left with drugs and anxiety about their future.”
Ever since I recovered from pharmaceutical abuse that nearly killed me over a decade ago, I haven’t used mental health services. There were many reasons for this and I can’t say I was always decidedly against them for myself, or entirely convinced I couldn’t be helped by a good therapist. And then I got lucky, and found someone I can talk to each week.
In an interview with the Scientific American, Stanford psychiatrist and neuroscientist, Amit Etkin, comments on the “wrong path” that psychiatry has taken as a field and his hopes for the future. “A report that came out recently in Health Affairs showed that spending within our health system in the U.S. is greater for mental illness than for any other area of medicine, and yet our understanding of these illnesses is incredibly backwards. Treatments are no different than they were 40 years ago, so that feels like a problem that is only getting bigger without an obvious solution,” Etkin writes. “The long and short of it is that people have named syndromes or disorders that they don’t actually know represent a valid entity that is distinct from another entity.”
Trauma-focused cognitive behavioral therapy (Tf-CBT) is effective at reducing the symptoms associated with PTSD in children and adolescents, according to a new trial out of Germany. The multicenter randomized control trial, published this month in the journal Psychotherapy and Psychosomatics, found the intervention to be significantly superior to control conditions at reducing negative emotional and behavioral responses following various types of trauma and abuse.
A new meta-analysis finds that the large antidepressant effects of exercise may have been underestimated in previous reviews. This latest report, published this month in the Journal of Psychiatric Research, examines twenty-five previous studies and concludes that regular exercise has a large and significant antidepressant effect in people diagnosed with moderate and severe depression.
The Association for Advancement in Philosophy and Psychiatry is issuing a call for abstracts, with a particular interest in submissions from service users. The 29th annual meeting, to be held next May 20th to 21st , 2017 in San Diego, California, will feature keynote presentations from MIA contributors Joanna Moncrieff and Nev Jones, among others.
A first of its kind neuroscience study, published this month in Cerebral Cortex, found changes in the brain electrical activity of infants exposed to SSRI antidepressants during pregnancy. The changes are associated with less-organized communication between the brain’s hemispheres and are comparable to the effects found in previous animal studies. The researchers call for more critical evaluations of the prescription of antidepressants during pregnancy and suggest that non-pharmacologic and therapeutic alternatives should be the preferred treatment.
Many experts expressed concern when the rate of antipsychotic prescriptions to children in foster care showed a rapid increase, peaking in 2008, and new recommendations and policies have tried to curb the use of these drugs. While the rate has plateaued, a new study points out that the “new normal” prescription levels are still dangerously high. The data reveals that almost one in ten children in foster care are currently being prescribed antipsychotic drugs with dangerous side-effects, many for diagnoses like ‘ADHD’ and disruptive behavior.
In December, MIA reported on a systematic Cochrane review on the research for the safety and effectiveness of Ritalin (methylphenidate) that found substantial bias in previous studies and a lack of quality evidence. Major medical associations, however, recommend this drug as a treatment for children and teens diagnosed with ‘ADHD.’ In a major step, the Journal of the American Medical Association (JAMA) has issued a “Clinical Evidence Synopsis” that reiterates the Cochrane findings and calls for guidelines to be reevaluated.
A new study, published in BMJ Open-Access this week, found a significant link between the level of air pollution in a community and the mental health of the children living there. After controlling for socio-economic status and other potential variables, researchers in Sweden discovered a strong association between the concentration of air pollution in a neighborhood and the amount of ‘antipsychotic’ and psychiatric drugs prescribed to children. The link remained strong even at pollution levels well below half of what is considered acceptable by the World Health Organization (WHO).
If a patient has high cholesterol or sugar, the doctor may prescribe a drug to lower what is too high, but he/she generally adds some suggestions: for instance to avoid certain types of food, to do more physical activity, to refrain from smoking. But if someone has a low mood and sees medical help, the doctor–particularly if he or she is a psychiatrist–will likely just prescribe a drug and not encourage any “self-therapy.” The problem with his approach to care is that psychiatric drugs, even when they are properly prescribed, may help very little in the long run and create a number of additional problems
As part of NBC's 'On Assignment' series reporter Kate Snow took a closer look at the prescribing of antipsychotic drugs "off-label" to children. The story focuses on Steven Francesco, a former drug company executive whose son died suddenly while taking antipsychotics. Originally planned to air on Sunday, June 12th the episode is now being rescheduled.
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