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Medicina
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The Therapeutic Landscapes and Patient Management in Psychiatry and Mental...
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The Therapeutic Landscapes and Patient Management in Psychiatry and Mental Health

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Psychiatry".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 5571

Special Issue Editors

Dr. Mihnea Costin Manea

E-Mail Website
Guest Editor
Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
Interests: affective disorders; psychotic disorders; anxiety; public health management; cognitive disorders; implications of neurodevelopmental disorders; comorbidities in psychiatry
Prof. Dr. Petru Ifteni

E-Mail Website
Guest Editor
Faculty of Medicine, Clinical Hospital of Psychiatry and Neurology Brașov, Transilvania University of Brașov, Brașov, Romania
Interests: schizophrenia; affective disorders; dementia; psychopharmacology

Special Issue Information

Dear Colleagues,

We believe that the introduction of a new Special Issue that focuses on mental health is crucial given the difficulties that the healthcare system is facing due to the rising prevalence of mental health disorders in patients with both acute and chronic illnesses.

A mental illness not only causes disruptions in the family but also society. Since psychiatry has developed alongside technological advancement, chronic disorders can now be treated with monotherapy.

Revolutionary chemicals reported to have fewer negative effects are helpful in this regard. Affective disorders and psychotic illnesses need prompt, specialized attention, just like any other chronic pathology, in order to help the patient.

Despite its decreasing relevance, the inherent stigma around psychiatry remains a social concern.

This Special Issue’s goal is to showcase current developments, cutting-edge theories of diagnosis, creative treatment strategies and innovative expectations related to affective, cognitive and psychotic disorders, chronic afflictions and comorbidities in psychiatry.

Dr. Mihnea Costin Manea
Prof. Dr. Petru Ifteni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • affective disorders
  • psychotic illnesses
  • stigma
  • treatment strategies
  • cognitive disorders
  • comorbidities in psychiatry

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (4 papers)

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Research

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15 pages, 1516 KiB  
Article
Comorbidity, Treatment, and Service Utilization Patterns in Difficult-to-Treat Depression Patients: A Retrospective Study in a Portuguese Community Mental Health Team
by João Gouveia, Marta Moura Neves, Nuno Madeira, Vítor Santos and António Macedo
Medicina 2024, 60(11), 1734; https://doi.org/10.3390/medicina60111734 - 22 Oct 2024
Viewed by 568
Abstract
Background and Objectives: Observational studies with data from real-world clinical practice with patients with difficult-to-treat depression (DTD) are rare. This study aims to collect observational data from the real-world clinical practice of a Portuguese community mental health team (CMHT) on the prevalence [...] Read more.
Background and Objectives: Observational studies with data from real-world clinical practice with patients with difficult-to-treat depression (DTD) are rare. This study aims to collect observational data from the real-world clinical practice of a Portuguese community mental health team (CMHT) on the prevalence of DTD and to explore differences between DTD and non-DTD groups. Materials and Methods: We conducted a retrospective chart review study using data from Electronic Health Records (EHRs) of adult patients with psychiatric disorders followed by a CMHT from the Department of Psychiatry of the Coimbra Local Health Unit (between 1 December 2020–31 December 2022). The Dutch Measure for quantification of Treatment Resistance in Depression (DM-TRD) was used to assess the degree of treatment resistance and the Charlson Comorbidity Index (CCI) to measure medical comorbidity. Results: A quantity of 473 patients were referred to Cantanhede CMHT for a first assessment. Of these, 219 patients met the criteria for a primary diagnosis of any depressive disorder. Assistant psychiatrists identified 57 patients with DTD during follow-up (approximately 26%). The DTD group had higher rates of depressive episodes, greater depression severity, increased service use, higher DM-TRD scores, and a higher prevalence of comorbid anxiety symptoms, personality disorders, and severe medical comorbidities. The DTD group also had a higher prescription rate of antidepressants. Differences were observed in the use of antidepressant augmentation strategies and in the prescription of anticoagulant/antiplatelet drugs and analgesics, with higher prescription rates in the DTD group. We found correlations between DM-TRD and CCI scores, and between DM-TRD scores and all service use variables. Conclusions: Our results are consistent with a similar study in the United Kingdom, highlighting the need for a different approach to the management of DTD patients, who continue to live with a significant burden despite usual pharmacological and non-pharmacological treatments. Full article
(This article belongs to the Special Issue The Therapeutic Landscapes and Patient Management in Psychiatry and Mental Health)
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13 pages, 2126 KiB  
Article
Inside the Hospitalization Voyage of Schizophrenia Care: A Single-Center Journey
by Răzvan Pop, Cătălina Angela Crișan, Ioana Valentina Micluția, Emilia Pop, Mihaela Iancu and Sorana D. Bolboacă
Medicina 2024, 60(8), 1214; https://doi.org/10.3390/medicina60081214 - 26 Jul 2024
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Abstract
Schizophrenia poses significant challenges for individuals and caregivers, often leading to recurrent hospitalizations. Limited information on patients with schizophrenia and multiple hospitalizations in Romania is available in the scientific literature. Our study aimed to evaluate the characteristics of patients with schizophrenia with multiple [...] Read more.
Schizophrenia poses significant challenges for individuals and caregivers, often leading to recurrent hospitalizations. Limited information on patients with schizophrenia and multiple hospitalizations in Romania is available in the scientific literature. Our study aimed to evaluate the characteristics of patients with schizophrenia with multiple hospitalizations in a single center in Cluj-Napoca, analyzing if specific patterns exist between patients with two or more hospitalizations or between men and women. We conducted a retrospective study on patients diagnosed with schizophrenia according to the 10th revision of the International Classification of Diseases (ICD 10), hospitalized at the County Emergency Hospital of Cluj-Napoca, Romania, between 2018 and 2022. Data on demographics, somatic comorbidities, symptom severity using the positive and negative syndrome scale (PANSS) or the brief psychiatric rating scale (BPRS), antipsychotic medication, and adverse effects were collected. We evaluated 62 patients, aged from 23 to 57 years, with 157 hospitalizations (ranging from two to seven per patient). No familial history of schizophrenia (56.5%) or bipolar disorder (71%) was reported by most patients. Forty-eight patients were male, and 45 had two hospitalizations. Age, sex, living place and conditions, season of birth, and marital status were similar in patients with two or more than two hospitalizations (p-values > 0.10). Significant differences were observed between patients with two or more than two hospitalizations regarding smoking (63.3% vs. 79.1%, p-value = 0.0029) and symptoms of fear at admission (40.0% vs. 65.7%, p-value = 0.0015). We observed lower scores in the overall PANSS and BPRS scores at discharge compared to admission (p-values < 0.001), regardless of the group (two or more than two hospitalizations, men vs. women). Men and women showed differences in hospitalization stays (median 17.25 vs. 15 days, p-value < 0.001) and BPRS scores at admission (p-value = 0.012) and discharge (p-value = 0.016). Fewer First-Generation Antipsychotics were prescribed for those with two admissions, and nearly half reported adverse effects, notably tachycardia (29%), with similar occurrence within groups. Our results showed that the candidate for multiple hospitalizations is a male, with a mean age of 37 years, unmarried, and living with someone in urban settings, more likely a smoker who exhibits fear symptoms. Full article
(This article belongs to the Special Issue The Therapeutic Landscapes and Patient Management in Psychiatry and Mental Health)
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12 pages, 1199 KiB  
Article
Effectiveness of Electroencephalography Neurofeedback for Improving Working Memory and Episodic Memory in the Elderly: A Meta-Analysis
by Yu-Ru Lin, Tien-Wei Hsu, Che-Wei Hsu, Peng-Yu Chen, Ping-Tao Tseng and Chih-Sung Liang
Medicina 2024, 60(3), 369; https://doi.org/10.3390/medicina60030369 - 22 Feb 2024
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Abstract
Background and Objective: Existing evidence indicates the potential benefits of electroencephalography neurofeedback (NFB) training for cognitive function. This study aims to comprehensively review all available evidence investigating the effectiveness of NFB on working memory (WM) and episodic memory (EM) in the elderly [...] Read more.
Background and Objective: Existing evidence indicates the potential benefits of electroencephalography neurofeedback (NFB) training for cognitive function. This study aims to comprehensively review all available evidence investigating the effectiveness of NFB on working memory (WM) and episodic memory (EM) in the elderly population. Material and Methods: A systematic search was conducted across five databases to identify clinical trials examining the impact of NFB on memory function in healthy elderly individuals or those with mild cognitive impairment (MCI). The co-primary outcomes focused on changes in WM and EM. Data synthesis was performed using a random-effects meta-analysis. Results: Fourteen clinical trials (n = 284) were included in the analysis. The findings revealed that NFB was associated with improved WM (k = 11, reported as Hedges’ g = 0.665, 95% confidence [CI] = 0.473 to 0.858, p < 0.001) and EM (k = 12, 0.595, 0.333 to 0.856, p < 0.001) in the elderly, with moderate effect sizes. Subgroup analyses demonstrated that NFB had a positive impact on both WM and EM, not only in the healthy population (WM: k = 7, 0.495, 0.213 to 0.778, p = 0.001; EM: k = 6, 0.729, 0.483 to 0.976, p < 0.001) but also in those with MCI (WM: k = 6, 0.812, 0.549 to 1.074, p < 0.001; EM: k = 6, 0.503, 0.088 to 0.919, p = 0.018). Additionally, sufficient training time (totaling more than 300 min) was associated with a significant improvement in WM (k = 6, 0.743, 0.510 to 0.976, p < 0.001) and EM (k = 7, 0.516, 0.156 to 0.876, p = 0.005); however, such benefits were not observed in groups with inadequate training time. Conclusions: The results suggest that NFB is associated with enhancement of both WM and EM in both healthy and MCI elderly individuals, particularly when adequate training time (exceeding 300 min) is provided. These findings underscore the potential of NFB in dementia prevention or rehabilitation. Full article
(This article belongs to the Special Issue The Therapeutic Landscapes and Patient Management in Psychiatry and Mental Health)
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Review

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12 pages, 1036 KiB  
Review
Exploring the Feasibility of Estrogen Replacement Therapy as a Treatment for Perimenopausal Depression: A Comprehensive Literature Review
by Xiuting Xiang, Praneetha Palasuberniam and Rahmawati Pare
Medicina 2024, 60(7), 1076; https://doi.org/10.3390/medicina60071076 - 30 Jun 2024
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Abstract
Perimenopausal depression (PMD) is a psychological disorder that occurs in women during perimenopause. In addition to the common clinical symptoms of depression, it often manifests as a perimenopausal complication, and its notable cause is the decline in estrogen levels. Despite numerous studies and [...] Read more.
Perimenopausal depression (PMD) is a psychological disorder that occurs in women during perimenopause. In addition to the common clinical symptoms of depression, it often manifests as a perimenopausal complication, and its notable cause is the decline in estrogen levels. Despite numerous studies and trials confirming the benefits of estrogen replacement therapy (ERT) for PMD, ERT remains unapproved for treating PMD. Therefore, we conducted a literature search using selected keywords in PubMed and Google Scholar to write a review discussing the feasibility of using ERT for PMD. This review examines the potential of ERT for PMD in terms of its underlying mechanisms, efficacy, safety, and time window. These four aspects suggest that ERT is a viable option for PMD treatment. However, the risk of thrombosis and stroke with ERT is a matter of contention among medical experts, with a paucity of clinical data. Consequently, further clinical trial data are required to ascertain the safety of ERT. Full article
(This article belongs to the Special Issue The Therapeutic Landscapes and Patient Management in Psychiatry and Mental Health)
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