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Diagnosis And Treatment Of Syncope

November 17, 2018October 21, 2017 by admin

In the evaluation of patients with syncope, the critical first step is a detailed medical history. A diagnostic strategy based on initial evaluation is warranted. The importance of the initial evaluation goes well beyond its capability to make a diagnosis as it determines the most appropriate subsequent diagnostic pathways and risk evaluation.

THE DIAGNOSTIC STRATEGY BASED ON THE INITIAL EVALUATION

According to the Guidelines on Syncope of the European Society of Cardiology (ESC)1,2the “initial evaluation” of a patient presenting with syncope consists of taking a careful history, and a physical examination, including orthostatic blood pressure measurements and standard electrocardiogram (ECG).

Three key questions should be addressed during the initial evaluation:

• Is loss of consciousness attributable to syncope or not? Differentiating true syncope from “non‐syncopal” conditions associated with real or apparent transient loss of consciousness is generally the first diagnostic challenge and influences the subsequent diagnostic strategy....

Mental Health Disorders And Sexually Transmitted Diseases In A Privately Insured Population.

November 17, 2018October 21, 2017 by admin

Abstract

OBJECTIVES:

To consider whether patients who use mental health services in privately insured settings are also more likely to have received sexually transmitted disease (STD) or human immunodeficiency virus (HIV) diagnoses and whether this relationship extends to patients with milder mental health disorders.

METHODS:

Using frequency tables stratified by age and sex, a logistic regression model, and difference of means tests, we examined the relationship between mental health claims and STDs in a sample of 289 604 privately insured people across the United States.

RESULTS:

Patients with mental health claims were more than twice as likely as other patients to have an STD claim in the same year after controlling for confounding factors (odds ratio, 2.33; 95% confidence interval, 2.11-2.58). This relationship held for severe and milder mental health diagnoses, for male and female patients, and in each age category from 15 to 44 years...

State Laws Affecting the Voting Rights of People with Mental Disabilities

February 20, 2019October 21, 2017 by admin

In California

The Legislature shall provide for the disqualification of electors while mentally incompetent CAL. CONST. art. 2, § 4.

A person shall be deemed mentally incompetent, and therefore disqualified from voting, if, during the course of any of the proceedings set forth below, the court finds that the person is not capable of completing an affidavit of voter registration in accordance with Section 2150 and a conservator is appointed or the person has pled not guilty by reason of insanity. CAL. ELEC. CODE § 2208(a). If the proceeding under the Welfare and Institutions Code is heard by a jury, the jury shall unanimously find that the person is not capable of completing an affidavit of voter registration before the person shall be disqualified from votin...

The Impact Of Mental Illness On The Risk Of Employment Termination.

November 17, 2018October 21, 2017 by admin

Abstract

BACKGROUND: Mental illness can adversely impact labor market outcomes in a variety of ways, through education attainment, employment possibilities, and income. However, little is known about the impact of mental illness on an individual's ability to maintain employment.

AIMS OF THE STUDY: This paper examines the impact of mental health on the risk of employment termination. We also distinguish between voluntary and involuntary employment termination.

METHODS: Using data from the Medical Expenditure Panel Survey, we used survival analysis techniques to examine the impact of a mental illness diagnosis on the risk of employment termination and propensity score matching techniques to construct similar comparison groups. Initially, we used Cox proportional-hazards models where the event of interest was termination of employment. We then used a competing risk framework to differentiate between voluntary and involuntary employment termination. We also stratified our analysis b...

RESULTS:

Interference and Inhibition in Cognition and Behavior: Unifying Themes for Educational Psychology

November 17, 2018October 21, 2017 by admin

Abstract

In this article, we review modern work on interference and inhibition in cognition and behavior. We begin by briefly reviewing the historical and conceptual roots of this new body of work. Next we discuss five new theoretical frameworks that use the concepts of interference and inhibition to explain cognitive and behavioral phenomena. In the section that follows, we review evidence of individual and developmental differences in inhibition and susceptibility to interference in “at-risk” students. We then consider the implications of this new body of work for research on educational psychology by discussing six selected areas of research: intelligence, strategies, reading comprehension, logical and mathematical reasoning, self-regulated learning, and retention. In the next section, we explore four critical issues that pose significant challenges to research in inhibition and interference. Finally, we discuss the relevance of this work to educational practice by focusing on its implications for the curriculum and instruction....

Women And Hysteria In The History Of Mental Health

November 17, 2018October 20, 2017 by admin

Abstract

Hysteria is undoubtedly the first mental disorder attributable to women, accurately described in the second millennium BC, and until Freud considered an exclusively female disease. Over 4000 years of history, this disease was considered from two perspectives: scientific and demonological. It was cured with herbs, sex or sexual abstinence, punished and purified with fire for its association with sorcery and finally, clinically studied as a disease and treated with innovative therapies. However, even at the end of 19th century, scientific innovation had still not reached some places, where the only known therapies were those proposed by Galen. During the 20th century several studies postulated the decline of hysteria amongst occidental patients (both women and men) and the escalating of this disorder in non-Western countries. The concept of hysterical neurosis is deleted with the 1980 DSM-III. The evolution of these diseases...

Mental Health in Schools and Public Health

November 17, 2018October 20, 2017 by admin

Health policy and practice call for health and mental health parity and for a greater focus on universal interventions to promote, prevent, and intervene as early after problem onset as is feasible. Those in the public health field are uniquely positioned to help promote the mental health of young people and to reshape how the nation thinks about and addresses mental health. And schools are essential partners for doing the work.

Young People's Mental Health is a Major Public Health Concern

The figures usually indicated for diagnosable mental disorders suggest that between 12% and 22% of all youngsters under age 18 are in need of services for mental, emotional, or behavioral problems.1 The picture worsens when one expands the focus beyond the limited perspective on diagnosable mental disorders to encompass the number of young people experiencing psychosocial problems and those who are at risk...

Effective Services for Parolees with Mental Illnesses

November 17, 2018October 20, 2017 by admin

Abstract

This article is divided into four major sections. The first describes the factors that have resulted in persons with serious mental illnesses' (PSMIs') becoming a growing segment of the correctional population. The second explores the changing face of parole supervision and the implications of those changes for the care of PSMIs on parole. Section three discusses the prevalence of mental illnesses among adult prisoners and probationers and draws inferences from those data to the parolee population. Section three also explores mental health care for prison inmates and special programs for PSMIs on probation and parole. The article concludes with several suggestions for improving parole practices to meet the needs of PSMIs...

Responding to Subpoenas for Mental Health Records in California

November 17, 2018October 20, 2017 by admin

In any case where the Plaintiff seeks compensation for mental distress or anguish, Defendants may find themselves needing to subpoena mental health records to probe into pre-existing mental health issues and the extent of the Plaintiff's current complaints. These records are subject to safeguards above and beyond the average medical record. Medical providers may find themselves in a conundrum since they must be protective of the patient's mental health records to comply with state and federal laws, but they are also legally required to comply with the subpoena in a timely manner. Two California laws provide the framework for responding to a subpoena requesting mental health records:

1) The Lanterman-Petris -Short ("LPS") Act or California Welfare and Institutions Code, Section 5328 et. seq.; and 2) The California Confidentiality of Medical Information Act ("CMIA") or Civil Code Section 56 et. seq.

Below is information about each law to take into consideration when responding to a subpoena.

Lanterman-Petris-Short Act...

Securing Stable Housing

November 17, 2018October 20, 2017 by admin

For someone with a mental health condition, the basic necessity of a stable home can be hard to come by. The lack of safe and affordable housing is one of the most powerful barriers to recovery. When this basic need isn’t met, people cycle in and out of homelessness, jails, shelters and hospitals. Having a safe, appropriate place to live can provide stability to allow you to achieve your goals.

You may run into housing issues after being discharged from an inpatient care unit or jail and find that you have no home to return to. Even if you haven’t been hospitalized, finding an affordable home can be difficult. Many people with a serious mental illness live on Supplemental Security Income (SSI), which averages just 18% of the median income and can make finding an affordable home near impossible.

Finding stable, safe and affordable housing can help you on your journey to recovery...

Law & Psychiatry: Murder, Inheritance, and Mental Illness

November 17, 2018October 20, 2017 by admin

Abstract

Should a murderer be allowed to inherit the victim's estate? The question dates from biblical times, but most jurisdictions today have statutes in place that bar inheritance by convicted murderers. However, a special problem arises when the killer has a severe mental illness and has been found not guilty by reason of insanity. Should such people, who have not been convicted of a crime, be permitted to collect their inheritance? Jurisdictions vary in their responses, with the rules reflecting a mix of practical and moral considerations influenced by different perspectives about what determines the behavior of persons with mental illness. (Psychiatric Services 62:707–709, 2011)

Have you killed, and also taken possession?” the biblical prophet Elijah asked Ahab, King of Samaria, who with his wife, Jezebel, was being accused of having done precisely that (1). Embodied in Elijah's question is the moral intuition that wrongdoers should not profit from their...

Chapter 6 Mental Health Care for Hispanic Americans

November 17, 2018October 20, 2017 by admin

Introduction

The Spanish language and culture are common bonds for many Hispanic Americans, regardless of whether they trace their ancestry to Africa, Asia, Europe, or the Americas. The immigrant experience is another common bond. Nevertheless, Hispanic Americans are very heterogeneous in the circumstances of their migration and in other characteristics. To understand their mental health needs, it is important to examine both the shared and unique experiences of different groups of Hispanic Americans.

One of the most distinguishing characteristics of the Hispanic-American population is its rapid growth. In the 2000 census, sooner than forecast, the number of Hispanics counted rose to 35.3 million, roughly equal to the number of African Americans (U.S. Census Bureau, 2001a). In fact, census projections indicate that by 2050, the number of Latinos will increase to 97 million; this number will constitute nearly one-fourth of the U.S. population. Projections for the...

Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to be Feared?

February 21, 2019October 20, 2017 by admin

In the 1950s, the public defined mental illness in much narrower and more extreme terms than did psychiatry, and fearful and rejecting attitudes toward people with mental illnesses were common. Several indicators suggest that definitions of mental illness may have broadened and that rejection and negative stereotypes may have decreased since that time. Howevev, lack of comparable data over time prevents us from drawing firm conclusions on these questions. To address this problem, the Mental Health Module of the 1996 General Social Survey repeated a question regarding the meaning of mental illness that was first asked of a nationally representative sample in 1950. A comparison of 1950 and 1996 results shows that conceptions of mental illness have broadened somewhat over this time period to include a greaterproportion of non-psychotic disorders, but that perceptions that mentally ill people are violent or frightening substantially increased, rather than decreased...

The State of Mental Health on College Campuses: A Growing Crisis

November 17, 2018October 20, 2017 by admin

In a December 19 article, the New York Times reported on a phenomenon that colleges across the country are all too familiar with: the rising number of students grappling with serious mental health problems that are seeking treatment at campus counseling centers. The article brought attention to an alarming and growing trend that began in the early to mid-1990s. At that time, university and college counseling centers noticed a shift in the needs of students seeking counseling services from more developmental and informational needs, to more severe psychological problems.

In the past decade this shift has not only solidified, it has reached increasingly higher levels. In the 2010 National Survey of Counseling Center Directors, respondents reported that 44 percent of their clients had severe psychological problems, a sharp increase from 16 percent in 2000. The most common of these disorders are depression, anxiety, suicidal ideation, alcohol abuse..,

Investing In Global Mental Health: The Time For Action Is Now

November 17, 2018October 20, 2017 by admin

Despite widespread acknowledgement of the economic and global burden of mental disorders (as represented in years of life lost to disability and mortality), acting on these concerns and creating an investment plan for global mental health has been challenging. This failure can be explained by many factors, including scepticism about prevalence data for mental disorders. Without precise biological measures, these disorders might be viewed as being defined culturally by high-income countries, or as having overly inclusive criteria that reject traditional ideas of normal human suffering. Additionally, a perceived absence of effective treatments in low-income countries already facing overwhelming challenges of infectious diseases and other disorders and limited infrastructure might make attention to mental illnesses less of an immediate priority. Likewise, mental disorders might be more overtly associated with disability than death, despite evidence of early mortality due to suicide or other medical disorders.

Diagnosing Mental Illness Through Neuroimaging Scans

November 17, 2018October 20, 2017 by admin

Table of Contents: Older Methods Potential Benefits Possible Drawbacks Good Choices Find Out More

Diagnosing a mental illness isn’t always easy. In fact, it can be a subjective process that allows one clinician to see one disease, while another sees a different disease and a third sees nothing at all, even when all three medical practitioners are looking at the same patient. This kind of uncertainty can be annoying, but it can also lead to very serious problems, as some might not get the right diagnosis or the right treatment for a very real mental health issue.

In a perfect world, a person with symptoms of a mental illness could get a simple test that would definitively diagnose the problem or prove that no problem really exists. Some believe that neuroimaging scans provide this opportunity, but others aren’t so sure that the scans can ever take...