International review of psychiatry
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Review
Rehabilitation: new term for or further development of social psychiatry? A Dutch perspective.
Social psychiatry as an academic discipline and field of clinical practice seems to have lost its prominence and is being incorporated in regular clinical services of mental healthcare and also in various branches of social, genetic, psychiatric or clinical epidemiology. However, the central debate in social psychiatry from its very beginning on how to care best for patients with severe mental illness (SMI) in the community, what to do with mental hospitals as potentially harmful pernicious institutions or with the hospitalization process, has never lost its momentum even in scientific meetings today. ⋯ Rehabilitation as an ideological and somewhat revolutionary movement of users and professionals in wanting to produce a fundamental change of mental healthcare (e.g. no compulsory treatment) and of society (e.g. elimination of stigma) developed its methods away from medicine and psychiatry and also away from testing these methods. Nowadays we observe growing scientific evidence for various psychosocial rehabilitative interventions which could substantiate the original mission of social psychiatry.
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Although Parkinson's disease (PD) has been considered to primarily affect motor abilities, increasing emphasis is being placed on cognitive and behavioural impairment in this disorder. Depression, dementia, psychosis and impulse control disorders have a major impact on quality of life for both patients and families. This article reviews cognitive and behavioural disturbances in PD and their relation to affective and motor symptoms, treatment of dementia associated with PD, and treatment approaches to psychosis in PD. We also discuss similarities between the dementia of PD and dementia with Lewy bodies.
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Mental health policy enables the translation of the knowledge base of 'how' to help children and families into the actual 'provision' of help. Amid competing pressures to leave the allocation of services to the market, policy is required to define needs, select priorities, match resources with need, and to measure what has been accomplished. Crafting policy requires balancing contrasting goals and approaches, here spelled out. Public mental health policy can be compared to other forms of continuous quality improvement (CQI).
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This paper discusses the tsunami disaster in Sri Lanka with special reference to Buddhism, which is the majority religion in the island. The role of religious beliefs and of religion in general in strengthening coping skills is well known. ⋯ This paper provides an overview of the relationship between culture and traumatic experiences, with a brief discussion of the role of religion in mental health. It then goes on to explore some relevant Buddhist concepts and practices which can be used in clinical settings.
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Sleepwalking and night terrors are considered to be manifestations of the same nosologic continuum. It has been proposed that a sudden arousal from non-rapid eye movement (NREM) sleep is the cause of these disorders. Benign forms of NREM arousal parasomnias occur frequently in childhood and attenuate in teen years; however, they can persist into or begin in adulthood. ⋯ Post-arousal EEG activity reveals altered consciousness during sleepwalking and sleep terror episodes. Pathophysiology of NREM arousal parasomnias consists of predisposing factors, which may be a genetically determined tendency for deep sleep, facilitating factors which deepen sleep and increase slow wave sleep, and triggering factors which increase sleep fragmentation, such as stress, environmental or endogenous stimuli, and stimulants. Recently published data on low delta power in the first sleep cycle and slow decline of delta power in successive sleep cycles suggest a chronic inability to sustain slow wave sleep.