A focused introduction to the importance of underpinning that a comprehensive understanding of a person’s behavioural, mental and emotional health issues, requires an understanding of the person, their environment and needs.
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
Premarital counseling is a type of therapy that helps couples prepare for marriage. Premarital counseling can help ensure that you and your partner have a strong, healthy relationship — giving you a better chance for a stable and satisfying marriage. This kind of counseling can also help you identify weaknesses that could become problems during marriage.
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
Premarital counseling is a type of therapy that helps couples prepare for marriage. Premarital counseling can help ensure that you and your partner have a strong, healthy relationship — giving you a better chance for a stable and satisfying marriage. This kind of counseling can also help you identify weaknesses that could become problems during marriage.
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
Separation Anxiety Disorder(SAD) is a psychological condition in which an individual has an excessive anxiety regarding separation from home or with whom the individual has a strong emotional attachment.
Milen xx philippines mental health promotion and practice strategiesMilen Ramos
PROMOTION OF MENTAL HEALTH AMONG WOMEN IN PHILIPPINES
CELEBRATION OF INTERNATIONAL WOMEN S DAY
STAGING MENTAL HEALTH PROMOTION AND SERVICES
INDIVIDUAL, COMMUNITY AND NATIONAL INTERVENTION
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Hard-hitting presentation about what is mental health with statistics that will open your eyes that this issue might be closer to home thank you think!
By Alison Roberts
Deals with the issue of child sexual abuse, how to identify the signs, how to handle situations related to child sexual abuse and penalties imposed by law, how to help a child who is a victim of sexual abuse and how to protect your child from sexual abuse.
in first few slide we have tried to explain briefly about psychotherapy and its type,later we have explained about the microbiological basis of psychotherapy
DR CONSTANT MOUTON - COULD DUAL DIAGNOSIS BE THE KEY TO PERSONALISED TREATMEN...iCAADEvents
As our knowledge about addiction is increasing the association between mental illness and addiction is better understood. The controversy about the appropriateness of the term Dual Diagnosis to describe such a heterogeneous group of patients has sparked a debate on treatment and assessment models. It highlighted the fact that as far as treatment modalities are concerned, one size might just not fit all. Dr Mouton reviews current knowledge on comorbidity in the addiction field. Focusing on more than psychiatric comorbidity, he also looks at physical, social, psychological, spiritual and cultural components affected by addiction. Describing the role of the psychiatrist in addiction care he poses the questions: What if dual diagnosis is actually the key to better understanding of our patients? What if this knowledge leads to more individualised treatments? And are we ready for personalised treatment in the addiction field?
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
Separation Anxiety Disorder(SAD) is a psychological condition in which an individual has an excessive anxiety regarding separation from home or with whom the individual has a strong emotional attachment.
Milen xx philippines mental health promotion and practice strategiesMilen Ramos
PROMOTION OF MENTAL HEALTH AMONG WOMEN IN PHILIPPINES
CELEBRATION OF INTERNATIONAL WOMEN S DAY
STAGING MENTAL HEALTH PROMOTION AND SERVICES
INDIVIDUAL, COMMUNITY AND NATIONAL INTERVENTION
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Hard-hitting presentation about what is mental health with statistics that will open your eyes that this issue might be closer to home thank you think!
By Alison Roberts
Deals with the issue of child sexual abuse, how to identify the signs, how to handle situations related to child sexual abuse and penalties imposed by law, how to help a child who is a victim of sexual abuse and how to protect your child from sexual abuse.
in first few slide we have tried to explain briefly about psychotherapy and its type,later we have explained about the microbiological basis of psychotherapy
DR CONSTANT MOUTON - COULD DUAL DIAGNOSIS BE THE KEY TO PERSONALISED TREATMEN...iCAADEvents
As our knowledge about addiction is increasing the association between mental illness and addiction is better understood. The controversy about the appropriateness of the term Dual Diagnosis to describe such a heterogeneous group of patients has sparked a debate on treatment and assessment models. It highlighted the fact that as far as treatment modalities are concerned, one size might just not fit all. Dr Mouton reviews current knowledge on comorbidity in the addiction field. Focusing on more than psychiatric comorbidity, he also looks at physical, social, psychological, spiritual and cultural components affected by addiction. Describing the role of the psychiatrist in addiction care he poses the questions: What if dual diagnosis is actually the key to better understanding of our patients? What if this knowledge leads to more individualised treatments? And are we ready for personalised treatment in the addiction field?
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
A PPT of Addiction Counseling by Dr Komal Verma.
Addiction counselors help patients overcome dependence on drugs, alcohol, and destructive behaviors like gambling. Counselors intervene when patients are often at their lowest points in their struggles with addiction. A certified drug and alcohol counselor may also work with the families of addicts to assist the healing process. These professionals may work in outpatient facilities, inpatient rehabilitation centers, halfway houses, or hospitals.
This program is part of a comprehensive School Mental Health and High School Curriculum Guide.
Find out more about the guide by visiting:
teenmentalhealth.org
Psychiatric Disorders in Chemically Dependent Individuals - October 2012Dawn Farm
This program provides an overview of co-occurring addiction and psychiatric illness, including standard diagnostic criteria, individual considerations for determining the appropriate course of treatment, available treatment interventions, and the perspectives of both the addict and the treatment provider on addiction and psychiatric illness. It is presented by Dr. Patrick Gibbons, LMSW, DO; Adjunct Clinical Instructor in Psychiatry at the University of Michigan; Medical Director of the WCHO Community Crisis Response Team; consultant with Pain Management Solutions in Ann Arbor; Medical Director of the Michigan Health Professionals Recovery Program, and Medical Director of Dawn Farm. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
Identifying and Treating Individuals and Families Experiencing Early and Acut...Sarah Amani
The main objective of this online workshop was to raise awareness about symptoms of psychosis and how to support individuals and families experiencing prodrome, early and acute psychosis in different settings ranging from primary care, community mental health and acute hospital
Similar to Co-occurring Disorders: The Rule, Not The Exception : Constant Mouton (20)
iCAAD Paris 2019 - Stuart Fenton - LGBT, the Courageous Communitiy: from stig...iCAADEvents
Stu Fenton will address the many specificities of the LGBT communities and individualities through a multifaceted approach linking identity quest, painful stigmas of Chemsex and addiction, and most importantly the courage and mindfulness of a community facing its challenges with hope and determination. We have so much to learn here.
Could it well be that a Minority is actually leading the Majority by example of self-discovery and self-introspection? As Stu Fenton & al. proposed in Berlin in 2018: “Surely gay culture is not just something depressing? It’s also about self-discovery, adventure, relating to a group of peers, have meaningful relations, reaching out to others in order to lift each other up and having all sorts of primal instincts satisfied.”
iCAAD Paris 2019 - Dr Colleen Kelly - Addiction and families - the solution i...iCAADEvents
How does the alcoholic or addicted individual effect the family and community? In what way do they equally become sick? What does intervention, treatment and aftercare look like for the family and how does this effect the individual with addiction?
This masterclass will examine the origins of addiction throughout a family’s history and find new ways to transform those old stories of shame and blame to survival and resilience. Participants will be provided a number of key points aimed at enhancing professional knowledge and performance. We will examine alternative ways to think beyond individual treatment, which include the entire family not only though current Family Therapy models, but by examining the stories and pain of past generations. This cutting-edge thinking regarding family work can transform the lives of generations yet to come who may escape the prison of addiction due to our ability to stand with our clients in their multigenerational story of trauma and adaptation. In conclusion, participants will examine how family therapy techniques including examining generations of Transgenerational Grief provide an opportunity for feelings that have been previously denied and lost in the family story can be named, explored, reframed and viewed as strength and hope.
iCAAD Paris 2019 - Chris John - Understanding the impact of transgenerational...iCAADEvents
This presentation will explain what transgenerational trauma is and highlight how parent-to-child carried emotional dynamics impact the child development and lead to mental health issues and addiction in adulthood. 64% of addicts had severe adverse childhood experience, abuse and trauma. Using the Adverse Childhood Experience Study (ACE) and its findings, participant will be presented with assessment and intervention tools directly applicable to their clinical and psychosocial work and practice. “It’s never too late to have a happy childhood”.
iCAAD London 2019 - Dr Alberto Pertusa - Addiction treatment: What new medica...iCAADEvents
In this presentation, Consultant Psychiatrist and international addictions specialist, Dr McPhillips, will provide an overview of emerging medical treatments for addiction and Dr Pertusa will discuss ADHD & addiction.
iCAAD London - Elizabeth Hampson and Kay Forsythe - THRIVING AT WORK, THE CAS...iCAADEvents
Deloitte believes that there is an unarguable business case for supporting individuals with mental health challenges, and creating mentally healthy working conditions. This case is not simply a financial one, although the costs of poor mental health are significant. Creating the right conditions for all colleagues to thrive has significant human and societal impact.
iCAAD London 2019 - Dr John Goldin - WORKING WITH THE MEDIA TO PROMOTE CHILD ...iCAADEvents
In this talk Dr Jon Goldin will discuss his experience of working with the media, illustrate this with examples, and offer advice and guidance for those who might undertake this kind of work.
iCAAD London 2019. Monday 6th May. Mark Drax - WE REPEAT WHAT WE DON'T REPAIR...iCAADEvents
We are only as sick as our secrets! An oft-used recovery phrase; but what does it actually mean? Any sort of trauma or abuse experienced in childhood can lead to us keeping secrets. We believe that what happened to us was our fault and we keep it hidden away.
iCAAD London 2019 - Dr Stefanie Carnes - COMPLEX TRAUMA IN WOMEN WITH COMPULS...iCAADEvents
Complex Trauma in Women with Compulsive and Addictive Sexual Behaviour Often compulsive and addictive behaviour is thought of as a male problem, however, more and more women are coming forward struggling with the behaviour.
iCAAD London 2019 - Dufflyn Lammers - RESILIENCE GAMESiCAADEvents
RESILIENCE GAMES is an experiential workshop that creates an empowering journey guiding participants through the discovery of all four types of resilience
iCAAD London 2019 - Stefanie Carnes - SEXUALLY COMPULSIVE AND ADDICTIVE BEHA...iCAADEvents
In recent years there has been tremendous controversy about sexually compulsive behaviour. Researchers and clinicians alike have argued about the best terminology to use, diagnostic criteria, and treatment approaches. In this presentation, Dr. Carnes discusses the concerns about labelling out control sexual behaviour and examines the new research and the controversy surrounding the diagnosis. Different perspectives on conceptualisation of the disorder and treatment will be discussed.
iCAAD London 2019 - Mel Pohl - CHRONIC PAIN AND ADDICTION: HOW WE MISSED THE...iCAADEvents
Chronic Pain occurs as a complicated web of emotions and physical symptoms. The most common way to treat pain is to use opioid medications, which actually complicate the course of chronic pain.
iCAAD London 2019 - Dr Michael McCann and Sarah Chilton - ADDICTION IN THE W...iCAADEvents
In this presentation, participants will learn the impact of addiction on an organisation and the implications for senior executives to develop a comprehensive Alcohol and Drug policy and Management Programme within a corporate setting.
London iCAAD 2019 - Daniel Souery - A TRANSDIAGNOSTIC APPROACH FOR PSYCHIATRI...iCAADEvents
Diagnostic approaches applied in psychiatry are often criticized and deemed unsatisfactory because of their relative lack of reliability and validity. One reason for this complexity lies in the purely symptomatic approach to diagnosis. This approach also results in misdiagnosis, difficulties and high risk of aberrant therapeutic choices. The problem is also the source of great difficulty in differentiating the normal from the pathological in situations of emotional and psychological distress that should not be the subject of a psychiatric diagnosis.
iCAAD London 2019 - Sheri Laine - MAINTAINING EQUILIBRIUM IN THE HERE AND NO...iCAADEvents
Designed for professionals working in Behavioural Mental and Emotional Health, this workshop will pinpoint mind-body techniques including, Meditation, Mindfulness, Acupuncture, Nutrition and Exercise.
London iCAAD 2019 - Nick Barton and Kirby Gregory - THE HEALTHY CONTAINERiCAADEvents
The combination presentation/workshop will examine the concepts of containment and holding environments and explore how they might apply to addiction treatment in terms of their implications for practice, service delivery and organisational development.
iCAAD London 2019 - Clarinda Cuppage and Lou Lebentz - NUMBING THE PAIN: CHI...iCAADEvents
Childhood sexual abuse (CSA) has seemed at the forefront of many news items recently and increasingly out there in the public domain. The statistics quoted in the UK are 1 in 4 women and 1 in 6 men are survivors, higher in other countries such as the USA. Indeed, most of our addiction clients tend to present with underlying trauma, many as a result of CSA. So as clinicians and treatment providers how do we deal with this epidemic in terms of numbers and the resultant increased disclosures and presentations?
iCAAD London 2019 - Chip Somers - REHAB – DEAD OR ALIVE?iCAADEvents
In this presentation Chip will talk about the parlous state of rehab. How it is possible that we have gotten to the point where we have all these rehabs but you can only really get in to them if you have money? How have we let local councils take over the medical care of addicts and alcoholics? How have we tolerated a system so clearly broken to continue?
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Co-occurring Disorders: The Rule, Not The Exception : Constant Mouton
1. Dr C Mouton
MBChB, FCPsychSA, KNMG Psychiatrist
Medical Director Triora
c.mouton@triora.com
Co-occurring Disorders:
The Rule, Not The Exception
iCAAD Amsterdam November 2018
2. Disclosure
(Potential) conflict of interest None
Relevant relations with industry None
Sponsoring or research money
Honorarium or financial payments
Shareholder
Other
None
None
None
None
3. Definition of addiction (1)
Addiction is a primary, chronic disease of brain reward,
motivation, memory and related circuitry. Dysfunction in these
circuits leads to characteristic biological, psychological, social
and spiritual manifestations. This is reflected in an individual
pathologically pursuing reward and/or relief by substance use
and other behaviors.
https://www.asam.org/resources/definition-of-addiction
4. Definition of addiction (2)
Addiction is characterized by inability to consistently abstain,
impairment in behavioral control, craving, diminished
recognition of significant problems with one’s behaviors and
interpersonal relationships, and a dysfunctional emotional
response. Like other chronic diseases, addiction often involves
cycles of relapse and remission. Without treatment or
engagement in recovery activities, addiction is progressive and
can result in disability or premature death.
https://www.asam.org/resources/definition-of-addiction
9. How frequently does it occur?
Lifetime prevalence of mood disorders 20,1%
Lifetime prevalence of anxiety disorders 19,6%
Lifetime prevalence of ADHD 9,2%
Lifetime prevalence of any mental illness 42,7%
Lifetime prev.: substance related disorders 19,1%
Lifetime prev: SUD in severe mental illness 40% - 60%
Pts in addiction units with mental illness 60% - 80%
De Graaf et al, NEMESIS-2
10. How frequently does it occur?
Schizophrenia also with SUD 47%
Bipolar also with SUD 52% - 56%
Depression also with SUD 19% - 27%
ADHD also with SUD 20% - 25%
Anxiety disorders also with SUD 24% - 35%
Post Traumatic Stress Disorder also with SUD 22% - 43%
Personality Disorders also with SUD 44%
(Alcohol)
NIDA
11. How frequently does it occur?
Lifetime prevalence: any other psychiatric disorder 97%
+ alcohol use disorder 75%
+ drug use 40%
Personality disorders > 60%
Mood disorders ~ 50%
Anxiety disorders > 40%
Pathological Gambling Disorder
Kesser RC, (2008) Petry (2005)
12.
13. Experimental
To feel good
Why do people start using?
To feel better
To do better
27. Diagnosis – some aspects
Does it matter?
Only diagnose if you are trained to do so
Be careful with sharing provisional / differential diagnoses
Stay clear of lay diagnoses
Questionnaires are never diagnostic
Capture the Big Picture
Psychodynamic diagnosis
DSM-5 / ICD
30. Recovery from the patients perspective
Feeling supported by family and peers and being able to
participate in the community - BEING CONNECTED
Holistic and individualized treatment approach, seeing
the person “behind the symptoms” – INDIVIDUALIZED
TREATMENT/ SHARED DECISION MAKING
De Ruysscher C, et al.. The Concept of Recovery as Experienced by Persons with Dual Diagnosis: A Systematic Review
of Qualitative Research From a First-Person Perspective. J Dual Diagn. 2017 Jul 12:1-16.
31. Recovery from the patients perspective
Having personal beliefs, such as fostering feelings of
hope, building a new sense of identity, gaining
ownership over one's life, and finding support in
spirituality – SPIRITUALITY
Importance of meaningful activities that structure one's
life and give one motivation to carry on -
MEANINGFULLNESS
De Ruysscher C, et al.. The Concept of Recovery as Experienced by Persons with Dual Diagnosis: A Systematic Review
of Qualitative Research From a First-Person Perspective. J Dual Diagn. 2017 Jul 12:1-16.
36. Same team
Same location
Same time
More effective than parallel treatment
At least ten studies show integrated treatment is more
effective than traditional sequential treatment
Drake et al, Schiz Bulletin 1998; Drake et al, Psych Services 2001 for summaries
Integrated Dual Disorder Treatment
37. Multidisciplinary Team
Stage-Wise Interventions (stages of change, stages of
treatment)
Access to Comprehensive Services (e.g., residential, etc.)
Time-Unlimited Services Assertive Outreach
Motivational Interventions (And invitational interventions,
ARISE?)
Substance Abuse Counseling
Drake et al, Schiz Bulletin 1998; Drake et al, Psych Services 2001 for summaries
Integrated Dual Disorder Treatment
38. Group Treatment
Family Participation
Participation in Alcohol & Drug Self-Help Groups
Pharmacological Treatment
Interventions to Promote Health
Secondary Interventions for Treatment of Non- Responders
Drake et al, Schiz Bulletin 1998; Drake et al, Psych Services 2001 for summaries
Integrated Dual Disorder Treatment
41. Mental Health Law Addiction Psychiatrist Person Of Medical Social Recovery Psychologist
Nurse Enforcement Counsellor Concern Doctor Work Specialists
52. Dr C Mouton
MBChB, FCPsychSA, KNMG Psychiatrist
Medical Director Triora
c.mouton@triora.com
Thank You
Editor's Notes
Definition of addiction looks like any other mental health disorder
1. Kessler RC, Hwang I, LaBrie R, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med. 2008;38(9):1351–60.
2. Petry NM, Stinson FS, Grant BF. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2005;66(5):564–74.
Why do people start with addictive substances or behaviours?
What happens if dual disorders are not treated?
QUESTION: Are these recognisable from your own practice?
1. Do not diagnose if you are not trained for diagnosing.