Introduction: Postpartum psychiatric disorders are defi ned as mental disturbances, occurring in women of childbearing age within four weeks of childbirth, which leads to illnesses that create considerable family distress and vulnerability which impairs a woman’s capability to do her normal work and manage her baby care. Postpartum depression, which is frequently failed to notice by primary health care providers, has been linked by means of turbulence in the mother-infant association and bonding in the child’s cognitive and emotional development.
Materials & Methods: A total of 50 postpartum female who were attending the Owaisi Hospital & Princess ESRA hospital were
randomly selected for the present study. Socio demographic data was gathered by using semi structured questionnaire. The SCL-90 is intended to measure symptom intensity on nine different subscales. The HAM-D was widely used to assess symptoms of depression.
Results: Primiparity is associated with greater severity of Somatic, Depressive, Anxiety symptoms. Spontaneous remission or lowering of severity of psychological symptoms is seen through one week to four of postpartum period. Type of delivery was not associated with the severity of psychological symptoms.
Presented at Bengkel Latihan Pengumpulan Data Kajian Postnatal Depression- Malaysia Aspire 2016, Hotel Concorde, Shah Alam, 21-24 Ogos 2016, and Bengkel Latihan Pengumpulan Data Kajian Postnatal Depression- Malaysia Aspire 2016, Hotel Klagan, Kota Kinabalu, Sabah, 26-29 Ogos 2016.
Management of Psychiatric Emergencies at Primary Care: Suicide and AggressionTuti Mohd Daud
These slides are not meant to be comprehensive in covering the two major topics in psychiatric emergencies. Readers are encouraged to refer to the references provided for further reading.
This document discusses psychiatric assessment. It describes the purpose of assessment as making a diagnosis for clinical, forensic, or medico-legal reasons. Methods of assessment include taking patient history, conducting a mental status examination, mini mental status examination, physical examination, investigations, and using assessment tools. A nursing assessment also includes risk assessment and obtaining background health information.
Addiction psychiatry focuses on evaluating, diagnosing, and treating people suffering from substance use and other addictive disorders. It is a medical subspecialty within psychiatry that has expanded due to growing scientific knowledge about addiction and treatments. Addiction psychiatrists must be certified general psychiatrists who have completed an accredited residency program in addiction psychiatry in order to treat addiction along with any co-occurring psychiatric conditions using medication, psychotherapy, and other methods.
This document provides information on the management of schizophrenia. It defines schizophrenia and its symptoms. It discusses the phases of treatment including acute, stabilization, and maintenance phases. It covers diagnostic evaluation, pharmacological treatment including antipsychotic medication selection and dosing, and non-pharmacological treatment. It also addresses management of agitation, treatment of relapse, and prevention of recurrence. The goal of treatment is to control symptoms, reduce risk of relapse, and help patients improve functioning.
Crisis situations can negatively impact a person's productivity and relationships. Nurses must be equipped to help patients and families overcome crises. A crisis is perceived as an intolerable difficulty exceeding one's coping abilities. It is precipitated by identifiable events, personal in nature, acute, and time-limited. Nurses assess contributing factors and intervene using techniques like catharsis, clarification, and exploring solutions. The goal is to provide a correct understanding of the situation and help manage intense emotions, ensuring safety and strengthening coping skills to aid in resolution. Mobile crisis programs, hotlines, and health education aim to minimize crises' harmful effects.
This study investigated the relationships between childhood trauma, psychological symptoms, and barriers to seeking mental health care among college students. It was hypothesized that childhood trauma would be correlated with both psychological symptoms and barriers to care, and that psychological symptoms would mediate the relationship between childhood trauma and barriers. Participants completed questionnaires measuring these constructs. Results found childhood trauma was correlated with both psychological symptoms and barriers to care. Psychological symptoms also mediated the relationship between childhood trauma and barriers, such that the relationship was weaker when accounting for psychological symptoms. This suggests childhood trauma influences barriers indirectly through its effect on increasing psychological symptoms.
The document provides information about World Mental Health Day, including:
1) It was established in 1992 by the World Federation for Mental Health to raise awareness about mental health issues around the world.
2) Each year it has a different theme such as depression, schizophrenia, mental health of older adults, and youth mental health.
3) The 2020 theme is "Mental Health for All" with a focus on increasing investment and access to mental health services globally.
Presented at Bengkel Latihan Pengumpulan Data Kajian Postnatal Depression- Malaysia Aspire 2016, Hotel Concorde, Shah Alam, 21-24 Ogos 2016, and Bengkel Latihan Pengumpulan Data Kajian Postnatal Depression- Malaysia Aspire 2016, Hotel Klagan, Kota Kinabalu, Sabah, 26-29 Ogos 2016.
Management of Psychiatric Emergencies at Primary Care: Suicide and AggressionTuti Mohd Daud
These slides are not meant to be comprehensive in covering the two major topics in psychiatric emergencies. Readers are encouraged to refer to the references provided for further reading.
This document discusses psychiatric assessment. It describes the purpose of assessment as making a diagnosis for clinical, forensic, or medico-legal reasons. Methods of assessment include taking patient history, conducting a mental status examination, mini mental status examination, physical examination, investigations, and using assessment tools. A nursing assessment also includes risk assessment and obtaining background health information.
Addiction psychiatry focuses on evaluating, diagnosing, and treating people suffering from substance use and other addictive disorders. It is a medical subspecialty within psychiatry that has expanded due to growing scientific knowledge about addiction and treatments. Addiction psychiatrists must be certified general psychiatrists who have completed an accredited residency program in addiction psychiatry in order to treat addiction along with any co-occurring psychiatric conditions using medication, psychotherapy, and other methods.
This document provides information on the management of schizophrenia. It defines schizophrenia and its symptoms. It discusses the phases of treatment including acute, stabilization, and maintenance phases. It covers diagnostic evaluation, pharmacological treatment including antipsychotic medication selection and dosing, and non-pharmacological treatment. It also addresses management of agitation, treatment of relapse, and prevention of recurrence. The goal of treatment is to control symptoms, reduce risk of relapse, and help patients improve functioning.
Crisis situations can negatively impact a person's productivity and relationships. Nurses must be equipped to help patients and families overcome crises. A crisis is perceived as an intolerable difficulty exceeding one's coping abilities. It is precipitated by identifiable events, personal in nature, acute, and time-limited. Nurses assess contributing factors and intervene using techniques like catharsis, clarification, and exploring solutions. The goal is to provide a correct understanding of the situation and help manage intense emotions, ensuring safety and strengthening coping skills to aid in resolution. Mobile crisis programs, hotlines, and health education aim to minimize crises' harmful effects.
This study investigated the relationships between childhood trauma, psychological symptoms, and barriers to seeking mental health care among college students. It was hypothesized that childhood trauma would be correlated with both psychological symptoms and barriers to care, and that psychological symptoms would mediate the relationship between childhood trauma and barriers. Participants completed questionnaires measuring these constructs. Results found childhood trauma was correlated with both psychological symptoms and barriers to care. Psychological symptoms also mediated the relationship between childhood trauma and barriers, such that the relationship was weaker when accounting for psychological symptoms. This suggests childhood trauma influences barriers indirectly through its effect on increasing psychological symptoms.
The document provides information about World Mental Health Day, including:
1) It was established in 1992 by the World Federation for Mental Health to raise awareness about mental health issues around the world.
2) Each year it has a different theme such as depression, schizophrenia, mental health of older adults, and youth mental health.
3) The 2020 theme is "Mental Health for All" with a focus on increasing investment and access to mental health services globally.
This document discusses the psychological problems experienced by patients in critical care units. It begins by defining critical care and explaining the common medical conditions that result in admission to critical care units. It then explores the psychological effects of the critical care environment, which can include stress, anger, depression, anxiety, PTSD, and sleep problems. Specific psychological problems addressed include stress, anger, depression, anxiety, PTSD, delirium, helplessness, hopelessness, low self-esteem, and body image issues. The document concludes by outlining the nurse's role in assessing and caring for patients' psychosocial needs, including conducting psychological assessments, developing nursing diagnoses, planning and implementing interventions, and evaluating outcomes.
This study assessed the knowledge and attitudes of 150 adolescent students regarding psychoactive substance abuse. It found that most students had adequate knowledge of addictive substances and their harms, but only a minority knew about treatment options. A minority also had negative attitudes toward substance abusers. The study concluded there was a positive correlation between knowledge and attitude. Knowledge scores were associated with the education level of the father, while attitude scores were associated with the sex of the adolescent. It recommends educational programs to improve adolescent knowledge and attitudes regarding psychoactive substance abuse.
This document provides an overview of psychiatric mental health nursing. It discusses the roles of various members of the interdisciplinary treatment team, including psychiatrists, nurses, psychologists, social workers and more. It also covers topics like the history of mental illness, cultural issues, rights of patients, and psychosocial rehabilitation approaches.
This document provides an overview of the history and foundations of psychiatric mental health nursing. It discusses definitions of mental health and mental illness from organizations like the WHO and APA. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is introduced as the taxonomy used by mental health professionals for diagnosis. The development of institutions and community mental health in response to developments like psychopharmacology is summarized. Current issues like the high prevalence of mental illness and limitations of treatment access are also outlined.
This study explored the health perceptions of 19 female survivors of intimate partner violence (IPV) who were receiving services at two domestic violence shelters. Semi-structured interviews were conducted with participants ranging from 30-90 minutes. The interviews were analyzed and coded to identify themes. The main themes that emerged were: 1) The complexity of moving forward from abuse and understanding its deep impacts, 2) Unaddressed mental health issues, lack of support, and barriers like fear, finances, and lack of awareness of resources, 3) Disrupted daily routines, lack of stability, and difficulty establishing healthy habits, and 4) Both positive and negative coping strategies utilized to deal with the effects of IPV. The study provides insight into the multifaceted
National mental health programm by Ritika SoniShimla
The National Mental Health Program (NMHP) was launched in India in 1982 to make basic mental healthcare services available and accessible to all. It aims to integrate mental health treatment into primary healthcare. The key components are treatment of mental illnesses, rehabilitation, and promotion of positive mental health. The District Mental Health Program (DMHP), launched in 1996, operationalizes the NMHP at district and sub-district levels through activities like outpatient and inpatient services, community outreach, training health personnel, and raising awareness. The NMHP also supports upgrading of central mental health institutes and mental health authorities.
Psychiatric nursing faces many challenges. These include challenges in effective care delivery due to issues like frequent patient relapse and complex symptoms, challenges associated with psychiatric nursing education like lack of clinical infrastructure and opportunities for knowledge application, and challenges to psychiatric nursing research such as ethical issues and lack of ground-level data. Stigma is also a significant social challenge to effective mental healthcare delivery. Addressing these challenges will help improve psychiatric nursing practice and the recovery of those with mental illness.
This document discusses psychiatry departments and services including de-addiction and lifestyle modification centers. It describes that psychiatry involves the diagnosis and treatment of mental disorders by physicians called psychiatrists. De-addiction centers and lifestyle modification centers aim to treat addiction and promote healthy behaviors through a team-based approach. The document also outlines the services, staffing, and basic requirements for establishing a psychiatry hospital or wing.
Community mental health involves promoting mental well-being and preventing mental illness at a community level. Community mental health nursing aims to maintain and improve mental health through populations and communities. It also aims to rehabilitate those with ongoing mental illness effects. Some innovative community mental health programs in India include crash programs introduced at NIMHANS in Bengaluru that utilize primary health centers, schools, home visits, satellite clinics, and training of workers to expand mental healthcare.
This document discusses various psychiatric emergencies that may present to emergency departments. It defines terms like stupor, violence, and suicide. It notes that psychiatric emergencies require immediate intervention to safeguard the patient's life and reduce anxiety. Common emergencies discussed include suicide attempts, violence or aggression, panic attacks, catatonic stupor, and grief reactions. It provides guidance on initial approaches and management of these various psychiatric emergency presentations.
CRIS LUTHER's ADVANCED HEALTH ASSESSMENT IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
The course title is: Advanced Health Assessment in Psychiatric & Mental Health Nursing. Nurses in all specialties practice assessment as the first step in the universal approach of problem-solving in nursing, the nursing process. The application of which in Psychiatric Mental Health Nursing has the same goal as it has in other areas of nursing.
Though, the goal of the nursing process in this specialty field is not different as mentioned, the process of assessment is composed of complex concepts the psychiatric mental health nurse must familiarize- theoretically and clinically. This posted a main challenge in the completion of this material.
The student performed repeated accession and elimination of concepts to finalize the contents which are deemed significant and consistent with the course title: Advanced Health Assessment in Psychiatric & Mental Health Nursing.
________________________________________
The text is organized in four parts presenting various approaches in psychiatric assessment. The focus remained on the basic principles of nursing assessment:
Part 1: Assessment of Psychiatric Mental Health Clients, discusses the basic principles of nursing assessment; the topic progresses to assessment procedures specific to the specialty field (M.S.E.), an example was presented to clearly understand its congruence to practice. Related terminologies and discussion of comorbid problems are important tools in identifying actual and potential health problems during client assessment.
Part 2: The DSM-IV-TR, An Essential Tool for Assessment and Diagnosis of Psychiatric-Mental Health Clients, presents vital components of this universal tool in diagnosing mental illnesses.
Part 3: Assessment Factors in Dual Diagnosis, addresses the need to thoroughly assess other equally significant problems that co-exist with the diagnosed primary mental illness. The co-existence of substance abuse is the commonest in dual diagnosis.
Part 4: Formulation of Assessment-based Care Plan. The nursing process has been referred to as an ongoing systematic series of actions, interactions and transactions. Hence, the inclusion of the entire process is a must to fully appreciate the essentiality of an assessment that is done in congruence with standards.
The document discusses prevention of mental illness. It notes that about 450 million people suffer from mental disorders globally. It defines different levels of prevention as universal, selective, and indicated. Universal prevention targets the whole population. Selective targets groups at higher risk, while indicated targets those at high risk of mental illness. The strategies proposed for prevention include community education, early intervention services, developing community resources, improving accessibility and cultural sensitivity, and enhancing protective factors in the environment. The overall aim is to reduce incidence, prevalence, and recurrence of mental disorders through evidence-based interventions.
The document discusses the classification and assessment of abnormal behavior. It provides information on how abnormal behavior is classified in the DSM manual. The DSM recognizes mental disorders as involving emotional distress, impaired functioning, or risky behavior. It also classifies generalized anxiety disorder and provides its diagnostic criteria and treatment options. The document explains the different axes of the DSM classification system.
Nursing care of clients with mental health disordersangeee2005
This document discusses nursing care for clients with mental health disorders. It defines characteristics of mental health and explains that mental disorders are caused by various genetic, biological, social and environmental factors. The document outlines the five-axis diagnosis system used in psychiatry and describes the role of nurses as part of a multidisciplinary treatment team. Key points covered include the stigma surrounding mental illness, its historical treatment, and advocacy efforts to support the vulnerable mentally ill population.
The document discusses the concepts of mental health nursing, including the use of the nursing process and a holistic approach. It describes methods for collecting data on clients, such as observation, interviews, examinations and collaboration. Specific areas of data collection are outlined, including psychosocial history, mental status examinations, standardized screening tools, and considerations across the lifespan. Common mental health diagnoses and therapeutic strategies are also mentioned.
This slide contains information regarding introduction to mental health. It contains historical overview of psychiatric nursing in Nepal. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This document discusses the psychological impact of the COVID-19 pandemic. It notes that the pandemic has caused stress, anxiety, depression, and other mental health issues in the general population and healthcare workers. Risk factors for worse mental health outcomes include being female, younger age, excessive social media use, pre-existing psychiatric conditions, and quarantine. The document also outlines neurological effects that have been observed in some severe COVID-19 cases, as well as strategies to help minimize the psychological impact, such as self-care, correct information dissemination, support for healthcare workers, and successful vaccination programs.
Management of mental health disorders in the communityTuti Mohd Daud
Intended learning outcomes:
a) describe the rationale of providing mental health services in the community
b) identify mental health & psychiatric services at the levels of primary care, general hospital and mental institutions settings
c) describe the role of the different levels & profession of multidisciplinary team members in providing services
The literature review summarizes two studies that evaluated the effectiveness of using screening tools to identify risk of postpartum depression in postpartum women. The Edinburgh Postpartum Depression Scale and Postpartum Depression Screening Scale were found to be reliable screening methods. One study found that 27% of women screened positive for depression symptoms using telephone screening 8 weeks postpartum. The other study identified that 25.6% of Turkish women screened positive for depression using the Edinburgh scale within the first postpartum year. Both studies support the conclusion that screening tools can effectively identify women at risk for developing postpartum depression when used by nurses.
Postpartum period is a critical period in the life of a female from the biopsychosocial perspective. There are a number of psychological conditions which have their origin post pregnancy viz postpartum blues, postpartum depression, postpartum psychosis. Given their lack of awareness and relatively common presentation, it is imperative to know more about these conditions.
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
A 32-year-old black female presents for a psychiatric evaluation due to symptoms of depression since giving birth two months ago. She reports crying frequently, difficulty sleeping, loss of appetite, lack of interest in activities, and feelings of worthlessness. Her symptoms are impacting her ability to care for her infant and interact with others. Differential diagnoses include postpartum depression, major depressive disorder, and postpartum blues. A psychiatric assessment finds depressed mood but no signs of psychosis. The primary diagnosis is determined to be postpartum depression based on the timing of symptoms onset and presentation of diagnostic criteria.
This document discusses the psychological problems experienced by patients in critical care units. It begins by defining critical care and explaining the common medical conditions that result in admission to critical care units. It then explores the psychological effects of the critical care environment, which can include stress, anger, depression, anxiety, PTSD, and sleep problems. Specific psychological problems addressed include stress, anger, depression, anxiety, PTSD, delirium, helplessness, hopelessness, low self-esteem, and body image issues. The document concludes by outlining the nurse's role in assessing and caring for patients' psychosocial needs, including conducting psychological assessments, developing nursing diagnoses, planning and implementing interventions, and evaluating outcomes.
This study assessed the knowledge and attitudes of 150 adolescent students regarding psychoactive substance abuse. It found that most students had adequate knowledge of addictive substances and their harms, but only a minority knew about treatment options. A minority also had negative attitudes toward substance abusers. The study concluded there was a positive correlation between knowledge and attitude. Knowledge scores were associated with the education level of the father, while attitude scores were associated with the sex of the adolescent. It recommends educational programs to improve adolescent knowledge and attitudes regarding psychoactive substance abuse.
This document provides an overview of psychiatric mental health nursing. It discusses the roles of various members of the interdisciplinary treatment team, including psychiatrists, nurses, psychologists, social workers and more. It also covers topics like the history of mental illness, cultural issues, rights of patients, and psychosocial rehabilitation approaches.
This document provides an overview of the history and foundations of psychiatric mental health nursing. It discusses definitions of mental health and mental illness from organizations like the WHO and APA. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is introduced as the taxonomy used by mental health professionals for diagnosis. The development of institutions and community mental health in response to developments like psychopharmacology is summarized. Current issues like the high prevalence of mental illness and limitations of treatment access are also outlined.
This study explored the health perceptions of 19 female survivors of intimate partner violence (IPV) who were receiving services at two domestic violence shelters. Semi-structured interviews were conducted with participants ranging from 30-90 minutes. The interviews were analyzed and coded to identify themes. The main themes that emerged were: 1) The complexity of moving forward from abuse and understanding its deep impacts, 2) Unaddressed mental health issues, lack of support, and barriers like fear, finances, and lack of awareness of resources, 3) Disrupted daily routines, lack of stability, and difficulty establishing healthy habits, and 4) Both positive and negative coping strategies utilized to deal with the effects of IPV. The study provides insight into the multifaceted
National mental health programm by Ritika SoniShimla
The National Mental Health Program (NMHP) was launched in India in 1982 to make basic mental healthcare services available and accessible to all. It aims to integrate mental health treatment into primary healthcare. The key components are treatment of mental illnesses, rehabilitation, and promotion of positive mental health. The District Mental Health Program (DMHP), launched in 1996, operationalizes the NMHP at district and sub-district levels through activities like outpatient and inpatient services, community outreach, training health personnel, and raising awareness. The NMHP also supports upgrading of central mental health institutes and mental health authorities.
Psychiatric nursing faces many challenges. These include challenges in effective care delivery due to issues like frequent patient relapse and complex symptoms, challenges associated with psychiatric nursing education like lack of clinical infrastructure and opportunities for knowledge application, and challenges to psychiatric nursing research such as ethical issues and lack of ground-level data. Stigma is also a significant social challenge to effective mental healthcare delivery. Addressing these challenges will help improve psychiatric nursing practice and the recovery of those with mental illness.
This document discusses psychiatry departments and services including de-addiction and lifestyle modification centers. It describes that psychiatry involves the diagnosis and treatment of mental disorders by physicians called psychiatrists. De-addiction centers and lifestyle modification centers aim to treat addiction and promote healthy behaviors through a team-based approach. The document also outlines the services, staffing, and basic requirements for establishing a psychiatry hospital or wing.
Community mental health involves promoting mental well-being and preventing mental illness at a community level. Community mental health nursing aims to maintain and improve mental health through populations and communities. It also aims to rehabilitate those with ongoing mental illness effects. Some innovative community mental health programs in India include crash programs introduced at NIMHANS in Bengaluru that utilize primary health centers, schools, home visits, satellite clinics, and training of workers to expand mental healthcare.
This document discusses various psychiatric emergencies that may present to emergency departments. It defines terms like stupor, violence, and suicide. It notes that psychiatric emergencies require immediate intervention to safeguard the patient's life and reduce anxiety. Common emergencies discussed include suicide attempts, violence or aggression, panic attacks, catatonic stupor, and grief reactions. It provides guidance on initial approaches and management of these various psychiatric emergency presentations.
CRIS LUTHER's ADVANCED HEALTH ASSESSMENT IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
The course title is: Advanced Health Assessment in Psychiatric & Mental Health Nursing. Nurses in all specialties practice assessment as the first step in the universal approach of problem-solving in nursing, the nursing process. The application of which in Psychiatric Mental Health Nursing has the same goal as it has in other areas of nursing.
Though, the goal of the nursing process in this specialty field is not different as mentioned, the process of assessment is composed of complex concepts the psychiatric mental health nurse must familiarize- theoretically and clinically. This posted a main challenge in the completion of this material.
The student performed repeated accession and elimination of concepts to finalize the contents which are deemed significant and consistent with the course title: Advanced Health Assessment in Psychiatric & Mental Health Nursing.
________________________________________
The text is organized in four parts presenting various approaches in psychiatric assessment. The focus remained on the basic principles of nursing assessment:
Part 1: Assessment of Psychiatric Mental Health Clients, discusses the basic principles of nursing assessment; the topic progresses to assessment procedures specific to the specialty field (M.S.E.), an example was presented to clearly understand its congruence to practice. Related terminologies and discussion of comorbid problems are important tools in identifying actual and potential health problems during client assessment.
Part 2: The DSM-IV-TR, An Essential Tool for Assessment and Diagnosis of Psychiatric-Mental Health Clients, presents vital components of this universal tool in diagnosing mental illnesses.
Part 3: Assessment Factors in Dual Diagnosis, addresses the need to thoroughly assess other equally significant problems that co-exist with the diagnosed primary mental illness. The co-existence of substance abuse is the commonest in dual diagnosis.
Part 4: Formulation of Assessment-based Care Plan. The nursing process has been referred to as an ongoing systematic series of actions, interactions and transactions. Hence, the inclusion of the entire process is a must to fully appreciate the essentiality of an assessment that is done in congruence with standards.
The document discusses prevention of mental illness. It notes that about 450 million people suffer from mental disorders globally. It defines different levels of prevention as universal, selective, and indicated. Universal prevention targets the whole population. Selective targets groups at higher risk, while indicated targets those at high risk of mental illness. The strategies proposed for prevention include community education, early intervention services, developing community resources, improving accessibility and cultural sensitivity, and enhancing protective factors in the environment. The overall aim is to reduce incidence, prevalence, and recurrence of mental disorders through evidence-based interventions.
The document discusses the classification and assessment of abnormal behavior. It provides information on how abnormal behavior is classified in the DSM manual. The DSM recognizes mental disorders as involving emotional distress, impaired functioning, or risky behavior. It also classifies generalized anxiety disorder and provides its diagnostic criteria and treatment options. The document explains the different axes of the DSM classification system.
Nursing care of clients with mental health disordersangeee2005
This document discusses nursing care for clients with mental health disorders. It defines characteristics of mental health and explains that mental disorders are caused by various genetic, biological, social and environmental factors. The document outlines the five-axis diagnosis system used in psychiatry and describes the role of nurses as part of a multidisciplinary treatment team. Key points covered include the stigma surrounding mental illness, its historical treatment, and advocacy efforts to support the vulnerable mentally ill population.
The document discusses the concepts of mental health nursing, including the use of the nursing process and a holistic approach. It describes methods for collecting data on clients, such as observation, interviews, examinations and collaboration. Specific areas of data collection are outlined, including psychosocial history, mental status examinations, standardized screening tools, and considerations across the lifespan. Common mental health diagnoses and therapeutic strategies are also mentioned.
This slide contains information regarding introduction to mental health. It contains historical overview of psychiatric nursing in Nepal. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This document discusses the psychological impact of the COVID-19 pandemic. It notes that the pandemic has caused stress, anxiety, depression, and other mental health issues in the general population and healthcare workers. Risk factors for worse mental health outcomes include being female, younger age, excessive social media use, pre-existing psychiatric conditions, and quarantine. The document also outlines neurological effects that have been observed in some severe COVID-19 cases, as well as strategies to help minimize the psychological impact, such as self-care, correct information dissemination, support for healthcare workers, and successful vaccination programs.
Management of mental health disorders in the communityTuti Mohd Daud
Intended learning outcomes:
a) describe the rationale of providing mental health services in the community
b) identify mental health & psychiatric services at the levels of primary care, general hospital and mental institutions settings
c) describe the role of the different levels & profession of multidisciplinary team members in providing services
The literature review summarizes two studies that evaluated the effectiveness of using screening tools to identify risk of postpartum depression in postpartum women. The Edinburgh Postpartum Depression Scale and Postpartum Depression Screening Scale were found to be reliable screening methods. One study found that 27% of women screened positive for depression symptoms using telephone screening 8 weeks postpartum. The other study identified that 25.6% of Turkish women screened positive for depression using the Edinburgh scale within the first postpartum year. Both studies support the conclusion that screening tools can effectively identify women at risk for developing postpartum depression when used by nurses.
Postpartum period is a critical period in the life of a female from the biopsychosocial perspective. There are a number of psychological conditions which have their origin post pregnancy viz postpartum blues, postpartum depression, postpartum psychosis. Given their lack of awareness and relatively common presentation, it is imperative to know more about these conditions.
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
A 32-year-old black female presents for a psychiatric evaluation due to symptoms of depression since giving birth two months ago. She reports crying frequently, difficulty sleeping, loss of appetite, lack of interest in activities, and feelings of worthlessness. Her symptoms are impacting her ability to care for her infant and interact with others. Differential diagnoses include postpartum depression, major depressive disorder, and postpartum blues. A psychiatric assessment finds depressed mood but no signs of psychosis. The primary diagnosis is determined to be postpartum depression based on the timing of symptoms onset and presentation of diagnostic criteria.
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
postpartumdepression is a ver y common disorders-170424094316.pdfDivyaThomas45
This document provides an overview of postnatal depression. It defines postnatal depression as a type of clinical depression that can affect both sexes after childbirth, with symptoms including sadness, low energy, changes in sleeping and eating patterns. Around 1 in 10 women experience postnatal depression within a year of giving birth. Risk factors include a personal or family history of depression, prenatal depression or anxiety, and life stress. Hormonal changes after childbirth as well as lifestyle and relationship factors may contribute to the causes. Screening tools can help diagnose postnatal depression, which has similar diagnostic criteria to other forms of major depression.
This document summarizes a study from the North American Prodrome Longitudinal Study (NAPLS 2) that examined prodromal symptoms in 764 individuals at clinical high risk of developing psychosis. The study found that over time, all prodromal symptoms as measured by the Scale of Prodromal Symptoms significantly improved, with most improvement in the first 6 months. Positive symptoms like unusual thought content and perceptual abnormalities were most common at baseline. The study provides insight into the presentation and course of prodromal symptoms.
PPD is similar to clinical depression.it is not only prevalent among women but also in men. sufferers are not alone and they can prevent this by talk, talk and talk.
Violence against women by their husband and postpartum depression finalChetkant Bhusal
The study aimed to determine the prevalence of violence against women by their husbands, postpartum depression, and the relationship between violence and depression in Nepal. The study found the incidence of postpartum depression was 19.4-22.2% and violence was 13.9-20.8%. No significant relationship was found between violence and depression, possibly due to small sample size. The study highlighted the need for further large-scale research on this topic in Nepal.
Introduction
The commencement of psychiatric training is a daunting task for any medical officer. Whilst exposure to mental illness and the institutional systems which operate around it may occur during graduate medical training programs and some junior resident medical officer rotations, nothing prepares the new trainee in psychiatry for their many responsibilities in this early phase of their careers.
Didactic content is provided for psychiatric trainees by the NSW Institute of Psychiatry and local training networks, however information on how to provide safe and effective care to people with mental illnesses is invariably acquired in the course of working in acute mental health settings. With this in mind, the contributors to this resource have attempted to provide accessible overviews of the kind of information which might be needed in the course of working in acute adult mental health settings.
This resource is set out in a series of themes. It does not seek to provide a comprehensive reference, nor does it attempt to summarize text-books or the current literature in psychiatry. Each contributor has written a brief account of different topics of relevance to practice in acute adult psychiatry. The style of writing aims to provide the reader with a grasp of the necessary information, which can be absorbed rapidly by the inexperienced psychiatric trainee. Whilst not a manual of ‘how to be a registrar’, it aims to provide a ready reference to both common and classic challenges in the setting of acute adult mental health.
This document discusses screening tools for depression and anxiety in youth. It notes that depression affects 3-8% of youth and anxiety is commonly co-morbid. Early recognition is important to prevent long-term impairment. Two screening tools are introduced: the PHQ-9 for depression screening, which has a sensitivity and specificity of 88% for major depression, and the SCARED questionnaire for anxiety screening. Both tools are self-report questionnaires that can help identify clinically significant problems to be addressed. The document advocates for screening in school settings but notes the importance of having next steps in care identified and streamlined if issues are detected.
Perinatal Depression: When Depression Hits at the Moment of Joy.Dr. Umi Adzlin Silim
The document provides an overview of perinatal depression and efforts to improve perinatal mental health services in Malaysia. It discusses (1) the need to move beyond biological models to recognize psychosocial risk factors for perinatal depression, (2) current lack of specialized perinatal mental health services in Malaysia, and (3) ongoing research efforts like the National Maternal and Child Health Survey and ASPIRE studies to better understand prevalence of perinatal depression in Malaysia and test interventions.
More than baby blues_Senefeld, Reider, Schooley_10.13.11CORE Group
Maternal depression has significant negative effects on mothers, infants, and children. It can compromise parenting, impair the mother-infant relationship, and negatively impact child growth and development. Screening and treatment programs are effective but underutilized, especially in developing countries. The HEAL program implements a group intervention model with Latina women that uses screening tools and educates participants on depression, stress management, and empowerment to help mitigate the impacts of maternal mental health issues.
This document provides an overview of mental health, including definitions, types of mental illnesses, causes, burden, prevention strategies, and the evolution of national mental health programs in India. Some key points include:
- Mental health is defined as a state of well-being where an individual can cope with stress and function productively.
- Major types of mental illnesses include psychosis like schizophrenia and bipolar disorder, as well as neuroses.
- Mental illnesses have multifactorial causes including genetics, medical conditions, life stressors, and social factors.
- Around 13% of Indians experience mental morbidity, which places a large burden on communities and the health system.
- The National Mental Health Program was established in
Please I need a response to this case study.1 pagezero plagi.docxcherry686017
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The Case:
The sleepy woman with anxiety
This week’s discussion presents a case study involving a 44-year old woman with a chief complaint of anxiety beginning at age 15 years old. She has a long history of mental illness and continued therapies. The purpose of this discussion is to analyze her case history to determine medication and treatment effectiveness.
Client Questions
Question 1. Are you having feelings of harming yourself or harming someone else?
Rationale: This is a possibly uncomfortable yet important set of questions to ask each client. Primary care providers may be in a unique position to prevent suicide due to their frequent interactions with suicidal patients. Reviews suggest that among patients who committed suicide, 80 percent had contact with primary care clinicians within one year of their death, whereas only 25 to 30 percent of decedents had contact with psychiatric clinicians within the year of their death (Stene-Lars & Reneflot, 2017).
Question 2. What was happening in your life as a teenager when the anxiety started and you began to self-medicate?
Rationale: Per our report, this patient began suffering signs and symptoms of anxiety at 15-years old. Asking these types of questions we may gain insight into an underlying cause or triggering event. Anxiety disorders are the most common psychiatric disorders with onset in childhood, with prevalence estimates ranging from 10 to 30 percent. Nearly 37 percent of behaviorally inhibited preschool-age children had social anxiety disorder at age 15, compared with 15 percent of non- behaviorally inhibited children
.
Children with anxiety disorders are more likely to have persistent anxiety disorders into adulthood. (Rapee, 2014).
Question 3. What was happening in your life a year ago when these symptoms returned and became debilitating? Let’s discuss what the triggering events may have been.
Rationale: Self-discovery of triggering events may help the client to come to terms with the determinants of her anxiety and depression. Studies have shown that specific types of stressors were found to differentially predict increases in specific facets of anxiety sensitivity; health-related stressors predicted increases in disease-related concerns and fear of mental incapacitation, whereas stressors related to family discord predicted increases in fear of feeling unsteady, fear of mental incapacitation, and fear of having publicly observable symptoms of anxiety (McLaughlin & Hatzenbuehler, 2009).
Support System
The support system as reported by our client is her husband. She states he is supportive and has little to no contact with the family of origin. She has a few friends and a few outside interests. As PMHNP, discussing relationships with the client is one avenue to gain insight into anxiety patterns and coping mechanisms as seen by outside support. With the client’s permissio.
Sahiba Verma and her teammates Shikha Suwetha and Aishwarya presented on the topic of mental health and wellbeing. They discussed that mental health refers to psychological, behavioral, and emotional well-being and how people think, feel and behave. It is more than just the absence of mental illness and includes the ability to understand one's emotions. Common myths about mental health were also dispelled, such as the misconception that only medications can treat mental illness or that everyone is either depressed or anxious. The COVID-19 pandemic was found to negatively impact mental health by increasing stress, anxiety, and risk of mental health disorders. Healthcare workers, children, and those in isolation or unemployment were particularly
This document provides an overview of psychiatry disorders in pregnancy. It discusses the prevalence and course of several disorders including anxiety disorders like panic disorder and PTSD, mood disorders like major depression and bipolar disorder, schizophrenia and psychosis, and eating disorders. For many disorders, data on incidence and course during pregnancy is limited. The document highlights that pregnancy does not necessarily improve psychiatric conditions. It also notes potential risks to pregnancy outcomes from conditions like depression, including preterm birth and low birth weight. The importance of understanding psychiatric illnesses and treatments during pregnancy is emphasized to guide clinical decision making.
This study examines the validity of using a 2-question screening tool called the Patient Health Questionnaire (PHQ-2) to detect depression in adolescents in primary care settings. The PHQ-2 is currently recommended for screening depression in adults but has not been tested for use with adolescents. The study administered the PHQ-2 along with two established depression measures, the Children's Depression Inventory and Beck Depression Inventory, to 85 adolescents ages 13-17. Results found a significant relationship between responses on the PHQ-2 and the other depression measures. Using the PHQ-2 to classify adolescents as depressed or not depressed correctly classified 73% of cases. This supports using the brief PHQ-2 screen to identify depression in adolescents
The document discusses the need for behavioral health services in Nueces County, Texas. It provides statistics on mental illnesses like bipolar disorder and major depressive disorder treated in the county. Suicide rates are also discussed both locally and nationally. The nursing implications are early detection, education on risk factors, and management of disorders. Nurses play a role in comprehensive assessment, advocacy, and linking patients to support services. Barriers to mental healthcare include stigma, lack of perceived need, and cost of treatment. Community education and support can help address these barriers.
This document provides information on postpartum psychiatric complications. It begins with an introduction to postpartum psychiatric disorders including classification into postpartum blues, depression, and psychosis. It then discusses risk factors, signs and symptoms, and management. Key points include that postpartum depression affects approximately 13% of women, risk factors include a history of depression and complications during pregnancy, and treatment involves counseling, antidepressants, and monitoring for suicidal ideation.
Similar to Scientifi c Journal of Depression & Anxiety (20)
A 5-year old boy, with an established diagnosis of a topic
dermatitis, previously treated by topical corticosteroids and emollient cream with a good improvement, developed widespread papules on his legs, hands and forearm that appeared 5 months ago.
Methods: Retrospectively, the file records of the patients who underwent sleeve gastrectomy were examined. Demographic features, Body Mass Index (BMI), the mouth opening, Mallampati score, thyromental distance, sternomental distance, neck circumference measurements and videolaryngoscopic examination results were recorded Results: In a total of 140 consecutive patients (58 male, 82 female) were included in the study. The mean age of the study participants was 35.40 ± 9.78 and the mean BMI of the patients was 44.33 ± 7.52 kg/m2
. The mean mouth opening of the patients was 4.82 ± 0.54 cm
and the mean neck circumference was 43.52 ± 4.66 cm. The mean thyromental distance was 8.02 ± 1.00 cm and the mean sternomental distance was16.58 ± 1.53 cm. Difficult intubation was determined in 8 (5.7%) patients. In logistic regression analysis, age (p : 0.446), gender (p : 0.371), BMI (p : 0.947), snoring (p : 0.567), sleep apnea (p : 0.218), mouth opening (p : 0.687), thyromental distance (p :0.557), sternomental (p : 0.596) and neck circumference (p : 0.838) were not the independent predictors of difficult intubation. However, Mallampati score (p : 0.001) and preoperative direct laryngoscopy findings (p : 0.037) performed in outpatient clinic were the significant
predictors of difficult intubation. Interestingly, all patients with grade 4 laryngoscopy findings had difficult intubation.
Introduction: Laparoscopic surgery has been performed in Mexico since 1989, but no reports about training tendencies exist. We conducted a national survey in 2015, and here we report the results concerning training characteristics during the surgical residence of the respondents. Materials and Methods: A prospective study was conducted through a survey questioning demographic data, laparoscopic training during pre and post surgical residency and other of areas of laparoscopic practice. The sample was calculated and survey piloted before
application. Special interest in this report was placed on type and quality of training received. Data are reported in percentages.
Heterotopic Ossification (HO) is defined as pathological bone formation at locations where bone normally does not exist. The
presence of HO has been found to be a rare complication after stroke in several studies, whereas there are only sporadic references relating HO to Cerebral Palsy (CP) and few for CP and stroke. No effective treatment for HO has yet been found, whereas the cellular and molecular mechanisms have not been completely understood. Therefore, increased awareness among physicians is required, as a challenge for early diagnosis and treatment. A case of a male patient with CP, who developed HO on the paretichip joint following an ischemic stroke is presented.
Objectives: To assess the practice of food hygiene and safety, and its associated factors among street food vendors in urban areas of Shashemane, West Arsi Zone, Oromia Ethiopia, 2019.
Methods: Cross-sectional study design was applied from December 28, 2019 to January 27, 2020. Data was collected from 120 food handlers, which were selected by purposive sampling techniques. Information was gathered from interview and field observation by conducting food safety survey and using questionnaires via face to face interview. The collected data was entered using Epi Data 3.1 and finally, it was analyzed using SPSS VERSION 20.
A Division I football player experienced acute posterior leg pain while playing. An ultrasound examination revealed an unusual injury - a complete rupture of the plantaris tendon mid-substance. This type of isolated plantaris tendon injury has rarely been reported. Ultrasound was useful for diagnosis and guided rehabilitation by monitoring healing over time. The athlete was able to return to full competition within 3 weeks through a progressive rehabilitation program focused on restoring range of motion and strength. This case suggests isolated plantaris tendon injuries may allow for faster return to play than other potential causes of posterior leg pain.
Type 1 Diabetes (T1D), is a severe disease, representing 5-10% of all reported cases of diabetes worldwide. Fulminant Type 1 Diabetes Mellitus (FT1D) is a subtype of type 1 diabetes mellitus that is largely characterized by the abrupt onset of Diabetic Ketoacidosis (DKA) and severe hyperglycemia without insulin defi ciency. Viral infections have been hypothesized to play a major role in the pathogenesis of Fulminant Type 1 Diabetes Mellitus (FT1D) through the complete and rapid destruction of pancreatic beta cells. Coxsackie viral infection has been detected in islets of 50% of the pancreatic tissue recovered from recent-onset Type 1 Diabetes (T1D) patients. In this report we have highlighted a case where the patient developed a Group B Coxsackie virus infection culminating in the development of Fulminant Type 1 Diabetes Mellitus (FT1D).
Methods: Cercariae are released by infected water snails. To determine the occurrence of cercariae-emitting snails in SchleswigHolstein, 155 public bathing places were visited and searched for fresh water snails. Family and genus of the collected snails were determined and the snails were examined for the shedding of cercariae, using a standard method and a newly developed method.
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Femoral hernias, comprise 2% to 4% of all hernias in the inguinal region, and occur most commonly in women. Th ey present typically with a mass below the level of the inguinal ligament. The sac may contain preperitoneal fat, omentum, small bowel, or other structures and have a high rate of incarceration and strangulation due to the small size of the hernia neck orifice, requiring emergency surgery. We present the case of a 54-year-old female patient with intestinal occlusion due to incarcerated femoral hernia, repaired by laparoscopic approach, that gave the patient the opportunity to attend her daughter’s wedding the same day.
Small Supernumerary Marker Chromosome (sSMC) is a rare genetic condition marked by the presence of an extra chromosome to the 46 human chromosomes. This case report describes a 4 year old child with SSMC on the 46th chromosome. The child presented with delayed speech and language development, seizures and mild developmental delay. Speech and Language evaluation was carried out and management options are discussed.
A catheter is a thin tube made from medical grade materials that serve a broad range of functions, but mainly catheters are medical devices that can be inserted in the body to treat disease or perform surgical procedures. Catheters have been inserted into body cavities, ducts, or vessels to allow for drainage, administration of therapeutic fluids or gases, operational access for surgery. Catheters help perform tasks in various systems such as cardiovascular, urological, gastrointestinal, neurovascular, and ophthalmic systems. A dataset of 12 patients with varying “weights” and “heights” was recorded along with the lengths of their catheter tubes. This data set was found from two revered statistical textbooks on linear regression and the Department of Scientific Computing at Florida State University. This data set was not able to be linked to any particular clinical or experimental research studies, but the data set can be used to help catheter manufacturers and medical professionals better decide on what particular catheter lengths to use for patients knowing only their height & weight. These research insights could be helpful to healthcare professionals that have patients with incomplete or no healthcare records
to decide what catheter length to use. The main investigative inquiry that needed to be answered was how does patient weight & height influence catheter length together and separately? We conducted linear regression and other statistical analysis procedures in R program & Microsoft Excel and discovered that this data exhibited a quality called multi collinearity. With multi collinearity, all predictors (2 or more
independent variables) are not significant in an all encompassing linear aggression, but the predictors might be significant in their own individual linear regressions. Individual linear regression analyses were conducted for both patient height & weight to see how much they both contribute to varying catheter length. Patient weight was found to be more impatful than patient height in relationship to catheter length, even though height and weight are a classical example of multi collinearity predictors.
Bovine mastitis has a negative impact through economic losses in the dairy sector across the globe. A cross sectional study was carried out from September 2015 to July 2016 to determine the prevalence of bovine mastitis, associated risk factors and isolation of major causative bacteria in lactating dairy cows in selected districts of central highland of Ethiopia. A total of 304 lactating cows selected randomly from five districts were screened by California Mastitis Test (CMT) for subclinical mastitis. Based on CMT result and clinical examination, over all prevalence of mastitis at cow level was 70.62% (214/304).
Two hundred fourteen milk samples collected from CMT positive cows were cultured for isolation of major causative bacteria. From 214 milk samples,187 were culture positive and the most prevalent isolates were Staphylococcus aureus 42.25% (79/187) followed by Streptococcus agalactiae 14.43%
(27/187). Other bacterial isolates were included Coagulase Negative Staphylococcus species 12.83% (24/187), Streptococcus dysgalactiae 5.88% (11/187), Escherichia coli 13.38% (25/187) and Entrococcus feacalis 11.23% (21/187) were also isolated. Moreover, age, parity number, visible teat abnormalities,husbandry practice, barn fl oor status and milking hygiene were considered as risk factors for the occurrence of bovine mastitis and they were found significantly associated with the occurrence of mastitis (p < 0.05). The findings of this study warrants the need for strategic approach including dairy extension that focus on enhancing dairy farmers’ awareness and practice of hygienic milking, regular screening for subclinical mastitis, dry cow therapy and culling of chronically infected cows.
A 36-year-old female developed right upper quadrant pain and nausea after taking the herbal supplement kratom for two weeks to manage back pain. Laboratory tests showed elevated liver enzymes. A liver biopsy ruled out other causes and determined she had drug-induced liver injury from kratom use. Her symptoms and liver enzymes gradually returned to normal over six weeks after stopping kratom. The case report discusses kratom's potential for hepatotoxicity and advises clinicians to consider its effects on patient health.
The assessment, diagnosis and treatment of critically ill patients is extremely challenging. Patients often deteriorate whilst being
reviewed and their rapidly changing pathophysiology barrages healthcare professionals with new data. Furthermore, comprehensive assessments must be postponed until the patient has been stabilised. So, important data and interventions are often missed in the heat of the moment. In emergency situations, suboptimal management decisions may cause signifi cant morbidity and mortality. Fortunately, standardisation and careful design of documentation (i.e. proformas and checklists) can enhance patient safety. So, I have developed a series of checklist proformas to guide the assessment of critically ill patients. These proformas also promote the systematic recording and presentation of information to facilitate the retrieval of the precise data required for the management for critically ill patients. The proformas have been modifi ed extensively over the last twenty years based on my personal experience and extensive consultation with colleagues in several world-renowned centres of excellence. The proformas were originally developed for use in the intensive therapy unit
or high dependency unit. However, they have been adapted for use by outreach teams reviewing patients admitted outside of critical care areas. The use of these tools can direct eff orts to provide appropriate organ support and provides a framework for diagnostic reasoning.
This review article discusses microvascular and macrovascular disease in systemic hypertension. It summarizes that:
1) Cardiac imaging plays a crucial role in risk stratifying hypertensive patients and identifying management strategies by properly diagnosing microvascular and coronary artery disease.
2) The nitric oxide synthase (eNOS) G298 gene allele may be a marker for microvascular angina in hypertensive patients, as studies have found it to be more prevalent in hypertensive patients with chest pain and reversible myocardial defects but normal coronary arteries.
3) Both structural changes like capillary rarefaction and functional changes like endothelial dysfunction can cause microvascular dysfunction and angina in hypertensive individuals in the absence of
This study characterized dengue infections in Pakistan by analyzing hematological and serological markers in 154 suspected dengue cases and 146 control patients with other febrile illnesses. NS1 antigen was detected in 55% of dengue cases, IgM antibodies in 30%, and both in 15%. Control groups primarily had malaria (71%) and enteric fever (20%). Hematological markers (platelet count, hematocrit, WBC) measured before and after treatment showed significant differences for platelet count and hematocrit but not WBC count between the groups. Analysis of clinical symptoms and serological/hematological markers helps diagnose dengue, assess prognosis, and inform prevention efforts to reduce morbidity, mortality and spread of the disease.
Researchers from Utrecht recently published yet another paper on the use of Magnetic Resonance Imaging (MRI)demonstrating an additional failed attempt to understand the importance of qualitative versus quantitative imaging, and anatomic versus physiologic imaging. Th e implications of this failure here cannot be overstated.
Introduction: Stroke is an even more dramatic major public health problem in young people. Goal of the study: Contribute to the knowledge of strokes in young people. Methodology: This was a retrospective study carried out over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Neurology department of the University Hospital
Center of the Sino-Central African Friendship (CHUSCA) of Bangui.
Background: This report describes a unique case of a patient that developed psychotic symptoms believed to be secondary
to a tentorial meningioma with associated hydrocephalus. These psychotic symptoms subsequently abated with placement of a
ventriculoperitoneal shunt. Case description: 60-year-old female was admitted to an inpatient psychiatric facility on a psychiatric involuntary commitment petition due to progressive paranoia, homicidal ideation and psychosis. The work up showed a calcified six cm tentorial meningioma with associated hydrocephalus. The patient initially rejected treatment but later became amenable to placement of Ventriculoperitoneal Shunt
(VPS).
More from SciRes Literature LLC. | Open Access Journals (20)
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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2. Scientific Journal of Depression & Anxiety
SCIRES Literature - Volume 1 Issue 1 - www.scireslit.com Page -024
INTRODUCTION
The time period commencing from the delivery of the placenta to
the next 6 weeks is considered as puerperium/postpartum. Most of
the changes occur during pregnancy, labor, and delivery resolve and
revert back the body to non-pregnant condition. After giving birth to a
child, women are susceptible to various severe psychiatric symptoms.
Women have roughly 22 times more probability to experience
manic or psychotic period, in the first month of postpartum than
any other period in their life time. Among childbirth associated
psychiatric illness, postpartum psychosis is the major severe form
with a prevalence of 1-2 per 1000 childbirths predicted in the general
population [1-3].
Mental turbulence is a condition that can occur in women of
child-bearing age within four weeks of childbirth. This can lead to
vulnerability, distress and can impair their day to day activities with
baby [4-5].
Postpartum blues, postpartum depression, postpartum psychosis,
and postpartum anxiety are considered as Postpartum Psychiatric
Disorders (PPD) [6-7]. Postpartum blues are associated with mood
disturbances that can occur within few days of delivery (on the 3rd or
4th day) and persist for several days. They can be mild, time limited,
and usually do not require special treatment [8]. 10-15% of women
after delivery suffer from Non-psychotic postpartum depression in
the first 6 weeks, showing signs of PPD. During this disorder suicidal
ideation has been frequently reported [9]. Puerperal or postpartum
psychosis is one of the severe and rare forms of postnatal disorder
at a rate of one to two episodes per 1000 deliveries [10]. Symptoms
start in the first 48-72 h or within first 2 weeks of postpartum. Manic
episodes accounts for only 15% of psychotic reaction [11], while
schizophrenic disorder accounts up to 30% of postpartum psychosis
[12]. Postpartum anxiety disorder is commonly associated with stress
and anxiety in about 10% of women, postpartum 6 weeks to 6 months
[13].
In most of the cases early symptoms include mood fluctuation,
insomnia, and obsessive concerns about the newborn. Severe
symptoms include hallucinations, delusions, serious mood
symptoms, and disorganized behavior [14-15] within 2 weeks
postpartum [16]. Symptoms, like “Schneiderian first-rank symptoms”
related to schizophrenia are found to be very low [15, 17-19]. Hence
postpartum psychosis is usually considered as a mood disorder and
not as a primary psychotic disorder. Risk factors may include a history
of bipolar disorder or a previous episode of postpartum psychosis. It
is a psychiatric emergency where an urgent psychiatric referral and
medical attention is needed to make sure the protection of mother
and baby.
Fortheearlyclinicalassessmentofpostpartumpsychosis,thorough
details of family history, physical, neurological and laboratory analysis
are needed to eliminate known organic causes for acute psychosis.
There are few case reports on misdiagnosis of postpartum psychosis,
enlightening a late-onset paraneoplastic encephalitis [20], primary
hypoparathyroidism, [21] citrullinemia type I [22] and urea cycle
disorder [23]. Differential diagnosis includes examination of vitamin
deficiencies, eclampsia, autoimmune diseases, infectious diseases,
stroke, metabolic diseases and drug-induced psychosis [24]. Hence,
tests are supposed to contain a complete picture of blood, metabolic
panel, thyroid, vitamins, urine panel and even head CT or MRI scan.
As a result, guiding women at high-risk for psychosis during
pregnancy and the postpartum period is a key challenge for mental
health practitioners and obstetricians, [25-27] for which secure and
effective relapse prevention would be the best possible strategy.
MATERIALS & METHODS
Subject Selection
A total of 50 postpartum female who were attending the Owaisi
Hospital & Princess ESRA hospital were randomly selected for the
present study. Female who were physically not well or have any
major psychiatric illness and female who were stay far way places
were excluded from the study. The study was done between June
and August 2011. Study was approved from Institutional Review
Board, Deccan College of Medical Sciences, Hyderabad and written
informed consent was taken from all the subjects.
Tools used for the study
Semi structured socio demographic questionnaire: Socio
demographic data was gathered by using semi structured
questionnaire in which age, current marital status, obstetric data
current and past, socio economic data, violence from husband or
family members were captured for every subjects.
ABSTRACT
Introduction: Postpartum psychiatric disorders are defined as mental disturbances, occurring in women of childbearing age within
four weeks of childbirth, which leads to illnesses that create considerable family distress and vulnerability which impairs a woman’s
capability to do her normal work and manage her baby care. Postpartum depression, which is frequently failed to notice by primary
health care providers, has been linked by means of turbulence in the mother-infant association and bonding in the child’s cognitive and
emotional development.
Materials & Methods: A total of 50 postpartum female who were attending the Owaisi Hospital & Princess ESRA hospital were
randomly selected for the present study. Socio demographic data was gathered by using semi structured questionnaire. The SCL-90 is
intended to measure symptom intensity on nine different subscales. The HAM-D was widely used to assess symptoms of depression.
Results: Primiparity is associated with greater severity of Somatic, Depressive, Anxiety symptoms. Spontaneous remission
or lowering of severity of psychological symptoms is seen through one week to four of postpartum period. Type of delivery was not
associated with the severity of psychological symptoms.
Conclusion: Based on our data we found that postpartum period is associated with Somatic, Depressive, and Anxiety symptoms and
these symptoms had higher severity in first week of postpartum.
Keywords: HAM-D; Postpartum; Psychiatric Disorders; SCL-90
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Symptom check-list 90 (SCL-90): The SCL-90 is intended to
measure symptom intensity on nine different subscales. It has since
been applied as a psychiatric case-finding instrument, as a measure of
symptom severity, and as a descriptive measure of psychopathology
in different patient populations.
Hamilton rating Scale (HAM-D): The HAM-D was widely
used to assess symptoms of depression. The HAM-D relies heavily
on clinically interviewing skills and experience of rater on evaluating
individuals with depressive symptomatology.
Interview was done to postpartum women in maternity ward.
Interview was conducted within 24hr after delivery. Women were
explained about the nature and procedure of the study, privacy of
information, publication of the study.
RESULT
For the present study a total of 19 postpartum women between the
age group of 15-20 and a total of 31 postpartum women between the
age group of 21-30 were included and their families monthly income
was Rs. 7185/- per month. Among them 54% of women had primary
education, 34% had secondary education and 12% were graduates.
In this study 58% women were primiparous (first delivery) and
42% were multiparous. 16% of women had history of abortion and
20% of women had history of fetus death. 52% of women had vaginal
delivery, 28% of women had assisted vaginal delivery and 20% of
women had undergone Cesarean section.
Mean score of postpartum on somatization subscale in the 1st
week is 15.6 and in the 4th
-5th
week is 9.5. Mean score of postpartum
on Depression subscale in the 1st
week is 14.32 and in the 4th
-5th
week
of is 9.4. Mean score of postpartum on Anxiety subscale in the 1st
week is 10.1 and in the 4th
-5th
week is 6.9. Mean score of postpartum
on additional items in the 1st
week is 2.4 and in 4th
-5th
week is 1.10.
Mean score of postpartum on Interpersonal items in the 1st
week is
1.3 and in 4th
-5th
week is 0.6. Mean score of postpartum on Anger
subscale in the 1st
week is 2.1 and in the 4th
-5th
week is 2.1. Mean score
of postpartum on Phobic subscale in the 1st
week is 0.31 and in the 4th
-
5th
week is 0.31. Mean score of postpartum on Paranoid subscale in
the 1st
week is 0.05 and in the 4th
-5th
is 0.04. Mean score on Psychosis
subscale in the 1st
week is 0.15 and in the 4th
-5th
is 0.15. Mean score
of postpartum on Global distress index score in the 1st
week is 52.2
and in the 4th
-5th
is 32.7. Mean score of postpartum on positive scored
items is in the 1st
week 30.1 and in the 4th
-5th
is 20.4. Mean score of
postpartum on Positive score index in the 1st
week is 1.7 and in the
4th
-5th
is 1.5. From the scores obtained from all the subscales it is clear
that there is a decrease in mean scores from 1st
week to 4th
-5th
week of
postpartum period and hence data obtained is statistically significant.
In Primiparous women the scores obtained on various HAM-D
subscales are noted as-Depressed mood subscale of HAM-D was 12,
Insomnia early subscale of HAM-D was 4, Insomnia late subscale of
HAM-D was 4, Work & Activities subscale of HAM-D was 8, Psycho-
motor retardation subscale of HAM-D was 10, Somatic symptoms
(general) subscale of HAM-D was 4, The score on Insight subscale of
HAM-D was 8, Diurnal variation subscale of HAM-D was 6.
In Multiparous women the scores obtained on various HAM-D
subscales are noted as- Depressed mood subscale of HAM-D was 4,
Insomnia early subscale of HAM-D was 2, Insomnia late subscale of
HAM-D was 2, Work & Activities subscale of HAM-D was 5, Psycho-
motor retardation subscale of HAM-D was 6, Somatic symptoms
(general) subscale of HAM-D was 3, Loss of weight subscale of
HAM-D was 2, Insight subscale of HAM-D was 4, Diurnal variation
subscale of HAM-D was 2. From the scores obtained above subscales
it was noted that HAM-D scores were significantly higher in
primiparous women than multiparous women in postpartum period.
HAM-D scores noted on various subscales at 1st
week Postpartum
women are- Depressed mood subscale of HAM-D was 16, Insomnia
early subscale of HAM-D was 6, Insomnia late subscale of HAM-D
was 6, Work & Activities subscale of HAM-D was 13, Psycho-motor
retardation subscale of HAM-D was 16, Somatic symptoms (general)
subscale of HAM-D was 7, Loss of weight subscale of HAM-D was
8, Insight subscale of HAM-D was 12, Diurnal variation subscale of
HAM-D was 8.
At 4 weeks HAM-D scores noted on various subscales of
Postpartum women are-Depressed mood subscale of HAM-D was 4,
Insomnia early subscale of HAM-D was 2, Insomnia late subscale of
HAM-D was 3, Work & Activities subscale of HAM-D was 4, Psycho-
motor retardation subscale of HAM-D was 4, Somatic symptoms
(general) subscale of HAM-D was 3. The score on Loss of weight
subscale of HAM-D was 3, Insight subscale of HAM-D was 2, and
Diurnal variation subscale of HAM-D was 2. The scores on the above
subscales of HAM-D were significantly decreased from 1st
to 4th
week
of postpartum period.
DISCUSSION
The present study was done at Deccan College of Medical Sciences
& Owaisi Hospital & Research Centre & Princess Esra General
Hospital, Hyderabad. The study group consisted of postpartum
women who were selected randomly. These women were interviewed
in the 1st
week and again in 4-5th
week of postpartum period. After
obtaining the socio demographic data, each subject was administered
SCL-90, & HAM-D scale. The data obtained was analyzed by statistical
methods and results were compiled.
In Postpartum women the minimum age was 15 yrs, maximum
age was 28 yrs and the mean age was 22.3yrs (Table 1). Studies by
O’Hara and Swain (1996) [9] and Beck (2001) [28] found that
development of postpartum depression and maternal age had no
relationship and the same was inferred in our study.
In the present study, average monthly income (AMI) of each
subject was calculated and estimated to be 7185 (in Rs) (Table 1).
In their research, Lee (2002) [29] and Senguin (1999) [30], financial
strain was found to be an important risk factor for postpartum
depression.
In the present study, education level of subjects was classified
into three groups, a) Primary (10th class or less), b) Secondary
Table 1: Age, Income & Education of Postpartum women.
Variable
Postpartum Women
(N = 50)
Class Interval Frequency
Age in years
15-20
21-30
19
31
Average Monthly Income Rupees per month 7185
%’s
Education
Primary 27 54%
Secondary 17 34%
Graduate 6 12%
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(intermediate to above) and c) Tertiary (Graduation and above). In
postpartum women 54% had primary education, 34% had secondary
education and 12% had tertiary education (Table 1). According to
O’Hara and Swain (1996) [9] and Beck (2000) [28], there was no
clear association between the level of education and postpartum
depression.
In our study, 29 women were primiparous and 21 women were
multiparous (Table 2). Data on SCL-90 scores was obtained for both
primiparous and multiparous women. Comparisons were made
between primiparous and multiparous women at one week & four
weeks in primiparous and multiparous women.
Primiparous women had higher and statistically significant
scores on Somatization, Depression, Anxiety, Obsession subscales
of SCL-90 than Multiparous women, (Table 3,4). Stein (1979) [31]
reported headaches, muscle pains; gastrointestinal, cardiovascular
symptoms are more common in postpartum women but are not
intensely severe. In our study severity of depressive symptom score
on SCL-90 was more in primiparous women than in multiparous
women. Eva Frommer (1976) also reported depressive symptoms
were more common in primiparous women. Anxiety symptoms
were also more and significantly different in primiparous women
than multiparous women. Additional items score on SCL-90 gives
information about sleep and appetite disturbances. These scores
were higher in primiparous women than in multiparous women.
Stein (1979) [31] primiparous women reported having insomnia
and loss of appetite. Anger, Hostility, Interpersonal, Phobic anxiety,
Psychosis, Paranoid subscale scores of SCL-90 did not differ between
two groups in a significant manner (Primiparous & Multiparous).
Global Distress Index (GDI) item of SCL-90 is suggested to be the
single best indicator of current level of disorder (Derogates 1983) [32].
Primiparous women showed higher and significant scores of GDI
than multiparous women. Positive score item of SCL-90 which access
response style of the subject didn’t differ in a significant way in both
groups. Positive Scored Index (PSD), which are total number of items
scored above zero, were significantly higher in primiparous women
than in multiparous women. These findings suggest primiparous
women suffer from greater amount of distress due to psychological
symptoms than multiparous women during postpartum period.
Mean scores of Somatization, Depression, Anxiety, obsession,
Interpersonal and Additional items on SCL-90 showed significant
decline through week one to week four. The mean values of Anger,
Paranoid, Psychosis and Phobic scores of SCL-90 had no significant
change through week one to week four.
Mean scores of Somatization, Depression, Anxiety, obsession,
Additional items on SCL-90 showed significant decline through week
one to week four. Anger scores, Paranoid scores, Psychosis score,
Table 2: Postpartum women Obstetric variables.
Parity % N 50
Primiparous 29 (58%)
Multiparous 21 (42%)
Fetus abortion Yes 8 (16%)
No 42 (84%)
Fetus death Yes 10 (20%)
No 40 (80%)
Type of delivery Vaginal 26 (52%)
Assisted vaginal 14 (28%)
Cesarean 10 (20%)
Table 3: Comparison of SCL-90 scores- lst
week of postpartum women and at
4-5 weeks of postpartum.
Subscales on SCL- 90
1st
week of
postpartum
period
4-5 weeks of
postpartum t-value
Mean SD Mean SD
Somatization 15.6 5.7 9.5 4.6 t = l 1.8**
Depression 14.32 6.9 9.4 8.2
Anxiety 10.1 4.8 6.9 5.74
Obsession 5.7 4.1 2.5 2.5
Additional 2.4 1.7 1.10 .9
Interpersonal 1.3 1.6 .6 .7
Anger scale 2.1 2.1 2.1 2.1
Phobic .31 .465 .31 .465
Paranoid .05 .2 .04 .2
Psychosis .15 .575 .15 .575
Global Distress Index (GDI) 52.2 21.2 32.7 18.1 t = 11.48**
Positive Scored Items(PSI) 30.1 10.9 20.4 9.2 t = 10.59**
Positive Score Index (PSD) 1.7 .3 1.5 .3 t = 3.64**
Table 4: Comparison of HAM-D Scores in primiparous & Multiparous Women
at 1 week and 4 weeks of postpartum.
Primiparous Multiparous 1 week
4
week
Depressed Mood 12 4 16 4
Guilt 2 1 3 0
Suicide 1 0 1 0
Insomnia Early 4 2 6 2
Insomnia Middle 1 0 1 0
Insomnia Late 4 2 6 3
Work and Activities 8 5 13 4
Psychomotor retardation 10 6 16 4
Agitation 2 0 2 0
Anxiety (Psychological) 2 1 3 1
Anxiety (Somatic) 3 2 5 2
Somatic Symptoms
(Gastrointestinal)
2 1 3 1
Somatic Symptoms (General) 4 3 7 3
Genital Symptoms 1 0 1 0
Hypochondriasis 1 0 1 0
Loss of weight 6 2 8 3
Insight 8 4 12 2
Diurnal variation 6 2 8 2
Depersonalization &
Derealization
0 0 0 0
Paranoid symptoms 0 0 0 0
Obsessional & Compulsive
Symptoms
1 0 1 0
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Phobic scores of SCL-90 did not change from their mean values in
a significant way through week one to four week. The mean score
of subscale items of SCL-90 at 1 week and 4 weeks were compared.
Global distress indicator of burden of psychopathology also showed
significant decrease through week one to week four.
Primiparous women had higher & statistically significant scores
on Depressed mood, Insomnia early & late, Work & Activities,
Psychomotor retardation, Somatic symptoms (general), Loss of
weight, Insight and Diurnal variation; subscales of HAM-D than
Multiparous women. The subscale scores of HAM-D at 1 week and 4
weeks of postpartum were compared and the scores had significantly
decreased from 1 week to 4 weeks of the same.
The subscales Guilt, Suicide, Insomnia middle, Agitation, Anxiety
(psychological/somatic),Somaticsymptoms(gastrointestinal),Genital
symptoms, Hypochondriasis, Depersonalistion & Derealisation,
Paranoid symptoms and Obsessional & Compulsive symptoms of
HAM-D at 1 week decreased by 4 weeks of postpartum but were of
less significance throughout the postpartum period.
CONCLUSION
Postpartum period is associated with Somatic, Depressive, and
Anxiety symptoms and these symptoms had higher severity in first
week of postpartum. Spontaneous remission or lowering of severity
of psychological symptoms is seen through weeks one to four of
postpartum period and type of delivery was not associated with the
severity of psychological symptoms. Results obtained in the study are
difficult to extrapolate to community, as this study is hospital based.
ACKNOWLEDGEMENT
Authors would like to thank Dr. Faheemuddin Athar Naveeed,
Sr. Resident, and Dr. Amir Mohamed Sheriff, Junior Resident,
Department of Psychiatry for helping to collect the study data.
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