On what basis should we select treatment in clinical psychiatry: a question too obvious to ask? (original) (raw)
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The Psychiatric Treatment Plan
Perspectives in Psychiatric Care, 2009
How the treatment planning process is developed and documented in clinical settings is often influenced by various accreditation processes. As healthcare organizations attempt to incorporate written findings and verbal recommendations of surveyors, an incremental approach to the treatment plan often results. The authors describe how they attempted to alleviate this problem by deuising a conceptual framework for the treatment planning process using current HCFA and JCAHO standards and data obtained by reuiewing treatment plans from almost 100 psychiatric hospitals.
ISRN Psychiatry, 2014
The discipline of psychiatry has a plethora of guidelines, designed to serve the needs of the clinician. Yet, even a cursory glance is enough to discern the differences between the various guidelines. This paper reviews the current standard guidelines being followed across the world and proposes a unified guideline on the backbone of current evidence and practice being followed. The algorithm for pharmacological and psychosocial treatment for bipolar disorder, major depressive disorder, and schizophrenia is formulated after cross-comparison across four different guidelines and recent meta-analytical evidence. For every disorder, guidelines have different suggestions. Hence, based on the current status of evidence, algorithms have been combined to form a unified guideline for management. Clinical practice guidelines form the basis of standard clinical practice for all disciplines of medicine, including psychiatry. Yet, they are often not read or followed because of poor quality or because of barriers to implementation due to either lack of agreement or ambiguity. A unified guideline can go a long way in helping clear some of the confusion that has crept in due to the use of different guidelines across the world.
Australasian Psychiatry, 2003
for many years, if not for life, and the damage done to their minds and bodies may be irreversible. Anorexia nervosa is characterized by a deliberate loss of weight and refusal to eat. Overactivity is common. Approximately 50% of patients also use unhealthy purging and vomiting behaviours to lose weight. There are two main areas of physical interest: the undernutrition and malnutrition of the illness and the various detrimental weight-losing behaviours themselves. Basic psychopathology ranges from an over-valued idea of high salience concerning body shape through to total preoccupation and eventually to firmly held ideas that resemble delusions. Comorbid features are frequent, especially depression and obsessionality. It is inadvisable in clinical practice to apply too strict a definition of AN because to do so excludes patients in the early stage of the illness in whom prompt intervention is most likely to be effective.
Psychiatric Consultation: Part II. Conceptual and Pragmatic Issues of Formulation
Psychiatry in medicine, 1973
Seven principles governing the selection and organization of data during the process of psychiatric consultation are presented. These are based upon conceptual decisions implicitly made by the psychiatrist during his clinical investigation. Three case examples illustrate the principles, followed by discussion which focuses on the pragmatic considerations influencing how these decisions are made. Three additional case examples serve to illustrate the effects of the pragmatic factors. The entire analysis is based upon the general systems model developed in Part I.'