Open Journal of Psychiatry
ISSN / EISSN : 2161-7325 / 2161-7333
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 394
Latest articles in this journal
Open Journal of Psychiatry, Volume 12, pp 1-10; https://doi.org/10.4236/ojpsych.2022.121001
Introduction: Zébé Psychiatric Hospital is the only psychiatric hospital able to receive forensic mentally ill patients in Togo. The aim of this study was to describe the socio-demographic, clinical and forensic aspects of forensic mentally ill patients. Method: This was a descriptive cross-sectional study conducted from August 16th to September 16th, 2021 among forensic patients admitted to the Zébé Psychiatric Hospital. Results: During the study period, we recorded 28 forensic mentally ill patients. Fifty-seven point one percent (57.1%) of the forensic patients came from rural areas. The mean age of these patients was 37.3 years, and ranged from 13 to 82 years. Males predominated in 96.4% of cases. Primary education represented 39.3% of cases. Single people predominated in 92.9% of cases. They were unemployed in 64.3% of cases. Forty-six point four percent (46.4%) of these patients were using at least one psychoactive substance. Forensic offenses were dominated by murder in 53.6% of cases. The victim was a family member in 53.6% of cases and male in 60.7% of cases. They had schizophrenia spectrum disorders in 78.6% of the cases. Forty-six point four percent (46.4%) of these patients were not responsible for their offences and 82.1% were abandoned by their families. Conclusion: The information gathered in this study will help to better organize strategies for mental health promotion and prevention of mental illness and crime in the general population.
Open Journal of Psychiatry, Volume 12, pp 49-52; https://doi.org/10.4236/ojpsych.2022.121005
The Association of Schizophrenia, psychosis, and Marijuana is decades old. Swedish Conscripts cohort study  was one of the earlier studies which reported dose-dependent associations between Marijuana use and schizophrenia. This landmark study was substantiated in other countries through research and systematic reviews , which further strengthened the dose-dependent association between Marijuana and Psychosis. The dose defined in these studies  was based on the frequency of use that is more times used means more risk of developing schizophrenia and or related psychosis. The concept of using highly concentrated marijuana is relatively new, especially in the light of episodes lasting longer than anticipated with treatment resistance. There is not much data on how it will change the course of psychosis and affect the current diagnostic criteria for Substance-induced psychosis, Schizophreniform Psychosis, and schizophrenia. Based on these challenges, we report a case of Dabs or concentrated Tetra Hydro Cannabinoid (THC)-induced prolonged psychosis with tachycardia and treatment resistance on two separate occasions. Both inpatient admissions were triggered using concentrated Tetra Hydro Cannabinoid (THC).
Open Journal of Psychiatry, Volume 12, pp 157-173; https://doi.org/10.4236/ojpsych.2022.122013
Purpose: Our study aimed to evaluate the psychological impact of COVID-19 pandemic on Chinese patients with common mental disorders in primary care in Hong Kong. Method: A cross-sectional study was conducted on 102 Chinese patients with common mental disorders and being followed up in two public integrated mental health clinics in Hong Kong from 1st November 2020 to 31st January 2021. Patients would be evaluated about the impact of COVID-19 pandemic on their mood and daily life by using a questionnaire which assessed social distancing effects, financial impact, relationship with family, anxiety and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 Questionnaire (GAD-7) would also be used to assess patients’ mood symptoms. Factors which were related to COVID-19 pandemic and associated with anxiety or depressive symptoms would be analysed. Results: The mean age of the subjects was 58.0 years and more patients were female (77.5%). There were 84.3% and 72.5% of patients reported their anxiety and depressive symptoms being affected by COVID-19 pandemic respectively. It was found that 17.6% of patients had their income decreased or were unemployed. About one-third (30.4%) of patients indicated that their relationship with their family was worsened while 8.8% was improved. Social distancing was significantly associated with anxiety (p = 0.006) and depressive symptoms (p 0.001) in patients with common mental disorders. Conclusion: There was considerably more psychological impact including an increase in anxiety and depressive symptoms due to COVID-19 pandemic in Chinese patients with existing common mental disorders in primary care. Primary care physicians should raise their awareness of the psychological impact of COVID-19 pandemic on their patients. Our findings shed light on mental health care planning and preventive measures during the COVID-19 pandemic and potential subsequent pandemics.
Open Journal of Psychiatry, Volume 12, pp 129-140; https://doi.org/10.4236/ojpsych.2022.122011
Background: When a disease is associated with stigma, there may be attendant negative consequences. Purpose: This review was to show how stigma-associated diseases impact negatively on the psychological and social wellbeing of the affected persons. Methods: The relevant articles for the review were obtained through PubMed and Google Scholar search on the internet using relevant keywords. Results: Several infectious and non-infectious diseases are associated with stigma. The causes of stigma in these diseases include fear of contracting the disease and dying from it, disfiguring caused by the disease and ignorance and misconception concerning the cause, nature and infectivity of the disease. Those suffering from stigma-associated diseases are usually discriminated against and denied the privileges and opportunities available for those not suffering from stigma-associated diseases. This often leads to psychosocial or psychiatric complications such as social isolation, depression or even suicidal ideation. Conclusions: Stigma-associated diseases still remain a very important health problem with attendant psychosocial consequences. Multi-disciplinary and multi-level efforts are required for its effective mitigation.
Open Journal of Psychiatry, Volume 12, pp 98-114; https://doi.org/10.4236/ojpsych.2022.121009
Screening patients for psychotic features can pose a problem when using verbal based tests. Establishment of validity of non-verbal psychotic screening scale can enhance diagnostic specificity and address challenges associated with verbal based tests. The goal of this study is to check whether Bender Visual Motor Gestalt Test-II will serve as a diagnostic specific tool for distinguishing between psychotic patients and healthy population. A total of 40 participants 22 males and 18 females were employed in the study. They were made of 10 patients diagnosed with schizophrenia, another 10 with depressions associated with psychotic features, 10 with substance/medication induced disorders and 10 healthy adults as the control. Their ages ranged from 20 - 65 with a mean age of 35.70 and standard deviation of 6.04. The healthy control group was staff of the hospital that was comparable to the patients in terms of age, gender and studies. All participants available who met the inclusive criteria who were willing to participate were selected. The instruments were (BVMGT-II) and (WHODAS 2.0). The design of the study was between group designs and One Way ANOVA was employed for data analysis. The findings of the study showed that BVMGT-II discriminated between patients with psychotic disorder and healthy population. It is recommended that BVMGT-II should be employed as screening instrument by the clinical/neuropsychologists in clinical psychological assessment for distinguishing psychotic patients from healthy population.
Open Journal of Psychiatry, Volume 12, pp 37-48; https://doi.org/10.4236/ojpsych.2022.121004
Introduction: Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. Methodology: Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. Results: We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. Conclusion: The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.
Open Journal of Psychiatry, Volume 12, pp 203-221; https://doi.org/10.4236/ojpsych.2022.122016
Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric out-patient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months’ periods was 24.2% (95% CI: 20.2% - 28.7%). The factors that were independently significantly associated with RSB were: trauma related (history of childhood trauma, past and current sexual abuse, past and current physical abuse) current psychosocial challenges (mental health stigma) and psychiatric illness factors (history of a past manic episode, current psychotic episode, severity of depressive symptoms and severity of manic symptoms). Conclusions: One quarter of clinic attending respondents with severe mental illness in Uganda practice risky sexual behaviour. Factors associated with risky sexual behaviour fall under the domains of past and present trauma, current psychosocial challenges and psychiatric illness factors. This calls for a multi-sectoral approach that includes community awareness about the nature of SMI and the rights of persons with SMI and measures to improve Psychiatric symptom management.
Open Journal of Psychiatry, Volume 12, pp 141-156; https://doi.org/10.4236/ojpsych.2022.122012
Introduction: Opioid use is a public health problem today. The aim of this study was to describe the socio-demographic characteristics, judicial aspects, addictive behaviours and medical aspects of heroin users placed on methadone (HUM) at the Integrated Addiction Care Centre of Kodjoviakopé (CEPIAK). Framework and Method: This was a descriptive cross-sectional study conducted at the CEPIAK in Lomé, Togo, from December 1st, 2020 to January 31, 2021. Results: A total of 200 HUM were included in this study. They were Togolese in 89.0% of cases. Their mean age was 43.4 ± 9.6 years with extremes ranging from 16 to 66 years. Males accounted for 90.5% of the HUM, i.e. a sex ratio of 9.5. Primary education accounted for 39.0% of cases. Single people accounted for 44.0% of cases. One hundred and nineteen HUM (59.5%) had a history of incarceration. Cannabis, tobacco and cocaine were the other drugs associated with heroin use in 79.5%, 74.5% and 59.5% of cases respectively. A history of overdose accounted for 18.0% of the HUM in our sample. Suicide attempts accounted for 19.5% of the HUM. Tuberculosis was detected in 5.5% of the HUM. HIV accounted for 3.0% of the HUM. Conclusion: It is important for the Togolese health system to give more importance to this issue, which is shared by the medical and social sectors, in order to effectively reduce and prevent these social ills.
Open Journal of Psychiatry, Volume 12, pp 115-127; https://doi.org/10.4236/ojpsych.2022.121010
Background: Physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition, and functioning in people who experience psychosis are interconnected factors. People experiencing psychosis are more likely to have low levels of physical activity, high levels of sedation, and sleep problems. Intervention: An eight-week intervention; including the provision of a Fitbit and its software apps, sleep hygiene and physical activity guidance information, as well as three discussion and feedback sessions with a clinician. Participants: Out of a sample of 31 using an early intervention psychosis (EIP) service who took part in the intervention, fifteen participants consented to be interviewed—9 (60%) males and 6 (40%) females, age range: 19 - 51 years, average age: 29 years. Method: In-depth interviews investigating patient experience of the intervention and its impact on sleep, exercise, and wellbeing were undertaken. Thematic analysis was applied to analyse the qualitative data and content analysis was used to analyse questions with a yes/no response. Results: Most of the participants actively used the Fitbit and its software apps to gain information, feedback, and set goals to make changes to their lifestyle and daily routines to improve quality of sleep, level of physical activity, and exercise. Conclusion: The intervention was reported to be beneficial, and it is relatively easy and low cost to implement and therefore could be offered by all EIP services. Furthermore, there is potential value for application in services for other psychiatric disorders, where there is often a need to promote healthy lifestyle, physical activity, and effective sleep.
Open Journal of Psychiatry, Volume 12, pp 53-72; https://doi.org/10.4236/ojpsych.2022.121006
The current paper is a theoretical proposal that interfaces the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and its emphasis on interpersonal consequences with the structured order of a Play Therapy Model for troubled 3 - 8-year-old children. This proposal is not a research paper or a review of literature; instead, it is a treatment proposal that is novel and untested. CBASP psychotherapy, an empirically validated treatment, was developed originally to treat the persistently depressed adult. CBASP’s major focus of interpersonal consequation will be interfaced with a Play Therapy structured model to rectify the maladaptive preoperational functioning of five interpersonal types of problem-children. The types are classified interpersonally using D.J. Kiesler’s Interpersonal Message Inventory (IMI). Kiesler’s IMI is employed in this proposal as an ongoing assessment modality, a source of information to make treatment strategy consequation decisions, and thirdly as an evaluative outcome variable. The troubled child types described herein frequently become candidates for early-onset Persistent Depressive Disorder (PDD) unless rescued by successful treatment. The origins of early-onset PDD arise in dysfunctional households where toxic interpersonal relationships predominate: where “survival from abuse,” not growth, describes the child’s modal developmental experiences. These children are often exposed to either serious traumas (e.g., sexual abuse, loss of a parent, physical abuse, physical or emotional neglect) or psychological insults (e.g., continuous, and chronic verbal and nonverbal abuse). The result, in the most serious cases, is a maturational stunting at the preoperational stage of development which, as noted above, if not successfully resolved, thrusts the child into early-onset PDD.