The Influence of the Mental State on the Emergency Colostomized Patients Postoperative Evolution

A colostomy creates a temporary or permanent opening for the colon through the abdominal wall, in order to eliminate fecal matter, which is collected in a closed or open bag, attached to the skin with the help of an adhesive. It is obvious that the patient with colostomy faces psycho-emotional problems, due to the alteration of the body image and the need to change the lifestyle.Under emergency conditions, when the informed consent of the critically ill patient, as well as the psychological preparation for the colostomized future, are difficult, incomplete or impossible to achieve, psychological assistance in the postoperative evolution of patients becomes a problem, on which the whole medical staff (doctors, nurses, psychologists, stomatotherapists) involved in their care must insist. In the immediate postoperative period, combating pain, ensuring biological comfort (hydric, caloric and nutritional), local care and prevention of so-called minor complications, are very important. The patient must also know the alternatives in choosing the type of colostomy bag and the prospects of social reintegration, over time. The measures of emotional support of these patients must be applied intensively, but with tact and professionalism, in parallel with the education and preparation for the new anatomical-physiological changes. In such situations, in addition to the surgical act and the postoperative physical care, the postoperative evolution and the therapeutic success depend, to a large extent, on the modelling of the patient’s mental state.The present paper focuses on the above-mentioned aspect, drawing on the data from the literature and the experience of the authors.</em

Social Resets and Suicides during Covid-19 Pandemic

Introduction. Well-known as a public health problem, suicide is known to cause many deaths during periods of economic and social unrest. Through the social changes imposed by the political and medical actors, the society knows old challenges, but also some completely new ones, which seem to influence the suicidal behavior among the population.Aim. The paper tries to present the effects of anti-Covid-19 social measures, especially those decided by the Romanian authorities between March 2020 and March 2021, on mental health and suicidal behavior. Also, by assessing the public policy intentions expressed publicly in European leadership circles for the medium-term future, we wanted to identify the impact on lifestyle and suicidal behaviour.Materials and method. The paper uses the medical literature in order to identify traditional or new risk factors for suicide, introduced into society by SARS-Cov-2 and the social restrictions that accompanied it. Also, sources from the domestic and international media are used to evaluate the future announced social resets and the possible impact on the suicidal behavior among the Romanian population.Results. The feeling of induced fear and the change of some social routines, imposed by the political factors in the context of the Covid-19 virus, are supposed to be accompanied by increases in the suicide rate. The new economic challenges and social antagonisms, predictable for the near future, bring with them the risk of increasing suicidal behavior among the world's population and Romania.Conclusion. In various countries, suicide rates have risen during the pandemic. New social measures are announced in authoritarian tones, with no intention of assessing the impact on the mental health of the population. The implementation of these innovative measures should be done only after balancing the psychological and psychiatric impact. The alternative could be the emergence of new epidemics of mental illness and suicide, which can unbalance society, as has never happened before.</p

Alcohol Addiction – A Psychosocial Perspective

AbstractAlcohol is the most widely used addictive substance, representing a genuine social phenomenon of global importance. Addiction to alcohol, as a dysfunctional pattern, has an undeniable impact on the overall functionality of the addict and his entourage. Alcohol addiction and alcohol itself represents something different for each individual depending on their socio-economic status and gender-based affiliation while maintaining a cultural cliché. The study aims to analyze the way in which individuals perceive alcohol and alcohol consumption according to gender, age, background, level of training and even consumer status

Persistent Depressive Disorder: the Clinical Approach of the Patient Associating Depression and Dental Pathology - Case Report and Clinical Considerations

Growing research literature has documented an increased association between depression and dental problems. Patients with severe dental problems suffer from psychosocial consequences, distress and psychiatric problems.AIM: To emphasize the relationship between resistant depression and poor dental health.METHOD:  This case report demonstrates the association between resistant depression and poor dental health in a 46-year-old female patient. Scores on clinical assessment measures suggested clinically severe levels of anxiety, worry, stigmatization, depression, sleeping and eating disorders and decreased satisfaction in quality of life at the beginning of the intervention. The theoretical rationale and treatment implications are presented.RESULTS: The scores on all these measures improved at the end of the dental interventions and no intense remaining depressive symptoms were reported afterward. Increased scores on life satisfaction and quality of life were documented as well. This case illustrates the potential benefit of dental treatment associating psychiatric treatment. A definitively positive association exists between poor dental health and depression. Once simultaneous treatment is initiated, there are chances for patients to have a positive evolution and social reinsertion.CONCLUSION: The high occurrence of depression, anxiety and stress among patients with dental problems highlights the importance of providing support programs and implementing preventive measures to anticipate and help persons with this type of pathology, particularly those who are most susceptible to higher levels of these psychological conditions.</p

Psychosis: between Dreams and Perceptual Reality

From the beginning of time, the layman always described and understood psychosis as a dream-like state. Researchers have characterized both psy-chosis and dreaming with common denominators, both displaying visuo-motor hallucinations, loose associations, metacognitive deficit, impaired reality discrimination, strong emotional component, resulting in a general lack of insight.The association of psychosis with dreaming was present in literature cen-turies ago, in the works of great thinkers such as Kant and Schopenhauer, which prompted many modern specialists to delve deeper into studying this connection for a better understanding of psychosis and possible ap-plications in the clinical practice. During REM sleep, which is the most associated with dreaming, visual and motor areas in the brain show in-creased activation, which is congruent with the presence of hallucinations, the hallmark of the dreaming state. Also, the amygdala, involved in emo-tion regulation, has a prominent role in the sleeping brain. The deactiva-tion of parts of the prefrontal cortex translate in altered capacity for mak-ing decisions and critical thinking. Several neuroimaging studies have shown similar neural patterns in the wakeful state of psychotic patients, especially those associated with the presence or absence of insight.As insight is thought to play a major role in treatment compliance and quality of life in psychotic patients, it is the most studied element linking psychosis and REM sleep. Lucid dreaming is a state of awareness of dreaming, while the individual is still asleep. The dreamer has a degree of control of the narrative and capacity for self-reflection, aspects deemed as insight. Lucid dreaming is a rare occurrence, but has the potential to be trained, concept with great relevance in researching modalities for insight gain in psychotic patients.In conclusion, the research of insight present in lucid dreaming shows great prospect for developing better interventions that target the lack of it in psychotic patients, thus contributing to significant improvement in their prognosis, quality of life and treatment compliance.</em

Evaluating the Impact of Dissociation in Psychiatric Disorders

Introduction: Dissociative symptoms are present in a various number of psychiatric disorders and are viewed as a major risk factor for suicidal and self-destructive behavior. Dissociation is defined in DSM-5 as a “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”. Assessing dissociation within different categories of mental disorders can be used to predict symptom severity and nonresponse to psychotherapeutic treatments. The most important tool in this process is the Dissociative Experiences Scale (DES). The purpose of the current study is to extend the understanding of dissociation in Psychiatric Disorders.Material and methods: The current study used PubMed and Cochrane databases to identify relevant articles that refer to the subject of dissociation in Psychiatric Disorders.Results and Discussions: Dissociation and dissociative disorders have been at the root of continuous controversy in psychiatric and psychology communities. The general confusion comes from the reduced conceptual distinction between dissociation as a symptom, process, deficit and psychological defense. At the high end of the DES score we find dissociative disorders, but closely followed by posttraumatic stress disorder, borderline personality disorder and conversion disorder with eating disorders, schizophrenia and anxiety disorders at midrange and the lowest scoring DES psychiatric disorder is found in bipolar disorders. Early intervention, based on these scores, show major improvement in maladaptive functionality, suicidal and self-destructive behavior, coupled with a reduction in total treatment cost.Conclusions: There is a significant benefit in careful assessment of dissociative symptoms for the entire spectrum of mental disorders. There is a major need to raise awareness in all mental health facilities, of the value that this has in the current clinical setting.</p

Emotional Exhaustion and Professional Satisfaction During Covid-19 Pandemic at the Level of Emergency Department Staff

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place.Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire.  Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.</p

TULBURĂRILE DIN SPECTRUL SCHIZOFRENIEI CU DEBUT ÎN COPILĂRIE ŞI ADOLESCENŢĂ – PROVOCAREA DIAGNOSTICĂ

Schizofrenia cu debut precoce şi foarte precoce, mai specifi c, manifestă înainte de 18, respectiv 13 ani, constituie o entitate nosologică încă insufi cient explorată, ce aduce cu sine o veritabilă provocare diagnostică dată de specifi cităţile vârstei timpurii la care apare. Totodată, schizofrenia cu debut în copilărie şi adolescenţă se întrepătrunde cu o serie de tulburări ale dezvoltării neurocognitive, având şi o importantă susceptibilitate genetică. Întregul context de apariţie a acesteia, difi cultatea detectării simptomelor psihoproductive în copilăria mică, severitatea simptomelor şi cronicizarea, impun o conduită diagnostică riguroasă şi o abordare multidisciplinară în vederea realizării terapiei optime de lungă durată şi integrării socio-familiale a pacienţilor. Lucrarea de faţă îsi propune sintetizarea datelor din litaratura de specialitate în vederea realizării unui precursor pentru cercetări viitoare ample, care să conducă la crearea unor ghiduri de abordare specifi că a schizofreniei la copil şi adolescent

Sleep Disorders Associated with Neurodegenerative Diseases

Sleep disturbances are common in various neurological pathologies, including amyotrophic lateral sclerosis (ALS), multiple system atrophy (MSA), hereditary ataxias, Huntington’s disease (HD), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB). This article reviews the prevalence and characteristics of sleep disorders in these conditions, highlighting their impact on patients’ quality of life and disease progression. Sleep-related breathing disorders, insomnia, restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and rapid eye movement sleep behavior disorder (RBD) are among the common sleep disturbances reported. Both pharmacological and non-pharmacological interventions play crucial roles in managing sleep disturbances and enhancing overall patient care

INTERRELAŢIA OBEZITATE – DEPRESIE LA COPIL ŞI ADOLESCENT

Obezitatea şi depresia reprezintă două probleme fundamentale de sănătate publică la nivel mondial, obezitatea pediatrică fi ind alarmantă atât per se, cât şi prin riscul menţinerii statutului de obez la vârsta adultă şi implicit a continuării expunerii la comorbidităţi. Pe de altă parte, depresia la copil este o veritabilă provocare diagnostică, dată fiind simptomatologia clinică mascată a acesteia, şi o necesitate date fi ind consecinţele severe ale acesteia şi, în particular, modifi cările patologice asupra comportamentului alimentar. Lucrarea de faţă îşi propune realizarea unei sinteze a literaturii de specialitate actuale cu privire la resorturile comorbidităţii obezitate – de presie la copil vizând interrelaţia şi originea etiopatogenică comună