5 research outputs found
INTEGRATED SPECIALIZED EARLY-COURSE PSYCHOSIS TREATMENT SERVICES - UNIVERSITY PSYCHIATRIC HOSPITAL VRAPCE MODEL
First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective
therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models
INTEGRATED SPECIALIZED EARLY-COURSE PSYCHOSIS TREATMENT SERVICES - UNIVERSITY PSYCHIATRIC HOSPITAL VRAPCE MODEL
First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective
therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models
First Psychotic Episode Treatment
Pravodobno otkrivanje i lijeÄenje oboljelih od prvih psihotiÄnih poremeÄaja jedan je od najveÄih izazova suvremene psihijatrije. Suvremeni pristupi lijeÄenju psihotiÄnih poremeÄaja naglasak stavljaju na funkcionalni ishod bolesti. Osnova i temelj lijeÄenja shizofrenije i drugih psihotiÄnih poremeÄaja iz spektra shizofrenije jest primjena antipsihotika. Antipsihotici se rabe i u lijeÄenju svih ostalih psihotiÄnih poremeÄaja. Ovisno o indikaciji, može se razlikovati preporuÄena duljina primjene antipsihotika. Zbog specifiÄnosti farmakoterapije u prvoj psihotiÄnoj epizodi potrebni su uvoÄenje antipsihotika druge ili treÄe generacije kao prve linije terapije, zapoÄinjanje niskom dozom te pažljivo i polako titriranje radi postizanja minimalne uÄinkovite doze lijeka. Psihosocijalne intervencije (u biopsihosocijalnom kontekstu) sastavni su dio lijeÄenja prve psihotiÄne epizode i tijekom akutnog lijeÄenja i u fazi postizanja i održavanja remisije.prva psihotiÄna epizoda; antipsihotici; rane intervencije; psihosocijalne metode lijeÄenj
APPROACH TO EMERGENCIES IN SCHIZOPHRENIA IN UNIVERSITY HOSPITAL "VRAPÄE"
Background: An emergency in psychiatric setting is any disorder in thought process, feelings and/or behavior of the patient that
requires urgent therapeutic intervention. In general, we can observe an increase in numbers of psychiatric emergencies throughout the world and in Croatia as well. Agitation and aggression are one of the most common causes of emergency in psychiatry. Agitation is common and frequent in patients suffering from schizophrenia. Patient can be agitated in various levels such as: mild, moderate or evere and can alternate between these levels in the same presentation. Agitated patients often require hospitalization that includes pharmacotherapy and sometimes physical restraining, in order to treat the cause of agitation and prevent auto and/or heterodestructive behavior.
Subjects and methods: In this paper we focus on patients suffering from schizophrenia that were admitted in University Hospital "VrapÄe" in 2017, and assess the numbers through the criteria of voluntary vs. involuntary admissions and physical restraint usage.
Results: Out of total observations, 130 (35.6%) were patients admitted for the first time and 179 (49%) were patients later
diagnosed with schizophrenia spectrum and other psychotic disorders. Court ordered involuntary hospitalization was ordered for 35 (2.8%) patients out of total admitted patients, and 68.6% (N24) of them were diagnosed with schizophrenia spectrum and other psychotic disorders. Physical restraint was used for 122 patients out of total admissions and 28.7% (N35) of restrained patients were diagnosed with schizophrenia spectrum and other psychotic disorders.
Conclusions: Emergencies in patient suffering from schizophrenia are extremely delicate and demanding situations in every-day
clinical practice of psychiatrist. There is an increased risk involved for the patient but for the staff as well. All interventions should be individualized and patient should carefully monitored throughout the entire process. All professionals involved in care for a patient should be up to date with medical and legal issues
Obuzeto-prisilni poremeÄaj
U radu su prikazane najnovije spoznaje o epidemiologiji, dijagnostici i lijeÄenje obuzeto-prisilnog poremeÄaja (OPP).
Prikazani rezultati pokazuju da je OPP znatno ÄeÅ”Äi no Å”to se ranije mislilo, a dijagnostika je obogaÄena nizom novih
neuroslikovnih istraživanja Å”to pobuÄuju nadu u bolje poznavanje etiologije poremeÄaja. Dat je pregled genetskih istraživanja,
kao i naÄini lijeÄenja poremeÄaja, kako psihofarmakoloÅ”ki, psihoterapijski tako i transkranijskom magnetskom
stimulacijom, dubokom stimulacijom mozga i neurokirurŔkim metodama