Prescribing Patterns of Antipsychotic Medication in a Long-Term Care Psychiatric Hospital

Introduction: In spite of recent pharmacologic advances, psychopharmacological treatment of patients with severe mental illness has remained a challenging task. Despite limited supporting evidence, the use of polypharmacy (prescription of more than one antipsychotic drug for an individual patient) has become a frequent approach. Polypharmacy has been associated with an increased incidence of adverse effects. Objective: To explore patterns of prescribing antipsychotic agents in a long-term inpatient facility. To examine the prevalence of polypharmacy and its association with age, sex, ethnicity and legal status in a sample of individuals with diverse psychiatric diagnoses. To determine the association of antipsychotic agents (single agent and polypharmacy use) and increased body mass index (BMI). Method: We examined the prescribing of antipsychotic drugs in a sample of 234 in-patients, during a 2-month period in a long term in-patient facility in Central Massachusetts during 2013. We performed a comprehensive review of patients ‘medical records and collected information on: age, sex, ethnicity, admission date, body mass index, primary and secondary diagnoses, and legal status (voluntary versus involuntary). We examined the use of the selected antipsychotic agents (haloperidol, clozapine, olanzapine, and risperidone) as well as determined median dose in milligrams for each agent. We created an additive score of antipsychotic to explore prescribing patterns in the described in-patients population and investigated the association of various demographic factors, diagnoses (affective versus psychotic disorder) with polipharmacy. We calculated the frequency of antipsychotic agents use in combination, and particularly determined the frequency of polypharmacy in patients receiving clozapine. Finally, we examined the association of high body mass index (\u3e25) with the use of particular antipsychotic agents alone, as well as with the use of polypharmacy

War exposure, PTSD, and Complex PTSD among parents living in Ukraine during the Russian war

Background: High rates of posttraumatic stress disorder (PTSD) have been documented in war-affected populations. The prevalence of Complex PTSD (CPTSD) has never been assessed in an active war zone. Here, we provide initial data on war-related experiences, and prevalence rates of ICD-11 PTSD and CPTSD in a large sample of adults in Ukraine during the Russian war. We also examined how war-related stressors, PTSD, and CPTSD were associated with age, sex, and living location in Ukraine. Method: Self-report data were gathered from a nationwide sample of 2,004 adult parents of children under 18 from the general population of Ukraine approximately six months after Russia’s invasion. Results: All participants were exposed to at least one war-related stressor, and the mean number of exposures was 9.07 (range = 1-26). Additionally, 25.9% (95% CI = 23.9%, 27.8%) met diagnostic requirements for PTSD and 14.6% (95% CI = 12.9%, 16.0%) met requirements for CPTSD. There was evidence of a strong dose-response relationship between war-related stressors and meeting criteria for PTSD and CPTSD. Participants who had the highest exposure to war-related stressors were significantly more likely to meet the requirements for PTSD (OR = 4.20; 95% CI = 2.96 -5.95) and CPTSD (OR = 8.12; 95% CI = 5.11 - 12.91) compared to the least exposed.Conclusions: Humanitarian responses to the mental health needs of the Ukrainian population will need to take account of posttraumatic stress reactions. Education in diagnosing and treating PTSD/CPTSD, especially in the situation of a significant lack of human resources and continuing displacement of the population, is necessary.<br/

Psychological consequences of war in Ukraine: assessing changes in mental health among Ukrainian parents

[Abstract unavailable.

Scoping Review: Digital mental health interventions for children and adolescents affected by war

Objective Over 200 million children and adolescents live in countries affected by violent conflict, are likely to have complex mental health needs, and struggle to access traditional mental health services. Digital mental health interventions have the potential to overcome some of the barriers in accessing mental health support. We performed a scoping review to map existing digital mental health interventions relevant for children and adolescents affected by war, examine the strength of the evidence base, and inform the development of future interventions. Method Based on a pre-registered strategy, we systematically searched MEDLINE, Embase, Global Health, APA PsychInfo, and Google Scholar from the creation of each database to 30th September 2022, identifying k=6,843 studies. Our systematic search was complemented by extensive consultation with experts from the GROW Network. Results The systematic search identified 6 relevant studies: one evaluating digital mental health interventions for children and adolescents affected by war and five for those affected by disasters. Experts identified 35 interventions of possible relevance. The interventions spanned from universal prevention to specialist-guided treatment. Most interventions directly targeted young people and parents/carers and were self-guided. A quarter of the interventions were tested through randomized controlled trials. Because most interventions were not culturally or linguistically adapted to relevant contexts, their implementation potential was unclear. Conclusion There is very limited evidence for the use of digital mental health interventions for children and adolescents affected by war at present. The review provides a framework to inform the development of new interventions