Notes

Parietal Encephalocele Along with Fenestrated Superior Sagittal Nose and chronic Falcine Nose.
To increase practicality and political feasibility, the optimal model was slightly modified.

The developed optimal model offers a politically and socially feasible set of policy instrument options, with which the placement of MDMA on List I can be revised, thereby reducing the damage of MDMA to users and society. For psychiatry, it means promoting therapeutic research and less nuisance from unnecessary stigmatization in the treatment of patients.
The developed optimal model offers a politically and socially feasible set of policy instrument options, with which the placement of MDMA on List I can be revised, thereby reducing the damage of MDMA to users and society. For psychiatry, it means promoting therapeutic research and less nuisance from unnecessary stigmatization in the treatment of patients.
Bipolar depression is a common clinical problem and forms a major challenge in clinical practice as there is a paucity of treatment options.

To review the evidence for pramipexole as a treatment option in treatment-resistant bipolar depression.

A PubMed search was performed using the search terms bipolar disorder or mood disorder or depressive disorder, treatment resistant and pramipexole or dopamine agonist. There were no limits on publication year. Furthermore, we contacted authors of included articles to help develop clinical recommendations for the use of pramipexole in bipolar depression.

Our results consist of 4 meta-analyses which are also systematic reviews. 2 RCTs, 1 open label trial, 2 naturalistic studies; 2 retrospective studies. The first RCT showed a significantly higher response compared to placebo (67% vs 20%), but not for remission (20% vs. 16%). A second RCT reported higher response and remission results with pramipexole compared to placebo (60% vs. 9%, 40% vs. 9%). Pramipexole was generally well tolerated.

The use of pramipexole in treatment resistant bipolar depression appears promising, but remains understudied. There is a need for randomized controlled trials.
The use of pramipexole in treatment resistant bipolar depression appears promising, but remains understudied. There is a need for randomized controlled trials.
Although mental health care for prisoners with mental health problems during and after detention improves re-integration and reduces criminal recidivism, prisoners with psychiatric problems seem to have difficulties connecting to regular mental health care after detention. Epigenetic inhibitor AIM To describe referrals from Flemish prisons to psychiatric hospitals or external therapeutic settings in the year 2019. METHOD All prisoners with mental health problems that were referred from a Flemish prison to mental health care in 2019 were studied (n = 577) , using data collected by the Flemish initiative TANDEM. RESULTS The vast majority of referrals were prisoners with a substance use disorder. In total, 1 in 5 prisoners with mental health problems directly had access to ambulatory or residential mental health care. 30% of these ultimately did not appear to start with the planned treatment.

Continuity of mental health care after detention is recommended and also has a social benefit. Improving cooperation between justice and external mental health care, taking into account the needs of the prisoner, is essential in the development of succesful treatment plans.
Continuity of mental health care after detention is recommended and also has a social benefit. Improving cooperation between justice and external mental health care, taking into account the needs of the prisoner, is essential in the development of succesful treatment plans.
Sexually transgressive behaviour by adolescents is a serious societal issue. Unfortunately, as this is a difficult group to research, the scientific evidence on which mental health workers can base their treatment is rather limited.

Mapping treatment interventions and their impact based on practical experience.

Qualitative research, through in-depth interviews with Flemish mental health workers (n = 10), presented as a narrative thematic analysis.

Adolescents who showed sexually transgressive behaviour were often scarred by developmental and psychological trauma. They should not necessarily be regarded as a separate category. Five main themes surfaced as focal points for treatment aligning with the profile of the adolescent, resistance and motivation, therapeutical relationship, need for a positive story, and the context. In addition, some common practical obstacles for succesful treatment were also identified.

Common factors of psychotherapy are key elements for their treatment as well. Treatment would also benefit from additional efforts, including investments into the continuity of care.
Common factors of psychotherapy are key elements for their treatment as well. Treatment would also benefit from additional efforts, including investments into the continuity of care.
There are concerns about the declining efficacy of antidepressants and antipsychotics in clinical trials. A potential cause may be found in poor training practices to achieve sufficient inter-rater reliability (IRR). However, it is unknown whether IRR and training procedures are currently reported.

To determine the proportion of publications concerning double-blind randomized controlled trials (RCTs) investigating antipsychotics or antidepressants that report IRR and training procedures.

We extracted all double-blind RCTs from five large meta-analyses concerning antidepressants and antipsychotics. Further, we conducted a Medline-search for double-blind RCTs investigating antidepressants from January 2016 - January 2020, and antipsychotics from January 2000 - January 2019.

In 179 double-blind RCTs with antidepressants, only 4.5% reported an IRR coefficient whereas 27.9% reported on training procedures. Further, in 207 double-blind RCTs with antipsychotics, 11.2% reported an IRR coefficient and 34.8% reported training procedures.

There is a substantial lack of reporting IRR and training procedures in RCTs with antidepressants and antipsychotics. Considering the implications of insufficient IRR, it is necessary to conduct and report training procedures and IRR. Reporting IRR and training procedures should be made mandatory by editorial boards of scientific journals.
There is a substantial lack of reporting IRR and training procedures in RCTs with antidepressants and antipsychotics. Considering the implications of insufficient IRR, it is necessary to conduct and report training procedures and IRR. Reporting IRR and training procedures should be made mandatory by editorial boards of scientific journals.
Antipsychotics are considered the cornerstone for the treatment of schizophrenia and are increasingly used in the treatment of mood disorders. A lack of drug adherence is a frequently occurring problem. Depot antipsychotics have been co-developed in order to deal with this problem.

To map the depot antipsychotics prescription behaviour of psychiatrists and general practitioners in outpatient practice in Belgium.

Analysis of sales data of antipsychotics between 1997 and 2016. Data were supplied by Pharmanet, a database within the National Institute for Health and Disability Insurance (NIHDI).

In the period 1997-2004, outpatient sales of depot antipsychotics decreased by 20%. The portion of depot antipsychotics in total antipsychotics sales dropped from 14.9% (1997) to 8.5% (2004). After second-generation depot antipsychotics were introduced from 2004, the sales figures of depot antipsychotics increased by 83%. In 2016, 9.8% of antipsychotic prescriptions was a depot antipsychotic prescription. As of 2012, more second-generation depot antipsychotics (52.2%) were sold than first-generation depot antipsychotics (47.8%). Psychiatrists were quicker to adopt second-generation depot antipsychotics than general practitioners, a trend similar to oral antipsychotics.

Outpatient sales of depot antipsychotics in Belgium were on the rise after second-generation long-acting preparations were introduced to the market. Recent Scandinavian studies suggest that an increase in prescription of depot antipsychotics may contribute to better clinical outcomes.
Outpatient sales of depot antipsychotics in Belgium were on the rise after second-generation long-acting preparations were introduced to the market. Recent Scandinavian studies suggest that an increase in prescription of depot antipsychotics may contribute to better clinical outcomes.
In various countries, general practitioners (GPs) play an important role after treatment for non-affective psychotic disorder (NAPD) in mental health care. It is unclear how these patients fare.

To compare the clinical course of patients largely recovered from NAPD and referred to the GP with the course of patients who remain in treatment at mental healthcare.

In a retrospective cohort study, 20 patients referred to GPs by mental healthcare (GP cohort) were compared to 20 patients who remained in treatment at mental healthcare (MH cohort), matched by age and gender. The clinical course was evaluated with the GPs and the mental healthcare practitioner, respectively. In addition, medication adherence and reasons for referral to the GP and mental healthcare were registered.

In the GP cohort more patients (70%) deteriorated than in the MH cohort (5%) (p <0.001). In the MH cohort more patients showed therapeutic compliance (90%) than in the GP cohort (67%) (p = 0.078). After about four years, 65% of the patients in the GP cohort were back in treatment at mental healthcare. Among the 13 patients who were referred to the GP while functioning stably, more patients (54%) deteriorated than their matched counterparts in the MH cohort (8%) (p = 0.034).

The results confirm that caution is needed in referring patients recovered from non-affective psychotic disorder to the GP.
The results confirm that caution is needed in referring patients recovered from non-affective psychotic disorder to the GP.
A clinical admission is a frightening event, especially in a crisis situation, and above all when it comes with legal measures. The effectiveness of an acute crisis admission has been demonstrated in a Cochrane review, but cohort studies of a clinic setting are not yet available.

To assess and determine the treatment effects after a crisis admission in a metropolitan acute psychiatric clinic of patients with severe mental illness (SMI patients).

In the context of routine outcome monitoring, the 12 HoNOS scores at admission and discharge (pre- and post-measurements) were rated by clinicians. The data of 1423 patients were analyzed by a statistician.

The crisis admissions have a substantial positive clinical effect 76 percent of the patients improved, 16 percent was stable and 10 percent worsened (effect size ES = 1.2). The patients improved most in regard to psychotic problems, aggressiveness and social problems. This applies equally to patients who have been admitted voluntarily, as well as to patients with a legal measure. The admission duration of patients is two months, except for patients with compulsory treatment (seclusion, sedation, forced medication). In this case the treatment duration prolongs to three months.

Acute short-term clinical admission is an effective part of the clinical and outpatient treatment chain for patients with severe mental illness (SMI). A substantial treatment effect is achieved by the crisis admission. These findings are an important addition to the Cochrane review.
Acute short-term clinical admission is an effective part of the clinical and outpatient treatment chain for patients with severe mental illness (SMI). A substantial treatment effect is achieved by the crisis admission. These findings are an important addition to the Cochrane review.
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