DOCSLIB.ORG

Summary of Junior MARSIPAN: Management of Really Sick Patients Under 18 with Anorexia Nervosa

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Summary of Junior MARSIPAN: Management of Really Sick Patients Under 18 with Anorexia Nervosa CR168s Summary of Junior MARSIPAN: Management of Really Sick Patients under 18 with Anorexia Nervosa COLLEGE REPORT College Report 168s October 2015 Approved by: Policy and Public Affairs Committee (PPAC), November 2014 Due for revision: 2016 © 2015 The Royal College of Psychiatrists College Reports constitute College policy. They have been sanctioned by the College via the Policy and Public Affairs Committee (PPAC). For full details of reports available and how to obtain them, visit the College website at http://www.rcpsych.ac.uk/publications/ collegereports.aspx The Royal College of Psychiatrists is a charity registered in England and Wales (228636) and in Scotland (SC038369). Contents Authors 2 Key recommendations 3 Risk assessment: how ill is the patient? 4 Location of care 9 Management in specific healthcare settings 11 Management in specialist eating disorders beds 18 Audit and review 20 Resources and further guidance 21 References 22 Contents 1 Authors The authors of this report are multidisciplinary, Dr Jane Whittaker, Consultant Child and independent, and have no conflicts of interest to Adolescent Psychiatrist, Manchester Children’s declare relating to the report. Hospital, Manchester Dr Agnes Ayton, Consultant Psychiatrist, Dr Damian Wood, Consultant Paediatrician, Cotswold House, Oxford Chair of the Royal College of Paediatrics and Child Health’s Young People’s Health Special Dr Rob Barnett, General Practitioner, Liverpool Interest Group, Nottingham University Hospital, Dr Mark Beattie, Consultant Paediatric Nottingham Gastroenterologist, Southampton General Hospital, Southampton Organisations that Dr Barbara Golden, Specialist Paediatrician, Honorary Senior Lecturer in Nutrition, University endorse CR168 of Aberdeen, Aberdeen BEAT Dr Lee Hudson, Consultant Paediatrician, Feeding and Eating Disorders Service, Great Ormond British Paediatric Mental Health Group Street Hospital, London British Society of Paediatric Gastroenterology, Ms Sarah Le Grice, Specialist Paediatric Dietician, Hepatology and Nutrition Royal Stoke University Hospital, Stoke-on-Trent Faculty of Eating Disorders, Royal College of Dr Colin Michie, Consultant Senior Lecturer in Psychiatrists Paediatrics, Ealing Hospital, Southall Nutrition Group of the Royal College of Paediatrics Dr Gail Moss, Consultant Paediatrician, Sheffield and Child Health Children’s Hospital, Sheffield Royal College of Psychiatrists Dr Dasha Nicholls, Consultant Child and Young People’s Special Interest Group, Royal Adolescent Psychiatrist, Feeding and Eating College of Paediatrics and Child Health Disorders Service, Great Ormond Street Hospital, London Dr Graeme O’Connor, Specialist Dietitian, Feeding Acknowledgements and Eating Disorders Service, Great Ormond With thanks to Dr Simon Chapman, Ms Sarah Street Hospital, London Cawtherley and Dr Sarah Ehtisham for comments Dr Paul Robinson, Consultant Eating Disorders on this summary. Psychiatrist, St Ann’s Hospital Eating Disorders Service, London Dr Francine Verhoeff, Consultant General Paediatrician, Alder Hey Children’s Hospital, Liverpool 2 College Report 168s Key recommendations 1 All health professionals should be aware that 7 The key tasks of the in-patient paediatric/ anorexia nervosa is a serious disorder with medical team are to: life-threatening physical and psychological { safely re-feed the patient, avoiding re-feed- complications, and patients require the same ing syndrome or underfeeding level of care and should be subject to the { manage, with CAMHS support, the same emergency protocols as a child with behavioural manifestations of anorexia any other serious illness. nervosa 2 Some risk parameters need to be adjusted for { use appropriate legal frameworks to treat age and gender, including body mass index patients under compulsion if needed (BMI). { arrange appropriate transfer to CAMHS 3 Parents/carers play a central role in care and as soon as it is safe to do so. decision-making until the patient is 18 years of 8 Health commissioners should: age, with increasing autonomy for the young person according to age, developmental { commission adequately resourced acute stage and capacity. paediatric services and appropriately skilled mental health services for the care 4 The role of primary care is to monitor patients of young people with anorexia nervosa and refer early to specialist services. { support joint working between services 5 A lead consultant paediatrician and a lead (e.g. fund CAMHS nursing staff during consultant psychiatrist should be identified to admission) coordinate care for Junior MARSIPAN patients and build working partnerships and develop { be aware of gaps in local resources and protocols to support admission, including pro- support referral to national centres for tocols for transition for young people 16–18 advice or treatment when necessary. years of age. 6 The clinical condition of the patient, the quality of liaison between paediatric and child and adolescent mental health services (CAMHS) eating disorder services and the clinican’s experience in managing malnutrition should be the primary factors in deciding appropriate location of care. Key recommendations 3 Risk assessment: how ill is the patient? Risk assessment combines clinical assessment underlying physical illness, it is important not to with investigations, assessment of motivation and delay re-feeding. engagement with treatment plans, and available Cardiologists increasingly use the ‘tangent method’ parent or carer support to determine the risk of to calculate the QTc interval (Postema et al, 2008). serious complications to a young person. For A tangent is drawn to the steepest slope of the example, some (but not many) people are healthy last limb of the T wave in lead II or V5. The end of and menstruating at low weights, and medi- the T wave is the intersection of the tangent with cally unstable patients can be a normal weight. the baseline. QTc is defined as QT/√RR (Bazett’s Behaviours associated with eating disorders are formula; Fig. 1). often covert, and children and pre-pubescent ado- lescents can present with atypical features. The Sick children and adolescents with eating disorders risk assessment framework presented in Table who need admission require the same level of 1 is intended as a guide to level of concern. The care as with any other serious illness. Decisions rationale for the parameters can be found in the about cardiac monitoring and admission to a full Junior MARSIPAN report (Royal College of high-dependency unit or psychiatric intensive care Psychiatrists, 2012a). The framework can be used unit are made by the admitting team. A sick child to assess and grade concern, but are not a sub- with an eating disorder needs senior paediatric stitute for assessment by an experienced clinician. review on admission and at least daily if there are paediatric (medical) issues. Eating disorders are relatively common, but many of the possible differential diagnoses are Physical assessment parameters and actions to not. If, after a careful clinical history, examina- take are presented in Table 2. tion and initial investigations, there is no obvious RR interval Tangent T P U Lead II or V5 Baseline QRS QTc = QT / √RR (sec) QT Fig. 1 Calculating the QTc interval. Reproduced with permission from Postema et al (2008). 4 College Report 168s Table 1 Risk assessment framework for patients with anorexia nervosa <18 years old Red (high risk) Amber (alert to high concern) Green (moderate risk) Blue (low risk) Body mass • % median BMI < 70% (~below • % median BMI 70-80% (~between • % median BMI 80–85% (~between • % median BMI > 85% (~above 9th 0.4th BMI centile) 2nd and 0.4th BMI centile) 9th and 2nd BMI centile) BMI centile) • Recent loss of ≥ 1 kg for 2 • Recent loss of ≥ 500–999 g/week • Recent loss of < 500 g/week for 2 • No weight loss over past 2 weeks consecutive weeks for 2 consecutive weeks consecutive weeks Cardiovascular • Heart rate (awake) < 40 bpm • Heart rate (awake) 40–50 bpm • Heart rate (awake) 50–60 bpm • Heart rate (awake) > 60 bpm health • Marked orthostatic changes (in • Moderate orthostatic • Pre-syncopal symptoms but • Normal orthostatic cardiovascular systolic BP of ≥ 20 mmHg, or in cardiovascular changes (in normal orthostatic cardiovascular changes heart rate > 30 bpm) systolic BP of ≥ 15 mmHg, or changes • Normal heart rhythm • History of recurrent syncope diastolic BP fall of ≥ 10 mmHg • Sitting blood pressure: • Normal sitting blood pressure for • Irregular heart rhythm (does not within 3 min of standing, or in – systolic <2nd centile age and gender with reference to include sinus arrhythmia) heart rate ≤ 30 bpm) (88–105mmHga) centile chartsa • Occasional syncope – diastolic <2nd centile • Sitting blood pressure: (40–45mmHga) – systolic <0.4th centile • Cool peripheries. Prolonged (84–98 mmHg) peripheral capillary refill time – diastolic <0.4th centile (normal central capillary refill time) (35–40 mmHga) ECG • All patients < 15 years: QTc • All patients < 15 years: QTc • All patients < 15 years: QTc 440– • All patients < 15 years: QTc abnormalitiesb > 460 ms > 460 ms 460 ms < 440 ms Risk assessment: how illisthepatient? • Females > 15 years: QTc > 460 ms • Females > 15 years: QTc > 460 ms • Females > 15 years: QTc 450– • Females > 15 years: QTc < 450 ms • Males > 15 years: QTc > 450 ms • Males > 15 years: QTc > 450 ms 460 ms • Males > 15 years: QTc < 430 ms • With evidence of bradyarrhythmia • Males > 15 years: QTc 430–450 ms or tachyarrhythmia (excludes • And taking medication known to sinus bradycardia
Load more

Recommended publications
  • University of Redlands Psychiatrist Referral List Most Major Insurances Accepted Including Medi-Medi and Other Government (909) 335-3026 Insurances
    University of Redlands Psychiatrist Referral List Most major insurances accepted including medi-medi and other government (909) 335-3026 insurances. But not limited to Aetna HMO/PPO, Cigna, TRIWEST, MANAGED Inland Psychiatric Medical Group 1809 W. Redlands Blvd. HEALTH NETWORK, Universal care (only for brand new day), Blue Shield, IEHP, http://www.inlandpsych.com/ Redlands, CA 92373 PPO / Most HMO, MEDICARE, Blue Cross Blue Shield, KAISER (with referral), BLUE CROSS / ANTHEM, HeathNet Providers available at this SPECIALTIES location: Chatsuthiphan, Visit MD Anxiety Disorder, Appointments-weekend, Bipolar Disorders, Borderline Personality Disorders, Depression, Medication Management, Obsessive Compulsive Disorder - Ocd Belen, Nenita MD Adhd/Add, Anxiety Disorder, Appointments-weekend, Bipolar Disorders, Depression, Medication Management, Meet And Greet, Obsessive Compulsive Disorder - Ocd, Panic Disorders, Phobias, Ptsd Adhd/Add, Adoption Issues, Aids/Hiv, Anger Management, Anxiety Disorder, Bipolar Disorders, Borderline Personality Disorders, Desai, David MD Conduct/Disruptive Disorder, Depression, Dissociative Disorder, Medication Management Farooqi, Mubashir MD Addictionology (md Only), Adhd/Add, Anxiety Disorder, Appointments-evening, Appointments-weekend, Bipolar Disorders, Conduct/Disruptive Disorder, Depression, Obsessive Compulsive Disorder - Ocd, Ptsd Julie Wareham, MD General Psychiatry, Inpatient hospital coverage for adolescent, adult, chemical dependency and consult and liaison services. Sigrid Formantes, MD General Psychiatry, General Psychiatrist Neelima Kunam, MD General Psychiatry, Adult Psychiatrist General Psychiatry, Adult Psychiatrist John Kohut, MD General Psychiatry, Adult Psychiatrist Anthony Duk, MD InlandPsych Redlands, Inc. (909)798-1763 http://www.inlandpsychredlands.com 255 Terracina Blvd. St. 204, Most major health insurance plans accepted, including student insurance Redlands, CA 92373 Providers available at this SPECIALTIES location: * Paladugu, Geetha K. MD Has clinical experience in both inpatient and outpatient settings.
    [Show full text]
  • First Episode Psychosis an Information Guide Revised Edition
    First episode psychosis An information guide revised edition Sarah Bromley, OT Reg (Ont) Monica Choi, MD, FRCPC Sabiha Faruqui, MSc (OT) i First episode psychosis An information guide Sarah Bromley, OT Reg (Ont) Monica Choi, MD, FRCPC Sabiha Faruqui, MSc (OT) A Pan American Health Organization / World Health Organization Collaborating Centre ii Library and Archives Canada Cataloguing in Publication Bromley, Sarah, 1969-, author First episode psychosis : an information guide : a guide for people with psychosis and their families / Sarah Bromley, OT Reg (Ont), Monica Choi, MD, Sabiha Faruqui, MSc (OT). -- Revised edition. Revised edition of: First episode psychosis / Donna Czuchta, Kathryn Ryan. 1999. Includes bibliographical references. Issued in print and electronic formats. ISBN 978-1-77052-595-5 (PRINT).--ISBN 978-1-77052-596-2 (PDF).-- ISBN 978-1-77052-597-9 (HTML).--ISBN 978-1-77052-598-6 (ePUB).-- ISBN 978-1-77114-224-3 (Kindle) 1. Psychoses--Popular works. I. Choi, Monica Arrina, 1978-, author II. Faruqui, Sabiha, 1983-, author III. Centre for Addiction and Mental Health, issuing body IV. Title. RC512.B76 2015 616.89 C2015-901241-4 C2015-901242-2 Printed in Canada Copyright © 1999, 2007, 2015 Centre for Addiction and Mental Health No part of this work may be reproduced or transmitted in any form or by any means electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system without written permission from the publisher—except for a brief quotation (not to exceed 200 words) in a review or professional work. This publication may be available in other formats. For information about alterna- tive formats or other CAMH publications, or to place an order, please contact Sales and Distribution: Toll-free: 1 800 661-1111 Toronto: 416 595-6059 E-mail: [email protected] Online store: http://store.camh.ca Website: www.camh.ca Disponible en français sous le titre : Le premier épisode psychotique : Guide pour les personnes atteintes de psychose et leur famille This guide was produced by CAMH Publications.
    [Show full text]
  • New Eating Disorder Service
    ORIGINAL PAPERS New eating disorder service Harry R, Millar Aims and method The paper describes the first three the Grampian area. We welcome direct enqui years experience of a new out-patient eating disorder ries from patients, relatives and friends, but service for adults. Clinical data on referrals using strongly encourage referral through the GP and standardised assessments are presented. if the GP is not involved a psychiatrist sees the Results The referral rate rapidly rose to over 200 referral. patients per annum. Forty-nine per cent of referrals We wish to enable generalist colleagues to were bulimic disorders and 26% had either anorexia continue seeing patients and offer a consul nervosa or atypical anorexia nervosa. Seventy per cent tative service to them but some managers were directly referred by general practitioners. seemed to believe that we should see all eating Clinical implications The creation of a specialist disorder patients. We had to explain that this eating disorder service quickly leads to a high referral is not logistically possible and not clinically rate suggesting a previously unmet need. A service necessary. based on assessment and treatment by nurse therapists is acceptable and feasible with appropriate training and support from psychiatry, clinical psychology and Assessment dietetics. Expectations of a specialist service include We have tried to provide a "comprehensive teaching, consultation, research and audit as well as multidimensional assessment" as recommended the provision of direct clinical care. by the American Psychiatric Association (1993). A Royal College of Psychiatrists (1992) report This includes two to three sessions with the recommends that across the country "a con primary therapist, a nutritional assessment by sultant-led local service for eating disorders the dietician, a physical assessment by a junior should be established, together with appropriate doctor and, if indicated, a psychiatric assess non-medial support." In 1994, an adult out ment by the consultant.
    [Show full text]
  • Neuroimaging in Criminal Trials and the Role of Psychiatrists Expert Witnesses: a Case Study
    International Journal of Law and Psychiatry 65 (2019) 101359 Contents lists available at ScienceDirect International Journal of Law and Psychiatry Neuroimaging in criminal trials and the role of psychiatrists expert witnesses: A case study Gkotsi Georgia Martha a,⁎, Gasser Jacques b, Moulin Valérie c a Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Site de Cery, Bat. Les Cèdres, 1008 Prilly, Lausanne, Switzerland b Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland c Maitre de Conferences of Universities, Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lau- sanne, Switzerland article info abstract Article history: Various neuroscientific techniques are increasingly being used in criminal courts causing a vivid debate on the Received 13 May 2018 way that this kind of techniques will and should be used as scientific evidence. The role of experts in this context Accepted 22 May 2018 is important, since it is them that analyse, present, interpret and communicate the results of these techniques to Available online 14 June 2018 the judges and the jury. In an attempt to contribute to the discussion about the role of the experts in criminal cases where neuroimaging Keywords: evidence was introduced, we examined twenty seven cases from the US and Europe. Focusing on the role of ex- Neuroscience fi Psychiatry perts and their presentation of neuroscienti c evidence, we aimed to examine the extent to which neuroimaging Experts data can contribute to the construction of a solid and more objective, “scientifically - based” case.
    [Show full text]
  • American Psychiatric Association the Principles of Medical Ethics
    American Psychiatric Association The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry 2013 Edition Copyright © 2010 American Psychiatric Association ALL RIGHTS RESERVED Manufactured in the United States of America 08 07 06 3 2 1 The Principles of Medical Ethics 2013 Edition (Previous editions 1973, 1978, 1981, 1984, 1985, 1989, 1992, 1993, 1995, 1995 Revised, 1998, 2001, 2001 Revised, 2006, 2008, 2009. 2009 Revised, and 2010 American Psychiatric Association 1000 Wilson Boulevard #1825 Arlington, VA 22209 THE PRINCIPLES OF MEDICAL ETHICS With Annotations Especially Applicable to Psychiatry 2013 Edition In 1973, the American Psychiatric Association (APA) published the first edition of The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry. Subsequently, revisions were published as the APA Board of Trustees and the APA Assembly approved additional annotations. In July of 1980, the American Medical Association (AMA) approved a new version of the Principles of Medical Ethics (the first revision since 1957), and the APA Ethics Committee1 incorporated many of its annotations into the new Principles, which resulted in the 1981 edition and subsequent revisions. This version includes changes to the Principles approved by the AMA in 2001. Foreword ALL PHYSICIANS should practice in accordance with the medical code of ethics set forth in the Principles of Medical Ethics of the American Medical Association. An up-to-date expression and elaboration of these statements is found in the Opinions and Reports of the Council on Ethical and Judicial Affairs of the American Medical Association.2 Psychiatrists are strongly advised to 3 be familiar with these documents. However, these general guidelines have sometimes been difficult to interpret for psychiatry, so further annotations to the basic principles are offered in this document.
    [Show full text]
  • Teenagers with Eating Disorders
    No. 02 May 2008 Teenagers with Eating Disorders In the United States, as many as 10 in 100 young women suffer from an eating disorder. Overeating related to tension, poor nutritional habits and food fads are relatively common eating problems for youngsters. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often. Parents frequently wonder how to identify symptoms of anorexia nervosa and bulimia. These disorders are characterized by a preoccupation with food and a distortion of body image. Unfortunately, many teenagers hide these serious and sometimes fatal disorders from their families and friends. Symptoms and warning signs of anorexia nervosa and bulimia include the following: • A teenager with anorexia nervosa is typically a perfectionist and a high achiever in school. At the same time, she suffers from low self-esteem, irrationally believing she is fat regardless of how thin she becomes. Desperately needing a feeling of mastery over her life, the teenager with anorexia nervosa experiences a sense of control only when she says "no" to the normal food demands of her body. In a relentless pursuit to be thin, the girl starves herself. This often reaches the point of serious damage to the body, and in a small number of cases may lead to death. • The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on huge quantities of high-caloric food and/or purges her body of dreaded calories by self-induced vomiting and often by using laxatives.
    [Show full text]
  • Psychiatric Consultant: Sample Job Description, Typical Workload
    Psychiatric Consultant: Sample Job Description, Typical Workload & Resource Requirements SAMPLE JOB DESCRIPTION The psychiatric consultant supports the collaborative care team—medical provider, patient, and behavioral health care manager—through regular consultation on an assigned caseload of patients. The psychiatric consultant advises the prescribing medical provider on appropriate medications and other treatment strategies, also providing the care team with educational support on diagnosing and managing behavioral health conditions. DUTIES AND RESPONSIBILITIES 1. Provide regularly scheduled (usually weekly) caseload consultation to behavioral health care managers. Case review consultations focus primarily on patients who are new to the caseload or who are not improving as expected under their current treatment plan. Case reviews may be conducted by telephone, video, or in person. 2. Work with behavioral health care managers to oversee the status and population health of their assigned patient caseload. The psychiatric consultant uses a registry to track all assigned patients and prioritize patients for case review and treatment adjustment. Registry functions can be accomplished through an EHR build, on a spreadsheet used in conjunction with an EHR, or can be built into a stand-alone clinical management tracking system that may or may not be linked to an EHR. 3. Recommend any treatment adjustments through the case review process or in ad hoc consultations, including medication recommendations and other interventions, within 24 hours of consulting with a behavioral health care manager or other team members. 4. Advise on treatment for patients who may need more intensive or more specialized mental health care, supporting treatment in the medical setting until patients can be engaged in specialized care as appropriate.
    [Show full text]
  • Glossary of Terms for Psychiatric Drugs
    GLOSSARY OF TERMS Citizens Commission on Human Rights 6616 Sunset Blvd, Los Angeles, CA. USA 90028 Telephone: (323) 467-4242 Fax: (323) 467-3720 E-mail: [email protected] www.cchr.org GLOSSARY OF TERMS ADDICTIVE: a drug, especially an illegal one or a activity: being lively, active; disorder: a condition psychotropic (mind-altering) prescription drug, that that has no physical basis but the diagnosis of which creates a state of physical or mental dependence or relies upon observing symptoms of behavior. These one liable to have a damaging effect. behaviors include: has too little attention, is too active, fidgets, squirms, fails to complete homework ADRENALINE: a hormone secreted by the inner or chores, climbs or talks excessively, loses pencils or part of the adrenal glands, which speeds up the toys and interrupts others. heartbeat and thereby increases bodily energy and resistance to fatigue. ATYPICAL: new, not typical, not like the usual or normal type. An atypical drug could be a new AKATHISIA: a, meaning “without” and kathisia, antidepressant or antipsychotic as opposed to older meaning “sitting,” an inability to keep still. Patients ones of the same class. The term atypical was used pace about uncontrollably. The side effect has been to market newer drugs as having fewer side effects linked to assaultive, violent behavior. than older drugs of the same class.Thorazine is a typical antipsychotic; Zyprexa is an atypical. Elavil AMPHETAMINES: any group of powerful drugs, or Remeron are typical antidepressants, Prozac and called stimulants, that act on the central nervous Zoloft are atypicals. system (the brain and the spinal cord), to increase heart rate and blood pressure and reduce fatigue.
    [Show full text]
  • Understanding a First Episode of Psychosis-Caregiver
    UNDERSTANDING A FIRST EPISODE OF PSYCHOSIS Caregiver: Get the Facts What does it mean when a Hearing a health care professional say your youth or health care young adult is experiencing a first episode of psychosis professional says can be confusing. The good news is that the emotions a “first episode and behaviors you have been concerned about are of psychosis”? often symptoms of a treatable disorder. By engaging in treatment and entering recovery, people with psychoses can feel better and can go on to lead productive, meaningful lives. Recovery does not necessarily mean a cure for people experiencing a first episode of psychosis. It does mean that people are actively moving toward wellness. It can be scary at first— “learning your child has a mental health diagnosis. But, once you really think about it, it is no different than learning your child has asthma or diabetes. It is important to talk with a health care provider about You become educated about the treatment options and additional information. Your provider may be a child and adolescent psychiatrist, condition, you find the resources general psychiatrist, psychologist, pediatrician, social and professionals your child worker, or other health care provider. If you are concerned that your youth or young adult is needs to be healthy, and you continue“ experiencing a first episode of psychosis, it is important to love your child just as to seek a thorough evaluation. The evaluation includes talking about their symptoms, blood and urine tests, much as you ever did. potentially a brain scan, and perhaps other tests to —Malisa, Parent ensure there is no underlying medical condition causing the symptoms.
    [Show full text]
  • Department of Psychiatry, Narcology, Neurology and Medical Psychology
    V. N. Karazin Kharkiv National University School of Medicine Department of Psychiatry, Narcology, Neurology and Medical Psychology GENERAL INFORMATION Today the Department of Psychiatry, Narcology, Neurology and Medical Psychology is one of the leading in Ukraine. Highly qualified specialists represent the researching and teaching staff. The department holds a high-level educational and methodical work with innovative approaches and presents the results of modern scientific research. DEPARTMENT’S HISTORY The history of the Department of Psychiatry, Narcology, Neurology and Medical Psychology at the School of Medicine of the V. N. Karazin Kharkiv National University actually begins with the foundation of the University. Recalling the history of psychiatry should be stressed that for the first time in Russia, professor of the Surgery Department of the Kharkiv Imperial University, P. A. Butkovskiy introduced the lectures of independent course of psychiatry since 1834. In the same year, the first Russian textbook of psychiatry "Mental Illness" was published. The teaching of Psychiatry at the Kharkiv Imperial University was conducted by the world famous professors: F. K. Albrecht, K. A. Demonsi, V. G. Lashkevich, J. S. Kremyanskiy. The first independent Department of Psychiatry and Neurology in Ukraine was established in 1877 and it was based on an independent course of psychiatry in the Kharkiv Imperial University, headed by professor P. I. Kovalevskiy. He trained many talented psychiatrists with a worldwide reputation: M. P. Popov, N. I. Mukhin, K. I. Platonov and others. After P. I. Kovalevsky the department was headed by N. I. Mukhin, and from 1894 to the October Revolution by J. A. Anfimov.
    [Show full text]
  • Katy Area Provider List of Therapists, Psychologists, and Psychiatrists
    Community Professionals Resource List (The professionals/agencies on this list are provided in response to requests for resources outside the school and are not recommended or endorsed by Katy ISD) Medi- Some Name Type Specialty Address City Zip Phone CHIP Website caid Insc. Agencies and Practices Katy Area Therapy for children ages 3 and up, teens, adults, families and couples. Groups offered, screenings for 3880 Greenhouse Banyan Counseling Practice depression, anxiety, ADHD, substance abuse. Katy/Houston 77084 281-855-1982 Yes Yes Yes www.banyancounseling.com Suite 306 Interventions and assessments for substance abuse problems. offers intensive outpatient(IOP), partial hospitalization(PHP), and Adult and Adolescent chemical dependency program. Affiliated with West 2900 Commercial Center Blvd. http://www.westoakshospital.com/exc Excel Center of Katy Agency Katy 77494 281-647-0020 Yes Yes Yes Oaks Hospital. For ages 13 and up. Will do a free Suite 102 elcenters/excel-katy.html assessment, but I would advise contacting before you go in Interface-Samaritan Counseling 1359 N. Mason New Agency Christian Counseling for children, adolescents, families Katy 77449 713-626-7990 No Yes No www.interface-samaritan.org Center Hope Presbyterian Church Multiple clinicians serving children, adolescents, adults 3880 Greenhouse Hope and Harmony Therapy Practice and families. Sliding scale offered. Sessions as low as Katy 77084 281-900-9575 No Yes No www.hopeandharmonytherapy.com Suite 216 $10 Counseling for children, adolescents, families, and Houston Center for Christian Practice individuals. **Only two clinicians accept CHIP and their 609 B. Park Grove Drive Katy 77450 281-398-0022 Yes Yes Yes www.christiancounselinghouston.com Counseling offices are in Sugar Land** Provide individual, couples, family and group counseling for children ages 5 and up.
    [Show full text]
  • Eating Disorder Consultant Psychiatrist Job Description for CR174 Revision
    Eating Disorder Consultant Psychiatrist Job Description for CR174 Revision Introduction Eating Disorders (ED) are a group of very complex Psychiatric Disorders and include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorders and Atypical Eating Disorders. The complexity of these disorders can be gauged from the fact that at 12 months only fifty percent of adolescents with anorexia nervosa go in remission and only 40 % of patients with bulimia nervosa go in remission by six months, with relapse common. Research indicates childhood onset of ED carries a high risk of continuity in adulthood. Hospitalisation of patients with ED appears to be associated with worse prognosis; the number of patients with eating disorders who needed hospitalisation has doubled in last three years. More than six out of every ten people with ED suffer from other psychiatric co-morbidities such as depression, anxiety and obsessive compulsive disorder (OCD). People with ED carry the highest risk of mortality among all the psychiatric disorders because of significant level of medical complexities associated with restriction of food intake. Patients with ED also carry higher risks of self-harm and suicide. People with Eating Disorders display a distorted attitude towards eating, weight and shape and may have irrational fear of becoming fat. The treatment of Eating disorders involves offering the patients individual and family based therapies, management of their physical and psychiatric risks and offering them nutritional support. The Consultant Psychiatrists with their comprehensive Psychiatric, Medical and Psychological training offer clinical leadership to Eating Disorder Services teams to deliver high quality care to patients who suffer from Eating Disorders and have very complex needs.
    [Show full text]