Open Access Case Study

A Rare Case of an Elderly Woman with Delusional Parasitosis (Ekbom’s Syndrome)

A. S. M. Rizwan, Shahida Akhter

International Neuropsychiatric Disease Journal, Page 51-54
DOI: 10.9734/indj/2021/v15i230152

Introduction: Delusional parasitosis is a form of relatively rare psychiatric disorder in which the sufferer holds firms false believe of their skin being infested by parasite. On 1938 scientist Ekbom published a case report detailing 8 patients suffering from this delusional perception and hence this condition is also known as Ekbom’s syndrome.

Case Presentation: We present a 67 years old normotensive non diabetic female patient who was brought to the outpatient Department by her son with complain that, insects are crawling under her skin. She has been suffering from this condition for three years and it was causing tremendous psychosocial and physical adverse consequences. She has never been on treatment by any specialist before but has received treatment from traditional village healers with little improvement.

Conclusion: Ekbom’s syndrome is a rare yet important delusional disorder. This is a hard to treat condition that Doctors should be aware of.

Open Access Original Research Article

Gay Behaviors and Persistent Problems: Looked Globally Through the Lens of an Overview and a Single Case Report

Basmah Abdulaziz Helmi, Naseem Akhtar Qureshi

International Neuropsychiatric Disease Journal, Page 1-13
DOI: 10.9734/indj/2021/v15i230148

Background: Prior to 1973, homosexuality was considered a mental disorder. Gay Rights Movement in European-Western world, controversial variegated theories and political all out efforts ultimately removed homosexuality from Diagnostic and Statistical Manual of Mental Disorders (DSM-I&II) with highly conflicting consequences to major religions of the world.

Objective: This study aimed to overview gay behavior and described a single case with assaults and mixed emotions of gay activities at younger age who visited psychiatric clinics for consultation and treatment of gay behavior.

Methods: Electronic searches of relevant literature were conducted for retrieving most influential articles published in PubMed, Google Scholar and ScienceDirect using keywords and Boolean Operators and following eligibility criteria retained 54 articles. We comprehensively evaluated this case in outpatient clinic and systematically administered 12 sessions of cognitive behavior therapy (CBT).

Results: Currently, the diagnostic terms in terms of sexual and transgender identity disorder are used to address the problems of gay people in DSM or high risk homosexual behavior having problems with lifestyle in International Classification of Diseases (ICD-10). One person with chronic passive gay behavior with distressful aversion at later stage presented to the psychiatric clinic, expressed strong desire and motivation to change it, and after 12 CBT sessions improved and began to enjoy heterosexual life.

Conclusion: Although homosexuality fully derecognized in two major diagnostic classification systems of mental disorders across the world, some persons with agonizing and painful gay symptoms and psychiatric disorders and addictions to various substances eventually seek help from mental health professionals who manage them by diverse interventions resulting in better outcome and good quality of life including marital stability. Therefore, gay people presenting with psychological conditions or distressful behaviors need mental health services for changing their gay to heterosexual style and simultaneously addressing mental and physical disorders globally.

Open Access Original Research Article

Diseases of Burnout during the Pandemic of the New Corona Virus in Intensive Care Physicians and Its Impact on Serving the Population: A Descriptive Bibliographic Review

Alaís Brito Nascimento, Brenda Marques Rodrigues, Emanuelle Negrão Quaresma, Daniele Salgado de Sousa, Rebeson Moraes da Silva

International Neuropsychiatric Disease Journal, Page 14-25
DOI: 10.9734/indj/2021/v15i230149

The mental health issue during the COVID-19 pandemic must consider different populations: doctors / health professionals; general population and patients with mental disorders. When analyzing the stress-generating environment, such as intensive care units and emergencies, one must keep in mind the great demand for work and overload of professionals who are in this current pandemic scenario. Thus, this study aims to review the literature on the problems arising from the Burnout Syndrome in intensive care physicians during the COVID-19 pandemic. This study constitutes a descriptive bibliographic review on information about the main mental health complications of intensive care physicians directly involved in coping with the COVID-19 pandemic. The searches were performed in bibliographic databases Medline, Embase, Pubmed and Central, after the re-reading of each article, the data of interest were extracted and analyzed in a descriptive way for the composition of this work. Among the factors that modify the working environment of intensive care physicians working in the front line to combat COVID-19, are: limited hospital resources, threat of exposure to the virus as an additional occupational risk, longer shifts, disturbed sleep patterns, subsequent high dilemmas regarding duties with the patient versus fear of exposure to family members, increased workload, increased physical and mental fatigue, stress, anxiety and physical exhaustion. That said, measures must be taken to support intensive care groups in this phase of global public health. The measures include psychological counseling, organization of the workday, provision of personal protective equipment and training on safety measures. The present review showed evidence of how accentuated the cases of burnout and other emotional manifestations related to work stress worsened with the pandemic of COVID-19. Such emotional conditions have a negative impact on the care of patients undergoing intensive care units, as work stress causes illness, low motivation, unproductiveness and less self-confidence in their own work skills.

Open Access Original Research Article

A Profile of Adolescents Admitted on an Inpatient Psychiatry Unit in Nigeria and Their Evaluation of the Service

Tolulope Bella-Awusah, Yetunde Adeniyi, Haleem Abdurahman, Kehinde Lawal, Victoria Onileimo, Olayinka Omigbodun

International Neuropsychiatric Disease Journal, Page 39-50
DOI: 10.9734/indj/2021/v15i230151

Aims: This study set out to describe the profile of adolescents admitted unto an inpatient unit in Nigeria and their evaluation of the service. 

Study Design: This was a retrospective cohort study.

Place and duration of study: Department of Child and Adolescent Psychiatry, University College Hospital Ibadan, Nigeria between January 2016 and February 2020.

Methodology: Patient notes and discharge summaries were used to collect the  demographic characteristics of adolescents and their families, diagnoses and treatments provided during the hospital stay. A feedback form was used to evaluate different aspects of the service.  Data were analysed using descriptive statistics, and thematic analysis for open ended responses. 

Results: There were slightly more females (56.4%) than males (43.6%)admitted during the period of study and their mean age was 18.2 years (SD =3.0). The most common psychiatry diagnosis was psychotic disorders (48.9%) followed by mood disorders (38.3%). Almost half (48.6%) had 2 or more psychiatric diagnosis. Second generation antipsychotics were the most frequently used medications by the participants (76.6%). Median length of stay on the unit was 2.5 weeks (IQR = 2.6). Themes which emerged from patients’ experiences on the ward were reductions in feelings of isolation, changes in mental health perceptions and self – discovery. Strengths of the unit included staff responsiveness and team work. Weaknesses of the unit cited were the poor physical environment, and inflexible routines.  Suggestions on how to improve the unit included increasing recreational and physical activities and staff re - training. Parents/guardians also wanted more support for themselves, and peer support for their children. 

Conclusions: Majority of patients admitted onto this unit were older adolescents with psychotic and mood disorders. They and their parents/guardians were generally satisfied with the treatment milieu of the unit, and gave recommendations for further improvement of services on the unit.  

Open Access Review Article

Restraints and Restrictive Interventions during Essential Personal Care in Elderly People Living with Dementia in Care Homes

Matthew Crooks, Katherine Wakenshaw, Julie Young, Kayleigh Purvis, Karin Smith, Jennifer Loan, Laura Bell, Ian Andrew James

International Neuropsychiatric Disease Journal, Page 26-38
DOI: 10.9734/indj/2021/v15i230150

Care home staff are frequently required to provide invasive personal care for their residents, and on occasions need to use restraint and restrictive practices with people with dementia. This often occurs in situations where the residents no longer have the insight that they require help and may misperceive the personal assistance as an assault. On a practical level, a significant number of people with dementia are currently being admitted to inpatient units due to their level of resistance around essential personal care. Often these same people are settled at all other times. This paper provides practical advice on how to support residents and their caregivers, and gives clinical, legal and ethical guidance. Previous work undertaken by the present authors have shown that care staff require supervision and coaching on this topic.

The paper includes training materials used by the authors.  This includes a composite, fictitious case example that illustrates approaches that are compliant with UK guidelines.  It addresses the training of staff working in care homes.

As such this paper provides a review and practical example of the appropriate use of restraint for residents unable to consent to the ‘intimate’ care they are receiving. It describes a method delivered in a person-centred manner and within a legal framework.  Having read this paper, care home staff should feel more confident, competent and secure in the assistance they are providing in this contentious area.