PURPOSE: Determinants of morbid obesity are complex and numerous, yet understanding the neurobiological underpinnings improves our knowledge of this serious issue. Emerging science supports a comparison of disordered eating with other addictive substances. DESIGN AND METHODS: The study used a sub-analysis of a cross-sectional study of nurses in a state-monitoring program. FINDINGS: A study of 173 participants in a state-monitoring program for impaired nurses revealed that 14% (n= 25) had undergone bariatric surgery. Of these, 17 developed an addiction after surgery. PRACTICE IMPLICATIONS: Evidence suggests that some individuals may require additional treatment, similar to those with pharmacological addictions.
Since 2001, the rapid pace of deployments of military personnel who are parents has created additional concern for the emotional and behavioral health of their children. Repeated deployments create prolonged periods of uncertainty and an increased sense of danger on the part of children and at-home spouses. Children of all ages have higher rates of anxiety and depressive symptoms. Academic problems for children of deployed parents also occur more frequently. The psychological stress of both at-home and deployed parents is associated with the child's level of emotional distress. Awareness of the possibility of greater challenges facing military families today is warranted to identify distress and referral to treatment.
Pediatric bipolar disorder differs from the adult form of the disorder, marked by longer episodes, rapid cycling, prominent irritability, and high rates of comorbid attention-deficit/hyperactivity disorder and anxiety disorders. A careful assessment by families of children's symptoms, including their duration and intensity, helps with accurate diagnosis. After the diagnosis is made and careful psychopharmacological intervention is initiated, psychiatric nursing treatment of children and adolescents with pediatric bipolar disorder should involve child- and family-focused cognitive-behavioral therapies, family support, and psychoeducation.
There is a pressing need for psychiatric nurse authors to write about their professional image as well as issues they face in clinical practice. In this article, two psychiatric nurses describe how using Covey's The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change can serve as a framework for increasing writing productivity. In addition, the Myers-Briggs Type Indicator ® can increase awareness of and appreciation for the strengths and differences in each author's writing style. Using these tools, writing can become a process of discovery.
Many health care professionals, including psychiatric nurses, are faced with increasing questions from patients about mobile applications (apps). The purpose of this article is to give psychiatric-mental health nurses (PMHNs) an overview of the world of mobile health and medical apps to answer their own questions as well as those of their patients. Mobile apps will continue to evolve; thus, this article will serve as a base for PMHNs to build knowledge and understanding to help their patients. [ Journal of Psychosocial Nursing and Mental Health Services, 52 (4), 42–47.]
Background: Depression is a major barrier to HIV treatment outcomes. Objective: To test whether antidepressant management decision support integrated into HIV care improves antiretroviral adherence and depression morbidity. Design: Pseudo-cluster randomized trial. Setting: Four US infectious diseases clinics. Participants: HIV-infected adults with major depressive disorder. Intervention: Measurement-based care (MBC) – depression care managers used systematic metrics to give HIV primary-care clinicians standardized antidepressant treatment recommendations. Measurements: Primary – antiretroviral medication adherence (monthly unannounced telephone-based pill counts for 12 months). Primary time-point – 6 months. Secondary – depressive severity, depression remission, depression-free days, measured quarterly for 12 months. Results: From 2010 to 2013, 149 participants were randomized to intervention and 155 to usual care. Participants were mostly men, Black, non-Hispanic, unemployed, and virally suppressed with high baseline self-reported antiretroviral adherence and depressive severity. Over follow-up, no differences between arms in antiretroviral adherence or other HIV outcomes were apparent. At 6 months, depressive severity was lower among intervention participants than usual care [mean difference −3.7, 95% confidence interval (CI) −5.6, −1.7], probability of depression remission was higher [risk difference 13%, 95% CI 1%, 25%), and suicidal ideation was lower (risk difference −18%, 95% CI −30%, −6%). By 12 months, the arms had comparable mental health outcomes. Intervention arm participants experienced an average of 29 (95% CI: 1–57) more depression-free days over 12 months. Conclusion: In the largest trial of its kind among HIV-infected adults, MBC did not improve HIV outcomes, possibly because of high baseline adherence, but achieved clinically significant depression improvements and increased depression-free days. MBC may be an effective, resource-efficient approach to reducing depression morbidity among HIV patients.
Suicide by children younger than 11 is a sad and tragic occurrence. Indeed, suicidal ideation and behavior has been documented in children as young as ages 3 to 7. The current overview provides a discussion of the frequency of suicide in children and associated predisposing conditions, such as depression and abuse. In response to these tragic events, nursing interventions are also proposed. [ Journal of Psychosocial Nursing and Mental Health Services , 54 (10), 27–30.]
