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Online Advanced Release
Articles appearing in this "Online Advanced Release" section have been peer-reviewed and accepted for publication in the Journal of Psychosocial Nursing and Mental Health Services and posted online before print publication. Articles appear on this site after copyediting and author corrections, but before final proofing. The content of the article will usually remain unchanged, and possible further corrections are fairly minor. The final published article will specify the issue and page numbers. Once the final version is available in print, the version posted here will be removed from this site.
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Table of Contents
Cranial Electrotherapy Stimulation for the Treatment of Depression
Mary Gunther, PhD, RN; Kenneth D. Phillips, PhD, RNMore prevalent in women than men, clinical depression affects approximately 15 million American adults in a given year. Psychopharmaceutical therapy accompanied by psychotherapy and wellness interventions (e.g., nutrition, exercise, counseling) is effective in 80% of diagnosed cases. A lesser known adjunctive therapy is that of cranial electrotherapy stimulation (CES). The major hypothesis for the use of CES in depression is that it may reset the brain to pre-stress homeostasis levels. It is conjectured that the pulsed electrical currents emitted by cranial electrical stimulators affect changes in the limbic system, the reticular activating system, and/or the hypothalamus that result in neurotransmitter secretion and downstream hormone production. While evidence is good for applied research, basic research about the mechanisms of action for CES remains in its infancy. A review of the literature provides an overview of current research findings and implications for clinical mental health practice.
Received: April 20, 2010; Accepted: May 6, 2010; Posted: July 22, 2010
doi:10.3928/02793695-20100701-01 [get full text]
Othello Syndrome: Preventing a Tragedy When Treating Patients with Delusional Disorders
Marcia A. Miller, PhD, RN; Andreas M. Kummerow, MS, RN; Tennyson Mgutshini, PhD, RCN, Pg Dip (Ed), MScOthello syndrome, sometimes referred to as delusional, pathological, morbid, or erotic jealousy, is a rare delusional disorder with high-risk implications. This article provides an overview of Othello syndrome and includes an individual example as well as a review of the literature. Pharmacological interventions and dialectical behavior therapy are discussed as options for pathological jealousy. Nursing considerations and assessment strategies of delusional jealousy are described for identification and evaluation of risk factors. Patient safety is addressed, and collaborative interventions are proposed for treatment. Staff development for the treatment team is advocated to help staff identify delusional patients and act prudently to avert possible tragic consequences associated with Othello syndrome.
Received: August 6, 2009; Accepted: March 4, 2010; Posted: July 22, 2010
doi:10.3928/02793695-20100701-05 [get full text]
Childhood Adversities and Adult Health
Teena M. McGuinness, PhD, CRNP, FAANChild abuse and neglect have lifelong ramifications for adult mental health and health in general. In this brief overview, a range of childhood adversities (including prenatal substance exposure and prenatal malnutrition) is reviewed, and the evidence for their later negative implications is considered. The role of a chronically stressed hypothalamic-pituitary-adrenal axis likely has significant influence in this process. Strategies for nurses include developing awareness of the presence of early adversity in the lives of many Americans, as well as helping parents improve their functional status by treating mental illness and addictive disorders.
Posted: July 22, 2010
doi:10.3928/02793695-20100701-04 [get full text]
Robert H. Howland, MDAbrupt discontinuation of antipsychotic drugs in patients with schizophrenia is associated with earlier, and often more severe, illness episodes than are seen with gradual discontinuation. Antipsychotic drugs can cause various abnormal motor syndromes, but abruptly stopping them has been associated with the seemingly paradoxical development of similar motor syndromes, such as withdrawal dyskinesias, parkinsonian symptoms, dystonias, and neuroleptic malignant syndrome. Dopamine-releasing and dopamine-agonist drugs are used to treat some of the motor syndromes caused by antipsychotic drugs, but their abrupt discontinuation can also be associated with abnormal syndromes. When antipsychotic drugs, lithium, or certain anticonvulsant drugs are used for treatment of bipolar disorder, rapid versus gradual discontinuation is more likely to lead to greater mood instability and manic relapse. If necessary, these medications should be gradually tapered to minimize all types of adverse discontinuation effects. Patients should be educated about the possible adverse effects of abrupt medication discontinuation.
Posted: July 22, 2010
doi:10.3928/02793695-20100708-01 [get full text]
Women’s Responses to Unemployment of Their Spouse: Implications for Psychiatric Nurses
Deborah I. Frank, PhD, MFT, ARNPThe current economic recession has resulted in extremely high rates of unemployment, with the majority of those losing jobs being men. There is much research exploring how men respond to unemployment, but little examines how wives experience this crisis. Although nearly half of the workforce is now female, many women are co-providers, not sole providers. This article uses a historical perspective within a framework of role theory to help psychiatric nurse clinicians understand the possible responses of women who seek counseling after their spouses become unemployed. Counseling interventions are suggested, and an individual example is presented. Directions for future research are noted.
Received: October 31, 2009; Accepted: April 29, 2010; Posted: July 22, 2010
doi:10.3928/02793695-20100701-03 [get full text]
Humor as a Teaching Tool: Use in Psychiatric Undergraduate Nursing
Michael A. Chiarello, PhD, PMHCNS-BC, NPPThe research and anecdotal literature has suggested therapeutic humor is beneficial in the treatment relationship between nurse and patient; however, the potential effects of therapeutic humor between students and faculty have largely been overlooked. The literature has substantiated that a positive rapport between teacher and student facilitates improved student performance during the clinical experience. The author posits that a teacher’s skillful use of humor can be an effective means of establishing and maintaining rapport with a student during potentially stressful clinical experiences. This article discusses the use of appropriate humor and how humor can be leveraged for effective academic and clinical instructional purposes, particularly in high-stress, high-demand settings. The article reflects on the potential for misinterpretation of humor, urging careful consideration of the context for its use.
Received: September 3, 2009; Accepted: May 6, 2010; Posted: July 22, 2010
doi:10.3928/02793695-20100701-02
[get full text]
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