Introduction:Though Focus of mental health care is negative emotional state, positive psychology appeals to masses. Because troubled person not only wants relief but also wants a life of meaning & purpose (National Mental health plan 2003-2004, Australian Govt.). and purposeful life without mentally healthy family is difficult. So family's transformation's imperative (Welsh Assembly Govt. 2005 a).Objective:To strengthen Family members to transform Dysfunctional family.Aim:Preserve family mental health & Prevent mental illness among family-members of mentally ill patient.Prevent deterioration of mentally ill patient.Method:Discussion -for therapeutic alliance.Therapeutic Transformation of dysfunctional family -Family Therapy: Why? Because family therapy focuses on well-being which is over & above the absence of depression-anxiety etc. Family therapy addresses problem and not individual unlike other therapies (NIMH, EFTA).Psycho-education: To build positive emotions which facilitate skills & resources needed for recovery (Fredrickson). It includes (i) Transactional-analysis (ii) Proactive behavior (iii) Social maturity (Robert Kegan).Positive Psychotherapy (PPT): Recovery rate was 85% (30%-single therapy) when psychotherapy was clubbed with pharmacotherapy. Positive emotions promote psychological resilience & positive emotional granularity. PPT focuses on pleasant, engaged & meaningful life (Seligman 2002).Spiritual Psychotherapy: Inevitable to future Psychiatry, because meditation alters levels of Melatonin, Serotonin, boosts immune response. Contents: (i) Meditation – changes brain (Dr Zedel, 2010) (ii) Spiritually-augmented CBT (SACBT), (iii) IBMT (Tang Y Y)/Yog-Nigra.Results:Family mental health is achieved.Conclusion:Thus attained family mental health will facilitate family's transformation.
Introduction: Mirtazapine is considered to be safest and versatile antidepressant. However, sedation is known to be dose dependent side effect. 7.5 mg/day mirtazapine induces more sedation than 15 mg/day mirtazapine. There is no other side effect of mirtazapine which is reported to be dose dependent. Case Report: Here is a case, where dose dependent urinary retention is detected. A 38-year-old married female reported with array of recurring symptoms like dysphoria, insomnia, loss of appetite, burning all over, uneasiness, increased frequency of micturation and stool, irritability, frustration, weeping often. She was symptomatic since last five to six years, despite regular psychiatric treatment. Her earlier psychiatrist had expressed inability to treat recurrence and intensity of her symptoms. She was kept on mirtazapine 7.5 mg per day to begin with. She responded favorably. To gain more relief dose of mirtazapine was increased to 15 mg/day. Within one to two days she complained of inability to pass urine. Her complaint was specific that she was not able to empty her bladder completely. After completing the act of micturation she used to experience much discomfort in pelvic region. Further investigations revealed significant urinary retention. Lowering of dose brought her relief immediately. Conclusion: Mirtazapine with dose of 7.5 mg per day effectively could treat recurring symptoms of a female patient. But increase in dose up to 15 mg/day caused significant side effect of urinary retention against the conventional belief of rise in dose of mirtazapine would increase the relief.
Introduction: Mirtazapine is considered to be safest and versatile antidepressant. However, sedation is known to be dose dependent side effect. 7.5 mg/day mirtazapine induces more sedation than 15 mg/day mirtazapine. There is no other side effect of mirtazapine which is reported to be dose dependent. Case Report: Here is a case, where dose dependent urinary retention is detected. A 38-year-old married female reported with array of recurring symptoms like dysphoria, insomnia, loss of appetite, burning all over, uneasiness, increased frequency of micturation and stool, irritability, frustration, weeping often. She was symptomatic since last five to six years, despite regular psychiatric treatment. Her earlier psychiatrist had expressed inability to treat recurrence and intensity of her symptoms. She was kept on mirtazapine 7.5 mg per day to begin with. She responded favorably. To gain more relief dose of mirtazapine was increased to 15 mg/day. Within one to two days she complained of inability to pass urine. Her complaint was specific that she was not able to empty her bladder completely. After completing the act of micturation she used to experience much discomfort in pelvic region. Further investigations revealed significant urinary retention. Lowering of dose brought her relief immediately. Conclusion: Mirtazapine
Human society was never fully monogamous. In fact, before civilization polygamy was socially acceptable. However, ascent of civilization brought the rule of monogamy. Monogamy is considered for the growth of institution of marriage. Marriage is a basis of family. Family functions as bonding tie to maintain civilization. Without civilization, human society cannot survive & evolve further. With this background, argument proceeds to the dilemma of adopting adultery or not. If no, then reasons with benefits are argued scientifically, biologically, psycho-socially. Methods to avoid adultery are discussed. Articles on adultery or infidelity or extramarital sex are published by many, but probably this is a first editorial written by any practicing psychiatrist-cum-psychotherapist. That is why this article becomes relevant to practice by any ordinary individual or by any expert in the field of medical science & psychology.
The WHS classification of Head, Neck and Face pain, Edition 1 Version 1 (WHS-MCH1) is the official document of the World Headache Society. It was conceptualized and developed by the Society's Classification Committee. The work began with a clean slate to create a comprehensive, updated and holistic classification of headache disorders; where 'headache' was defined as any pain above the shoulders, thus including head, neck and face pain. This new classification reflects a scientifically robust understanding of disease and also places patient experience in the qualia of pain. It is a training manual to be used at the bedside and office as an aid to the diagnosis and management of headache disorders. The dynamic nature of this first ever live classification of headaches also means that ultra-rapid updates, or versions, will be available electronically. It is not a disease criteria but a classification criteria (1) and is useful to pick extended spectra and 'mimickers' of diseases. Although increased sensitivity usually comes at the expense of reduced specificity, an expanded spectrum of diseases in this case also means increased specificity. WHS-MCH1 is a syndromic classification. A syndrome is a recognizable complex of symptoms and physical findings which may have more than one aetiology. Although disease is nominalist and culture-relativistic (2) , a syndrome based approach reflects the discipline of first widening the view of possibilities before analysing each to formulate a diagnostic hypothesis. Such an approach provides a useful framework for organizing the complexity of clinical experience in order to derive inferences about outcome and guide decisions about treatment. WHS-MCH1 has a vertical grouping designed for use by clinicians of all levels of experience; this is linked to the horizontal groupings which are syndrome-based. The syndrome groups are also interlinked to one another. This design enables clinicians to efficiently create the 'big picture' so as not to miss any diagnosis. Axis 1 and 2 are the vertical and horizontal grouping categories, respectively. Axis 3 is the patient narrative of bothersome symptoms and level of impairment. Axis 4 are biomarkers that may be derived from investigations and this is the best example of the continuum of better understanding of disease defining markers. Axis 5 is an objective impairment scale that clinicians may choose based on availability. The World Headache Society hopes that the use of such a robust and inclusive framework will lead to better patient outcomes and improved patient and clinician satisfaction with the investigative and diagnostic process.
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