Hallucinatory experiences of psychiatric patients in seclusion

Kennedy, Bernice; Williams, Carol A.; Pesut, Daniel J.

doi:10.1016/0883-9417(94)90050-7

Cited by 12 publications

(19 citation statements)

References 21 publications

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“…The resulting strengthening of aberrant, internally focused memories might contribute to the dissociation of mental processes from changing social context and lead to delusions and hallucinations. Hallucinations are observed with sensory and social deprivation, even in healthy individuals (Hayashi et al, 1992;Teunisse et al, 1996), and strongly increase with seclusion in schizophrenic patients (Kennedy et al, 1994).…”

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confidence: 99%

Storage, recall, and novelty detection of sequences by the hippocampus: Elaborating on the SOCRATIC model to account for normal and aberrant effects of dopamine

2001

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ABSTRACT:In order to understand how the molecular or cellular defects that underlie a disease of the nervous system lead to the observable symptoms, it is necessary to develop a large-scale neural model. Such a model must specify how specific molecular processes contribute to neuronal function, how neurons contribute to network function, and how networks interact to produce behavior. This is a challenging undertaking, but some limited progress has been made in understanding the memory functions of the hippocampus with this degree of detail. There is increasing evidence that the hippocampus has a special role in the learning of sequences and the linkage of specific memories to context. In the first part of this paper, we review a model (the SOCRATIC model) that describes how the dentate and CA3 hippocampal regions could store and recall memory sequences in context. A major line of evidence for sequence recall is the "phase precession" of hippocampal place cells. In the second part of the paper, we review the evidence for theta-gamma phase coding. According to a framework that incorporates this form of coding, the phase precession is interpreted as cued recall of a discrete sequence of items from long-term memory. The third part of the paper deals with the issue of how the hippocampus could learn memory sequences. We show that if multiple items can be active within a theta cycle through the action of a short-term "buffer," NMDA-dependent plasticity can lead to the learning of sequences presented at realistic item separation intervals. The evidence for such a buffer function is reviewed. An important underlying issue is whether the hippocampal circuitry is configured differently for learning and recall. We argue that there are indeed separate states for learning and recall, but that both involve theta oscillations, albeit in possibly different forms. This raises the question of how neuromodulatory input might switch the hippocampus between learning and recall states and more generally how different neuromodulatory inputs reconfigure the hippocampus for different functions. In the fifth part of this paper we review our studies of dopamine and dopamine/NMDA interactions in the control of synaptic function. Our results show that dopamine dramatically reduces the direct cortical input to CA1 (the perforant path input), while having little effect on the input from CA3. In order to interpret the functional consequences of this pathway-specific modulation, it is necessary to understand the function of CA1 and the role of dopaminergic input from the ventral tegmental area (VTA). In the sixth part of this paper we consider several possibilities and address the issue of how dopamine hyperfunction or NMDA hypofunction, abnormalities that may underlie schizophrenia, might lead to the symptoms of the disease. Relevant to this issue is the demonstrated role of the hippocampus in novelty detection, a function that is likely to depend on sequence recall by the hippocampus. Novelty signals are generated when reality does not match ...

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confidence: 99%

Storage, recall, and novelty detection of sequences by the hippocampus: Elaborating on the SOCRATIC model to account for normal and aberrant effects of dopamine

2001

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“…The recruitment process was explained in nine of the qualitative studies [35-37,8,14,12,41,43,44], and in ten of the quantitative studies [46,10,48-50,13,54-56,15]. In qualitative study recruitment was accomplished by staff (n = 1) and by researcher (n =4) or voluntary participation (n = 4) inviting participants by mail, information sessions or aided by the outpatient staff.…”

Section: Resultsmentioning

confidence: 99%

Methodological and ethical challenges in studying patients’ perceptions of coercion: a systematic mixed studies review

et al. 2014

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BackgroundDespite improvements in psychiatric inpatient care, patient restrictions in psychiatric hospitals are still in use. Studying perceptions among patients who have been secluded or physically restrained during their hospital stay is challenging. We sought to review the methodological and ethical challenges in qualitative and quantitative studies aiming to describe patients’ perceptions of coercive measures, especially seclusion and physical restraints during their hospital stay.MethodsSystematic mixed studies review was the study method. Studies reporting patients’ perceptions of coercive measures, especially seclusion and physical restraints during hospital stay were included. Methodological issues such as study design, data collection and recruitment process, participants, sampling, patient refusal or non-participation, and ethical issues such as informed consent process, and approval were synthesized systematically. Electronic searches of CINALH, MEDLINE, PsychINFO and The Cochrane Library (1976-2012) were carried out.ResultsOut of 846 initial citations, 32 studies were included, 14 qualitative and 18 quantitative studies. A variety of methodological approaches were used, although descriptive and explorative designs were used in most cases. Data were mainly collected in qualitative studies by interviews (n = 13) or in quantitative studies by self-report questionnaires (n = 12). The recruitment process was explained in 59% (n = 19) of the studies. In most cases convenience sampling was used, yet five studies used randomization. Patient’s refusal or non-participation was reported in 37% (n = 11) of studies. Of all studies, 56% (n = 18) had reported undergone an ethical review process in an official board or committee. Respondents were informed and consent was requested in 69% studies (n = 22).ConclusionsThe use of different study designs made comparison methodologically challenging. The timing of data collection (considering bias and confounding factors) and the reasons for non-participation of eligible participants are likewise methodological challenges, e.g. recommended flow charts could aid the information. Other challenges identified were the recruitment of large and representative samples. Ethical challenges included requesting participants’ informed consent and respecting ethical procedures.

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“…For instance, patients have expressed seclusion-or restraint-related feelings of safety and security, protection, trust, helpfulness, and a decrease of stimulation (Binder and McCoy 1983;Mann et al 1993;Kennedy et al 1994;Chien et al 2005;Kuosmanen et al 2007;Kontio et al 2012). Information on the reasons for seclusion and restraint helped patients to understand these restrictions (Meehan et al 2004;Chien et al 2005;Kontio et al 2012).…”

Section: Patients' Perception Of Seclusion and Restraintmentioning

confidence: 96%

“…After seclusion or restraint is over, ventilation and discussion are needed to process all the feelings experienced, to provide psychological and emotional support, to accept the reasons for seclusion and to discuss treatment plans for the future (Mann et al 1993;Kennedy et al 1994;Meehan et al 2000;El-Badri and Mellsop 2008;Ryan and Happell 2009;Keski-Valkama et al 2010a;Larue et al 2010;Needham and Sands 2010;Kontio et al 2012). The importance of being respected as a unique fellow human being cannot be emphasised enough (Välimäki 1998;Chien et al 2005).…”

Section: Patients' Perception Of Seclusion and Restraintmentioning

confidence: 96%

“…Furthermore, patients have suggested alternatives to seclusion such as constant observation, medication, a time-out programme, resting in one's own room, verbal de-escalation, activities, music, and an opportunity for interaction (Meehan et al 2000;Keski-Valkama et al 2010a). Other suggestions have included more interaction, caring behaviour and a calm manner on behalf of staff as well as more medication (Binder and McCoy 1983;Kennedy et al 1994;Meehan et al 2000Meehan et al , 2004Chien et al 2005).…”

Section: Patients' Perception Of Seclusion and Restraintmentioning

confidence: 98%

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Patient Experience of Coercive Measures

Soininen

Kontio

Joffe

et al. 2016

The Use of Coercive Measures in Forensic Psychiatric Care

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Coercive situations are complicated and stressful for both the one being forced as well as the one forcing the other. Patients' experiences of coercion have been studied since the end of the 1970s, and interest in this theme has increased since about 2000. It seems that involuntary treatment as a general concept is more accepted than individual, specific coercive measures, such as forced medication, seclusion or restraint, which patients usually deem unnecessary. Patients' views on seclusion and restraint have been mostly but not always negative. For instance, patients have expressed seclusion-or restraint-related feelings of safety and security, protection, trust, helpfulness and a decrease of stimulation. Moreover, perceptions vary according to, for example, patients' age and gender and their adaptation to the illness and treatment system. The importance of patients' perspective and service user involvement in the development of services has been officially recognised. Indeed, taking patients' experience into proper consideration is a matter of the services' quality. In this chapter, we also discuss these future challenges.

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Hallucinatory experiences of psychiatric patients in seclusion

Cited by 12 publications

References 21 publications

Storage, recall, and novelty detection of sequences by the hippocampus: Elaborating on the SOCRATIC model to account for normal and aberrant effects of dopamine

Storage, recall, and novelty detection of sequences by the hippocampus: Elaborating on the SOCRATIC model to account for normal and aberrant effects of dopamine

Methodological and ethical challenges in studying patients’ perceptions of coercion: a systematic mixed studies review

Patient Experience of Coercive Measures

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