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Focus on Mental Health

• Editor's Note
• List of Articles

List of Articles

• Psycho-Oncology Services for Gynecologic Cancer
  The purpose of this document is to begin to bridge the gap between clinicians' and patients' expectations of how psychosocial services should be used in response to distress screening. The Women's Health and Education Center (WHEC) supports professional organizations with the mission to improve survival and quality of life for cancer patients through standard-setting, prevention, research, education and the monitoring of comprehensive quality care. In 2014, the WHEC approved new standards to promote patient-centered care, an exciting shift driven by research over the past decade showing that patient-centered services improve outcomes. Patient-centered standards include the provision of treatment and survivorship plans, palliative care services, genetic services, navigation programs, and psychosocial distress screening. Given that the popularity of distress screening is increasing exponentially, and begins to bridge the gap between clinicians' and patients' expectations of how psychosocial services should be used in response to distress screening. Key findings and implications for service delivery were: 1) receptivity to referral is a separate issue from that of distress level, 2) strong preference among those who declined psycho-oncology referral to cope on their own emphasized the potential role of self-management interventions, and 3) low social support was a major theme among those accepting referral, suggesting that assessing family support might further contribute to identifying patients in need of additional psychological assessment. Additional studies are needed to further examine, on a large scale, patients' preferences for follow-up care after distress screening. Several different approaches to distress screening are discussed above, and additional studies should examine their comparative acceptability and efficacy.
  
  
• The Diseases of Addiction: Opiate Use and Dependence
  Dependence on opioids is associated with seri­ous morbidity and mortality, and advances in the understanding of the dependence have led to the development of effective treatments. A confusing aspect of the body of research on opi­ate abuse and dependence is the inconsistent use of important terminology that describes the nature and severity of involvement with therapeutic and illicit opiates. The purpose of this document is to provide the reader with a current, evidence-based overview of opiate abuse and dependence and its treatment. Topics covered in this review include the history and demographics of illicit and prescription opiate abuse; risk factors, background characteristics, and comorbid conditions of opiate abusers; the pharmacology of opiate drugs; the biological and behavioral characteristics of opiate dependence; and management of opiate dependence, including treatment of overdose, detoxification and with­drawal, agonist replacement therapy, and drug-free approaches. Additional areas of the course are devoted to the abuse liability of prescription opiates and the impact of abused opiates on the fetus.
  
  
• The Diseases of Addiction: Methamphetamine Abuse
  The admissions rates for treatment of methamphetamine-related disorders have ballooned alarmingly in some areas, particularly in rural or frontier areas, causing public health concerns. As a result, it is important that healthcare professionals have a solid knowledge of the effects and appropriate treatment of methamphetamine abuse and dependence. Various programs addressing substance abuse and methamphetamine abuse are also discussed. The Fellowship of Crystal Meth Anonymous works a Twelve Step program of recovery. Crystal Meth Anonymous is a fellowship of men and women who share their experience, strength and hope with each other, so they may solve their common problem and help others to recover from addiction to crystal meth. The only requirement for membership is a desire to stop using.
  
  
• The Diseases of Addiction: Disorders Relating to Alcohol
  Mind-altering substances all yield four basic types of disorders: Substance Dependence; Abuse; Intoxication, and Withdrawal. The etiology and pathophysiology of addictive behavior has been somewhat a mystery to the primary care physician. As such, patients with addiction issues are a particularly difficult group to treat in a coherent and comprehensive manner. The common pathways in reward circuitry that affect memory and learning, motivation, control, and decision making are also involved in the addictive process. It is hoped through these publications; the cycle of addiction can be better understood and managed. Citizens of this century have an ever-widening variety of mind-altering substances to use, but doing so still leads to a few basic sorts of problems with behavior, cognition, and physiological symptoms. These behaviors and alcohol abuse are discussed in this chapter.
  
  

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