Tag Archives: clinical

Madness and childbirth.

Posted on by

Madness is a complication of childbirth. This graph is from a Scandinavian Paper about first time mothers. One can easily see that there is quite a high rate in the first few months. This rapidly decreases towards the usual incidence of madness, which is about one person per 1000 a year in the young.

For women, childbirth, not having children, is a risk period. But there are risks for this.

If you allow for previous psychiatric illness — the big hazard ratio is not being with your partner at the time of birth.

I’d speculate this reflects the common sense of most traditional societies; women with small babies need their family and relatives around to support them through the first few weeks.

There are effective treatments for trauma.

Posted on by

One of the good things about the Cochrane review is that it is available to the public, and the summaries are written in fairly plain English.

This review of psychological treatments for PTSD — which is the rubric under many people are treated by ACC has this summary.

Psychological treatment of post traumatic stress disorder (PTSD)

This review concerns the efficacy of psychological treatment in the treatment of PTSD. There is evidence that individual trauma focused cognitive-behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There is some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management are more effective than other therapies. There is insufficient evidence to show whether or not psychological treatment is harmful. Trauma focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD. Psychological treatments can reduce symptoms of post traumatic stress disorder (PTSD). Trauma focused treatments are more effective than non-trauma focused treatments.

via Psychological treatment of chronic post-traumatic stress disorder (PTSD).

Now, this is much more specific than counselling. There are treatments that add more than the effect empathic listening has.

Pity ACC does not insist on them.

Problems, more problems.

Posted on by

One of my employers is dealing with an outbreak of infection: this has led to a number outpatient clinics being closed and meetings being cancelled. The instructions on infection control are similar to those which were routine two to three decades ago: wash your hands: do not wear your work clothes away from the hospital (don’t wear uniform away from the hospital, wash your work clothes in hot water and sun dry (and iron).

The basics matter.