RESUMEN
PURPOSE: This paper will acquaint the psychiatric nurse with attachment theory-based therapy through a narrative of post traumatic stress disorder (PTSD) treatment of a Vietnam veteran with a history of compound trauma in childhood. DESIGN AND METHODS: Application of attachment-based therapy is discussed within the context of its guiding principles and tenets. FINDINGS: Attachment-based therapy is effective in reducing PTSD symptoms in a Vietnam veteran through forming secure base scripts from which the patient better evaluated and managed stressors, resulting in improved life functioning. PRACTICE IMPLICATIONS: Attachment theory provides valuable tools with which to treat PTSD sufferers by utilizing nurses' expert skills in establishing rapport and relationship building to form the basis of effectual therapy.
Asunto(s)
Relaciones Enfermero-Paciente , Apego a Objetos , Psicoterapia/métodos , Trastornos por Estrés Postraumático/terapia , Veteranos/psicología , Anciano , Humanos , Masculino , NarraciónRESUMEN
PURPOSE: Currently only one-third of patients treated for depression enjoy complete remission of their negative symptoms. This paper explores ketamine research as it applies to understanding and treating mood illnesses. CONCLUSIONS: Ketamine's rapid antidepressant effect implicates downstream signal transduction involving the spontaneous transmissions associated with ketamine's action at the NMDA receptor. PRACTICE IMPLICATIONS: Better understanding of brain neuropathophysiology offers hope for symptom relief to those living with affective illness refractory to currently available medical management.
Asunto(s)
Antidepresivos/metabolismo , Antidepresivos/uso terapéutico , Trastorno Depresivo/tratamiento farmacológico , Ketamina/metabolismo , Ketamina/uso terapéutico , Factor Neurotrófico Derivado del Encéfalo , Humanos , Receptores de N-Metil-D-Aspartato/metabolismo , Transmisión Sináptica/efectos de los fármacosRESUMEN
When a patient suffering from bipolar II disorder is misdiagnosed as experiencing unipolar depression, the recommended treatment of the latter may precipitate a hypomanic or manic episode. Unchecked hypomanic symptoms may include risky behaviors, through which a patient could sustain irreparable damage to relationships, careers, and finances. Sometimes, patients are familiar enough with bipolar illness that they may anticipate or interpret inquiry regarding hypomanic symptomology (Goodwin & Jamison, 1990). Applying their own stigmas to bipolar illness, such patients may only admit to depressive symptoms to avoid a bipolar diagnosis (Goodwin & Jamison, 1990). Also, hypomanic symptoms can be nuanced and difficult to detect in patients who may misinterpret the elevated mood state as a return to good mental health rather than the pathologic condition it is. These and other factors, such as poor memory, substance use, physical problems, and co-morbid mental illnesses, contribute to the misdiagnosis and delayed diagnosis of bipolar II disorder for many patients (APA, 2013; Goodwin & Jamison, 1990). The astute clinician, however, can bypass the cascade of events leading up to the poor outcomes associated with unrecognized and mistreated hypomanic symptoms by committing to due diligence when assessing mood symptoms, depressed and elevated.