Social Stigma of the Mentally Ill Essay

Social Stigma of the Mentally Ill
Social Stigma of the Mentally Ill

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Social Stigma of the Mentally Ill

Angermeyer, M. C., Holzinger, A., Carta, M. G. & Schomerus, G. (2011). Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. The British Journal of Psychiatry, 199 (5); 367-372.

Aim; investigating if mental illness’ biogenetic causal attributions were linked to more tolerant attitudes in the general public, and if such attributions were connected to lower responsibility and guilt perceptions due to social stigma. There was also an exploration of the extent to which responsibility notions were linked to rejection of the mentally ill people. Finally, evaluating how prevalent responsibility notions were in the general public in relation to various mental disorders.

Research design; systematic review of population studies that were representative. There was an examination of the attitudes towards the mentally ill as well as the beliefs about the disorders.

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Key research findings/ recommendations; biogenetic causal models should cease being used to reduce rejection of the mentally ill. biogenetic causal attributions are not linked to attitudes that are more tolerant but are connected to stronger rejection (schizophrenia), social stigma. The self-responsibility stereotype was not connected to rejection. Mental disorder’s public images are more dominated by dangerousness and unpredictability stereotypes. Responsibility is minimally relevant.

Strengths and weaknesses; there was use of an adequate number of studies. However, there is no mention of what can be used instead of the biogenetic causal models.

Deacon, B. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33, 846-861.
Aim;
the study aimed at exploring the biopsychosocial model that is often neglected in studying mental disorders.

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Research design; a scientific approach was used to investigate the speculations.

Key research findings/ recommendations; in America, the healthcare system has been dominated by the biologically-focused strategy to practice, policy, and science for over three decades. Within this period, there has been a rise in the psychiatric medications use. Moreover, mental conditions have been more commonly seen as brain diseases that result from chemical imbalances which can be corrected using disease-specific drugs.

Regardless of the widespread hope in the neuroscience’s potential of revolutionizing mental health practice, evidence shows that the biomedical model broadly lacked clinical innovation. It was also characterized by mental health impacts that were very poor. The biomedical paradigm profoundly has affected clinical psychology through drug trial methodology adoption in psychotherapy research.

Regardless of the fact that that this approach has brought about the development of psychological treatments that are empirically supported for different mental diseases, it ignores the treatment process inhibits dissemination and treatment innovation, and resulted to the classification of this field along practitioner and scientist lines.

Strengths and weaknesses; noteworthy, the researchers recommend the biopsychosocial mode as the appealing biomedical approach’s alternative. In addition, there is advice on the need for a public and honest dialogue regarding the utility and validity of the common biomedical paradigm.

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Haslam, N. & Kvaale, E.P. (2015). Biogenetic Explanations of Mental Disorder: The Mixed-Blessings Model. Current Directions in Psychological Science, 24(5), 399-404
Aim;
exploring how the mentally ill people are perceived in relation to biogenetic explanations from the perspectives of clinicians, the affected, and public.

Research design; systematic review.

Key research findings/ recommendations; regardless of the fact that biogenetic explanations might soften public stigma through diminishing blame, they escalate it through inducing avoidance, pessimism as well as the belief that those affected are unpredictable and dangerous. Such explanations might also induce helplessness and pessimism among the affected people and minimizes the empathy the treating clinicians often feel for them.

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Strengths and weaknesses; it is recommendable for the authors to mention that they interpreted the findings in the light of the social psychology research in relation to mechanistic and essentialist thinking. However, a lot more studies need to be conducted so as to explain many aspects that this study does not touch on.

Pattyn, E., Verhaeghe, M., Sercu, C., & Bracke, P. (2013). Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study. Soc Psychiatr Psychiatr Epidimiol, 48, 1637-1645.

Aim; the aim of this study was contrasting mental illness’ medicalized conceptualization with the psychologizing mental illness. It also examined the consequences of sticking to one model as opposed to the other for social stigma and help seeking.

Research design

There was used of survey research approach. Face-to-face interviews were conducted in a representative sample that consisted of a general population from Belgium. The vignette technique was essential for depecting schizophrenia. Te disease view, labeling processes, and causal attributions were addressed. Data analysis was through linear and logistic regression models using SPSS Statistics 19.

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Key research findings/ recommendations; mental illness’ medicalization requires a package deal, that is, the disease view’s application to promote medical treatment recommendations, and biopsychosocial causal attributions. Labeling triggers stigmatizing attitudes. General medical care is recommended by those who prefer the biopsychosocial approach while specialized medical care is recommended by those who use the disease view.

In relation to informal help, those that use the biopsychosocial model rarely recommend consulting friends compared to those who prefer the psychosocial model. Those who use the medical label barely recommend self care. Those who use the medical model are likely to exclude others socially, especially those that have undergone through psychiatric treatment.

Strengths and weaknesses

There is a clear comparison between different model but the results are limited to the Belgians.

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Mental Illness and social stigma

Mental Illness and social stigma
Mental Illness and social stigma

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Mental Illness and social stigma

Angermeyer, M. C., Holzinger, A., Carta, M. G. & Schomerus, G. (2011). Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. The British Journal of Psychiatry, 199 (5); 367-372.

Aim; investigating if mental illness’ biogenetic causal attributions were linked to more tolerant attitudes in the general public, and if such attributions were connected to lower responsibility and guilt perceptions. There was also an exploration of the extent to which responsibility notions were linked to rejection of the mentally ill people. Finally, evaluating how prevalent responsibility notions were in the general public in relation to various mental disorders.

Research design; systematic review of population studies that were representative. There was an examination of the attitudes towards the mentally ill as well as the beliefs about the disorders.

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Key research findings/ recommendations; biogenetic causal models should cease being used to reduce rejection of the mentally ill. biogenetic causal attributions are not linked to attitudes that are more tolerant but are connected to stronger rejection (schizophrenia). The self-responsibility stereotype was not connected to rejection. Mental disorder’s public images are more dominated by dangerousness and unpredictability stereotypes. Responsibility is minimally relevant.

Strengths and weaknesses; there was use of an adequate number of studies. However, there is no mention of what can be used instead of the biogenetic causal models.

Deacon, B. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33, 846-861.
Aim;
the study aimed at exploring the biopsychosocial model that is often neglected in studying mental disorders.

Want help to write your Essay or Assignments? Click here

Research design; a scientific approach was used to investigate the speculations.

Key research findings/ recommendations; in America, the healthcare system has been dominated by the biologically-focused strategy to practice, policy, and science for over three decades. Within this period, there has been a rise in the psychiatric medications use. Moreover, mental conditions have been more commonly seen as brain diseases that result from chemical imbalances which can be corrected using disease-specific drugs.

Regardless of the widespread hope in the neuroscience’s potential of revolutionizing mental health practice, evidence shows that the biomedical model broadly lacked clinical innovation. It was also characterized by mental health impacts that were very poor. The biomedical paradigm profoundly has affected clinical psychology through drug trial methodology adoption in psychotherapy research.

Regardless of the fact that that this approach has brought about the development of psychological treatments that are empirically supported for different mental diseases, it ignores the treatment process inhibits dissemination and treatment innovation, and resulted to the classification of this field along practitioner and scientist lines.

Strengths and weaknesses; noteworthy, the researchers recommend the biopsychosocial mode as the appealing biomedical approach’s alternative. In addition, there is advice on the need for a public and honest dialogue regarding the utility and validity of the common biomedical paradigm.

Want help to write your Essay or Assignments? Click here


Haslam, N. & Kvaale, E.P. (2015). Biogenetic Explanations of Mental Disorder: The Mixed-Blessings Model. Current Directions in Psychological Science, 24(5), 399-404
Aim;
exploring how the mentally ill people are perceived in relation to biogenetic explanations from the perspectives of clinicians, the affected, and public.

Research design; systematic review.

Key research findings/ recommendations; regardless of the fact that biogenetic explanations might soften public stigma through diminishing blame, they escalate it through inducing avoidance, pessimism as well as the belief that those affected are unpredictable and dangerous. Such explanations might also induce helplessness and pessimism among the affected people and minimizes the empathy the treating clinicians often feel for them.

Want help to write your Essay or Assignments? Click here

Strengths and weaknesses; it is recommendable for the authors to mention that they interpreted the findings in the light of the social psychology research in relation to mechanistic and essentialist thinking. However, a lot more studies need to be conducted so as to explain many aspects that this study does not touch on.

Pattyn, E., Verhaeghe, M., Sercu, C., & Bracke, P. (2013). Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study. Soc Psychiatr Psychiatr Epidimiol, 48, 1637-1645.

Aim; the aim of this study was contrasting mental illness’ medicalized conceptualization with the psychologizing mental illness. It also examined the consequences of sticking to one model as opposed to the other for stigma and help seeking.

Research design

            There was used of survey research approach. Face-to-face interviews were conducted in a representative sample that consisted of a general population from Belgium. The vignette technique was essential for depecting schizophrenia. Te disease view, labeling processes, and causal attributions were addressed. Data analysis was through linear and logistic regression models using SPSS Statistics 19.

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Key research findings/ recommendations;  mental illness’ medicalization requires a package deal, that is, the disease view’s application to promote medical treatment recommendations, and biopsychosocial causal attributions. Labeling triggers stigmatizing attitudes. General medical care is recommended by those who prefer the biopsychosocial approach while specialized medical care is recommended by those who use the disease view.

In relation to informal help, those that use the biopsychosocial model rarely recommend consulting friends compared to those who prefer the psychosocial model.  Those who use the medical label barely recommend self care. Those who use the medical model are likely to exclude others socially, especially those that have undergone through psychiatric treatment.

Strengths and weaknesses

            There is a clear comparison between different model but the results are limited to the Belgians.

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Mental Health Consumer Care

Mental Health
Mental Health

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Mental Health Consumer Care

“How would you feel when almost every individual within the society treats you differently by avoiding any form of interaction? Well, no one prefers to be treated that way. Mental health consumers are more often marginalized because of their mental state. This aspect can worsen their entire being and situation, which can propel them to neglect the self. By definition, a mental health consumer refers to persons who use mental health services in order to empower their mental health status while obtaining support or treatment.

Evidently, suffering from mental illness can be devastating to a patient and that situation can affect various aspects of their lives ranging from their physical status to their emotional being. On the other hand, self-neglect refers to the behavioral situation in which a person neglects or fails to attend to their personal basic needs such as feeding, appropriate clothing, tending appropriately to medical conditions, feeding or personal hygiene. Nonetheless, in extreme cases of self-neglect, the situation can be inferred to as Diogenes syndrome (Townsend, 2013).

Despite the severity of self-neglect in a mental health consumer, nursing professionals need to care for them in an attempt to improve their mental health issues. This presentation focuses on the relevance of nursing care of mental healthcare consumers who self-neglect to modern mental health nursing as well as to recognize the appropriate linkages with other mental health care providers.

In order to appropriately identify patients suffering from mental health problems, it is ideal to identify the various aspects that help in identifying them or the factors that assist in characterizing them. Most cases involving self-neglect are often recognized as a result of numerous complaints received from several sources such as community organizations, neighbors, GPs and healthcare professionals (Naik, Lai, Kunik & Dyer, 2008).

The process of managing and identifying cases is very complex and difficult, which requires a multi-disciplinary and multi-agency approach. Based on several studies, individuals with mental health problems are often poor and indulge in smoking habits, lack exercise, consume alcohol, have poor diets and consumer other drugs (Middleton, 2008; Richardson, 2007). The deteriorating state of their daily lives often affects their energy levels, organization skills, attention, physical abilities or motivation.

The effect on the patient can cause them to neglect the self. Studies also indicate that the side effects of certain psychiatric medications can cause a decrease in the motivation levels among mental patients (Townsend, 2008; Gunstone, 2003). Therefore, self-neglect among mental patients can be caused by illness alone. With the help of medical practitioners including nursing care cases of self neglect among mentally ill patients re likely to reduce.

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Notably, nurses constitute the largest population of health care professionals, thus, they have a key role in the management and identification of self-neglect among mentally ill patients. The relevance of nursing care to mental healthcare consumers in the modern nursing practice can be identified through the assessment, diagnosis, outcome identification, planning, and implementation and evaluation steps (Peate, Wild, & Nair, 2014).

In the initial process, nurses establish a database in which the database relates to the client using assessment tools such as KELS, geriatric depression scale and nutrition assessment (Pickens et al., 2007). The next process involves identifying the patients’ health care needs as well as the specific goals for care. The third process involves establishment of the specific criteria that measures the achievement of anticipated outcomes while the forth process involves designing the most appropriate strategy that facilitates the achievement of the desired goals.

The implementation process involves initiating and finishing actions that are necessary in accomplishing goals as the final process involves determination of the degree to which the objectives and goals of the implemented care have been achieved (Boyd, 2010). Through this sequential step, a nursing practitioner is capable of analyzing personal achievements in relation to providing care to patients, especially those with mental illness and having self-neglect. The outcomes of this process help both the nursing specialists and other medical professionals to identify the various steps that in deed help in solving the problem of self-neglect among mentally ill patients, for future referencing.

Currently, the nursing profession is working towards providing holistic care to patient. This means that other than assisting patients within hospitals, nurses also help patients outside the hospitals such as acceptance within the society. With reference to mentally ill patients, they are among the mostly segregated groups of people within the society. The nursing education helps in providing additional knowledge to nurses and it is disseminated to the public by informing them that mentally ill patients are just like other people with slight differences in their ways of thinking and making decisions.

Some of the interventions include adult protection services, drug misuse rehabilitation, housing services, budgeting services and neurological assessment among many others (Lauder, Anderson & Barclay, 2005). These shape the current approach in providing care to patients by integrating friendly approaches towards the patients. By dealing with cases of self neglect, nurses are capable of reducing the stigma that mental patients receive, which in turn promotes their general well-being.

In conclusion, within the modern nursing field, practitioners are more propelled towards the identification and management of self-neglect cases among mentally ill patients as a means of preventing the reoccurrence of the phenomenon. Since nurses constitute the largest portion of individuals within the health care sector, they play a chief role in ensuring the provision of proper care to patients.

In the nursing profession, taking care of mentally ill patients helps in identifying the most appropriate ways of providing care. Treating mentally ill patients with self-neglect issues helps in improving the health of the patients in general.”

References

Boyd, M. (2010). Psychiatric nursing: Contemporary practice. Philadelphia: Lippincott Williams & Wilkins. https://books.google.co.ke/books?id=a-GcGVtBnqQC&pg=PA893&lpg=PA893&dq=Nursing+Care+of+Mental+patients+Who+Self+%E2%80%93+Neglect+relevance++to+contemporary+mental+health+nursing.&source=bl&ots=H7F7RnZ_WT&sig=hFRFTS4lxe5tl53BEFM-1drGcpA&hl=en&sa=X&redir_esc=y#v=onepage&q=Nursing%20Care%20of%20Mental%20patients%20Who%20Self%20%E2%80%93%20Neglect%20relevance%20%20to%20contemporary%20mental%20health%20nursing.&f=false

Gunstone, S. (2003). Risk assessment and management of patients whom self-neglect: a ‘grey area’ for mental health workers. Journal of Psychiatric and Mental Health Nursing, 10, 3, 287-296. http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2850.2003.00568.x/abstract

Lauder, W., Anderson, I., & Barclay, A. (2005). A framework for good practice in interagency interventions with cases of self-neglect. Journal of Psychiatric and Mental Health Nursing, 12, 2, 192-198. http://www.ncbi.nlm.nih.gov/pubmed/15788037

Middleton, J (20 June, 2008). Self-neglect 2: nursing assessment and management. Nursing Times. Retrieved from http://www.nursingtimes.net/roles/older-people-nurses/self-neglect-2-nursing-assessment-and-management/1584631.fullarticle

Naik, A. D., Lai, J. M., Kunik, M. E., & Dyer, C. B. (2008). Assessing capacity in suspected cases of self-neglect. Geriatrics, 63, 2, 24-31. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847362/

Peate, I., Wild, K., & Nair, M. (2014). Nursing Practice: Knowledge and Care. Hoboken: Wiley. https://books.google.co.ke/books?id=xqXCBwAAQBAJ&pg=PA250&lpg=PA250&dq=Nursing+Care+of+Mental+patients+Who+Self+%E2%80%93+Neglect+relevance++to+contemporary+mental+health+nursing.&source=bl&ots=a6pjAEpAMS&sig=XBJXGriVDaILTkHpVefKU3FG_2o&hl=en&sa=X&redir_esc=y#v=onepage&q=Nursing%20Care%20of%20Mental%20patients%20Who%20Self%20%E2%80%93%20Neglect%20relevance%20%20to%20contemporary%20mental%20health%20nursing.&f=false

Pickens, S., Naik, A. D., Burnett, J., Kelly, P. A., Gleason, M., & Dyer, C. B. (2007). The utility of the Kohlman evaluation of living skills test is associated with substantiated cases of elder self-neglect. Journal of the American Academy of Nurse Practitioners, 19, 3, 137-142. http://www.ncbi.nlm.nih.gov/pubmed/17341281

Richardson, B. K. (2007). Psychiatric nursing. Clifton Park, NY: Thomson Delmar Learning. https://books.google.co.ke/books?id=yw2HAQAACAAJ&dq=psychiatric+nursing+by+richardson&hl=en&sa=X&redir_esc=y

Townsend, M. C. (2008). Nursing diagnoses in psychiatric nursing: Care plans and psychotropic medications. Philadelphia: F.A. Davis Co. http://www.sbmu.ac.ir/uploads/townsend2011.pdf

Townsend, M. C. (2013). Essentials of psychiatric mental health nursing: Concepts of care in evidence-based practice. Philadelphia: F.A. Davis Co. https://books.google.co.ke/books?id=cxdengEACAAJ&dq=Essentials+of+psychiatric+mental+health+nursing:+Concepts+of+care+in+evidence-based+practice.&hl=en&sa=X&redir_esc=y


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Dementia PICO Analysis Method

Dementia
Dementia

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Dementia PICO Analysis Method

Part I: PICO analysis of research topic

Step 1: Frame clinical question using PICO method

P: the patients include people with dementia and psychosis

I: the anticipated intervention is to utilize typical antipsychotic drugs

C: the current standard or comparison group is atypical antipsychotics

O: the desired outcome is to have less mortality rates for elderly people with dementia and psychosis

The PICO question basically stands for patient, intervention, comparison and outcome (Elkins, 2014).

Part II: Search strategy

The PICO question is as follows: In elderly patients who have dementia and psychosis (P), does treatment with typical antipsychotics (I) or atypical antipsychotics (C) result in less mortality (O).

Step 1: Resources utilized to find articles

A number of scholarly articles relating to the identified issue are identified. The resources that were used in finding the articles that relate to the topic include the following: handbooks, electronic databases research, encyclopaedias, relevant books, and reputable journals.

Step 2: Search terms and criteria

With regard to search terms and criteria that were utilized, the search terms include the following: dementia, mortality, psychosis, atypical antipsychotics, and typical psychotics. The inclusion criteria was as follows: scholarly peer-reviewed journal articles only, articles not older than 5 years, articles that are published in the English language, articles that focus on dementia and psychosis among the elderly population, and article that reports on primary research.

Step 3: Boolean search strings

With regard to the exclusion criteria, the articles that would be excluded are as follows: articles that are older than 5 years, articles not published in English, and articles that do not focus on the elderly patients with dementia. Using different Boolean search strings, keywords would be combined with operators like OR, NOT as well as AND in order to generate additional results that are relevant. For this research, the Boolean search strings that would be utilized include the following: atypical antipsychotics and psychosis, atypical antipsychotics and dementia, typical antipsychotics and dementia, typical antipsychotics and psychosis. Therefore, the search results would be limited only to the two keywords.

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Part III: Analysis of literature

Step 1: Summary of five articles

The following 5 articles in the table below were selected from the research effort.

Table 1: Summary of analyzed articles

CitationConceptual framework / theoryMain findingResearch MethodStrengths of studyWeaknesses of studyLevel of evidence
Ballard, C., Creese, B., Corbett, A., & Aarsland, D. (2011). Atypical antipsychotics for the treatment of behavioural and psychological symptoms in dementia, with a particular focus on longer term outcomes and mortality. Expert Opinion on Drug Safety, 10(1): 35-43Not specifiedAtypical antipsychotics medications provide modest benefits up to twelve weeks /short term treatment of psychosis and dementia. Nonetheless, these benefits should be balanced against the risk of major adverse events such as increased death. With longer term prescribing, there are clear benefits, but the risk of death also increase. Review of existing studies. The authors provide a summary of the evidence that pertain to safety and efficacy from short-term randomized controlled trials, as well as main findings from case register studiesStudy is thorough. Presents both benefits and shortcomings of atypical antipsychotic drugs. The review provides an up-to-date and balanced overview of the safety concerns and effectiveness that relate to atypical antipsychotics in elderly patients with dementia, giving a full overview of mortality riskThe study only focuses on atypical antipsychotic drugs and does not also look into the safety concerns and efficacy of typical antipsychotics.High level
Haddad, P. M., & Sharma, S. G. (2012). Adverse effects of atypical antipsychotics: Differential risk and clinical implications. CNS Drugs, 21(11): 911-936Not specifiedBroad statements that compare the comparative risk of specific adverse effects between conventional and atypical antipsychotics are mainly insignificant. Instead, comparisons need to be made between particular typical and particular atypical antipsychotic drugs.  The authors reviewed various studies including post marketing, surveillance studies, and observational studies and randomized controlled trials.The study is comprehensive, thorough and up-to-dateA small number of studies were reviewedHigh level
Piersanti, M., Capannolo, M., Turchetti, M., Serroni, N., De Berardis, D., Evangelista, P., Costantini, P., Orsini, A., Rossi, A., & Maggio, R. (2014). Increase in mortality rate in patients with dementia treated with atypical antipsychotics: A cohort study in outpatients in Central Italy. Riv Psichiatr, 49(1): 34-40Not specifiedUsing atypical antipsychotics to treat dementia amongst older adults is linked to a higher rate of mortality. A cohort study was conducted that comprised 696 elderly patients with Alzheimer The study recommends new approaches for managing dementia to replace the use of atypical antipsychotic drugs which have potential risks of mortalityA small sample size was used and the study was carried out within a single hospital. This affects the generalizability of the findingsMedium level
Rochon, P. A., Gruneir, A., Gill, S. S., Wu, W., Fischer, H. D., Bronskill, S. E., & … Gurwitz, J. H. (2013). Older Men with Dementia Are at Greater Risk than Women of Serious Events After Initiating Antipsychotic Therapy. Journal Of The American Geriatrics Society, 61(1), 55-61. doi:10.1111/jgs.12061Not specifiedShortly after initiating oral atypical antipsychotic drug, the likelihood of developing a major event in elderly people with dementia was high.This was a population-based, retrospective cohort study.A large sample size was used that comprised 21,526 elderly men and women with dementiaThe study had more women that. Women were 13,760 while the number of men was 7,766.High level
Schneider, L. S., Dagerman, K. S., & Insel, P. (2012). Risk of death with atypical antipsychotic drug treatment for dementia – Meta-analysis of randomized placebo-controlled trials, JAMA, Journal of the American Medical Association, 294(15): 1934-1943 Atypical antipsychotic medicines might be linked to a slight increased likelihood for death in comparison to placebo where typical antipsychotic drugs were used.The authors assessed the evidence for high death rates from atypical antipsychotic medications for patients who have dementia. The data sources were obtained from Cochrane Controlled Trials Register, MEDLINE, and meetings and presentations.A large sample size is used hence the findings could be generalized. There a total of 5,101 participantsSome very old data materials from the 1960s were used which may not be relevant for use todayHigh level

Step 2: History and purpose of research question 

Every antipsychotic drug has warnings of increased mortality for elderly patients (Schneider, Dagerman & Insel, 2012). Antipsychotic medications are broadly utilized in managing psychological and behavioural symptoms in dementia in spite of concerns as regards their safety (Ballard et al., 2011; Piersanti et al., 2014). Compared to typical or conventional antipsychotic drugs, atypical antipsychotic drugs are linked to a statistically significant rise in the likelihood of mortality for older men and women who have dementia (Haddad & Sharma, 2012).

The purpose of the research question is to find out whether the use of typical antipsychotic medication, which is the intervention, results in less mortality rates than atypical antipsychotic medication, which is the comparison group, in elderly patients who have dementia and psychosis.

Step 3: Strengths and weaknesses of existing literature

The strengths of the existing literature is that there are studies which focus mainly on the atypical antipsychotics and others that focus mainly in typical/conventional antipsychotics and their correlation with mortality. The weakness of the existing literature is that there are no studies that compare typical antipsychotics and atypical antipsychotics on the rates of mortality on elderly patients with dementia and psychosis (Rochon et al., 2013).

Step 4: Gap in current literature

At the moment, the gap in current literature is that there are no studies which have focused specifically on the association of atypical and typical antipsychotic medications on the rates of mortality among the older adults who have dementia.

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Conclusion

In conclusion, the PICO question for the research study is as follows: In elderly patients who have dementia and psychosis (P), does treatment with typical antipsychotics (I) or atypical antipsychotics (C) result in less mortality (O). The purpose of the research question is to find out whether the use of typical antipsychotic medication results in less mortality rates than atypical antipsychotic medication in elderly patients who have dementia and psychosis. The resources used to find articles included electronic databases research, relevant books, and reputable journals. The search terms that were utilized include dementia, mortality, psychosis, atypical antipsychotics, and typical psychotics.

References

Ballard, C., Creese, B., Corbett, A., & Aarsland, D. (2011). Atypical antipsychotics for the treatment of behavioural and psychological symptoms in dementia, with a particular focus on longer term outcomes and mortality. Expert Opinion on Drug Safety, 10(1): 35-43

Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59-60. Retrieved from the Walden Library databases.

Haddad, P. M., & Sharma, S. G. (2012). Adverse effects of atypical antipsychotics: Differential risk and clinical implications. CNS Drugs, 21(11): 911-936

Piersanti, M., Capannolo, M., Turchetti, M., Serroni, N., De Berardis, D., Evangelista, P., Costantini, P., Orsini, A., Rossi, A., & Maggio, R. (2014). Increase in mortality rate in patients with dementia treated with atypical antipsychotics: A cohort study in outpatients in Central Italy. Riv Psichiatr, 49(1): 34-40.

Rochon, P. A., Gruneir, A., Gill, S. S., Wu, W., Fischer, H. D., Bronskill, S. E., & … Gurwitz, J. H. (2013). Older Men with Dementia Are at Greater Risk than Women of Serious Events After Initiating Antipsychotic Therapy. Journal of the American Geriatrics Society, 61(1), 55-61. doi:10.1111/jgs.12061

Schneider, L. S., Dagerman, K. S., & Insel, P. (2012). Risk of death with atypical antipsychotic drug treatment for dementia – Meta-analysis of randomized placebo-controlled trials, JAMA, Journal of the American Medical Association, 294(15): 1934-1943

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