Postpartum psychosis in a non-native language-speaking patient: A perspective on language barriers and cultural competency

Mental health professionals' perspectives and suggestions on religious and superstitious activities engagement of patients with serious mental illness: A national survey in Thailand

BACKGROUND

Patients with serious mental illness (SMI) often engage in religious and superstitious activities. The implications of such engagements remain unclear, with no established guidelines for mental health professionals.

AIMS

This study aimed to survey perspectives and gather suggestions from various disciplines within mental healthcare regarding the engagement in religious/superstitious activities of SMI patients: schizophrenia spectrum disorders, bipolar disorder, major depressive disorder.

METHOD

This cross-sectional study was conducted between November and December 2023 among Thai mental health professionals. Participants used 10-point Likert scales to rate their agreement levels for engaging each activity. Additional suggestions were obtained through textual responses, which were subsequently summarised and synthesised.

RESULTS

Of the 403 professionals participated, the majority were female (73.2%), Buddhist (87.6%) and psychiatrists (42.2%), with a median age of 34.0 years. Among patients with active symptoms, patients with major depressive disorder tended to receive the highest mean agreement scores for engagement, while patients with schizophrenia consistently scored the lowest across most activities. Similar trends were observed among patients in remission. From textual responses, two key themes were synthesised: (1) environmental factors and (2) impacts on natural courses.

CONCLUSIONS

Patients with active schizophrenia received the lowest levels of agreement while patients with major depressive disorder tended to receive the highest mean agreement scores on engaging religious/superstitious activities.

Postpartum Psychosis

PURPOSE OF REVIEW

Postpartum psychosis is a psychiatric emergency that can affect the health and life of mothers, infants, and families. Postpartum psychosis (PPP) is distinct from non-postpartum psychosis in many ways, and it is crucial to study and understand PPP to identify, treat, and possibly prevent this condition. We therefore sought to review the latest research findings about PPP with the intention of updating readers about the latest evidence base.

RECENT FINDINGS

Multiple physiologic pathways have been implicated in the development of PPP, and further understanding these pathways may allow for early detection and treatment. Risk assessment and treatment should include consideration of the woman patient but also the mother-infant dyad and the larger family. It is our hope that this review of research updates in postpartum psychosis may inform clinical practice and promote specialized, evidence-based diagnosis, risk assessment, and treatment.

Further Reduction in Help-Seeking Behaviors Amidst Additional Barriers to Mental Health Treatment in Asian Populations: A Contemporary Review

Under diagnosis and treatment of mental health illnesses lead to chronic presentations and consequences. Multiple factors contribute to gaps in treatment, including the role culture plays in the development or suppression of help-seeking behaviors (HSBs). In the Asian community, conversation and recognition of mental health and its disorders are considered shameful. This review presents an analysis of literature to identify barriers to mental health treatment pronounced in Asian populations and discusses how culture influences these barriers and treatment-seeking behaviors, particularly in the context of the Asian-origin Coronavirus disease 2019 (COVID-19) global pandemic. It is the purpose of this review to discuss Asian American underutilization of mental health services and understand the factors the contribute to psychiatric care resistance in Asian communities.

Providing Culturally Competent Care for COVID-19 Intensive Care Unit Delirium: A Case Report and Review

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. Caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, its high transmissibility required infected individuals to be placed in negative pressure isolation rooms when admitted to intensive care units (ICU). Studies have shown that limited social support can increase the risk of developing delirium during ICU stays. Minimal research exists on COVID-19-associated ICU delirium as hospitals and government organizations focus on combating equipment shortages and case surges. Here, we present the case of a 64-year-old Filipino male with COVID-19 ICU delirium status post-intubation and ventilation. His hospital course was complicated by the medical staff's assumption that the patient spoke Spanish and improved after being assigned a Tagalog-speaking nurse who facilitated family communication. This case highlights the importance of cultural competency and communication in the management of COVID-19 associated ICU delirium. In particular, Filipino cultural practices and their intersection with healthcare in the larger context of providing culturally competent care are highlighted. The use of culturally competent care serves to assure the use of appropriate services and reduces the occurrence of medical errors due to misunderstandings caused by differences in language or culture. Familial involvement is critical for ICU delirium; however, the COVID-19 pandemic has required healthcare providers to think beyond conventional means. The use of technology to virtually communicate with family also serves as a helpful tool to treat signs of delirium. As seen in this case, a lack of understanding of the Filipino culture resulted in assumptions on the part of the healthcare provider which led to the prolongation of delirium in a COVID-19 ICU patient, but the correct utilization of cultural competence helped the patient recover successfully.