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Clinical management of people with severe mental disorders: diagnosis, rehabilitation and psychosocial integration


Author: Chihai Jana
Degree:doctor habilitat of medicine
Speciality: 14.00.18 - Psihiatrics and Narcology
Year:2022
Scientific consultants: Anatol Nacu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Larisa Spinei
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Petrea Ionela
doctor în medicină, Institutul Trimbos de Sănătate Mintală și Adicții, Utrecht, Olanda
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 21 December, 2022 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document – 2.01 Mb / in english
Adobe PDF document – 1.51 Mb / in romanian

Thesis

CZU 616.89-008-07-08(043.2)

Adobe PDF document 8.48 Mb / in romanian
261 pages

Keywords

Severe mental disorders, drug and non-drug treatment, recovery, social and family integration

Summary

Thesis structure: Introduction, 5 chapters, general conclusions and recommendations, bibliography of 322 sources, 8 annexes, 146 pages of basic text, 47 figures, 21 tables. The obtained results are published and disseminated în 21 scientific papers.

Aim of the thesis: Identification of clinical-epidemiological features, diagnosis of people with severe mental disorders, satisfaction, social functionality and quality of life în various mental health services provided for the development of a medical and psychosocial rehabilitation protocol. Research objectives: 1. Evaluation of community and hospital mental health services, as well as the analysis of the course and evolution of political, legislative, organizational and system changes în the field of MS în the Republic of Moldova. 2. Analysis of the incidence and prevalence of severe mental disorders în the Republic of Moldova, 2007-2020. 3. Analysis of the clinicalepidemiological course of people with severe mental disorders în hospital and community mental health services în the country. 4. Comprehensive diagnostic and functional evaluation of the beneficiaries of mental health services, în order to determine the needs în mental health services. 5. Analysis of the quality of life, disability and level of self-stigma of people with MSDs în hospital services compared to those în the community, based on the recovery of people with severe mental disorders. 6. Analysis of the dynamics of indicators of quality of life, functionality and disability of people with severe mental disorders at 18 months after the start of the pilot study. 7. Development of a protocol for rehabilitation and psychosocial integration of people with severe mental disorders adjusted to the context of the Republic of Moldova. Novelty and scientific originality: The complex clinical, psychological and socio-functional evaluation of patients în mental health institutions is an important component în effective clinical management.

Research results: Contributes to the efficient clinical management of people with MSDs, facilitates the creation, development and reorganization of MS services and helps to develop individualized and deinstitutionalized intervention plans and programs for people with MSDs. Theoretical significance: The quality of life and functionality of people with severe mental disorders depends on the approaches and types of treatment applied în various mental health services Applicative value: Establishing the profile of the patient from the hospital services as well as from the community ones; highlights profile differences; assist în the development of effective programs and additional services within MS services.

Implementation of scientific results: It is used în the practice of Community Mental Health Centres and Psychiatric Hospitals.