PSYCHIATRIE

CENTRUM PSYCHIATRIE

ARTIKELS

ABSTRACT 1

Een delirium of een acute psychose na een cerebrovasculair accident rechts frontaal: een belangrijke differentiaaldiagnose.

Casselman L, Titeca K, Geerts P Tijdschrift voor Geneeskunde, 2020, 76(7), 339-344

ABSTRACT Dit abstract beschrijft de casus van een 84-jarige dame die een psychose ontwikkelt na een cerebrovasculair accident (CVA). Een goede observatie en een correcte klinische beschrijving op basis van diagnostische criteria en gestandaardiseerde meetinstrument.

ABSTRACT 2

Electroconvulsive therapy in a patient with multiple cerebral cavernous malformations.

Boonen I, Titeca K, Geerts P The Journal of ECT, 2020, 36(3), DOI: 10.1097/ YCT.0000000000000654

Er is geen abstract beschikbaar

ABSTRACT 3

Phenibut: harmless dietary supplement or dangerous drug?

Evenepoel J, Titeca K Tijdschrift voor Psychiatrie, 2020, 62(2), 157-160

ABSTRACT In clinical practice, more and more alarming signals are picked up concerning addiction and withdrawal after the use of Phenibut. Phenibut is a psychotropic agent that acts on gaba receptors. Phenibut is freely available online as a dietary supplement, but appears to have potent and potentially harmful psychotropic effects. We describe the case of a 19-year-old man with social anxiety who self-medicated by using Phenibut, which he subsequently got addicted to. We outline the dangers linked to the use of Phenibut and offer suggestions for treatment. ABSTRACT 4

The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study.

Verhofstadt M, Audenaert K, Van den Broeck K, Titeca K, et al. BMC Psychiatry, 2020, 20, article 400, DOI: 10.1186/ s12888-020-02792-w

INTRODUCTION Since its legalisation in 2002, the number of times euthanasia has been carried out in response to requests from adults with psychiatric conditions (APC) has continued to increase. However, little is known about why and how psychiatrists become engaged in the assessment of such euthanasia requests.

MATERIALS/METHODS A cross-sectional survey study was conducted between November 2018 and April 2019 of 499 psychiatrists affiliated with the Flemish Psychiatry Association. Chi square/ Fisher’s exact tests were performed to examine if, and to what extent, psychiatrists’ backgrounds relate to their concrete experiences. The answers to the open question regarding motives for (non-) engagement were thematically coded.

RESULTS Two hundred one psychiatrists participated, a response rate of 40%. During their careers, 80% of those responding have been confronted with at least one euthanasia request from an APC patient and 73% have become involved in the assessment procedure. Their engagement was limited to the roles of: referring physician (in 44% of the psychiatrists), attending physician (30%), legally required ‘advising physician’ (22%), and physician participating in the actual administration of the lethal drugs (5%). Within the most recent 12 months of practice, 61% of the respondents have been actively engaged in a euthanasia assessment procedure and 9% have refused at least once to be actively engaged due to their own conscientious objections and/or the complexity of the assessment. The main motive for psychiatrists to engage in euthanasia is the patient’s fundamental right in Belgian law to ask for euthanasia and the psychiatrist’s duty to respect that. The perception that they were sufficiently competent to engage in a euthanasia procedure was greater in psychiatrists who have already had concrete experience in the procedure.

CONCLUSION Although the majority of psychiatrists have been confronted with euthanasia requests from their APC patients, their engagement is often limited to referring the request to a colleague physician for further assessment. More research is needed to identify the determinants of a psychiatrist’s engagement in euthanasia for their APC patients and to discover the consequences of their non-, or their restricted or full engagement, on both the psychotherapeutic relationship and the course of the euthanasia request.

ABSTRACT 5

Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions: a survey.

Verhofstadt M, Audenaert K, Van den Broeck K, Titeca K, et al. BMC Psychiatry, 2020, 20, article 374

INTRODUCTION Although the Belgian assessment pathway for legal euthanasia requires the engagement of at least one psychiatrist, little is known about psychiatrists’ attitudes towards euthanasia for adults with psychiatric conditions (APC). This study aims to gauge psychiatrists’ attitudes towards and readiness to engage in euthanasiaassessment and/or performance procedures in APC.

MATERIALS/METHODS This cross-sectional survey study was performed between November 2018 and April 2019. The survey was sent to a sample of 499 eligible psychiatrists affiliated to the Flemish Association for Psychiatry, a professional association that aims to unite and represent all psychiatrists working in Flanders, the Dutch-speaking, northern part of Belgium. The Association’s members comprise an estimated 80–90% of all psychiatrists active in Flanders. Only psychiatrists working with APC (83% of the association’s total membership) were included. Factorial Anova and Chi Square tests were performed to examine if and to what extent psychiatrists’ backgrounds were associated with, respectively, their attitudes and their readiness to play a role in euthanasia procedures concerning APC.

RESULTS One hundred eighty-four psychiatrists completed the questionnaire (response rate 40.2%); 74.5% agree that euthanasia should remain permissible for APC. However, 68.9% question some of the approaches taken by other physicians during the euthanasia assessment and only half consider euthanasia assessment procedures compatible with the psychiatric care relationship. Where active engagement is concerned, an informal referral (68%) or preliminary advisory role (43.8%) is preferred to a formal role as a legally required advising physician (30.3%), let alone as performing physician (< 10%).

CONCLUSION Although three quarters agree with maintaining the legal option of euthanasia for APC, their readiness to take a formal role in euthanasia procedures appears to be limited. More insight is required into the barriers preventing engagement and what psychiatrists need, be it education or clarification of the legal requirements, to ensure that patients can have their euthanasia requests assessed adequately.