Phiphopthatsanee, Nacharin
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Phiphopthatsanee, Nacharin
Main Affiliation
Email
nacharin.ph@kmitl.ac.th
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Item type:Publication, Migraine and its psychiatric comorbidities: The role of the amygdala(2018-01-01); Psychiatric comorbidities are common among patients with migraine. These comorbidities can compromise the quality of life of patients and may affect the result of treatment. The prevalence is higher in patients with migraine who overuse abortive medication. The mechanisms underlying these comorbidities remain unclear, but the amygdala is likely to be involved in their pathogenesis. This brain area has important functions in integrating sensory experiences with unpleasant emotions. The central amygdala plays a general integrative role in autonomic functions related to pain, and receives input from the outer layers of the trigeminal nucleus caudalis via the lateral parabrachial nucleus. A recent study showed that neurons in lateral parabrachial nucleus are activated more strongly by noxious stimulation of the face than of the hind paw. Increased excitability of laterocapsular division of the central nucleus of the amygdala has been observed in animals with cortical spreading depression, an electrophysiological phenomenon underlying the aura phase of migraine. Chronic treatment with analgesics further increases the neuronal excitability in the central nucleus of the amygdala and increases cortical spreading depression-evoked expression of Fos in the trigeminal nucleus caudalis and amygdala. These preclinical evidences imply the role of amygdala in pathogenesis of comorbid depression and anxiety commonly observed in patients with migraine. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Treatment with medication for patients with psychosis within 2 days during waiting in the accident and emergency department and its correlation with length of in-patient stay: retrospective database study(2024-11-11); Hampsey, ElliotBackground One of the ‘critical goals’ for psychiatric liaison services is reducing hospitalisation. Psychotropic medication is a treatment for psychosis, although research determining the efficacy of early medication administration is lacking. Aims To determine whether commencing psychotropic medication within 2 days of psychiatric liaison input in the accident and emergency (A&E) department is correlated with length of inpatient psychiatric admissions for patients with psychosis. Method We gathered data on patients presenting to A&E sites covered by South London and Maudsley (SLaM) National Health Service Trust, who were subsequently admitted to and discharged from SLaM psychiatric in-patient wards with discharge diagnosis of psychosis between 2015 and 2020. The analysis set comprised 228 patients waiting in the A&E department under psychiatric liaison care for ≥2 days, of which 140 were started on medication within those 2 days (group A) and 88 were not (group B). Group A was divided into A1 (patients restarted on previous psychotropic medication taken within 1 week) and A2 (others, including those new to psychotropic medication or with past usage). Results Although Kaplan–Meier survival curves with log-rank tests demonstrated no statistically significant difference of in-patient admission duration between groups A and B or groups B1 and B2, further analysis revealed that subgroup A1 had statistically significant shorter admissions than group B (P = 0.05). Conclusions Restarting patients with psychosis on medication they were taking within the week before A&E department attendance, within 2 days of arrival at the A&E department, is associated with statistically significant shorter admissions. The limitation is a relatively small sample size. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Mental health law in Thailand(2025-11-01)Thailand’s first Mental Health Act was enacted on 20 February 2008, with an amendment enforced on 15 July 2019. The Act provides a framework for mental health professionals, aiming to protect patient rights and promote societal safety by minimising the risks associated with mental illness. This article highlights key practical aspects of the legislation and discusses issues regarding its real-life application.